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33% with HIV in UK don't know they're infected
  By Judith Duffy, Sunday Herald Health Correspondent
Gay men and young heterosexuals increasingly complacent about safe sex and risk of transmission
UP TO 20,000 people in the UK have HIV but are unaware they are carrying the virus, doctors have warned.
According to experts, more than a third of people who have HIV have not been diagnosed, with many GPs missing possible signs of the condition and failing to offer tests.
And while major advances in treatment of the condition mean that being diagnosed with HIV is no longer a death sentence, some patients are still at risk of dying as they are seeking help too late.
advertisement The claim came from experts at a major conference on HIV that took place in Edinburgh last week. Professor Margaret Johnson, chair of the British HIV Association, told the Sunday Herald that identifying patients who were unaware they had HIV was an important issue.
"Looking at the anonymous prevalence studies, we think that approximately a third of patients in the UK with HIV infection are undiagnosed," she said. "We know that percentage is a little bit higher than in the US, where they have been more pro-active in trying to identify the undiagnosed.
"The patients that present late are the patients that die, and now that we have effective antiretroviral therapy, clearly for that patient and that family it is very disastrous."
Professor Johnson said that healthcare workers such as GPs were missing opportunities to offer HIV tests to patients, particularly to heterosexuals, who had conditions that could point to the virus being present. And she argued that, although there had been an emphasis on counselling people before they had the test in the past, that was no longer necessary.
"When we had no treatment, that was much more appropriate, but now that we have good treatment, I'm not quite sure why having an HIV test is different to sending somebody to have a chest X-ray where you might find lung cancer," she said.
Rates of HIV have been increasing steadily in the UK, and it is estimated that around 65,000 people now have the virus, including around 20,000 who are unaware of their infection. While many of the new cases are people who have come to the UK from parts of the world where the disease is common, such as sub-Saharan Africa, experts are concerned that infections among gay men and heterosexuals are also rising.
Dr Nick Beeching, president of the British Infection Society, described the number of HIV infections among heterosexuals as "worrying".
"We are seeing young people who have just gone out for the night and not really thought about the risks," he said. "Heterosexuals clearly don't think they are at risk, and we need to get the message across for safe sex in a way that people take on board."
He also suggested that gay icons could do more to help raise awareness of the issue among that population.
"We are seeing a big increase in infections in gay men, which is disappointing as the gay community led the way in the 1980s, but somehow the message is not there," he added.
Lisa Power, a spokeswoman for the Terrence Higgins Trust, said that reliable home testing kits for HIV, which would allow people to get the results in the privacy of their own home, should be made available in the UK.
"It the promotion and sale of home testing kits was actually made illegal in the UK in 1992 when there were no reliable treatments and HIV was effectively a death sentence at that point," she pointed out.
"But things have changed enormously now, and people should be able to buy a kit over the counter or on the internet which is guaranteed good quality and has information on where they can go for counselling."
However, David Johnson, director of Scottish HIV charity the Waverley Care Trust, argued that there was still a need for proper counselling for patients undergoing HIV tests.
"The reality is that, for many people, getting an HIV diagnosis is still incredibly traumatic," he said.
"For most people it is no longer a death sentence, but there is no cure, so you are still going to have to live with this illness forever. The stigma and discrimination in particular still have a major impact, and people are still very fearful of what the reaction will be."
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