NEW HIV diagnoses in Scotland are now higher in heterosexual people than gay and bisexual men, according to the latest figures.
Data from Public Health Scotland found that for the first time since 2007 the number of heterosexual people receiving a diagnosis of HIV exceeded in both number and proportion the number of men who have sex with men receiving the same diagnosis.
Last year, 42% of new HIV diagnoses were in heterosexuals compared to 29% in gay, bisexual and other men who have sex with men.
The level of late diagnosis was also slightly higher in heterosexuals, meaning damage to the immune system may already have started in 27% of those who received a diagnosis (compared to 23% of gay and bisexual men).
The decline in the number of gay and bisexual men receiving a diagnosis is owed, in part, to the uptake of the HIV prevention pill PrEP.
Between July and December 2022, they accounted for 85% of first-time prescriptions.
If taken correctly the drug significantly reduces the chances of someone contracting HIV, even if they have sexual contact with a partner who is positive and not on antiretroviral drugs.
Accessible HIV testing, condoms, and people living with HIV adhering to treatment which suppresses the virus have also been highlighted as reasons for the decline.
It comes after the Scottish Government announced it would launch the world’s first online clinic HIV prevention clinic, which would allow people to test for the virus at home and manage their medication without needing to attend a specialist clinic.
Ministers have previously committed to ending new transmission of the disease in Scotland by 2030.
Alan Eaglestone, the head of Scotland services at the Terrance Higgins Trust, said the figures showed Scotland was making progress but that more needed to be done if the 2030 is to be reached.
He said: “Today’s statistics show that Scotland is making progress on ending new cases of HIV by 2030 – but we won’t get there by accident.
“The clock to 2030 is clicking and while today’s statistics show some progress, more must be done to ensure that equitable progress is being made, and that no communities are left behind.”
“The availability of PrEP has been a success story in Scotland’s mission to end new cases of HIV. While we await a finalised proposal of what Scotland’s online PrEP clinic will look like, further work must be undertaken now to expand access of the pill outside of sexual health services and into GPs and community pharmacies.”
“Scotland can – and should – be the first country in the world to eliminate new transmissions of HIV and Public Health Scotland’s data shows some progress towards this goal. The Scottish Government must now set out a clear action plan that delivers on Scotland’s 2030 HIV ambition.”
Yet while diagnosis among gay and bisexual men has declined, there has been a 13% in heterosexual diagnoses since 2019 (the vast majority of whom acquire the disease abroad).
In an attempt to stop this increase the charity also called on the Scottish Government to implement opt-out HIV testing in emergency departments, a scheme which has seen some success in England.
It is thought such testing reduces the barriers to people getting a test, particularly among those who are less likely to regularly attend a sexual health clinic.