1. Annual Epidemiological Spotlight on HIV in London: 2014 data Field Epidemiology Services PHE Publications gateway number 2015509

2. Summary of 2014 data for London residents 2,516 new HIV diagnoses New diagnosis rate: 36 per 100,000 residents aged 15 years or older 63% of new diagnoses in MSM / 33% of new diagnoses in heterosexuals 22% of new diagnoses in Black Africans 37% of diagnoses are late (2012-14) 35,363 people living with diagnosed HIV Diagnosed prevalence rate: 5.9 per 1,000 residents aged 15-59 years Only one LA in London (Havering) had a diagnosed prevalence below the 2 per 1,000 threshold above which expanded HIV testing is recommended. 12% of Londoners living with HIV remain undiagnosed (estimated 5,100 people) 90% of those diagnosed are on antiretroviral therapy (ART) 95% of those on ART are virally suppressed 2Annual Epidemiological Spotlight on HIV in London: 2014 data

3. Figure 1: New HIV diagnosis per 100,000 population aged 15 years or older by PHE centre of residence, 2014 3Annual Epidemiological Spotlight on HIV in London: 2014 data Source: Public Health England, HIV and Aids New Diagnosis Database (HANDD). The number of new diagnoses will depend on accessibility of testing as well as infection transmission.

4. Figure 2: New HIV diagnoses per 100,000 population aged 15 years or older by upper tier local authority of residence, London residents, 2014 4Annual Epidemiological Spotlight on HIV in London: 2014 data Source: Public Health England, HIV and Aids New Diagnosis Database (HANDD). The number of new diagnoses will depend on accessibility of testing as well as infection transmission.

5. Figure 3: New HIV and AIDS diagnoses and deaths, London, 2005-2014 5Annual Epidemiological Spotlight on HIV in London: 2014 data Source: Public Health England, HIV and Aids New Diagnosis Database (HANDD). The number of new diagnoses will depend on accessibility of testing as well as infection transmission. *Numbers may rise as further reports are received. This will impact on interpretation of trends in more recent years.

6. Figure 4: New HIV diagnoses by probable exposure category (adjusted for missing information), London residents, 2005-2014 6Annual Epidemiological Spotlight on HIV in London: 2014 data Source: Public Health England, HIV and Aids New Diagnosis Database (HANDD). The number of new diagnoses will depend on accessibility of testing as well as infection transmission.

7. Figure 5: Number of new HIV diagnoses by age group and gender (A) and probable exposure category in males (B), London residents, 2014 7Annual Epidemiological Spotlight on HIV in London: 2014 data (A) (B) Source: Public Health England, HIV and Aids New Diagnosis Database (HANDD). The number of new diagnoses will depend on accessibility of testing as well as infection transmission.

8. Figure 6: Number of new HIV diagnoses by ethnic group (adjusted for missing information), London residents, 2005-2014 8Annual Epidemiological Spotlight on HIV in London: 2014 data Source: Public Health England, HIV and Aids New Diagnosis Database (HANDD). The number of new diagnoses will depend on accessibility of testing as well as infection transmission.

9. Figure 7: Number of new HIV diagnoses by world region of birth (adjusted for missing information), London residents, 2005-2014 9Annual Epidemiological Spotlight on HIV in London: 2014 data Source: Public Health England, HIV and Aids New Diagnosis Database (HANDD). The number of new diagnoses will depend on accessibility of testing as well as infection transmission.

10. Figure 8: Percentage of new HIV diagnoses that were diagnosed late by upper tier local authority of residence, London, aged 15 years and over, 2012-2014* 10Annual Epidemiological Spotlight on HIV in London: 2014 data Source: Public Health England, HIV and AIDS New Diagnosis Database, CD4 Surveillance, Survey of Prevalent HIV Infections Diagnosed (SOPHID). * Only includes new diagnoses for which CD4 count was reported within 91 days of diagnosis; late diagnosis defined as CD4 count <350 cells/mm3. The underlying population will impact on the proportion diagnosed late, e.g. MSM are less likely to be diagnosed late..

11. Figure 9: Percentage of new HIV diagnoses that were diagnosed late by probable exposure category (A) and ethnic group (B), London residents, aged 15 years and over, 2012-2014* 11Annual Epidemiological Spotlight on HIV in London: 2014 data (A) (B) Source: Public Health England, HIV and AIDS New Diagnosis Database, CD4 Surveillance, Survey of Prevalent HIV Infections Diagnosed (SOPHID). * Only includes new diagnoses for which CD4 count was reported within 91 days of diagnosis; late diagnosis defined as CD4 count <350 cells/mm3.

12. Figure 10: Diagnosed HIV prevalence per 1,000 residents aged 15-59 years by PHE Centre, 2014 12Annual Epidemiological Spotlight on HIV in London: 2014 data Source: Public Health England, Survey of Prevalent HIV Infections Diagnosed (SOPHID).

13. Figure 11: Number of residents living with diagnosed HIV and accessing care, London, 2005-2014 13Annual Epidemiological Spotlight on HIV in London: 2014 data Source: Public Health England, Survey of Prevalent HIV Infections Diagnosed (SOPHID).

14. Figure 12: Number of residents living with diagnosed HIV and accessing care by probable route of transmission (adjusted for missing information), London, 2014 14Annual Epidemiological Spotlight on HIV in London: 2014 data Source: Public Health England, Survey of Prevalent HIV Infections Diagnosed (SOPHID).

15. Figure 13: Percentage of residents with diagnosed HIV and accessing care by age group, London, 2005 and 2014 15Annual Epidemiological Spotlight on HIV in London: 2014 data Source: Public Health England, Survey of Prevalent HIV Infections Diagnosed (SOPHID).

16. Figure 14: Diagnosed HIV prevalence per 1,000 residents by ethnic group (aged 15-59 years), London, 2014 16Annual Epidemiological Spotlight on HIV in London: 2014 data Source: Public Health England, Survey of Prevalent HIV Infections Diagnosed (SOPHID).

17. Figure 15: Diagnosed HIV prevalence per 1,000 residents aged 15- 59 years by local authority, London, 2014 17Annual Epidemiological Spotlight on HIV in London: 2014 data Source: Public Health England, Survey of Prevalent HIV Infections Diagnosed (SOPHID).

18. Figure 16: Diagnosed HIV prevalence per 1,000 residents aged 15- 59 years by local authority, London, 2014 18Annual Epidemiological Spotlight on HIV in London: 2014 data Source: Public Health England, Survey of Prevalent HIV Infections Diagnosed (SOPHID).

19. Figure 17: The London HIV treatment cascade among adults living with HIV, 2014 19Annual Epidemiological Spotlight on HIV in London: 2014 data ǂ The number of diagnosed from multi-parameter evidence synthesis data. * Viral load (VL) <200 copies/ml

20. Acknowledgements Produced by Josh Forde, Paul Crook and Zheng Yin from Public Health England Local sexual health and HIV clinics for supplying the HIV data Institute of Child Health PHE Centre for Infectious Disease Surveillance and Control (CIDSC) HIV and STI surveillance teams for collection, analysis and distribution of data Stefano Conti of the PHE CIDSC modelling team for providing estimates of the total number of people living with HIV and the proportion that remain undiagnosed 20Annual Epidemiological Spotlight on HIV in London: 2014 data

21. More information Please access the online ‘Sexual and Reproductive Health Profiles’ for further information on a whole range of sexual health indicators: http://fingertips.phe.org.uk/profile/sexualhealth http://fingertips.phe.org.uk/profile/sexualhealth For more information on local sexual health data sources please access the PHE guide: https://www.gov.uk/government/uploads/system/uploads/attachment_data/fil e/395207/PHE_Guide_to_National_Local_Sexual_Reproductive_Health_Da ta.pdf https://www.gov.uk/government/uploads/system/uploads/attachment_data/fil e/395207/PHE_Guide_to_National_Local_Sexual_Reproductive_Health_Da ta.pdf For an epidemiology summary of STIs in London https://www.gov.uk/government/publications/sexually-transmitted-infections- london-2014-data https://www.gov.uk/government/publications/sexually-transmitted-infections- london-2014-data For a detailed report on STIs and HIV in MSM in London https://www.gov.uk/government/publications/hiv-and-stis-in-men-who-have- sex-with-men-in-london For more information please contact Field Epidemiology Services at fes.seal@phe.gov.uk 21Annual Epidemiological Spotlight on HIV in London: 2014 data