A new report by Public Health England shows that for the first time the number of new HIV diagnoses in gay and bisexual men outnumber new diagnoses in heterosexual adults by only 100 cases.

The number of gay and bisexual men (GBM) with newly diagnosed HIV fell to the lowest point in 20 years, according to a new report from Public Health England (PHE) published today.

The report shows there were 1,700 new HIV diagnoses in GBM in 2019 compared to 1,500 in 2000.

Overall, the number of people with a new HIV diagnoses fell by 10% (from 4,580 in 2018 to 4,139 in 2019). There was also a 34% decline from a peak of 6,312 new diagnoses in 2014.

There were 1,700 new HIV diagnoses in gay and bisexual men (GBM) in 2019 compared to around 1,600 cases in heterosexual adults. This is the lowest number of new HIV diagnoses in GBM since the year 2000 (1,500) and since 1998 in heterosexual adults (1,600).

HIV transmission in GBM has fallen by 80%; newly acquired HIV infections fell from an estimated peak of 2,700 cases in 2011 to an estimated 540 in 2019 (see background information).

While the proportion of people diagnosed late remained high at 42%, the overall number decreased from around 1,900 in 2015 to 1,300 in 2019. People diagnosed late in 2019 had an eight-fold risk of death compared to those diagnosed promptly.

The decline in HIV transmission in GBM can be directly linked to the increase in combination prevention, including:

• the use of condoms

• pre-exposure prophylaxis (PrEP)

• frequent HIV testing in a wide range of settings

• starting antiretroviral therapy (ART) as soon as possible after diagnosis

Treatment is now so effective that 97% of people receiving ART have undetectable levels of virus, which means it is impossible to pass the virus on, even if having sex without condoms. Undetectable = untransmittable (U=U).

HIV testing is vital for preventing HIV-related illness and death and to achieve the goal of ending HIV transmission in the UK by 2030. The UK continues to meet the United Nations Programme on HIV and AIDS (UNAIDS) 90-90-90 targets for the third consecutive year – however, there are opportunities to improve uptake of testing and support those testing positive to continue their treatment.

Almost 300,000 people declined to have an HIV test when they attended a specialist sexual health service. Black African heterosexual women attendees were more likely to decline a test than Black African heterosexual men (20% versus 9% declined testing) but less likely than heterosexual women and men overall (25% versus 13%). More focused conversations on HIV, testing, prevention and treatment in schools and clinical settings can help to combat high rates of declined tests.

By comparison, only 4% of GBM attending specialist sexual health services declined an HIV test – this is the group in which greatest declines in HIV transmission have been achieved.

Dr Valerie Delpech, Head of HIV Surveillance at PHE, said:

In the UK, we have made great progress towards eliminating HIV transmission by 2030. Frequent HIV testing, the offer of PrEP among those most at risk of HIV, together with prompt treatment among those diagnosed, remain key to ending HIV transmission by 2030.

Further progress can only be achieved if we also address the inequalities in reducing HIV transmission that exist around sexuality, ethnicity and geography.

The most common way of getting HIV in the UK is through sex with a person who is unaware of their HIV infection.

You can protect yourself from HIV by consistent and correct condom use with new and casual partners, by using PrEP, or if your partner is on treatment and is undetectable if they are living with HIV. Correct and consistent condom use will also stop you getting or transmitting other sexually transmitted diseases (STIs).

People can get tested through free tests available from sexual health clinics, GP surgeries, as well as through a self-sampling service or by using a self-testing kit.

Background information

Those at risk of HIV and STIs can still access services through sexual health clinics during the COVID-19 pandemic. Many clinics offer online testing, which means people can order tests using clinic websites, take them in the privacy of their own home, return by post and receive results via text, phone call or post.

New HIV diagnoses reflect diagnoses that occurred within a year. Since people can live with HIV for many years without being aware of their HIV infection, trends in diagnoses do not necessarily reflect trends in newly acquired infections. We use models to estimate newly acquired infections (infections acquired recently) for gay and bisexual men only.

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State Department employees complained this month after members of Secretary of State Mike Pompeo’s advance team discovered overtly anti-gay flyers when scoping out the site of a Florida event with a conservative Christian group that promotes conversion therapy for LGBTQ individuals.

Pompeo’s decision to address the Florida Family Policy Council was initially flagged by members of his advance team to their supervisors, and other State Department employees also complained after finding the group offers LGBTQ individuals “help leaving the gay lifestyle” on its website, according to two sources familiar with the internal protest.

Lisa Kenna, executive secretary at the State Department, was alerted to the concerns and attempted to mitigate fallout from the event.

Pompeo ultimately addressed the Florida group’s Oct. 3 event virtually. The gathering — which filled a ballroom in Orlando with roughly 700 guests — coincided with an outbreak of COVID-19 at the White House that infected President Donald Trump and some of his closest aides.

The State Department frequently condemns conversion therapy programs abroad in its human rights reports as among “acts of violence, discrimination, and other abuses based on sexual orientation and gender identity.” Conversion therapy is a discredited practice that aims to change the sexual orientation of lesbian, gay, bisexual and transgender individuals.

One source described several aides as “appalled” the event still took place despite the concerns, and that afterward, the secretary highlighted his appearance in his latest “Miles with Mike” message to department employees.

The event was opened by Jannique Stewart of Missouri, a speaker who described her work as training others in opposing abortion and in “countering some of the agenda when it comes to LGBTQ.”

Before joining the Trump administration, first as CIA director and then as secretary of State, Pompeo made his views on LGBTQ rights explicit, opposing same-sex marriage and once alluding to homosexuality as a “perversion.”

The Florida Family Policy Council says on its website the phrase “conversion therapy” is an ideological term used to discredit therapeutic practices, but it also explicitly opposes efforts to restrict conversion therapy.

“Conversion therapy bans disguise themselves as bans on ‘abuse.’ Rather, such bans place unconstitutional limits on freedom of speech because they do not consider the patient’s (or minor patient’s parents) right to pursue avenues of therapy consistent with their beliefs and choices,” the website states.

The group’s website also includes links to multiple religious-based organizations that offer help “Leaving Gay Lifestyle” and a YouTube video titled “If Conversion Therapy Is Bad, Why Is Sex Reassignment Good?”

A spokesperson for the State Department downplayed internal dissension over Pompeo’s appearance at the event, but did not address the group’s views or answer questions on whether the secretary supports conversion therapy.

“The Secretary was asked to speak to this group about the mission of the State Department and he did. The Secretary believes that organizations like Florida Family Policy Council are entitled to hear from him on important national security policy matters,” the spokesperson said.

“The Secretary was not made aware of any concerns with respect to speaking before this group given that other major leaders have addressed this event,” the spokesperson said.

John Stemberger, president of the Florida Family Policy Council, in an emailed statement said there had been nothing on conversion therapy related to the event.

“There were no flyers about anything, let alone conversion therapy at our dinner, either from us or other organizations,” Stemberger said. “We did not talk with the State Department about conversion therapy. We did meet with members of the Diplomatic Security and advance team to do a walk through before the event. The State Department never asked about conversion therapy, and we as an organization, do not [do] any therapy or counseling at all.”

DOMESTIC POLITICAL SPEECHES

Pompeo and his wife have been the subjects of an ongoing internal inquiry from the State Department inspector general looking into whether they used taxpayer dollars and official personnel for personal errands.

The Democratic-led House Foreign Affairs Committee is now also investigating whether Pompeo has used State Department resources to deliver a series of domestic political speeches ahead of the Nov. 3 presidential election, including the Oct. 3 Orlando event, a Sept. 23 visit to the Wisconsin State Capitol and a Sept. 20 speech to a Texas church.

“It is concerning that the Secretary is suddenly crisscrossing the country at taxpayers’ expense,” Democratic Reps. Eliot Engel of New York and Joaquin Castro of Texas wrote to the State Department on Oct. 5. “The nexus of speeches about the Secretary’s personal religious beliefs, to a swing-state legislature accompanied by a former senior Republican party official, and at a paid-access event for an anti-abortion advocacy group, to the Secretary’s official duties as America’s lead diplomat is unclear and possibly illegal.”

Pompeo was initially scheduled to address the Orlando event in person, and an invitation to the gala obtained by CNN offered a “personal visit” with Pompeo for those who sponsored a table for $10,000. Access to a VIP reception was also being offered as part of tickets that were sold for $3,000 and $5,000.

The Florida Family Policy Council is a state-based affiliate of the national group, Focus on the Family, which has long opposed same-sex marriage. Pompeo has repeatedly engaged with the national group over the years to promote religious freedom.

The state group is a well-known advocacy organization for social conservative issues in Florida and has hosted several national Republican politicians, such as former Rep. Michele Bachmann of Minnesota, Sen. Marco Rubio of Florida, and Dr. Ben Carson, before he became Housing secretary. Former Kansas Sen. and Gov. Sam Brownback addressed the group in 2007 ahead of his unsuccessful run for president in 2008, and now is the State Department’s ambassador at-large for international religious freedom.

Stemberger, an Orlando lawyer who is also a registered lobbyist in Tallahassee, is a longtime supporter of Republican politicians, including Trump, and has pushed for legislation like a bill signed into law by Florida Gov. Ron DeSantis that requires minors seeking an abortion to obtain parental consent.

The Florida Family Policy Council’s events, including the annual awards dinner and forums with candidates running for political office, are often important stops for Republican politicians seeking to win influence with conservative Christians, particularly in contested Republican primaries.

Stemberger has also been at odds with some Florida Republicans, including Rep. Matt Gaetz, over issues like legalizing medical marijuana.

ANGER AMONG LGBTQ

Progressive groups that fight for gay rights said it was an inappropriate venue for a speech from a secretary of State.

“The Florida Family Policy Council is an anti-LGBTQ extremist group that has sought to undermine and attack our community’s most vulnerable at every opportunity,” Alphonso David, president of the Human Rights Campaign, said. “The highest levels of the State Department clearly knew about FFPC’s extremism and yet, even over the objections of staff, chose to embrace it anyway.”

Tom Witt, the executive director of Equality Kansas, the leading LGBTQ rights organization in Pompeo’s home state, criticized Pompeo’s decision to address a group that promotes conversion therapy.

“I’m stunned that our secretary of state would be spending his time going to local organizations whose actions drive kids to suicide, to drop out of school, to otherwise dangerous behaviors because the adults around them are trying to force them to change their sexual orientation or gender identity, which is not something that can be done,” Witt said, noting the State Department’s advocacy for LGBTQ rights abroad.

Witt lives in Wichita, the largest city in Pompeo’s former congressional district.

During his four successful runs for Congress, Pompeo opposed several key LGBTQ rights measures, including the legalization of same-sex marriage and the 2010 repeal of the “Don’t Ask, Don’t Tell” policy to allow openly gay individuals to serve in the military.

“He’s never supported equality for LGBT Americans, even the ones who are fighting for our country,” Witt said.

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