Cases of women being infected with HIV from sleeping with men on the rise

[somethingnewandexciting]

Does anyone know the cause of this? I heard it on Woman's Hour yesterday, am a couple of days behind, and couldn't figure out how it is possible for men's rates to drop and women's to increase at the same time.

The only thing I can think is that these are transwomen changing the health figures for women? The lady WH had on to discuss it didn't seem to know why either but as WH aren't exactly clear on gender data it could have been she didn't want to say it's transwomen? Surely Public Health resources spent advocating for women to be aware isn't going to actually make much of a difference if this is so...? Please someone tell me the NHS doesn't just lump transwomen in with women on campaigns we the public fund with tax?

https://committees.parliament.uk/committee/328/women-and-equalities-committee/news/210497/concerning-rise-in-hiv-diagnosis-rates-among-women-and-stretched-services-require-attention-in-hiv-action-plan-wec-says/

“New diagnoses in 2024 (compared to 2019) were 35% lower in men exposed through sex with men (1,238 to 810), 17% higher in men exposed through sex with women (540 to 634) and 26% higher in women exposed through sex with men (596 to 749). Overall, new diagnoses in men decreased from 2,094 to 1,802 (-14%) and increased from 728 to 965 (33%) in women, according to the UKHSA data cited in the report.

There were significant decreases in new diagnoses among people of White ethnicity (-40%), but diagnoses in Black African and Asian populations increased by 80% and 40% respectively.”

Yes, but are these actual women or transwomen?
Targeting an African or Asian female in her spaces for a health campaign is going to be very different to a health campaign targeting male or transwomen.
How do we protect women if we don't know what the figures mean any more?

I think it’s really important that stats are reported correctly but I don’t think this is to do with trans. I googled and it gave me this

New HIV diagnoses have been decreasing overall in some regions, but this decline is starkly unequal, with rates in women (particularly heterosexual women and young women/adolescent girls) remaining stable or even increasing while rates in men (particularly gay and bisexual men) have decreased. This disparity is driven by a complex interplay of biological vulnerability and deeply entrenched social, economic, and behavioral factors.

Reasons for Higher and Rising Rates in Women

• Gender Inequality and Power Imbalances: Unequal power dynamics often mean women are less able to negotiate safer sex practices, such as condom use, or refuse unwanted sexual advances. This vulnerability is worsened by economic dependence on male partners, which can force some women into transactional sexual relationships, further increasing their risk.
• Biological Vulnerability: Women are biologically more susceptible to HIV infection through heterosexual intercourse. The vaginal lining has a larger mucosal surface area that is exposed to seminal fluid for a longer duration, increasing the risk of transmission from an infected male partner.
• Sexual Violence: A high prevalence of gender-based violence and sexual coercion significantly increases women's risk of HIV acquisition.
• Access to Prevention and Care: There is a "stark" gender gap in the uptake and provision of Pre-exposure Prophylaxis (PrEP), an effective HIV prevention drug. While PrEP use has been high among men who have sex with men (MSM), awareness and access among women, especially women of color and heterosexual women, is significantly lower. Women may also face greater barriers to accessing general healthcare, education, and HIV testing services due to social and financial burdens.
• Delayed Diagnosis and Stigma: Women often experience or report fewer initial symptoms, leading to delayed diagnoses. Stigma can also deter women from seeking testing or disclosing their status, which delays access to life-saving treatment and prevention measures.

Reasons for Decreasing Rates in Men

• Effective Targeted Interventions: The significant decline in diagnoses among men who have sex with men (MSM) in many high-income countries is largely due to the successful, targeted implementation and high uptake of comprehensive prevention strategies, particularly PrEP and frequent testing.
• Higher Testing Rates: In some regions, men are more likely to be tested in general practice than women (though women are more likely to be tested overall, this metric points to differences in care access points), which allows for earlier diagnosis and treatment, reducing further transmission.
• Earlier and Larger Decline: In some high-prevalence settings, men experienced an earlier and larger decline in HIV incidence, potentially consistent with the effective scale-up of male circumcision programs and higher rates of men achieving consistent viral suppression through treatment.

From the UKHSA report: “There were 12 new HIV diagnoses among trans and gender diverse people in 2024 in England compared to 8 in 2023.”

https://www.gov.uk/government/statistics/hiv-annual-data-tables/hiv-testing-prep-new-hiv-diagnoses-and-care-outcomes-for-people-accessing-hiv-services-2025-report

The access to PrEP and just the awareness in the gay community probably mans that gay men take far more precautions during sex. Testing rates will also be higher. Straight men and women won't have HIV on their radar as much. I think rates of STDs in general have risen in recent years as well?

I was going to say this, how many women are taking PREP and how many have even heard of it?
Perhaps it is time for public health England (or Britain) to do some HIV campaigns aimed at providing women with information about life saving drugs.

Yes they discussed the stigma a lot, largely because of culture. I think the jump 8 to 12 in 1 year is a large one for the transwoman community, so maybe that is the increase - any statisticians? I don't doubt that as a group the minorities are slower on the uptake of services, because it is usual across the board, I just couldn't understand why the sudden jump. The transwoman increase in cases and them being reported as women seems to make this statistic more understandable.

At least some of these women will be immigrants and so unless they come with specific paperwork, their "diagnosis" on an NHS system will count as new in statistics like these. Some of the immigrants genuinely won't know their status until they arrive.

It only matters in the sense that these women didn't necessarily contract HIV in this country so it doesn't speak of transmission rates here. It does praise our timely diagnosis, hopefully.

Yes that also makes sense.

They explained that with PrEP it can be managed and not transmitted. They also touched on how the medication works for breastfeeding mothers to reduce the risk of passing it to their children. Hopefully it's just a matter of getting the right women aware and challenging the stigma.

For instance, a woman from another English speaking country moved here aware of her diagnosis. She did have paperwork supporting her diagnosis but of course it was confirmed with a HIV test when she registered with a GP here. As she was "new", it automatically triggered all of the "newly diagnosed" procedures (such as counselling and other clinical things) that she actually didn't need. She just needed referral to specialist services.

So she had HIV for years but the system probably recognises her as someone diagnosed very recently in this country. Any audited data will not pick that up.

@Just4ThisTopic I was also wondering about the poor Sundanese women who are being raped as part of warfare. If we are taking in refugees from there it is likely to be an increased risk.

The figures seem to be compatible with it spreading more amongst heterosexuals. Rates are going down for gay men but up for both men and women who are heterosexual. More for women because they catch it more easily. 4 extra trans women isn’t going to skew the statistics for women nationwide.

I meant as a proportion 8 rising to 12 in 1 year is a big jump. To be honest I don't know who transwomen sleep with, I guess men but actually have no clue if they are mostly bi, but it would matter if that rate continues every year. Health campaigns would need to distinguish between them and a woman or child arriving from a war torn country, for example, if they are trying to tackle stigma.

I was on a thread last week where a mum was querying why her young gay adult son would be taking a preventative medicine for HIV. Posters explained that it is very normal for gay own to take this drug. This was new to me. But possibly this is a driver as to why gay male rates are falling so much.

When the underlying count rate is low, the relative variability of observed counts is high. A change from 8 to 12 observed counts per year is quite compatable with a constant underlying count rate; from 80 to 120 would suggest something else going on.

The increase from 8 to 12 is for transgender and gender diverse people. It’s not broken down by trans men and women so we don’t know if extra 4 are all trans women.

For women it increased from 728 to 965, so even if all 4 were trans women and included in that number, it still doesn’t explain the 33% increase for women

Are we now expecting everyone to be using PrEP? No wonder the NHS is in so much trouble if people are expecting it to pay people to have unprotected casual sex.

Is a little bit of PREP not cheaper than paying for antiretrovirals for a lifetime?

It's good that the prices of PrEP has come down (it was originally £6k a year when it was being offered to gay men who wanted lots of unprotected casual sex).

But you're using the argument of factoring in the price of something else that needn't happen.

It's the same argument for NHS fat jabs, "it's cheaper than paying for treatment of obesity", not the main argument that perhaps people should have a better diet in the first place.

Why do people have a right to have state-funded unprotected casual sex? Why should the state fund risky behaviour?

Yes these are also women who could be picked up by an audit as "women who have recently got HIV" and then it be skewered to make it seem as if they definitely contracted it here.

Because otherwise it will have to pay for the consequences.

PrEP wasnt easily available for women who aren't sex workers until recently. That's probably why the stats are how they are. I also think the rise in heterosexual anal sex might be a factor as it is a high risk activity.

Again, why should the NHS pay for people to have unprotected casual sex?

We can't people accept personal responsibility.

They already fund treatment for type 2 diabetes, high blood pressure, high cholesterol, birth control is free, nicotine replacements are on prescription, methadone is free. I’m not sure which of those lifestyle choices you would get rid of next.

I would guess that gay men are becoming increasingly cautious about not spreading infection, whereas straight people might not be. Though if you look at the numbers, and compare to the distribution of sexualities across the population, it seems you are still far more likely to get HIV if you have gay (male) sex than if you have straight sex.

Why not make everything free on the NHS? Close Boots down and let the NHS give all of it out for free. People moan that the NHS doesn't get enough funding, yet it goes through £0.5bn a day, and every day there is yet more demand for the NHS to be spending more money on lifestyle treatments.

Giving away PrEP has seen a rise in other STDs because people aren't using protection.

I personally think it is insane that we have state-funded bare-backing from the NHS.