HIV infection from overseas

2 December, 2004

The increase in heterosexual infection
The annual figures for HIV infections, published recently, show an alarming trend. Homosexually acquired infections have been relatively stable for ten years (they are now at about 1700 a year). However, heterosexually acquired HIV has increased by a factor of five from about 700 in 1994 to 3,800 in 2003.

Infection acquired overseas
The increase has been particularly sharp since 1999, much of it due to imported infections. In 2003 about 90% of newly diagnosed heterosexual infections were thought to have been acquired overseas, mostly in Africa. Of the 35,500 patients seen for care in that year 15,600 (44%) had been exposed to heterosexual infection in Africa.

South East Africa
Three countries Malawi, Zambia and Zimbabwe accounted for about 1500 cases in each of the last two years. This was about a quarter of all new infections in the UK.

Cost
According to Professor Pat Troop, Chief Executive of the Health Protection Agency "Each HIV infection prevented can save between 500,000 and 1million in treatment and lost productivity " Taking the lower figure gives the cost of infection, just from these three countries as 750 million a year. The governments response so far is to increase funding for all Sexually Transmitted Diseases by 100m a year for three years.

Immigration from South East Africa
At present visas are not required for Malawians. In 2003, visas issued to the other two countries were as follows:

The prevalence rates for HIV among adults in these countries at the end of 2003 were, according to the UN, Zambia 16.5%, Zimbabwe 24.6%, and Malawi 14.2%. The total number of cases was estimated at 3.6 million.

Conclusion
The Health Protection Agencys annual report makes it abundantly clear that these three countries are a major source of HIV infection in Britain. The immigration figures suggest that about 6,500 people a year continue to be granted visas for admission to Britain without any check on their HIV status. Malawians do not even need visas. This situation cannot be allowed to continue. 47 other countries, including Australia, Canada, New Zealand and the United States require HIV tests of immigrants. The application is then considered in the light of all the circumstances. Britain should follow suit without further delay.