Record numbers of people were diagnosed with HIV in Ireland last year amid concerns that a growing ambivalence about the disease is putting increasing numbers of people at risk.
More than 500 new cases of HIV were diagnosed, the highest rate since records began. Rates have been rising steadily since 2011, with the rate of new infections increasing significantly within the past two years.
The figures come at the same time that new research shows the life expectancy for young people with HIV in the western world is now as high as 76, helped by ever-improving treatments.
"Projections suggest that life expectancy of a 20-year-old who began treatment from 2008 onwards and had a low viral load after a year of treatment may approach that of the general population [about 78 years old]," the study published in The Lancet HIV journal this week states.
Newly released figures from Ireland’s Health Protection Surveillance Centre (HPSC) show that 512 people were diagnosed with the human immunodeficiency virus in 2016. Of these, 77 per cent were male and 23 per cent female.
However, over half of the new cases are people who were born outside of Ireland, but who came to Ireland in recent years. So far this year, there have been 183 new HIV cases. If this trend continues, 2017 will surpass last year’s figure.
Nearly half of the new HIV cases resulted from sex between men. Nearly a fifth came after heterosexual sex. Just 4 per cent of cases are reported from people who inject drugs.
However, the source of nearly a third of all of the cases – 31 per cent – recorded by the HPSC remained “unknown”, according to the HSE website.
A HSE spokeswoman said the rise was a cause for concern. It said that homosexuals from Latin America were a particularly high-risk group “some of whom are acquiring HIV in Ireland, and others who are coming to Ireland already infected with HIV”.
Part of the HSE response includes increased funding for screenings and working with the Gay Health Network to promote sexual health.
Niall Mulligan of HIV Ireland said the steady increase was "extremely concerning" but that some of the increase could be attributed to better detection procedures.
“There has been a steady increase over the last few years. Some of that is down to improved testing, so we are getting the numbers quicker.
“The other side is people are coming into Ireland, either students or coming from abroad to work. If they have already been diagnosed with HIV in the country they are coming from, they still have to go through HIV testing.”
Experts have also attributed the rise to an increase in unprotected sex in the gay community spurred by online dating apps such as Grindr and the use of recreational drugs during sex.
"I think there is definitely a scene which I suppose internationally would be described as the 'chemsex' scene. It's the association of the use of chemical drugs with multiple sexual partners, group sex and unsafe sex," Dr Des Crowley, addiction specialist at the Mountjoy Square Treatment Centre, said.
“Then I suppose within another sub-group of that is people who are choosing to have less safe sex. My own view is that people don’t really see HIV as being as serious a disease as previously.”
The new Lancet study states that, thanks to a variety of factors such as less-toxic treatment drugs and better adherence to treatment programmes, a 20-year-old man with HIV can expect to live to about 73 years of age while a woman can expect to live to about 76.
The study tracked 88,504 people with HIV from 18 European and North American cities who started antiretroviral treatment between 1996 and 2010.
Andrew Leavitt of the Dublin HIV/Aids activist group Act Up said that although some surveys showed condom use was dropping among homosexuals, it was overly simplistic to attribute the rise in HIV cases to ambivalence about the issue.
“Condom use isn’t necessarily the best proxy for what kind of risks people are taking. A lot of people understand that treatments which help people live longer also prevent transmission.
“There isn’t one single factor we can point to for increased HIV diagnoses,” Mr Leavitt said. “The idea that treatment is making people care less also ignores the fact the HIV is really heavily stigmatised, particularly in the gay community.”