Well considering my posts get deleted, as you can be homophobic here but not challenge homophobia it seems, I assume the top NHS bureaucrat gets his or hers deleted before I see them? I work alongside lots of people who can be disparagingly called top NHS bureaucrats, and am fascinated by their intelligence in the face of political pressure, media nonsense, poor care in places and, in this context, scare stories perpetuated by people who don't even have the excuse of looking after shareholders in their newspapers. Must be common or garden bigotry then.

In any event, perhaps Keith can use his hobby of searching for snippets that support his diatribe to find where anybody said "NAT has little credibility with The NHS at the best of times." I'm curious. I have criticised NAT in terms of unrealistic expectation by the way, but that's what pressure groups are for. Their website is an excellent repository of facts and information about the condition. A bit London centric but credible. I fear context is a victim here. And no, not "mistaken" but as ever, maliciously.

As I said before, many times, and despite Keith saying I don't tell the facts, there they are again for The UK;

These figures represent the calendar year 2012. Whilst NHS commissioning bodies have the raw data for the final quarter of 2012/13, they will form part of the 2013 figures. Now The Health Protection agency no longer exists, the successor body aims to harmonise figures to budgeting years to allow harmonised investment in services.

There is an estimate, an official estimate based on prevalence rather than risk, but as good as estimate as any other, that just over 20,000 people could have been sufferers of HIV in The UK and not aware.   During that year, to include both screening and diagnosis from symptom, we picked up 6,360 new cases. Of these, just under half were late stage, or in other words, the prognosis would have been better if they had been picked up earlier, as with any disease or disorder.

We do not know how many people were tested for HIV in that period. We know that the NHS sexual health services, (paid for by The NHS regardless of who supplied it) carried out 903,000 or thereabouts tests, as it can be calculated from invoices to put it crudely. We do not know however the exact number carried out in primary care (GP practices who carry it out rather than referring to sexual health) or most secondary care, where it is one of a range of tests carried out, say, prior to an operation if you fall into a high risk group. Positive tests are in the figures but negative ones can be in bundles of tests, so aren't unpickable if negative. Also, prison testing where the prison service provides the healthcare direct rather than commissioned do not necessarily report the number of actual screening. This is unfortunate as the prison population is very high risk, not only sexually but through needle share and other blood hygiene contraction.

So... If the figures are accurate, which is moot but workable, then it appears that 0.03% of the population may have undiagnosed HIV. 0.15% of the population are living with HIV. More specifically, 0.06% of the population got their infection status through male on male sex, (41,000 men) and of those yet to be diagnosed, the figures suggest a further 7,300.

Now, these figures are awful. But they are not spreading extensively and rapidly, they are not a widespread occurrence at a particular time and whilst those definitions could have been applied to certain clusters at certain times, especially in the '80s, they do not make the public health definition of epidemic. They do, curiously enough, feed into an global pandemic, but western world epidemiology suggests we have contained the spread, if not the risk.

It is however a chronic condition, not only in terms of living with the condition, but that with international travel, migrancy and relocation, it is chronic as it will be with us in a way polio and smallpox aren't.

If you want a success story, it is this. The fact that one in four people with a positive HIV status are over 50, the message is getting through loud and clear. Younger people are more prone to practice safe sex, according to GU services in general and this has a knock on effect for anal sex. The not so good news that cannot be extrapolated from historical prevalence is that audits of colo rectal issues in surgical terms suggests that more young women see anal sex as part and parcel of life, whereas this wasn't the case only a few years ago, and that could identify the next hard to reach group.

Try to read this quickly eh? In a couple of hours, you can read all about how it is a pack of lies.
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