1. HIV and STI Department, Health Protection Agency - Colindale HIV and AIDS Reporting System RITA as part of routine national HIV surveillance: Experience from the United Kingdom Adamma Aghaizu, Jenny Tosswill, Gary Murphy, Meaghan Kall & Valerie Delpech Health Protection Agency, Colindale, London, UK HIV and AIDS Reporting System HIV and STI Department, Health Protection Agency - Colindale

2. HIV and AIDS Reporting System HIV in the UK  An estimated 100,000 people are living with HIV in the UK  6500 new diagnoses per year  RITA program began in 2009  Results returned to patient & integrated as part of routine HIV surveillance

3. HIV and STI Department, Health Protection Agency - Colindale HIV and AIDS Reporting System RITA program: Methods Serum samples from individuals newly diagnosed with HIV tested using the Abbott HIV 1/2 gO avidity assay AI < 80% are considered possible recent infections AI 75-85% are retested in duplicate, and mean used Assay results are linked to reports of new diagnoses report

4. HIV and STI Department, Health Protection Agency - Colindale HIV and AIDS Reporting System The RITA surveillance system HIV New Diagnosis AIDS and Deaths Database New HIV diagnosis report Virus Reference Laboratory Specimens of individuals newly diagnosed with HIV Avidity results Recent Infection Testing Algorithm Database ( Test + CD4 count + ART + AIDS history = final RITA result) Recent Infection Testing Algorithm Database ( Test + CD4 count + ART + AIDS history = final RITA result) Data linked on clinic, clinic id, soundex, DOB and sex Health Protection Agency CD4 Surveillance Additional CD4 data Survey of Prevalent HIV Infections Diagnosed Additional AIDS and ARV data Patient attends clinic Serum specimen local laboratories

5. HIV and STI Department, Health Protection Agency - Colindale HIV and AIDS Reporting System Results 2009-2011 17,411 new diagnoses E W and NI: 40% MSM, 28% hets women, 19% hets men RITA coverage: 37% for the 3 years, increasing from 25% in 2009 to 48% in 2011 No. of RITA results No. Recent% Recent Probable exposure category MSM277261722.3% Heterosexuals Men1115877.8% Women16771378.2% Total27942248.0% Injecting drug use8966.7% Other/Not Reported7878811.2% Total644293514.5%

6. HIV and STI Department, Health Protection Agency - Colindale HIV and AIDS Reporting System Proportion of recent HIV infection among newly diagnosed MSM by age group, England, Wales and Northern Ireland 2009-2011

7. HIV and STI Department, Health Protection Agency - Colindale HIV and AIDS Reporting System Conclusions 50% coverage of RITA programme over 3 years High proportion of recent infection among MSM indicating high levels of ongoing transmission, particularly among younger MSM. RITA results will be incorporated into population incidence estimates in the future. Outcomes of the CEPHIA programme will enable adjustments for misclassifications. The role of RITA results in the clinical setting and contact tracing is undergoing further research.