Siobhan Ryan looks at the HIV situation in Sussex after new national figures showed the number of people being diagnosed is higher than ever before.

The new figures also show the majority of new cases being diagnosed are amongst the heterosexual rather than the gay community.

Twenty years ago this month, the first reports of normally rare infections appearing among gay men in Los Angeles were published in the US.

They were later recognised as being infected with Human Immunodeficiency Virus, and the spectre of an Aids epidemic loomed over the world.

In the 20 years since that discovery, more than 36 million people have become infected across the world.

It has been a long time since the Eighties when doom-laden Government adverts announced the emergence of the disease HIV/Aids and the devastating impact it would have on people's lives.

The death yesterday of 12-year-old Nkosi Johnson from South Africa, who was an outspoken symbol of the disease and who campaigned all his life to raise awareness of the disease, has also brought home its consequences.

Nearly 20 years on, despite endless awareness campaigns, the number of people contracting the disease is continuing to rise and it seems the message is still not getting across.

There has been a ten per cent rise in the number of people receiving treatment for HIV in the East Sussex, Brighton and Hove Health Authority area in the last three years.

For the last two years Brighton and Hove has bucked the national trend which shows that more new cases of HIV/Aids are among the heterosexual rather than the gay community.

Generally, about 90 per cent of new cases diagnosed in the city involve gay men, but even here the trend is changing.

Martin Fisher, a consultant in HIV/Aids based at Brighton Health Care NHS Trust says the latest figures he has are showing a drop to 70 per cent instead.

His Brighton-based clinic has between 700 and 800 people on its books, with the majority coming from the city.

Last year, Mr Fisher's clinic added 144 patients to its books and 67 of these were newly diagnosed cases.

He said: "In 2000 we saw the highest number of new cases that we have ever seen since testing first became commonplace and the trend for this year is looking the same.

"However, the situation is more complex than that.

"Some of that number are made up of people who have already been diagnosed but have just moved into the area while others may be ones who contracted the disease several years ago and have only just had a test.

"Either way, there is a concern that the number of people contracting the virus is continuing to go up.

"The fact that we have also seen an increase in the number of other sexually transmitted diseases indicates that people could be relaxing their stringency when it comes to protecting themselves and that is a matter of concern."

Mr Fisher says rapid developments in treatments could also give a misleading impression.

He said: "Everybody is aware that the progress in treatments for HIV is remarkable but they are not a cure and we are urging people to think more carefully about their sexual health."

There is also a growing indication that a quarter of people newly infected with HIV may be resistant to one of more of the drugs used to treat the condition.

The Public Health Laboratory Service (PHLS) found 15 per cent of long-term patients were failing treatment because they were resistant to all or some of the triple cocktail which has become the main treatment for HIV.

Trials of a new drug called T20 which prevent the virus binding to target cells, are being carried out in Brighton.

The PHLS says a record 3,425 cases of the virus were reported in the UK last year - a 14 per cent increase on 1999 and the highest figure recorded in any year since testing became widely available 16 years ago.

And around 10,000 people may be living with the virus without knowing.

Dr Barry Evans, head of the HIV division of the PHLS, warned that many of the new cases are preventable, pointing especially to an increase in unsafe sex in the past five years.

He said: "We cannot afford to be complacent about unsafe sex and the basic prevention message must remain the same - use a condom when having sex with a new casual partner and in the case of injecting drug use, never share needles."

Thousands of people who suspect they may have the virus but are too scared to come forward are also being urged to have the test "for their own good".

A spokeswoman for the PHLS said the service hoped to make it clear to people that it is in their own interest to be tested for the virus so they can seek treatment.

She said: "Although an HIV infection cannot be cured, treatment can largely prevent progression of the disease."

She added that new treatments can also help reduce the chances of women passing the virus to their children.

Staff at the Sussex Beacon, the Brighton-based charity which looks after people with HIV/Aids, says the number of people it helps is increasing rapidly and they believe the situation is probably much worse than official figures show.

A spokesman said: "We are there a large number of people out there who are carrying the virus but are not aware of it.

"We are seeing a large number of people who have come to us when they are very ill and have never had a test and we expect that there are many more to come."

Paul Martin, sexual health programme manager for East Sussex, Brighton and Hove Health Authority, said he was aware of growing concerns about people becoming less careful.

He said: "Our research has shown this is probably not the case as most people we speak to are fully aware of the implications of contracting the disease but it is certainly something that we are keeping a close eye on."