Liverpool’s oldest LGBTQ+ charity has warned the Government’s goal to end new transmission of HIV by 2030 could be “at risk”.
Sahir House claims the two biggest threats the UK faces to achieving its goal are “complacency and funding cuts”. It added that HIV has “not gone away” and there is still a vital need to raise money, increase awareness, fight prejudice and improve education about the virus.
Ant Hopkinson, Sahir House’s CEO, told the ECHO: “I think it would be fair to say that the UK’s goal is at risk. Whilst certain fast-track areas - including Liverpool - may well get very close to achieving the goal, several factors make it highly unlikely that we’ll hit the mark as a nation.
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“In terms of complacency studies have shown those at the highest risk of HIV may be less likely to know of risk factors or may believe that HIV is no longer a serious health threat. For example, young people who have grown up without seeing the epidemic’s devastating effects may be particularly vulnerable and those who were in long-term heterosexual monogamous relationships at the time of the first public health campaign but are now sexually active.
“We know that commissioners and providers of sexual health services have been making repeated calls to the government to address the long-term funding and capacity challenges across local authority-commissioned sexual health services. Unless greater recognition and funding are given to councils to invest in prevention services, a reversal in the encouraging and continuing fall in some STIs and more unwanted pregnancies is now a real risk as is their ability to respond to unforeseen challenges such as Monkeypox. The same can be said for preventative action around HIV transmission."
Ant explained how even with effective treatments and access to pre-exposure prophylaxis (PrEP) to reduce the spread of HIV, barriers to support, care and treatment access still exist, particularly for vulnerable populations.
He added: “Systemic prejudice and discrimination, housing inequality, educational disparities, unemployment, criminality and substance misuse, and more can affect a person’s ability to protect themselves from infection or manage their HIV status. Additionally, simply nurturing health literacy among people to empower them to practice safer sex and adhere to treatment regimes continues to prove a challenge.”
In Liverpool, a new provider has recently been appointed to provide HIV prevention and support services for the city's residents - something which Ant said “time will tell” if this has an impact on the efforts to end new transmissions of HIV by 2030.
Over 36 million people worldwide have died of HIV/AIDS-related illnesses. An estimated 37 million people are currently living with HIV, making it one of the most important global public health issues in recorded history. Around 106,890 people in the UK are currently living with HIV - 9,750 of whom live in the North West.
Today, with early diagnosis and treatment, people living with HIV can expect to live a normal life span. However, stigma and discrimination are still a reality for many people. People living with HIV, who are on effective antiretroviral therapy (ART), cannot pass the virus on as undetectable equals Untransmittable (U=U). 99% of those living with HIV in the North West are on ART.
Ant added: “Whilst with proper medical care, HIV can be controlled – there is still no cure for the virus. It is still here and we should not be complacent or ignorant of the risks. Every single one of us has a role to play in HIV prevention as well as in supporting those living with HIV. There are simple steps we can take to protect ourselves, our sexual partners, and our loved ones from HIV infection and transmission. We can all help end HIV stigma through our words and actions in our everyday lives.”
Regular steps, encouraged by Sahir House, the general public should be taking include getting tested often, having safe sex, considering PreP and learning that undetectable equals untransmittable.
If the goal is reached it would mean the UK would be one of the first countries to reach the UN zero-infections target by 2030. However, Ant pointed out the importance of knowing that no new cases of transmission does not mean the virus will have been eliminated.
He added: “It is very important that the UK continues to lead the way in our fight against HIV. Working together to end new transmissions of HIV across the UK would certainly help against stigma. Challenging stigma is critical to stemming the spread of HIV. We know that whilst a lot of people now understand how HIV is transmitted, stigma and discrimination against those people living with HIV still persist. Eliminating HIV will take a comprehensive and joined-up international effort far beyond current efforts."
HIV transmission continued to decline in gay, bisexual and men who have sex with men (GBMSM) from 2019 to 2021. Whereas new diagnoses rose slightly in heterosexual men and women despite lower levels of HIV testing in this group in 2020 and 2021 compared with 2019.
Dr Alison Brown, interim head of HIV surveillance at the UK Health Security Agency, said: “The end of HIV transmission is within our reach in England, with reductions in the number of people living with undiagnosed HIV infection, however, the COVID-19 pandemic has slowed progress in some areas – including testing among heterosexuals and engagement in care for those already living with HIV. Addressing these inequalities, ramping up testing to pre-pandemic levels and getting people started on HIV treatment earlier will all be crucial in delivering the HIV Action Plan ambitions.
“No matter your gender, or sexual orientation, using condoms, using PrEP - if you’re eligible - getting tested and if you test HIV positive, getting treated remain vital in protecting your health and that of your partners.”
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