The ‘HIV Action Plan for England 2022–2025’ — published by the Department of Health and Social Care in December 2021 — contains some ambitious goals to dramatically reduce HIV transmission, preventable deaths and stigma related to the disease.
Each of these goals contribute to a long-term commitment for there to be zero HIV transmissions by 2030, and England hopes to be the first nation in the world to achieve this.
Just over a year into the plan, we analyse the progress made so far and highlight what further work needs to be done to ensure England successfully achieves these important targets.
Between 2019 and 2025, reduce…
… the number of people first diagnosed with HIV in England by
… number of people diagnosed with AIDS within three months of an HIV diagnosis by
… preventable HIV-related deaths in England by
… HIV-related stigma — the Joint United Nations Programme on HIV/AIDS 2025 targets set an ambition for stigma to be experienced by under 10% of people living with HIV by 2025.
By 2030:
new HIV transmissions
new AIDS diagnoses
HIV-related
deaths
stigma
“Eliminating late diagnoses by increasing testing rates is likely to be the biggest factor that will help us reach the goal of zero transmissions. In the last few years, there has been significant progress in improving this metric”
Heather Leake Date, consultant pharmacist HIV/sexual health
New HIV diagnoses in England have been falling since 2017 but rose slightly again during the COVID-19 pandemic
The number of people diagnosed with AIDS within three months of their initial HIV diagnosis dropped between 2019 and 2020 but rose slightly again in 2021
“In a recent study, 40% of people surveyed reported difficulty in booking a sexual health appointment online; 23% of people were turned away due to a lack of available appointments”
Andrew Gwynne, shadow minister, Health and Social Care
The estimated number of HIV-related preventable deaths in England rose between 2019 and 2020 but started to come down the following year
HIV-related stigma
HIV-related stigma remains a significant factor in people’s experience of living with HIV and negatively impacts on access to testing and effective prevention interventions. Survey results published by Terrence Higgins Trust — a leading HIV and sexual health charity — in December 2022 revealed that:
of respondents had experienced stigma or discrimination owing to their HIV status.
said they had experienced discrimination while accessing healthcare.
had experienced HIV discrimination in the workplace.
Further work with the government’s HIV Action Plan Implementation Steering group and other stakeholders will focus on further developing key indicators to monitor quality of life and stigma for people living with HIV — see flowchart below:
Eliminate late diagnoses by increasing testing rates
But there has been roll out of opt-out HIV testing in England. On World AIDS Day 2021 the government announced £20m in funding to expand opt-out testing over three years across emergency departments in areas with the highest diagnosed prevalence of HIV infection.
Improve access to pre-exposure prophylaxis
Between October 2017 and July 2020, the Impact Trial in England recruited 24,268 participants. Participants received pre-exposure prophylaxis (PrEP), during and after the trial period and until the rollout of a routine PrEP service in specialist sexual health services (SHSs) in the autumn of 2020.
“PrEP prevents HIV and the pill is covered by NHS England, but thousands are still missing out … awareness of PrEP is far too low and it cannot be given out by GPs, pharmacies, community or maternity services. That means that the burden is solely on local government-funded sexual health services.”
Lloyd Russell-Moyle, Labour/Cooperative MP, Brighton Kemptown
“The fight for PrEP isn’t over while the benefits of it are being felt so unequally – with people still being turned away from getting it and others facing unacceptably long waiting times. Addressing the stark inequalities in PrEP access is crucial to the UK becoming the first country in the world to end HIV transmissions.”
Ceri Smith, Head of Policy at Terrence Higgins Trust
Sources
- UK Health Security Agency: HIV: annual data tables, HIV UK Action plan
- Department of Health and Social Care: Towards Zero: the HIV Action Plan for England — 2022 to 2025
- NHS England
- Terrence Higgins Trust: New data exposes shocking stigma and discrimination against people living with HIV
- UK Parliament: World AIDS Day – in the House of Commons (debate)
Infographics: MagRox Design
