Debate: World AIDS Day, November 2022

  • By Amy Leppänen

Overview: Reducing HIV in London

London boroughs are working together and continuing to make good progress at reducing HIV rates across the capital. As we celebrate World Aids Day on Thursday 1 December, boroughs are continuing their efforts to reach the United Nations targets to eliminate new HIV transmissions by 2030.

We understand there are over 36,804 people living with HIV in London. Reducing HIV remains an important public health challenge as boroughs aim to tackle health disproportionality mwithin their communities.

According to recent UKSHA data (published in October 2022), in 2021 there was a decrease in numbers of new HIV diagnoses, AIDS at HIV diagnoses and deaths from HIV compared to 2020 and 2019. There were 71 fewer new HIV diagnoses in 2021 compared to 2020 (883 compared to 954, respectively). During 2021, 36,804 people in London were seen for HIV care, 25,956 of which were men and 10,772 of which were women. Despite this demand, London continues to provide good quality care for people living with HIV.

The London HIV Prevention Programme

The London HIV Prevention Programme has played an integral role in London’s success at tackling HIV. It was set up in 2014, with the support of London borough Directors of Public Health, and enables boroughs to work together and develop a collaborative response to reduce HIV and support affected communities. The programme includes an awareness campaign called Do it London and health promotion outreach work with voluntary sector partners.

This year’s Do it London campaign was launched in October 2022 and is called ‘Be Sure. Know the Four.’ This references the four scientifically proven, free, accessible ways to prevent HIV: regular testing; condoms; the use of PrEP (the HIV drug that prevents infection) and undergoing effective treatment to become ‘undetectable’. Frequent HIV testing and the offer of PrEP among those most at risk of HIV remains key to ending HIV transmission.

Fast Track Cities Programme

In 2018 London joined the Fast Track Cities Initiative along with other global cities to end HIV. The partnership consists of statutory partners including London Councils, NHS England, the Mayor of London and Greater London Authority, and the Office of Health Improvement and Disparities (OHID).

In 2019 Fast Track Cities secured NHS England funding of £3 million - the HIV Improvement Community Fund - which gave funding to voluntary sector groups to tackle HIV stigma at all levels. In April 2022, the Fast Track Cities Initiative supported the roll out of HIV, Hepatitis A and Hepatitis B opt out testing in Emergency Departments across London, with the aim of diagnosing and treating more people and to normalise the testing process.

London’s HIV Challenge

London’s collaborative approach and focus on early intervention is paying dividends. However, there are an estimated 1,650 people living with an undiagnosed infection in London who can potentially spread the virus to others if they remain unaware of their condition. Identifying the groups more likely to be affected by HIV and to better understand the impact of behaviour changes following the Covid-19 pandemic will be crucial if the current success is to continue.

London boroughs and other health partners are working on approaches to reduce the persistent issue of late diagnoses. In London in 2021, 39% of HIV diagnoses were categorised as late, causing delays in treatment and harm to health, as well as increasing the risk of onward HIV transmission. Reducing stigma and working with our voluntary sector partners will proVide a better understanding about why people fail to seek treatment earlier.

Supporting London’s efforts to reduce HIV

In 2022/23, London boroughs were allocated £0.69 billion of public health funding through the public health grant, compared to £0.67 billion in 2021/22. The vast majority of this funding is to provide sexual health services, which includes HIV testing.

Earlier this year London’s sexual health clinics supported the response to the Monkeypox virus and will continue to support the vaccination programme as vaccines are rolled out. As a result, our sexual health clinics are under considerable strain as no additional funding was provided for this and clinics are struggling to offer other services.

The government should:

  • Support councils to deliver an expanded, but appropriately resourced, role in public health, building on the successes of the pandemic and vaccination programme.
  • Provide funding increases that mirror those of the NHS to ensure that funding is spent more efficiently within the whole health and care system.
  • Update the Public Health Grant funding formula to better reflect local need.
  • Recognise the additional financial pressures caused by the Monkeypox virus and the impact this has had on our sexual health services, as demand for all public health services is expected to increase following the Covid-19 pandemic.

 

Amy Leppänen, Parliamentary Officer