The London HIV Prevention Programme (LHPP) is a collaborative programme across London local authorities, which supports the commissioning and delivery of a limited number of HIV prevention interventions where there is a case for taking a city-wide approach. The LHPP works with partners to deliver sexual health promotion outreach to men who have sex with men, and a free condom distribution scheme across more than sixty gay venues in the capital. The programme has been running successfully since 2014, following a comprehensive DsPH-led needs assessment for the capital and is delivered on their behalf by Lambeth Council on behalf of London boroughs.
In October 2018, London borough Leaders agreed to continue to fund the LHPP for another three years from April 2019 until March 2020. Through its Do It London public awareness campaign, free condom distribution, community-based HIV testing and targeted outreach, the LHPP has made a major contribution to the capital’s declining HIV rates. LHPP is regarded as an important programme evidencing borough public health leadership and is often cited as a flagship example of London borough collaboration.
The most recent data from Public Health England (December 2018) reported an overall 37 per cent reduction in new HIV diagnoses in the capital since the boroughs began Do It London in 2015. In men who have sex with men (the group most affected by HIV in London), that figure reduced by 40 per cent in the same period.
London is making more progress than anywhere else in England and leads the way in HIV prevention internationally, recently becoming one of the first global cities to exceed the UN’s worldwide diagnosis and treatment targets. As a member of the Fast Track Initiative, London has pledged to achieve zero HIV transmissions, zero deaths, and zero stigma by 2030.
Figures released in September 2018 confirmed HIV infection rates are declining, with a substantial decrease over the past two years. At the same time, testing rates have continued to grow: 1,675 people were diagnosed with HIV in London in 2017 compared to 2,090 in 2016 and compared to 2,671 in 2013 (the year councils took over responsibility from the NHS); the 2016-17 decrease represents a fall of 21 per cent in London, compared to the UK-wide decrease of 17 per cent. The number of new diagnoses in 2015 was 2,729, meaning London has seen a decrease of 38 per cent between 2015 and 2017.
From 1 April 2013 a range of public health responsibilities, including the commissioning of HIV prevention services, transferred from the NHS to local authorities. A Pan-London HIV Prevention Programme had been jointly commissioned by the London Primary Care Trusts, but was due to come to an end in March 2013.
In February 2013, our Leaders' Committee commissioned a needs assessment and options appraisal to consider the case for future pan-London commissioning.
In the light of this work, in November 2013, our Leaders' Committee agreed a new three-year £3.4 million London HIV Prevention Programme would be commissioned to deliver a limited number of key HIV prevention services.
The services are aimed at men who have sex with men and black African communities (the groups at highest risk of contracting HIV) and will include media campaigns, condom distribution and some outreach work.
Boroughs remain responsible for any additional HIV prevention commissioning required to meet the needs of their communities. The London Borough of Lambeth is hosting the London HIV Prevention Programme. Queries about the programme should be addressed to Paul Steinberg, the Programme Manager ([email protected]).
Since its launch of the ‘Do It London’ campaign, it has achieved 55,500,000 digital display advert impressions on Londoners’ mobiles, tablets and laptops and has appeared on at least 13,000 ad panels inside London Underground Tube trains, just over 13,000 ad panels inside London’s buses and nearly 17,000 street-side adverts. Between 2014 and the end of 2017 the free condom distribution scheme has issued 4,200,000 condoms and 4,100,000 lube packets were distributed to Londoners.
LHPP’s Do It London campaign has helped to increase awareness of HIV, safer sexual behaviours and drive up rates and the frequency of HIV testing and maintain and increase reported levels of condom usage.
London HIV Prevention Programme - Campaign 2019
The campaign’s messages are set to be promoted in the capital across a wide range of channels, including on-street billboards, posters on the London Underground and bus network, in print and digital media, via specialist magazines, on radio and social media. There will also be on-the-ground outreach and condom distribution teams at the iconic London Pride parade (on Saturday 6 July) and other events in the coming months.
Cllr Ray Puddifoot, London Councils’ Executive Member for Health & Care, said: “London is now not just a national but a global leader in HIV prevention.
“Through collaborating and jointly funding the Do It London public health programme, the boroughs’ commitment to tackling HIV has made a major contribution to the capital’s record of success. This approach ensures strong and consistent messages are communicated to Londoners about HIV prevention.
“Today we’re in the exciting position where London can achieve zero new HIV infections by 2030 if current trends continue. To maintain positive progress, it’s crucial that Londoners keep making safer choices – and that’s why our latest Do It London campaign is so important.”
Paul Steinberg, lead commissioner of the London HIV Prevention Programme, said: “The reduction in HIV diagnoses in recent years is a very promising development, not least because it means Londoners themselves are making effective choices to stop the transmission of HIV.
“But this is no time for complacency. That’s why London boroughs continue to work together to encourage everyone to prevent HIV, in order to achieve our ambitious target of zero new infections by 2030.
"The London HIV Prevention Programme is proud to have played its part in the continued downturn in HIV incidence, alongside London’s world-class sexual health services, our clinical colleagues, the HIV voluntary sector, and the communities most affected by HIV. London is now a Fast Track City, part of an ambitious global effort to end the HIV epidemic by 2030, and we will continue to lead the way in efforts to prevent HIV and combat the harmful stigma needlessly associated with the virus.”
Despite the overall reduction in HIV, the virus remains a major public health concern in London. There are around 36,000 Londoners living with HIV and the capital continues to have a much higher new diagnosis rate than the rest of England (21.7 per 100, 000 versus 8.7).
Another on-going challenge is the number of late diagnoses, with an average 35% of London’s HIV diagnoses since 2015 categorised as ‘late’ (meaning the virus has already started damaging the immune system when the diagnosis is made). Late diagnosis causes delays in treatment and harm to health, as well as increasing the risk of onward HIV transmission. Londoners who are diagnosed late are more likely to be heterosexual, including a significant number from black African communities – another key target audience for the Do It London campaign.