Sexual health charity Terrence Higgins Trust has reacted to new HIV data for England, released by the UK Health Security Agency. According to Terrence Higgins Trust, the new HIV data for England “shows the pace of change is too slow towards the Government’s target of ending new HIV cases by 2030,” which, is “unacceptable when we have all of the tools we need to achieve it”.
For the first time, the figures from the “highly successful” Emergency Department HIV testing programme are included in the official figures, with at least 153 people diagnosed in this new setting in 2022. However, as A&Es ramp up HIV testing the progress in sexual health services is “disappointing“ – HIV testing levels increased by 10% from the previous year, but remain 15% lower than before the Covid-19 pandemic in 2019 in all groups other than gay and bisexual men. According to Terrence Higgins Trust, there is a “clear testing gap”, with testing rates among gay and bisexual men at the highest level on record in 2022, with 192,503 tests, and driven by those living in London.
Richard Angell, Chief Executive of Terrence Higgins Trust, said: “The new HIV data shows real and demonstrable progress towards ending new HIV cases in this country by 2030, but it must also serve as a clear warning that urgent action is needed to prevent that historic and pioneering goal from being missed. While there is much to celebrate about the effectiveness of A&E testing and more people accessing effective treatment and care, the progress being made isn’t fast enough nor being felt equally across all the groups impacted by HIV. No one should leave a sexual health clinic without having a HIV test.
“The next parliament is the last chance of acting to make ending new HIV cases by 2030 a reality or not. And, when we have the tools necessary to do it, anything less would be absolutely indefensible. We cannot miss this chance.”
“While testing rates among heterosexuals in sexual health services has increased markedly since 2021, they still lag behind pre-Covid levels at a time when they need to be far, far higher. Testing among heterosexual and bisexual women was at 81% of the level seen in 2019, with heterosexual men even worse at two-thirds of pre-Covid levels.
“The option to order a HIV test online to do at home is helping to increase testing rates, but this shouldn’t be at the expense of building back face-to-face testing. We need more heterosexual men, more heterosexual women and more people of colour to be accessing HIV testing and prevention – which means offering testing and PrEP where people actually access their sexual and reproductive healthcare and an expansion of the ways in which they are available.
“HIV testing hit a record high among gay and bisexual men in 2022 which is great news about how testing is being normalised and prioritised among many in that group. However, this is driven by gay men in London, with testing actually falling by 2% outside of the capital. This again shows some of the unequal progress and the importance of addressing geographical disparities, including through expanding routine testing in A&E departments right across the country.
“We need more heterosexual men, more heterosexual women and more people of colour to be accessing HIV testing and prevention.”
“Ramping up HIV testing across the board is the bedrock of ending new HIV cases by 2030 and it’s vital every single one of the next six years is maximised. Opt-out HIV testing in A&E departments among areas of very high relative prevalence has been hugely successful in finding people living with undiagnosed HIV who are very unlikely to test via any other route.
“Those diagnosed in the pilots were more likely to be heterosexual, women and of Black ethnicity than those diagnosed via sexual health departments. That innovative intervention via A&E departments now needs to be urgently expanded beyond London, Brighton, Manchester and Blackpool to build on that progress and identify more people who are HIV positive, but unaware of their status and potentially inadvertently transmitting the virus.
“PrEP usage has been growing for the best part of a decade, but it remains under-utilised. Our recent research found that the average waiting time for a PrEP appointment at a sexual health clinic was a whopping 12 weeks. It is time to make PrEP more accessible – it should be available through a year-round online service and in community pharmacies and GPs.
“Ramping up HIV testing across the board is the bedrock of ending new HIV cases by 2030 and it’s vital every single one of the next six years is maximised.”
“Levels of late diagnosis are high across all groups and particularly in heterosexual men. Gay and bisexual men are least likely to be diagnosed late, but with 37% of that group being diagnosed at a late stage that’s still unacceptably high. Late diagnosis means damage to the immune system has already begun, as well as increasing the chances of HIV being unwittingly passed on. Initiatives like National HIV Testing Week are making inroads in normalising HIV testing, but there’s work to do to engage more people in the importance of HIV prevention and testing.
“We have all the tools we need to end new HIV cases by 2030 and diagnose those out there who are unaware they’re living with HIV. But with just six years left to achieve that goal, it’s worrying that the pace of change is much too slow. This week is the Conservative Party Conference with a General Election on the horizon. Those MPs elected at the polls in the next 12-18 months have an incredible opportunity to do something truly life-changing and end HIV transmission in this country. The next parliament is the last chance of acting to make ending new HIV cases by 2030 a reality or not. And, when we have the tools necessary to do it, anything less would be absolutely indefensible. We cannot miss this chance.”
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