To end new HIV cases in the UK by 2030, these things still need to happen

As we get another year closer to 2030, this is what still needs to happen to reach the goal of ending new HIV cases in the UK.

WORDS BY RICHARD ANGELL, CHIEF EXECUTIVE OF TERRENCE HIGGINS TRUST
HEADER IMAGE BY ANISA CLEAVER

2024 is a big one for me as I – unbelievably – turn 40 at the start of the year. But it’s an even bigger one for us at Terrence Higgins Trust with the clock ticking down at pace on the life-changing goal of ending new HIV cases in the UK by 2030. Now just six short years away.

We’re clear: that 2030 target is absolutely achievable – but it’s not going to be easy and we won’t drift over the finish line with business as usual. Which means we need proper focus, ambition and leadership to make the UK the first country in the world to achieve the feat. It also means making significant progress each and every year, including the one just beginning.

That’s why two of our big focuses for the next 12 months are:

• Easier access to HIV prevention drug PrEP;
• Engaging those living with HIV but not taking treatment.

I’ve said it hundreds of times before, but it bears repeating: PrEP is highly effective at preventing HIV and a brilliant way to protect yourself. We’ve known that for almost a decade, but it was confirmed yet again just last month with the publication of the largest ever real-world study based on NHS England’s PrEP Impact Trial. The question is no longer ‘does PrEP work?’ but instead ‘how can we finally utilise it properly?’

Because, while PrEP is commonly used among gay, bisexual and other men who have sex with men, its usage by other groups – including women – remains extremely low. Then even for those who know about PrEP and want to take it, our recent research found there is on average a 12-week wait for a PrEP appointment at sexual health clinics in England. That’s a horrible statistic and it pains me to think that even after a long, hard fight for its availability on the NHS, many are still facing long waits to access PrEP.

To overcome these barriers – when sexual health clinics remain over-stretched and under strain – we need to see PrEP available in other settings and sharpish. That includes via an online portal, in community pharmacies and through GP surgeries like the contraceptive pill is.

Alongside PrEP, another crucial piece of the jigsaw for ending new HIV cases, is the brilliant, incredible, can’t-be-said-too-often fact that people living with HIV and on effective treatment cannot pass HIV onto their partners. Which means those who are diagnosed and taking their daily medication are playing a huge role in HIV prevention.

But the reality is a growing number of people who know they are living with HIV are not engaged with an HIV clinic or taking treatment. For gay, bisexual and other men who have sex with men this can be linked to drugs, alcohol or chemsex, while poverty, racism, mental health and stigma are also significant factors. We also know those new to the country are unaware that healthcare is free at the point of access.

For too long this has been a hidden issue with the focus on prevention, testing and diagnosis. But it’s an issue that’s grown considerably since the COVID-19 pandemic and we’re steadfast that investment is made in re-engaging these thousands of people.

For context, the UK Health Security Agency estimates this could be up to 22,670 people. It’s our belief it’s more like 15,000 across England, Scotland and Wales. But, whatever the figure, there’s no doubt that engaging and supporting this cohort of people living with HIV needs to be stepped up. Because ending new HIV cases is about so much more than prevention, it’s also about supporting people living with HIV to live well – including after that 2030 deadline passes.

I’ve been saying it since I started as Chief Executive and I’m going to keep saying it: at Terrence Higgins Trust, we’ve been around for 40 years and we will be there until the last person living with HIV needs us.

Unfortunately I don’t have the word count to outline everything we need to happen to end new HIV cases in the UK by 2030. But it almost goes without saying that an absolutely key moment for us – and the country – is this year’s General Election.

That’s because the next parliamentary term is the last chance of acting to make 2030 a reality. The current Government has just announced the significant expansion of opt-out HIV testing in A&Es to an additional 46 hospitals – meaning an additional two million HIV tests a year helping to find those extremely unlikely to test via any other route. While the Labour Party has already committed to updating the current HIV Action Plan which only runs to 2025’s interim targets.

But all eyes are now on the health and equality priorities set out in manifestos – including for actions on PrEP and reengaging people living with HIV in care and in treatment. Because, if urgent action isn’t taken, the life-changing goal will be missed and that will be on the watch of all of us.

But it’s a New Year and I’m feeling optimistic, determined and motivated. Together – and only together – we can end new HIV cases by 2030.

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