Views

A new paper published in Eurosurveillance today finds that there has been substantial progress towards achieving the global UNAIDS targets across Europe and Central Asia. Despite this, an estimated 1.2 million people living with HIV still have transmissible levels of the virus because they have been unable to access prevention methods, testing or treatment for HIV. This paper is the first output of nearly two years’ work by NAT as part of the Dublin Declaration monitoring team.

In 2015, an HIV outbreak was detected amongst people who inject drugs (PWIDs) in Glasgow. Three years on the outbreak has still not been controlled, and over 100 PWIDs in Scotland have been diagnosed with HIV. Those diagnosed have complex needs and experience severe social exclusion, with 40% having a history of incarceration and 45% reported ever being homeless.

Do we have PrEP in England? Well, yes and no. We have the PrEP Impact trial which currently has 10,000 places available for PrEP in sexual health clinics across the country. The study is being paid for by NHS England, which is a great step forward from where we were two years ago. Back then, the NHS were insisting that they didn’t have the powers to pay for PrEP. NAT had to take the NHS to court to convince them otherwise.

Last week the Government published the 2017 Drugs Strategy, the first national drugs strategy since 2010. The previous drug strategy was heavily criticised for its focus on abstinence, and little mention of harm reduction initiatives. The 2017 Drugs Strategy unfortunately does not go much further.

In two years, investment in community based HIV prevention decreased by over a third in London. This coincided with significant Government cuts to the public health grant. In the same period, there has been reduction in HIV diagnoses amongst MSM in some parts of the city. So, do the funding cuts to prevention matter? If we want to sustain and build on our success, then yes, they matter a lot.

We’re calling on the next government to stand with people affected by HIV

One argument you see amongst those critical or worried about the introduction of PrEP is that it will result in big increases in STIs as gay and bisexual men (and indeed others at risk of HIV) throw away their condoms. But does the evidence support such fears? And as importantly, what do those fears tell us about our views of HIV and gay sexual health?

Following the news that Glasgow will open the first safe injecting rooms in the UK, Daniel Vincent asks if we’re doing enough in England and Wales to meet the health needs of people who inject drugs.