Time to read
Three decades in HIV and sexual health
I have been working in sexual health and HIV for over 30 years, as a trustee, a volunteer, a civil servant, a local authority commissioner, and now proudly as CEO of National AIDS Trust. I’ve seen how far we’ve come – from the days when people needing treatment had to take multiple pills every day, to U=U, where those on effective treatment can no longer transmit the virus. This year, the introduction of long-acting injectable PrEP adds another powerful tool to prevent HIV acquisition.
In that time HIV has become a recognised protected characteristic under equality legislation, and – campaign by campaign – we have successfully chipped away to change unlawful and inequitable policies and practices.
I really believe that now we are closer than we have ever been to being able to take the right steps to end new cases of HIV.
Tools exist, but action is still needed
It’s consistently recognised that we have the tools (the quality of HIV care and prevention medications) to end new transmissions of HIV, but we know that medicine and treatment alone won’t get us to the 2030 goal to end new HIV cases that every UK Government, and all administrations across the UK, have committed to. That’s why I am so pleased that the UK Government, in this new Action Plan, has recognised and set out some compelling initiatives and steps that we believe are urgently needed.
In our work Getting on Track with partners Terrence Higgins Trust and Elton John AIDS Foundation, we engaged with voluntary sector and community groups, people living with HIV, public health professionals, clinicians, and commissioners to understand what the key challenges are and what is needed next. We highlighted the need for a national re-engagement programme that can find and bring back into HIV care the thousands who have been diagnosed but are no longer receiving HIV treatment. We also made it clear that unless we tackle the stigma that is still prevalent in healthcare settings we will not get to 2030. I’m delighted that Government has heard this call and has committed funding and action for both areas.
But it’s only right to recognise that a government Action Plan can only ever take us so far. It can lay the foundations and initiate much needed interventions. But the response to HIV, and its success, has always been founded on community and voluntary action – the campaigning of groups and people, the commitment and activism of volunteers, the expertise of voluntary sector professionals delivering tailored and innovative services.
The essential role of the voluntary sector
The pivotal role of on-the-ground insight informing national policy, and challenging preconceptions and assumptions cannot be overstated. This Action Plan must also be an opportunity to recognise this value and put in place strategies to ensure the voluntary sector can continue to play its vital role, and that essential services are sustained.
We recognise that this Action Plan in 2025 is being published in a very different world than when the first action plan one was launched in 2022. The public funding pressures in the UK are acute, and the global funding cuts to international programmes have been devastating. We have seen a retreat from some of the protections and rights that we may have thought of as secure, and for some people – including trans and non-binary people – the world right now is a less safe than it was.
This wider political, social and economic context will affect us, and our communities, over the next five years of the Action Plan, and beyond. And if there’s one thing that has been true throughout my time working in the HIV sector, is that we can never talk about HIV, or have a plan to end it, without also campaigning for equality across the board. This means challenging the wider health inequities (the social determinants of health) that we continue to see impacting people living with HIV.
Looking ahead to 2030
To bring it back to where we are now, this Action Plan contains a lot, and a lot of it is very encouraging. I know a great deal of work – from all parties – has gone into getting this to this point. But in the charity sector we are always impatient, we want things done yesterday, and we will be quicker to call out what’s not right than credit what is going well.
So, while I want to give credit where it’s due for the publication of the Action Plan, I think it’s important to end with a look ahead: 2030 is just five years away, and there’s no time to waste. We have a new plan – now we need action.