Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they will take to ensure that people in prisons have effective access to HIV prevention tools, including condoms, pre-exposure prophylaxis, post-exposure prophylaxis, and harm-reduction measures.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The new HIV Action Plan sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing, and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including the challenges of HIV prevention and care in prisoners.
Sexual health services in prisons are commissioned by NHS England under the Section 7a Public Health Functions Agreement with the Department. They are required to deliver care and ensure access in accordance with the British Association for Sexual Health and HIV’s prison standards, helping to ensure that all individuals in custody receive equitable healthcare comparable to that available in the community.
Access to HIV pre-exposure prophylaxis in England is via commissioned level three sexual health services. These are commissioned by local authorities for people in the community. NHS England Health and justice commissioners arrange for these providers to enable access for detained people via referral for assessment. The service is accessed by the detained person via in-reach provision, where the sexual health team come on-site, or out-reach provision, where the individual goes out to clinic. The level three sexual health team use the same commissioning policy to provide the service on the same basis to detained people and people in the community.
HIV post exposure prophylaxis is accessed by prisoners in the same way as people in the community. They attend accident and emergency or access a Sexual Assault Referral Centre based on locally commissioned arrangements.
To inform future action, the UK Health Security Agency is working with regional partners to carry out an audit to understand the provision of HIV diagnosis, prevention, and care in English prisons.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure uninterrupted access to antiretroviral therapy for people living with HIV when they enter, transfer between, or leave prison, including provision of long-acting injectable treatments where appropriate.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The new HIV Action Plan, published on World AIDS Day on 1 December 2025, sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing, and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including the challenges of HIV prevention and care in prisoners.
People entering prison receive healthcare assessments on reception which identify current healthcare needs and treatment. This includes identifying people who are receiving treatment for HIV. The healthcare team will use processes for accessing critical medicines to arrange an urgent supply of HIV medicines from the specialist clinic if required. The healthcare team will then ensure a referral to the local HIV specialist team if the patient is in a prison, in a location which lies outside of the area covered by their current specialist. HIV services have clear processes used to promptly transfer care between specialists.
The UK Health Security Agency is working with regional partners to carry out an audit to understand the provision of HIV diagnosis, prevention, and care in English prisons.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to improve the collection, monitoring, and publication of data on HIV prevalence, testing, prevention, and treatment in prisons.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The UK Health Security Agency (UKHSA) publishes overall HIV prevalence and HIV testing data annually in the HIV Monitoring and Evaluation Framework and the HIV Official Statistics, which are available on the GOV.UK website. Our recently published 2025 report Understanding HIV testing contains further information on people in prison. The report is also available on the GOV.UK website.
The Chief Medical Officer’s annual report in 2025, The health of people in prison, on probation and in the secure NHS estate in England, also available on the GOV.UK’s website, highlighted the significant health challenges faced by people in prison, including in sexual health and HIV, and we are committed to addressing this.
The UKHSA is working with regional partners to carry out an audit to understand the provision of HIV diagnosis, prevention, and care in English prisons. This will highlight what barriers people are facing and what we need to do to ensure every person gets the care they deserve.
Furthermore, the UKHSA is currently independently reviewing blood borne virus service provision in prisons, including the opt-out testing programme which has been in place since 2014 to update guidance, identify areas to optimise implementation, and ensure prisoners are fully supported.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the implementation and uptake of opt-out HIV blood-borne virus testing in prisons across England; and what actions they plan to take if inconsistencies or low uptake are found.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The new HIV Action Plan sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including the challenges of HIV testing in prisons.
HIV testing upon entry into prison is part of a national programme of opt-out blood borne virus (BBV) testing which tests people for hepatitis C, hepatitis B, and HIV. Sexual health services in prisons are commissioned by NHS England under the Section 7a Public Health Functions Agreement with the Department. This sets out targets for this opt-out BBV testing programme, with an efficiency target of 50% testing uptake, and an optimal performance standard of 75% testing uptake.
While uptake of a BBV test has risen from 11% in 2016/17 to 72% overall in 2022/23, this is below the 75% target and there is variation by region and prison. To inform future progress, the UK Health Security Agency is working with regional partners to carry out an audit to understand the provision of HIV diagnosis, prevention and care in English prisons.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure consistent implementation of opt-out HIV testing for all prisoners upon entry to prison and throughout their sentence, and how uptake is monitored across prison estates.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The new HIV Action Plan, published on World AIDS Day on 1 December 2025, sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including the challenges of HIV testing in prisons.
HIV testing on entry into prison is part of a national programme of opt-out blood borne virus (BBV) testing which tests people for hepatitis C, hepatitis B, and HIV. Sexual health services in prisons are commissioned by NHS England under the Section 7a Public Health Functions Agreement with the Department. This sets out targets for this opt-out BBV testing programme, with an efficiency target of 50% testing uptake, and an optimal performance standard of 75% testing uptake.
While uptake of a BBV test has risen from 11% in 2016/17 to 72% overall in 2022/23, this is below the 75% target and there is variation by region and prison. To inform future progress we are supporting regional partners to complete and review the BBV and sexually transmitted infections prisons audit to understand provision of HIV prevention and care in prisons from primary care and sexual health services.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they plan to publish annual data about HIV prevalence, testing uptake and treatment adherence in prisoners, disaggregated by gender and security category.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The UK Health Security Agency (UKHSA) publishes overall HIV prevalence and HIV testing data annually in the HIV Monitoring and Evaluation Framework and the HIV Official Statistics, available on the GOV.UK website.
Our recently published 2025 report Understanding HIV testing contains further information on people in prison. The report is also available on the GOV.UK website.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to guarantee uninterrupted access to antiretroviral therapy for prisoners living with HIV, particularly during transfers between facilities and upon release.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The new HIV Action Plan, published on World AIDS Day on 1 December 2025, sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including the challenges of HIV prevention and care in prisoners.
People entering prison receive healthcare assessments on reception which identify current healthcare needs and treatment. This includes identifying people who are receiving treatment for HIV. The healthcare team will use processes for accessing critical medicines to arrange an urgent supply of HIV medicines from the specialist clinic if required. The healthcare team will then ensure a referral to the local HIV specialist team if the patient is in a prison in a location which lies outside of the area coveted by their current specialist. HIV services have clear processes used to promptly transfer care between specialists.
No data is available on HIV treatment attendance for people in prison or on probation. However, engagement work has reported gaps in care, including treatment interruptions. To address this, regional and local partners are being asked to complete and review the blood borne virus and sexually transmitted infections prisons audit to understand provision of HIV prevention and care in prisons from primary care and sexual health services, which will inform future action.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what policies are in place to provide prisoners with HIV prevention methods, such as condoms, pre-exposure prophylaxis and post-exposure prophylaxis, and what steps they take to ensure equitable access for women and other vulnerable groups.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The new HIV Action Plan, published on World AIDS Day on 1 December 2025, sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing, and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including the challenges of HIV prevention and care in prisoners.
NHS England Health and Justice commissioned services are required to deliver care and ensure access in accordance with the British Association for Sexual Health and HIV’s prison standards, helping to ensure that all individuals in custody, including women and other vulnerable groups, receive equitable healthcare comparable to that available in the community. Access to HIV PrEP in England is via commissioned level 3 sexual health services. These are commissioned by local authorities for people in the community. NHS England Health and Justice commissioners arrange for these providers to enable access for detained people via referral for assessment. The service is accessed by the detained person via in-reach, where the sexual health team come on-site, or out-reach, where the individual goes out to clinic, provision. The service provided to individuals by the level 3 sexual health team is on the same basis provided to people in the community using the same commissioning policy. HIV post exposure prophylaxis is accessed by prisoners in the same way as people in the community. They attend accident and emergency or access a Sexual Assault Referral Centre based on locally commissioned arrangements.
To inform future action we are supporting regional partners to complete and review the blood borne virus and sexually transmitted infections prisons audit to understand the provision of HIV prevention and care in prisons from primary care and sexual health services.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how the HIV Action Plan for England, 2025 to 2030, published on 1 December, will specifically address the challenges of HIV prevention and care in prisoners, and what funding has been allocated to support those initiatives.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The new HIV Action Plan, published on World AIDS Day on 1 December 2025, sets out how the Government will enable every level of the healthcare system to work together to engage everyone in prevention, testing and treatment, tackling stigma, and reaching our ambition to end new HIV transmissions by 2030. This includes a dedicated action to deliver tailored and targeted HIV prevention, treatment, and care services to meet the needs of local populations and address inequalities, including the challenges of HIV prevention and care in prisoners.
NHS England Health and Justice commissioned services are required to deliver care and ensure access in accordance with the British Association for Sexual Health and HIV’s prison standards, helping to ensure that individuals in custody receive equitable healthcare comparable to that available in the community. NHS England Health and Justice regional commissioners ensure the level 3 sexual health services for detained people includes the HIV PrEP access pathway, and that prison healthcare teams and prisoners know how to access it. Prisoners with HIV should be seen for HIV care at least once a year. However, no data is available on HIV treatment attendance for people in prison or on probation. To address this, we are supporting regional partners to complete and review the blood borne virus and sexually transmitted infections prisons audit to understand the provision of HIV prevention and care in prisons from primary care and sexual health services, to inform future action.
Asked by: Baroness Barker (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the demographic profile of requesting an HIV testing kit during National HIV Testing Week in each of the years 2020 to 2023 inclusive.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
During the period between 1 and 7 February 2021, 19,342 HIV testing kits were dispatched, and 84 were reactive. The following table shows, using the data currently available, the number of HIV testing kits that were ordered and dispatched for National HIV Testing Week (NHTW) campaigns between 2019/20 and 2022/23:
England Total | Ordered kits | Dispatched kits | HIV reactive | HIV reactivity |
2019/20 | 19,863 | 19,496 | 81 | 0.8% |
2020/21 | 30,612 | 30,876 | 135 | 0.7% |
2021/22 | 24,409 | 23,520 | 75 | 0.6% |
2022/23 | 22,408 | 21,626 | 79 | 0.4% |
Notes:
NHTW focuses on communities disproportionately affected by HIV though tests are available to be ordered by anyone in England. We have some data available on the demographic profile of people requesting an HIV testing kit during NHTW, with 44% of HIV testing kit requests in 2023 coming from gay and bisexual men who have sex with men.
Black African people’s uptake of testing kits has tripled since 2021, accounting for 10% of orders made. During NHTW in 2023, self-testing kits were made available for the first time and were particularly popular amongst black African groups. The percentage of heterosexual men who requested a testing kit has doubled since 2021, from 11% to 22% in 2023 and the percentage of heterosexual women has also steadily increased year on year.
We continue working closely together with our key partners in the HIV Prevention Programme monitoring and evaluating the results of the campaign to ensure we continue progressing towards our 2030 ambitions.