HIV Diagnosis: Clinical Guidance

Debate between Lord Prior of Brampton and Baroness Gould of Potternewton

Thursday 1st December 2016 Lords Chamber

[Baroness Gould of Potternewton]

To ask Her Majesty’s Government, in the light of the forthcoming review of testing guidelines in 2017, what steps they are taking to ensure new national clinical guidance is adopted by the National Health Service and local authorities to reach people in the United Kingdom still living with undiagnosed HIV.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, we welcome the new HIV testing guidelines from NICE, which are particularly timely on World AIDS Day. Early diagnosis of HIV through increased testing carries huge benefits. Progress is being made and in 2015 the rate of undiagnosed HIV fell to 13% from 25% in 2010. We will keep working with partners to use the guidelines to encourage people to get tested and fight the stigma associated with HIV.

[Baroness Gould of Potternewton (Lab)]

I thank the Minister for his reply. Can he elaborate a little on the Government’s plans for promoting the guidelines to raise awareness—which I hope they will do—and monitoring the use of the guidelines to reduce the 17% rate of undiagnosed HIV and the continuing levels of HIV? The responsibility of government is absolute in making sure that the guidelines are adopted. On the same basis, can the Minister indicate what support or otherwise the Government are giving to ensuring that PrEP is made available to all those who might be at risk of HIV transmission?

[Lord Prior of Brampton]

My Lords, the undiagnosed rate of HIV is not 17%, as the noble Baroness said. That was in 2014. It is 13% now. So there is an improvement here and the trend is in the right direction. We have a whole range of programmes to try to improve the rates of testing, including self-sampling, and 1.1 million people attended GUM clinics last year. There is the HIV Prevention Innovation Fund and all the work being done by the Terrence Higgins Trust. There is a Question on PrEP later. Perhaps I could deal with it then.

[Baroness Gould of Potternewton]

My Lords, I must declare that I was on the innovation panel for Public Health England.

[Lord Black of Brentwood (Con)]

My Lords, all those living with HIV, particularly those diagnosed late, require significant levels of care for both their physical and mental health. Does my noble friend agree that specialist doctors and nurses in the NHS provide exceptional care for those living with the virus, and join me in paying particular tribute to the work of pioneering centres, such as the Ian Charleson Day Centre at London’s Royal Free Hospital, which have made a real difference to the lives of thousands of patients?

HIV: Barriers to Treatment

Debate between Lord Prior of Brampton and Baroness Gould of Potternewton

Thursday 1st December 2016 Lords Chamber

[Lord Prior of Brampton]

I thank the noble Baroness for coming to my rescue on that. It is very difficult, as she knows, because the HIV virus is complex. What is remarkable is the extraordinary advances that have been made in treating HIV over the last 20 years; that has been a real triumph of the pharmaceutical industry. I will still write to the noble Baroness, Lady Tonge, about vaccines.

[Baroness Gould of Potternewton (Lab)]

My Lords, I was not going to refer to vaccines but to something else, but a report on the radio this morning said that South Africa believes it has developed a vaccine that will prevent HIV. Maybe we could find out more about that in due course.

I wanted to ask the Minister about barriers, of which there seem to be two. My noble friend has raised one—stigma—and I got the impression that the Minister felt it was perhaps not as serious as it used to be. It is very serious; there are still many examples, particularly of women, who will not go to a clinic, thus creating a barrier, because of the stigma that is attached. The other barrier that is equally important is that local authorities that fund testing are having huge difficulty in raising the funds to do so. Maybe we should be looking at whether there is a positive way in which the Government can help with resources to local government.

[Lord Prior of Brampton]

Frankly, this is an area where government can never do enough. We should take some comfort from the fact that the level of undiagnosed HIV is consistently coming down; it is now down to 13%, and we are within touching distance of the WHO’s 90% level. So we are making progress, but I accept what the noble Baroness says. On stigma, I am sure there is much more that we can do.

Health: HIV

Debate between Lord Prior of Brampton and Baroness Gould of Potternewton

Monday 4th July 2016 Lords Chamber

[Lord Prior of Brampton]

It is true that in the control group used in the PROUD trial there was a very high level of success—85% or 87%, I think—but it is critical to identify the right group of people. That is why NHS England is providing £2 million to test Truvada as a prophylactic among a wider group of people to see whether it is equally efficient.

[Baroness Gould of Potternewton (Lab)]

My Lords, I declare my interests as a member of the All-Party Parliamentary Group on HIV and AIDS and as a patron of many HIV organisations. Further to the Minister’s last reply and to the fact that trials are going to take place, will he indicate what action the Government are taking to ensure that there is no gap in the provision of Truvada—PrEP—for those who are on the PROUD trial? Those people will be in great difficulty if they have to stop taking the drug. Will they be included in the trial, how are the trials going to be determined and who is going to decide how the money is going to be spent? Lastly, we think the trial will be a two-year process, so it will be 2019 before we get a decision. Will the Minister say how the decision is ultimately going to be taken?

[Lord Prior of Brampton]

I can confirm that all the people who are receiving PrEP as part of the PROUD trial will continue to receive it going forward, which I think answers the main point made by the noble Baroness. In terms of the conduct of the trials that I referred to earlier, they will largely be organised and shaped by Public Health England.

Gender-based Violence: Women with HIV

Debate between Lord Prior of Brampton and Baroness Gould of Potternewton

Wednesday 25th November 2015 Lords Chamber

[Baroness Gould of Potternewton]

To ask Her Majesty’s Government what action they have taken to assist women with HIV who are experiencing gender-based violence.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, sexual health and HIV services are already sensitive to the risk of domestic abuse and sexual violence, including gender-based violence, in their routine consultations. In recent years, the Government have put nearly £40 million into specialist domestic and sexual violence support services and national helplines. We have also set up 15 new female rape support centres to raise the total to 86. We have taken strong action in the fight to eradicate female genital mutilation.

[Baroness Gould of Potternewton (Lab)]

I thank the Minister for that reply but, with respect, it is not sufficient to answer the Question that I asked, which was about the relationship between HIV and sexual and gender abuse. Does the Minister not accept that the Government have a responsibility to work across the relevant departments, as others have said, to ascertain the number of women who are in this dire situation, to encourage them to seek support and help, which they so desperately need but which many are prevented from doing because of the stigma of their situation; and crucially to provide the resources, both staffing and financial, to help these women in such terrible situations?

--- Later in debate ---

[Lord Prior of Brampton]

I have not been to the Upper Waiting Hall to see the exhibition but will endeavour to do so if I have time after Questions this afternoon. The noble Baroness referred to the research done at the Homerton in 2013. I think the figure that study came up with was 52%. There has been a subsequent study but I cannot remember the name of it. It may not have been as extensive as the one done at the Homerton and put a figure slightly less than 52%—but it was still very significant. I will ask officials the status of that subsequent research to see whether we need more.

[Baroness Gould of Potternewton]

To help the Minister, it was Positively UK that did the other piece of work.