National HIV Testing Week

Andy Slaughter Excerpts

Thursday 8th February 2024 Commons Chamber

[Andy Slaughter (Hammersmith) (Lab)]

It is a pleasure to follow the Father of the House, and I thank my hon. Friend the Member for Warrington North (Charlotte Nichols) for so clearly setting out the issues. I do not need to repeat them, as I want to speak briefly.

I represent a constituency that has had a high incidence of HIV infection for many years. It has a young, mobile and diverse population, and a very busy sexual health clinic at 10 Hammersmith Broadway, which I visited last summer. I pay tribute to all the staff there and at the other clinics around the country. They offer a fantastic service and they are engineering testing and comprehensive treatment under very difficult circumstances and with very limited resources. I also pay tribute to the Terrence Higgins Trust and the National AIDS Trust, and all the other charitable organisations that have done so much over the past few decades.

We should pause in this debate to mark the successes and the transformation in both the prevention and the treatment of HIV and AIDS over the past few years. There has been great success. We know now that early diagnosis is important but, after diagnosis, those who are infected can live normal lives of normal duration. That would have been unthinkable even 20 years ago. There is very effective prevention through PrEP and other methods. To go from where the risk of infection was a few years ago to where we are now is extremely significant.

Given that testing and treatment are available—and prevention should be available—it is even more frustrating that we are in the situation that my hon. Friend outlined. First, the fact that 4,500 people are undiagnosed in the UK is entirely unnecessary. One of the solutions, which the Government are expanding, is opt-out testing in A&E and other locations. That needs to be embedded and extended. Until we get to the stage of preventing transmission altogether—for which there is an ambitious target—opt-out testing needs to be expanded and made more usual. In turn, that will help to eliminate the disparities in testing rates between different parts of the population—between men and women, and heterosexuals and men who have sex with men. This is not rocket science. This is about simply making sure that the proper remedies are available.

The other issue that has come up repeatedly over the past couple of years is the availability of PrEP and other preventive measures. That is partly down to the pressure on sexual health clinics, through an upsurge in other STIs such as gonorrhoea and syphilis, of which we have seen not quite epidemics but serious outbreaks. Last year we saw several episodes of monkeypox. Understandably, they have taken priority in sexual health clinics, but that means that less time is available for consultation, and there are fewer prescriptions of PrEP and other medications. The waiting times are still far too long, but at one stage they were being measured in months rather than weeks. It is clearly a missed opportunity if people are willing to be prescribed PrEP and understand its advantages, but are not receiving prescriptions because they simply cannot get an appointment at their local clinic, through no fault of the clinic or its staff.

These problems need to be tackled, and it would be relatively inexpensive to do so. The problems are relatively clear and straightforward. The drugs and products are safe and tried and tested, and the methods—whether postal testing or in A&E or outreach—are well known and proven to work. The only issue, which I hope the Minister will address, remains why it is not being done. Obviously, there were problems during covid, as there were in many health services, but that is no longer a good enough excuse. There is no reason why people should not be able to readily accept testing, medication and preventive measures.

I would like to hear a further commitment from the Minister today on opt-out testing, resources for sexual health clinics and the availability of PrEP. It has been suggested that, given the expansion in services now provided by pharmacies, PrEP could be added to them. I see no reason why that cannot be the case. It could be perfectly safe to prescribe it in that way. It would take the pressure off clinics and it would make the medication more accessible and easier for those who are not currently receiving prescriptions.

I ask the Minister and the Government to consider those points. They are not difficult and they will not take a long time, but they could have a significant effect on many hundreds and thousands of people who are unnecessarily at risk.

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[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

I congratulate my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) and the hon. Member for Warrington North (Charlotte Nichols) on securing this important debate. My right hon. Friend has been called away to his constituency today, but I am grateful to both him and the hon. Lady for their strong advocacy for National HIV Testing Week.

I pay tribute to all the other Members who have contributed today: my hon. Friend the Member for Worthing West (Sir Peter Bottomley), the hon. Members for Hammersmith (Andy Slaughter), for Strangford (Jim Shannon), and for East Dunbartonshire (Amy Callaghan), and the shadow Minister, the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill). It is clear that there is cross-party consensus on the need to challenge ourselves to meet our ambition of no new HIV transmissions by 2030, and I am sure that we can do that if we stick together on this subject. I listened carefully to all Members’ speeches, and I will try to answer all the questions that were asked.

Let me begin by saying how grateful I am to everyone who has taken part in in National HIV Testing Week, especially all those who have been tested in Portcullis House thanks to the work of the excellent Terrence Higgins Trust. I also commend the work of other charities, including the National AIDS Trust, Tackle HIV, LGBT Foundation, George House Trust and many others supporting families up and down the country—and I salute the work of the all-party parliamentary group on HIV and AIDS.

We should remember the way in which heroic NHS staff stepped up to care for people living and dying with HIV and AIDS in the 1980s, at a time when AIDS was a terrifying new disease that spared no one. It was to honour their legacy, and to complete the work that our NHS began 40 years ago, that this Government made a bold and ambitious commitment in 2019 to end new transmissions in England by 2030. To that end, we published the first, groundbreaking national HIV action plan just over two years ago. Testing is one of the plan’s central pillars, and I am proud to say that we have been making huge strides, setting an example to the rest of the world to follow. Last year the UK ranked first in the European combined sexual and reproductive health rights ranking atlas 2020 to 2023, in front of 43 other countries, and the UK Health Security Agency has confirmed that for the third time in a row, England achieved or exceeded the UN’s 95-95-95 targets. That means that 95% of people with HIV are being diagnosed, 98% of those diagnosed are being treated, and 98% of those receiving treatment are unable to pass on the condition.

However, while we have made excellent progress, we are not complacent, and we will not be satisfied until the number of transmissions is brought to zero. We have therefore put National HIV Testing Week at the heart of our efforts, year on year. We know that tailored and targeted campaigns are the most effective, so we have increased the number of tests and widened the scope of our campaign, ensuring that our messaging reflects and appeals to the different groups whom we are trying to reach. We are undertaking ever greater efforts to reach those who have been missed before and have become disengaged from the process. Last year we introduced the option of self-testing, with near-instant results at home, to give people more choice and more control over their testing, and this year we are partnering with local businesses to offer tests in places that regularly serve people from, for example, the black African community, who we know are less likely to want to go for a test.

These efforts have brought results. Since we launched the HIV action plan, we have sent out nearly 100,000 tests and received more than 300 reactive results, allowing us to immediately begin the process of getting vital treatment to those who need it. So far this year, the figures show that more than 4,000 self-sampling and self-testing kits have been ordered and nearly 500 results have been reported, nine of them reactive. Our campaign’s message is simple: “I test”—not “eye test”! I am pleased to tell the House that, like the hon. Member for East Dunbartonshire, I tested this week, so I can say from experience that testing is quick, easy, confidential and free. I engaged in a good bit of banter with my fellow Health Ministers as we undertook our testing together, so ours was not very confidential, but it was done through choice, and we were demonstrating how easy it is to do. Everyone should test. It takes two minutes, so I say: please do it.

Our most recent figures show that although new HIV diagnosis rates are steadily decreasing, they sadly remain disproportionately higher among gay men, bisexual men and other men who have sex with men, as well as heterosexual people from the black African community. Similarly, disparity can be found in testing: despite huge progress and record testing rates among gay men, lower levels of testing persist among black African and hetero- sexual groups.

NHS England has invested £20 million to deliver opt-out HIV testing in emergency departments in areas of extremely high HIV prevalence to ensure that people who need it receive the right treatment as early as possible. Anyone having blood taken in A&E in those centres has been automatically—with the potential to opt out—tested for blood-borne viruses, which means that people who would not have been reached via any other testing route have been diagnosed. This saves the NHS millions of pounds, relieves pressure on the service, and helps to address inequalities in testing. In under two years, the programme has already proved value for money by diagnosing more than 4,000 people with blood-borne viruses including HIV, hepatitis B and hepatitis C. The National Institute for Health and Care Research is investing an additional £20 million to find out how we might go further, faster, in tackling HIV rates in the additional 47 sites of high HIV prevalence across England.

[Andy Slaughter]

That may be a good initiative, but it is limited by time, geography, and the type of institution offering the test. Are the Government committed to going further, and spreading opt-out testing to other health facilities and other parts of the country?

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[Dame Andrea Leadsom]

I completely agree. We would like to see this being done around the world. The UK is, I believe, the third biggest donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria, which seeks to eradicate those diseases and to which we have donated £5.5 billion, so our interest is in eradicating those diseases throughout the world. Closer to home, the hon. Gentleman is absolutely right: that crucial part of the United Kingdom, Northern Ireland, should also be supported and helped to roll out this testing, and that will be possible now that the Northern Ireland Assembly has been re-established, which I am delighted about.

Of course, there is still much more to be done to smash the stigma attached to HIV testing and treatment. I pay particular tribute to Becky from Sheffield and Akhona from Leeds for coming forward recently and telling their stories to the BBC. They are setting an example for people up and down the country who should come forward for testing or treatment, and we are backing their efforts to spread awareness by funding HIV Prevention England’s HIV stigma symposium in March at the International Convention Centre in Birmingham. The event will bring together community experts, activists, healthcare professionals and affected people to discuss the impact of HIV stigma and look at effective stigma-reduction strategies. I am sure that it will generate promising stigma-reduction solutions, and I will listen carefully to its recommendations. I am pleased that HIV Prevention England is focusing its efforts on giving a platform to speakers from underserved areas.

Of course, HIV prevention goes beyond testing. The use of pre-exposure prophylaxis, commonly known as PrEP, is an important part of combination HIV prevention. It has been called a “miracle drug” that prevents HIV-negative people from acquiring the virus, and it is a vital tool in our battle to end new HIV transmissions by 2030. Oral PrEP has been routinely available in specialist sexual health services since 2020.

However, we recognise that certain groups have challenges in accessing the PrEP they need. That is why we have developed a PrEP road map with colleagues from Government, local authorities, professional bodies and the voluntary and community sectors, and it will be published on 15 February.

[Andy Slaughter]

At the moment, because it can be accessed only through sexual health clinics, the average wait to access PrEP is more than 12 weeks. Sexual health clinics have seen about a 30% real-terms funding cut over the last few years, so will the Minister either increase the resources available to clinics or increase the number of outlets, such as pharmacies, from which PrEP can be obtained? That is where the logjam is occurring.

[Dame Andrea Leadsom]

As I have just said, we have developed a PrEP road map precisely to increase access to PrEP, and its report will be published in a few days’ time. I encourage the hon. Gentleman to look at that report. I thank everyone who played their part in drafting the road map, working tirelessly towards our 2030 goal of zero new transmissions.

I also thank all our partners for supporting the promotion of HIV testing through National HIV Testing Week, our sexual health summer campaigns, the roll-out of PrEP throughout the country, the introduction of opt-out testing, the development of a PrEP access and equity road map; and so much else besides.

These results would not have been possible without Kevin Fenton, the Government’s chief adviser on HIV and chair of the HIV action plan implementation steering group. His bold leadership has brought together partners across the health landscape towards our shared goals, and I pay particular tribute to him.

So many of us have a part to play as we reach the endgame of ending new HIV transmissions in England by 2030. I reiterate my sincere thanks to all colleagues who have shared their stories, advice and experiences to support our efforts for so long. I hope that today’s debate will inspire thousands of people to do the right thing and take an HIV test.