HIV and AIDS in the UK

Baroness Healy of Primrose Hill Excerpts

Thursday 1st December 2011 Lords Chamber

[Baroness Healy of Primrose Hill]

First, I congratulate the noble Lord, Lord Fowler, on securing this important debate on World Aids Day and must say how privileged I was to have served on the Select Committee that was so expertly chaired by him.

The report calls for urgent action by the Government and I wish to highlight two recommendations in particular. Recommendation 72 states:

“HIV awareness should be incorporated into wider national sexual health campaigns, both to promote public health and to prevent stigmatisation of groups at highest risk of infection. We recommend that there should be a presumption in favour of including HIV prevention in all sexual health campaigns commissioned by the Department of Health”.

Recommendation 139 states:

“Ensuring that as many young people as possible can access good quality SRE”—

sex and relationship education—

“is crucial. We recommend that the Government’s internal review of PSHE”—

personal, social, health and economic education—

“considers the issue of access to SRE as a central theme. Teaching on the biological and social aspects of HIV and AIDS should be integrated into SRE”.

The report makes it clear that although there is a widespread assumption that the danger has gone away, nothing could be further from the truth. Thousands of people are still being infected every year and the number of those diagnosed with HIV continues to grow relentlessly. Next year it is estimated that there will be 100,000 people with HIV in the UK. Although medical advances have ensured much better treatment and enabled those diagnosed with the illness to live much longer thankfully, serious medical and mental health problems remain for many with HIV.

As the report states:

“Patients can now live with HIV, but all those infected would prefer to be without a disease, which can still cut short life and cast a shadow over their everyday living”.

I highlight those two recommendations as part of the way forward to help prevent the disease and to increase understanding and tolerance by the public for those who have contracted the virus. The problem of stigma has already been raised by the noble Lord, Lord Fowler. It leads to isolation and fear of getting treatment and possibly prevents people seeking a test in case they are found positive and excluded by their community. Our report argues that the awareness of responsibility and risk must extend to the population as a whole, and general campaigns may be necessary to educate the wider population. Evidence from charities noted by the Select Committee suggests that a general HIV prevention campaign would be valuable. As the report says in paragraph 100:

“Discrimination against those affected by HIV is based, at best, on ignorance and, at worst, on prejudice, and we unreservedly condemn it. This underlines the need for a general public awareness campaign on HIV”.

I am particularly disappointed that the Government have responded to this by saying:

“We do not support the Committee’s recommendations on the need for a national campaign aimed at the general public as there is little evidence that this would be effective”.

I hope they will think further on this and that with the publication of their new sexual health policy framework planned for 2012 they will have reassessed,

“where further work is needed to ensure a strong and sustained response to tackling HIV”.

Complacency is not an option when looking at the scale of infection in the UK. As the report states:

“There has also been a dramatic increase in the yearly number of new HIV diagnoses since the late 1990s. This peaked in 2005, with more than 7,800 new diagnoses ... In 2010, there was a year-on-year increase for the first time since then, with an estimated 6,750 people diagnosed”.

By next year, the report states, and I repeat, that the figure for people living with HIV is likely to be above 100,000.

The need to increase awareness remains, and so does the need to ensure that young people are taught about the illness and how to guard against it. The committee heard evidence of the increase in numbers of young people contracting the virus. The Health Protection Agency report of 6 June 2011 states that,

“a quarter of MSM”—

—men who have sex with men—

“newly diagnosed in 2010 probably acquired their infection 4-5 months prior to diagnosis, with higher recent rates in younger ages”.

According to the HPA, in 2009 10 per cent of diagnoses for HIV were among those aged between 15 and 24 years old. The National AIDS Trust has highlighted that since 2000 new HIV diagnoses among 15 to 24 year-olds have risen by nearly 70 per cent and among young gay men they have more than doubled. As a generation grows up without memories of the widespread health promotion messages of the 1980s, spearheaded by the then Secretary of State, now our formidable chairman of this Select Committee, the noble Lord, Lord Fowler, reliable HIV information for young people remains essential.

Given the lack of either a vaccine or a cure, then,

“prevention is better than cure when there is no cure”,

as Dr John Middleton, vice-president of the UK Faculty of Public Health said. One of the best means of prevention lies in education. Present teaching looks at HIV and AIDS within the science curriculum. However, the separate subject of SRE, with its focus on broader social issues, which can increase levels of safe sexual behaviour according to the Sex Education Forum, should also be considered as part of HIV and AIDS prevention methods. While the report calls for the mandatory teaching of SRE in schools, the Government have indicated that that was,

“not the approach we are taking to education policy”,

and that it was,

“imperative that parents will maintain a right to withdraw their children from SRE lessons”.

Yet a recent survey commissioned by Brook, the charity, found that 43 per cent of young people said that their SRE was unsatisfactory or non-existent. More alarming is the recent Sex Education Forum research, which found that one in four young people did not learn about HIV in school, which was described by a government Minister, Nick Gibb, as “unforgivable”.

The Select Committee report states that,

“ensuring that as many young people as possible can access good quality SRE is crucial”,

and recommends that the internal government review of PSHE considers access to SRE as a central theme. In a report in 2010, Ofsted highlighted SRE as an area for improvement, finding that in a third of schools visited students’ knowledge of SRE was no better than satisfactory. In a previous report, Ofsted expressed concerns about teaching around HIV and stated specifically:

“In particular, schools gave insufficient emphasis to teaching about HIV/AIDS. Despite the fact that it remains a significant health problem, pupils appear to be less concerned about HIV/AIDS than in the past”.

I am pleased to see that the government response to this report states:

“The reviews of the National Curriculum and of PSHE by the Department for Education will take account of the Committee's recommendation”,

but where compulsion is not appropriate I return to the report's call for a national sexual health campaign. We cannot afford to let public awareness of HIV and AIDS fade away, and young people must be given the information either through such a campaign or by better education in schools or preferably both. It will help young people to learn to look after themselves and their health better and to increase their understanding and tolerance of those who live with the illness. The success of the “Don't Die of Ignorance” campaign in the 1980s should serve as a lesson to the Government to ensure that young people do not live in ignorance today.