World AIDS Day

Caroline Johnson Excerpts

Wednesday 27th November 2024 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Sir Mark.

As we mark World AIDS Day, we are called to reflect on the progress that we have made, on the challenges that remain and on the road ahead in our collective fight against HIV and the stigma so often associated with it, especially in the past. The UK has much to be proud of in that effort. Through the introduction of an HIV action plan, we set ambitious goals, such as an 80% reduction in new HIV infections by 2025. Remarkably, we achieved the UNAIDS 95-95-95 target back in 2020: 95% of individuals were living with HIV diagnosed, or presumed to be living with it diagnosed; 99% of them were on treatment; and 97% were achieving good viral suppression. Those figures reflect the dedication of our healthcare professionals and the effectiveness of our public health strategies. When diagnosed early, people with HIV in the UK can now expect a relatively normal life expectancy. The disease is no longer the death sentence it once was. The hon. Member for Uxbridge and South Ruislip (Danny Beales) spoke about that.

Sadly, that is not the case worldwide. My right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) highlighted the starkness of the global picture. Last year, AIDS-related illnesses claimed as many lives as did the sum total of all wars, homicides and natural disasters that ravaged our planet. In parts of southern Africa, in countries such as Botswana and Zimbabwe, more than one fifth of the adult population live with HIV. Such figures remind us that the global fight against AIDS is far from over.

Troublingly, within our own borders, we are starting to witness a reversal of hard-won gains. A long and steady decline of HIV rates in the UK has suddenly and sharply risen in recent years. HIV diagnoses in England doubled from roughly 3,000 to a little more than 6,000 between 2020 and 2023, unfortunately reversing more than a decade of progress and throwing the Government’s goal to end HIV transmission by 2030 into some jeopardy.

We must focus on what is driving that resurgence. One key factor is a worrying trend identified by the World Health Organisation: a decline in condom use, especially in younger populations. Between 2014 and 2022, a survey of nearly 250,000 adolescents across Europe found that only 61% of sexually active young men and 48% of young women in England reported using a condom during their last sexual encounter.

The hon. Member for Uxbridge and South Ruislip talked about the success of PrEP, its greater availability and how it is an important tool in preventing HIV infections. It has undoubtedly saved lives. The Minister therefore has a complex challenge in how he will continue to promote lifesaving interventions such as PrEP while reinforcing the importance of safe practices such as the use of condoms. I am interested in the Minister’s plans to achieve that.

Another part of the answer is an effective testing strategy. As the hon. Member for Uxbridge and South Ruislip said—to quote more of his speech—it is about testing, testing, testing. I know that the Labour party like to have the same word three times in a row. Successive Governments have been working very hard to reduce stigma and normalise HIV testing through campaigns such as the “I Test” programme, which helped to normalise HIV testing as something routine and beneficial, both for the individual concerned and wider society. Such campaigns have largely been targeted at communities with a higher HIV presence.

The Conservative Government introduced opt-out testing, which has had a significant impact and is now available in 34 emergency departments across the country. It has identified hundreds of people who were previously undiagnosed or had been lost and followed up with treatment of HIV and hepatitis B and C. The identification of those cases helps the individual concerned and also helps to reduce transmission among the wider population.

What plans do the Government have to expand the testing into more areas of the country and into A&Es across the country so that we can find out what other undiagnosed cases might be out there? Between 2019 and 2021, the estimated number of undiagnosed cases in England declined, but opt-out testing has suggested that there are more cases than we realise. Does the Minister have plans to re-estimate the number of cases of undiagnosed HIV that may be out in the community waiting to be treated?

When one studies the statistics of new HIV diagnoses, it is clear that there has been a rise driven more recently by the migration of individuals who are HIV positive. I wonder what considerations the Minister has given to HIV testing for this population, and what plans he has to target measures to reduce HIV within that group.

Finally, I want to talk about education, which has been and remains a key pillar in protecting young people from HIV and AIDS and reducing the stigma associated with testing and living with HIV. We must recognise the extent to which the pandemic disrupted health outreach programmes and traditional learning, leaving many young people without access to vital information. It is important that young people feel comfortable seeking advice and accessing resources. I would like to take a moment to acknowledge the tireless work of organisations such as the Terrence Higgins Trust, the National AIDS Trust and local sexual health clinics, who have continued to provide lifesaving services under incredibly difficult circumstances. However, those organisations cannot tackle the crisis alone. Indeed, with the Government’s new Budget, they face high charges for national insurance contributions. The Terrence Higgins Trust employs more than 200 people. What conversations has the Minister had with the Treasury about exempting such charities from paying national insurance on their employees so that they can continue their good and lifesaving work, rather than just paying more tax into this Government?

We need to ensure that those charities have the funding and resources to expand their outreach, particularly in underserved and high-risk communities. On this World AIDS Day, let us reaffirm our commitment to ending this epidemic. Let us celebrate the progress we have made while recognising that there is still much work to be done. Let us ensure that future generations can live in a world that is free from the shadow of AIDS.