National HIV Testing Week

Charlotte Nichols Excerpts

Thursday 8th February 2024 Commons Chamber

[Charlotte Nichols (Warrington North) (Lab)]

I beg to move,

That this House has considered National HIV testing week.

I am the understudy today for the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell), who secured this debate. It has been 42 years since the untimely death of Terrence Higgins, who was not only the first recorded British person to die of HIV/AIDS, but a Commons Hansard reporter. Since then, we have made huge progress in the testing, diagnosis and treatment of HIV. Today, people living with HIV can continue to live very normal lives. It is essential to remember, however, that HIV remains a critical global health issue, with millions of people living with the virus and many more at risk of infection.

Early diagnosis and treatment of HIV is essential in reducing the spread of the virus, improving health outcomes and reducing the stigma associated with the disease. I thank charities such as the Terrence Higgins Trust, the National AIDS Trust, the George House Trust and others that have worked tirelessly to lead the fight against HIV. They have done and continue to do phenomenal work to help those living with HIV and to achieve the goal of no new HIV transmissions by 2030. I take the time on behalf of all the members of the all-party parliamentary group on HIV and AIDS to thank the outgoing chief executive of the National AIDS Trust, Deborah Gold, for her hard work and dedication to the charity for the past 10 years, and for her immense contribution to the fight against HIV. I am sure that everyone will join me in wishing her the best of luck in her new chapter.

As Members will be aware, HIV weakens a person’s immune system and their ability to fight everyday infections and disease. HIV is passed from human to human and, if left untreated, can progress through a series of stages leading to acquired immune deficiency syndrome, or AIDS. Though there is currently no cure for HIV, treatments are available that enable a person to live a long and healthy life. A person living with HIV has a similar life expectancy to a HIV-negative person, provided that they are tested and diagnosed in good time. In 2022, the Government introduced the national HIV action plan. It had the clear aim of reducing new infections by 80% by 2025 and, crucially, ending infections and deaths from HIV by 2030. That goal can be achieved only if the plan is properly financed and implemented.

In November, at the event to honour Sir Elton John organised by the APPG on HIV and AIDS and hosted by Mr Speaker, the Secretary of State for Health and Social Care outlined that the UK Government would be expanding the hugely successful NHS opt-out virus testing programme for HIV and hepatitis to 46 new emergency departments across England. Expansion of the programme from the current 33 sites to every high-prevalence area could identify a significant proportion of the estimated 4,500 people living with undiagnosed HIV, prevent new transmissions and save more lives.

As hon. Members will know, we have been marking National HIV Testing Week with events across the country, including on the parliamentary estate, to raise awareness of HIV testing. This annual campaign aims to raise awareness of the importance of regular testing to reduce the number of people living with undiagnosed HIV and those diagnosed late, and the campaign’s strapline “I test” is in its second year. I urge everyone to take advantage of the services available during National HIV Testing Week and throughout the year to get tested and know their status.

Recent UK Health Security Agency data highlights that while HIV diagnoses among white gay and bisexual men are falling, inequalities are deepening. HIV transmissions have increased in the last year among heterosexual men and women, as well as gay and bisexual men of other ethnicities. Persistent inequalities must be overcome. At the same time, the experience of people living with HIV is not equal or equitable. Worrying numbers of people living with HIV are afraid to visit healthcare settings, with women and people of black African ethnicity more likely to be afraid than men or people of white ethnicity. Those inequalities are mirrored in the experience of people offered an HIV test: 40% of women eligible for a test were not offered one when attending a sexual health service. I urge the Minister to do everything she can to tackle the inequalities in the HIV response in order to deliver the Government’s action plan and end new transmissions by 2030.

Along with tackling inequalities, we need to tackle the growing number of people previously diagnosed with HIV who are not accessing the care they need. The UKHSA estimates that as many as 14,000 people living with HIV in England have not been seen by their HIV clinic for at least a year, often for complex social and stigma-related reasons. They are essentially lost from the health system. One in three of those testing positive for HIV through opt-out HIV testing in accident and emergency departments knew about their status but were not accessing care. Hospitals in London are now reporting that people lost to care have overtaken undiagnosed HIV as the leading cause of HIV-related hospitalisation and mortality. Those are entirely preventable incidents.

Pilot work in south London funded by the Elton John AIDS Foundation has shown that with case finding, focused follow-up and wraparound support, people can be successfully returned to care at an average cost of £3,000 a person. HIV clinics currently do not have the resources to do that work, but it is significantly cheaper than care costs when people develop serious illness. A national programme must be urgently introduced to find everyone lost to HIV care in England and ensure that they are getting the lifesaving treatment they need. Will the Minister confirm what action the Government are taking to find people living with HIV who have been lost to care?

Finally, we must tackle late diagnosis. Certain groups are more likely to be diagnosed late and therefore experience worse health outcomes. Last year, 44% of people diagnosed with HIV in England were diagnosed at a late stage, and late diagnosis rates are even higher for women, at 51%. The number of people living with HIV who know their status but are not in care could be higher than the number of people with undiagnosed HIV. That is a risk to their health, expensive for the NHS and threatens HIV elimination. People not in HIV care are disproportionately from underserved communities, including black communities, women and people who use drugs.

The impact of late diagnosis can be extremely damaging: as well as meaning that someone might unknowingly pass on the virus, if they receive a late diagnosis, their chance of dying in the first year after diagnosis is 10 times greater than if they had received an early diagnosis. Additionally, late diagnosis can have a detrimental impact on an effective response to treatment, which in turn leads to greater healthcare costs at a time when there are already financial strains on the NHS. Late diagnosis is particularly common among certain groups, with 54% of heterosexual British black Africans and 29% of gay and bisexual men diagnosed late. Opt-out testing has allowed us to identify that those are the groups most likely to be HIV-positive.

Although opt-out testing highlighted that those groups were most likely to have HIV, we need to encourage more people from them to get tested. A simple solution for that could be to use public message campaigns. Targeted messaging across radio, television and social media could be created to encourage people to come forward and get tested. It could also specify the importance of testing and tell people where their nearest local test centre is.

Ultimately, to address late diagnosis in both primary and secondary care services, HIV testing needs to become more prominent across the entire NHS primary and secondary estate. If we want to turn the UK into a science and health superpower, and if we want there to be no new cases of HIV transmission by 2030, it is essential that we address the issues that I am highlighting. In particular, it is vital that we rapidly increase testing levels in high and very high prevalence areas through opt-out testing. That will not only save the NHS money and reduce the backlog but enable patients to know quickly whether they have HIV.

My challenge to the Minister is to fight her corner and fight the inequalities in the HIV response, ensure that access to testing is increased and ensure that once testing has started in hospitals, funding for it will continue until we find the last person living with undiagnosed HIV in England. The opportunity to eliminate new cases of a long-term condition is rare, yet we have the tools to do just that now. We must grasp that opportunity and create a culture where failure to follow guidelines is considered wrong and HIV testing is considered routine.

I end on this note. It is crucial that HIV and AIDS remain firmly on the agenda of our Governments, both domestically and internationally. They must be held to their promise to reach zero new infections by 2030.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the Father of the House.

--- Later in debate ---

[Charlotte Nichols]

I thank all hon. and right hon. Members who have made such thoughtful contributions today. Again, I thank the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell), who secured this debate, for giving us this opportunity.

The cross-party consensus on the importance of HIV testing and the tone in which today’s debate has taken place represent the very best traditions of this House. I hope all those listening will consider taking a test to know their status, and I look forward to continuing to work with members of the APPG on HIV and AIDS to hold the Government to account on their progress towards the 2030 target.

Question put and agreed to.

Resolved,

That this House has considered National HIV testing week.