Health: HIV/AIDS

Earl Howe Excerpts

Monday 5th September 2011 Lords Chamber

[Lord Fowler]

To ask Her Majesty’s Government what steps they are taking to prevent the spread of HIV and AIDS in the United Kingdom.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, the Government fund national HIV health promotion programmes for men who have sex with men and for African communities, the groups most affected by HIV in the UK. This is in addition to harm minimisation programmes for injecting drug users, NHS HIV prevention programmes and open-access testing and treatment services. The White Paper, Healthy Lives, Healthy People, sets out the Government’s strategy for reform of public health in England. This includes sexual health and HIV.

[Lord Fowler]

My Lords, I thank my noble friend for that reply, but does he really think that we are getting the message over on the dangers of HIV? Is it not a fact that the number of people accessing care for HIV has trebled in the past 10 years, that we now have almost 100,000 people with HIV in the United Kingdom and that the cost of treatment and care has now risen to almost £1 billion a year? Given that this is an entirely preventable disease, does not my noble friend agree that we have devoted disgracefully little to HIV prevention programmes over the past decade and that our efforts here should now be urgently increased?

[Earl Howe]

My Lords, may I begin by paying tribute to my noble friend Lord Fowler in his continuing interest in HIV and AIDS, here and internationally? He has done a huge amount to raise the issue’s profile in Parliament and more widely. I agree with much of the thrust of what he said; there is no doubt that over the past 10 or 12 years great progress has been made in a number of areas, but we are still concerned about the increasing incidence of HIV among men who have sex with men and sub-Saharan African communities, which are the groups most affected and vulnerable to HIV in the UK. That is why our prevention campaigns have been targeted primarily at those communities. There is much more work to do. The sexual health framework report that we are publishing later this year will have a separate section on HIV, and I hope that in that document my noble friend will be reassured that our efforts in this area will not let up.

[Lord May of Oxford]

Would the Minister agree that while HIV is of special importance it is also a fact that all other sexually transmitted infections are showing similar marked patterns of increase? Should not the Department of Health be showing more concern about this than it currently seems to?

[Earl Howe]

The noble Lord is right to draw attention to the rising incidence of other sexually transmitted diseases. I draw the House’s attention in particular to the large numbers of cases of chlamydia and herpes, where he is perfectly correct in saying that the statistics are rising. In other areas, the statistics are stabilising—but he is generally right in the point that he makes. The data show that in 2010 there was a 1 per cent decrease in all diagnoses, but within that there are areas on which we undoubtedly have to concentrate.

[Baroness Gould of Potternewton]

My Lords, I am sure that the Minister appreciates how important it is to have early testing. What efforts will the Government make to ensure that GPs and other primary care professionals routinely offer HIV testing to all new patients, particularly in high prevalence areas? More than that, is any action being taken to give the new GPs and other new professionals the confidence, skills and ability to be able to offer that test?

[Earl Howe]

The noble Baroness with her experience makes a central point here. We absolutely agree that increasing the offer and uptake of HIV testing in a variety of healthcare settings is important to reduce undiagnosed HIV. We welcome the BHIVA professional guidelines in this area, which have been extremely helpful. The sooner a person with HIV is diagnosed, the sooner they can benefit from treatment and also make any behavioural changes to prevent transmission. It is those behavioural changes that count most strongly.

The department funded pilots to support the implementation of recommendations from the BHIVA, and those were extremely successful. In the coming days, we will consider carefully the report that is due to be published by the Health Protection Agency to see how we can take forward its findings in this area.

[Baroness Masham of Ilton]

My Lords, as a member of the House of Lords committee that produced the report, I pay tribute to our chairman, the noble Lord, Lord Fowler, for his excellent work. Is the Minister aware that one-quarter of the people with HIV do not know that they have it? That is extremely dangerous; late diagnosis costs a lot and many of those people die early. Will he do more to promote prevention?

[Earl Howe]

The noble Baroness is correct that about one-quarter of those with HIV are unaware of it, which is why testing in a variety of healthcare settings is vital and a targeted preventative approach to the two communities that I mentioned has to continue.

[Baroness Trumpington]

My Lords, following on from the previous speaker, perhaps my question is appropriate. The Minister knows my interest in this subject but would not the legitimisation of brothels be a great help, with regular health checks therein?

[Earl Howe]

My noble friend makes a serious point. This is not a subject on which I or, as far as I know, the Government have a fixed view, but I will ensure that her question is fed into our deliberations on the sexual health framework document.

[Baroness McIntosh of Hudnall]

My Lords, as a member of the committee of the noble Lord, Lord Fowler, I ask the Minister if he agrees that the contribution made by the voluntary sector to the effort both to prevent and to inform about AIDS is very significant. It is particularly important in the combating of stigma, which, as he will be aware, is a tremendous impediment to the good take-up of treatment and testing. Will he reassure the House that funding to the voluntary organisations that are most involved in HIV/AIDS will not be affected by the cuts that are currently being undertaken?

[Earl Howe]

My Lords, I readily join the noble Baroness in paying tribute to those voluntary organisations, not least the Terrence Higgins Trust, which over the past 10 years has done a great job in leading the department’s national programme of work—we believe that that has contributed in a major way to the increased uptake of testing in clinics—while for African communities the African Health Policy Network has managed the department’s national programme, working with community-based groups in a very positive way. Those two groups in particular are being funded this year. No decisions have been made about next year because a tendering process will apply, but this work needs to continue in some form.