HIV Testing Week

Debate between Florence Eshalomi and Caroline Johnson

Thursday 13th February 2025 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Dr Allin-Khan. I congratulate my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) on securing this important debate, and I thank the hon. Member for Sittingbourne and Sheppey (Kevin McKenna) for sharing his lived experience of this condition.

As we mark National HIV Testing Week 2025, we should be proud of the progress we have made since the ’70s and ’80s in raising awareness of the disease and reducing stigma, but we must reflect on the great challenges that remain in the battle against HIV and AIDS. I pay tribute to charities such as the National AIDS Trust, the George House Trust and the Terrence Higgins Trust, whose work has been at the forefront of the fight against HIV and to improve the nation’s sexual health.

The campaign strapline for National HIV Testing Week is “I test”—a message that cannot be repeated enough. Public campaigns such as this have helped to normalise HIV testing as routine and beneficial to both the individual concerned and society at large. Testing is quick, easy, confidential and free. It is the gateway to prevention and treatment and, ultimately, to ending new HIV transmissions. During National HIV Testing Week, anyone in England can order a free postal HIV test, funded by the Department of Health and Social Care and delivered by the Terrence Higgins Trust, as part of the national HIV prevention programme for England. I encourage anyone who is concerned to get such a test and take it.

There has been encouraging progress in reducing the prevalence of HIV across England in recent years. In introducing a national HIV action plan, the last Government sought to achieve an 80% reduction in new infections by 2025. Remarkably, the UK achieved the UNAIDS 95-95-95 targets back in 2020: 95% of individuals living with HIV were thought to be diagnosed, 99% of them were on treatment and 98% were achieving good viral suppression.

A growing proportion of HIV testing has been taking place by post or at home—44% in 2023 compared with 19% in 2019—which shows that the tests are acceptable to the public and welcomed by them. There has been a substantial increase in the number of tests taking place in emergency departments, with 857,000 in 2023 compared with 114,000 in 2019, mostly because of the opt-out testing introduced by the last Government.

We cannot be complacent. Although there have been areas of progress, in recent years we have seen a reversal of hard-won gains in reducing HIV transmission. Data published by the UK Health Security Agency in 2024 shows that the number of heterosexual men and women in England newly diagnosed with HIV has increased by more than 30% since 2022. Around 5,000 undiagnosed people are currently living with HIV in England.

HIV and AIDS cannot be solved in the UK without acknowledging the global context. Last year, AIDS-related illness claimed as many lives as the total of all wars, homicides and natural disasters that have ravaged our planet. In parts of southern Africa, in countries such as Botswana and Zimbabwe, more than a fifth of the adult population is living with HIV. Such figures remind us that the global fight with HIV is far from over.

I was troubled to hear in a House of Lords debate earlier this week that the head of UNAIDS has warned that global HIV infections could increase by more than 600% by 2029 if the US continues to suspend the UN HIV/AIDS programme. That will mean higher infection rates here in the UK, as communicable diseases do not recognise national borders.

[Florence Eshalomi]

I thank the shadow Minister for highlighting that. Does she share my concern that data and research from the Elton John AIDS Foundation shows that almost 228,000 people a day will miss out on HIV testing due to the pause in US aid? What should we do collectively, on a cross-party basis, to call that out?

[Dr Johnson]

The key is to ask the Government what support they will give to the UN and what conversations they are having with their US counterparts about the benefits to people both overseas and at home of ensuring that the battle against HIV and AIDS is won.

[Florence Eshalomi]

The hon. Lady was formerly the public health Minister, so I know she cares passionately about this issue. Does she agree that HIV has to be a cross-party issue, and that both the Government and the Opposition should be calling out the US pause?

[Dr Johnson]

It is clear that the battle against HIV is a cross-party issue. We have seen strides and improvements over the years under Governments of different colours. Yes, I was the public health Minister, and we met at an event where I announced the results of the first year of the opt-out testing and its success in reducing infections.

HIV testing is really important. I was pleased to see the Prime Minister test earlier this week; that is helpful in reducing the stigma associated with testing. It showed that anybody in any circumstances can have a test. Opt-out testing has identified cases where people who were thought to be very low risk unexpectedly turned out to be HIV-positive. When we brought in the opt-out testing, we targeted first the A&Es in areas of the highest risk, and we need to continue to target those highest-risk areas.

In October 2024, the Department of Health and Social Care revealed that over half of those with HIV had been previously diagnosed abroad. Will the Department consider the implications of these trends when it puts together its new HIV action plan in order to achieve the goal of no new HIV transmissions in the UK by 2030? Countries such as Australia and New Zealand require applicants to take an HIV test before they obtain a visa. Have there been any discussions between the Department of Health and Social Care and the Home Office about introducing such a requirement in the UK, as we have for tuberculosis?

Guidance from the Office for Health Improvement and Disparities—the Government’s own guidance, effectively —suggests that all men and women, and recently arrived children, known to be from a country of high prevalence should be recommended a test. It might be helpful if the Government followed their own guidance, because if we test the high-risk population, we stand more chance of picking up more cases, which would be beneficial.

Under the opt-out testing scheme brought in by the Conservative Government, a patient can explicitly decline instead of explicitly accept an HIV test. It has been rolled out in many A&Es across the country, and I am pleased that it will be coming to more. It has identified hundreds of people who were undiagnosed or lost to follow-up for treatment for HIV, and includes hepatitis B and C. Identification of those cases helps the individuals concerned and helps to reduce transmission across the wider population.

Between 2019 and 2020, the estimated number of diagnosed cases in England declined. However, somewhat counterintuitively, opt-out testing suggests there are more cases than we realise. Does the Minister have plans to re-estimate the number of undiagnosed HIV cases that may be out in the community waiting to be treated, in the light of the evidence from opt-out testing? The Opposition welcome the Government’s commitment to fund opt-out testing until March 2026, but NHS services need clarity on funding beyond that point. Will the Minister clarify whether long-term funding for opt-out HIV testing will be considered as part of this year’s spending review?

HIV prevention goes beyond testing. A perennial issue is access to PrEP treatment, to maintain the reduction in HIV cases in England. PrEP has been described as a miracle drug, which prevents HIV-negative people from acquiring the virus, and is a key tool to stop new HIV transmissions by 2030. However, waiting times for PrEP are too long—at one point, they were measured in months rather than weeks. What steps is the Minister taking to improve that? The last Government improved access to PrEP across the country by setting up the PrEP access and equity task and finish group. What steps have been taken to implement the group’s recommendations since the Government took office?

We have only one Parliament left to finally eradicate new cases of HIV by 2030. We owe it to everyone who has lost their life to this virus, everyone who has faced the stigma—thankfully, that is reduced but it still exists—of being HIV-positive and everyone who is living with HIV today to end new transmissions once and for all. I hope the Government continue the progress of the last Government with their new HIV action plan, and I hope that it will be developed soon. The former Minister, the hon. Member for Gorton and Denton (Andrew Gwynne), said in November that the plan was in production. I hope that it is getting closer to completion and that the Minister can give us an idea of when it will be complete. I hope that today’s debate will inspire thousands of people to get themselves tested.