HIV Testing Week

Debate between Florence Eshalomi and David Mundell

Thursday 13th February 2025 Westminster Hall

[David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)]

I beg to move,

That this House has considered HIV Testing Week.

It is a great pleasure to serve under your chairmanship, Dr Allin-Khan. I am grateful to the Backbench Business Committee for granting this debate during National HIV Testing Week in England. Each year, the campaign funded by the Department of Health and Social Care, and delivered by the Terrence Higgins Trust as part of the national HIV prevention programme in England, brings us together to raise awareness of HIV and to promote regular HIV testing, in particular among the groups most affected by HIV. It is always the way that Parliament works that this debate coincides with a debate on LGBT+ History Month, although the two subjects are so linked.

Over the Christmas recess, I was reading Alan Hollinghurst’s book “The Line of Beauty”, which brings home the fact that, at that time in the 1980s, a test was potentially a death sentence. People dreaded going for one, because of the result it might bring and the impact on their life and the lives of their family and those close to them. We have moved on to be able to say with 100% certainty that, if someone gets a positive result from an HIV test —which people can do in their own home—treatment means they can have a normal life expectancy and cannot pass the virus on. That remarkable fact is what makes this a generation that can end new HIV cases across this country.

I encourage everyone in the Chamber, across Parliament or watching these proceedings to take part in the current campaign and to order a free HIV test. I was particularly pleased to see the Prime Minister take a test and demonstrate how straightforward and lacking in process it is. Many people still think a test might involve needles and health service professionals, but a test can be taken at home with an easy-to-access kit.

[Florence Eshalomi (Vauxhall and Camberwell Green) (Lab/Co-op)]

I thank the right hon. Member for his excellent opening remarks. Does he agree that the Prime Minister taking that test in Downing Street highlights the issues around stigma and the fact that people can test safely within the confines of their own home, without anyone else or the glare of a clinic? It is that person and the test kit, with sample results.

[David Mundell]

I absolutely agree with the hon. Lady, who is one of my co-chairs on the all-party group on HIV, AIDS and sexual health. She has done so much to promote this issue, particularly among difficult-to-reach groups in the black and minority ethnic community and among women, and I commend her for that. I agree absolutely: taking a test, as I have done many times, is a routine matter that, in essence, involves merely pricking a finger and delivering a small amount of blood. That can be returned anonymously, and the result comes back without anyone else being involved. Were any issues to arise from the test, the person would know that proactive and supportive contact would generally be made with them.

Normalising HIV testing is crucial if we are to find the 5,000 people across the UK living with undiagnosed HIV. Central to that is opt-out testing in emergency departments. I am proud that with parliamentary colleagues on the all-party parliamentary group, and with the help of Sir Elton John and the amazing campaigning of HIV charities, we won the case for a £20 million investment in opt-out testing in England in 2021 and for a further £20 million for expansion to 47 more A&Es in 2023.

Since its routine introduction in 2022, opt-out testing has been an incredible success in normalising HIV testing in the health sector. Across 34 emergency departments over just two years, nearly 2 million HIV tests have taken place. In its first 18 months in London, Brighton, Blackpool and Manchester, more than 900 people were newly diagnosed with HIV or were found, where they had been lost to HIV care. A further 3,000 were found to have hepatitis B or hepatitis C.

This approach also relieves pressure on the health service. Data from Croydon university hospital found that when it first started opt-out testing, the average hospital stay for a newly diagnosed HIV patient was almost 35 days. Within two years, the average stay was just 2.4 days.

I am proud that the last Government were the first to fund opt-out testing. I am also pleased that in November the Prime Minister announced further funding to extend the testing intervention period. That will bring to 89 the number of hospitals funded to routinely test for HIV anyone who has their blood taken in the emergency department.

As a Scottish MP, I want to be able to tell hon. Members how we are leading the way in addressing the HIV epidemic in Scotland, but unfortunately that is not quite the case. There are good news stories. Early action to make pre-exposure prophylaxis—PrEP—freely available on the NHS has helped to drive down new transmission of HIV in Scotland. Year round, everyone in Scotland has access to free at-home HIV testing, which is made available through the Terrence Higgins Trust testing service and funded by the Scottish Government. In 2023, a landmark campaign delivered by the Terrence Higgins Trust addressed the stigma that we all know surrounds an HIV diagnosis. It is astonishing that that campaign was the first of its kind since the tombstone adverts four decades ago. I hope that that important work to combat HIV stigma continues in Scotland and across the rest of the UK; it cannot be a one-off.

However, for all this success, the reality is that progress towards achieving the historic feat of ending new HIV cases in Scotland by 2030 is now at risk. I have mentioned the resounding success of emergency department opt-out testing in England, and the role that that will play in helping to get the NHS in England back on track towards reaching zero new HIV cases by 2030. The clear evidence is that opt-out testing works, yet Scotland is still to adopt the same universal approach to HIV testing. As it stands, no area designated as high prevalence, such as Glasgow and Edinburgh, is benefiting from the opt-out testing programme. I have again written to Scotland’s Health Minister, Neil Gray, to ask that that be reconsidered.

An estimated 500 people are living with undiagnosed HIV in Scotland, and a growing population of people are living with diagnosed HIV but are no longer accessing vital treatment and care. If we are to succeed in getting to our 2030 goal across the UK, we must reach each and every one of those people. Every day that emergency department opt-out HIV testing is not on offer, opportunities to find and support people living with HIV are being missed.

Although Scotland is clearly not within the Minister’s remit, I hope that she, the public health Minister and the Health Secretary will use opportunities to raise this issue with the Scottish Government and to highlight their own successes. As she may know, the Scottish Government are keen to highlight what they perceive to be health failures in England. This is a great opportunity to highlight a health success and to call the Scottish Government out on their own approach.

That also applies to HIV testing week. For this week to be most effective, it should apply across the United Kingdom, so that we can benefit from the positive publicity that came from the Prime Minister’s test. That is not available to people in Scotland, because HIV testing week is not happening there this week, despite my calls last year for it to be extended to Scotland. There is a testing week in Wales, but it is not as co-ordinated on a UK basis as we would want to see. Such co-ordination would allow everyone to benefit from promotional campaigns such as the excellent one in Parliament this week, which the Terrence Higgins Trust facilitated for Members of the House.

I very much recognise the work of Terrence Higgins Trust Scotland and Waverley Care, which I had the great pleasure of visiting at its premises in Edinburgh recently. They are doing a great job, but when we have National HIV Testing Week, it needs to be across the whole United Kingdom. Testing is the only way we know to find a person’s HIV status, and that is why the current campaign, testing week and interventions such as opt-out testing are so integral to our HIV response.

We are now five years away from 2030, and in no part of the UK are we on track to achieve our goal of ending new cases of HIV. Getting there will require cross-party working, and we have always worked cross party on the all-party parliamentary group, which has the highest number of members of any APPG in this Parliament and has been around for over 30 years. Many Members across Parliament work tirelessly in that group to ensure that we reach the 2030 goal, and I am sure the Minister will tell us more in her response about what is being done to achieve that.

I know that this is not directly within her remit, but it would be remiss of me not to mention testing in other countries. We have heard about HIV testing week here in the UK, but poorer countries rely on the Global Fund to Fight AIDS, Tuberculosis and Malaria, and particularly the United States President’s Emergency Plan for AIDS Relief, which it funds along with the US to deliver testing and treatments. We know that the future of US funding is, at best, uncertain. This country has always been at the forefront of the Global Fund, and leadership on this year’s replenishment is important. I was pleased to hear what the Prime Minister had to say yesterday about Gavi and vaccinations, and I hope he will be able at some point to give a similar commitment on the Global Fund. I hope all Members would agree that it would be quite wrong if we were to achieve the target in the UK, but just left poorer countries and the rest of the world to get on with it and, in fact, go backwards as a result. I make that call in relation to the wider issue.

I encourage anyone to take a test. It is very straightforward and easy, it will help to identify those we do not know about and it will help us to achieve that 2030 goal.