World AIDS Day

Debate between Lloyd Hatton and Danny Beales

Wednesday 27th November 2024 Westminster Hall

[Danny Beales]

I thank my hon. Friend for that vital point. HIV is a condition that knows no boundaries. It does not affect any one type of person: there is no one community that is alone affected by HIV. It knows no boundaries; it affects everyone.

After 14 difficult years for the health service, we are not on track to reach the 2030 goal. At every single stage of the HIV treatment process, we are missing critical opportunities to get people on PrEP, test for HIV and ensure that everyone living with HIV has the support that they need.

Pre-exposure prophylaxis—we can see why it is called PrEP for short—is an incredible advance in HIV prevention. It is a simple daily pill, now in generic form and therefore incredibly cheap, that prevents HIV completely if taken correctly. I have spoken before about how life-changing a drug it is in removing the fear and stigma of HIV. As a gay man who grew up in the 90s and noughties, the legacy of HIV has always weighed on me and, I am sure, on many others like me. Our sense of self, our sexuality and our relationships were always intertwined with the stigma and presence of HIV. Being able to take PrEP is game-changing, and not just for the individual and their wellbeing: it has a massive public health benefit. It has driven the significant falls in new transmissions, particularly among gay men, who have largely been the people who have accessed the drug to date.

It is unacceptable that the drug is not being accessed by everyone who could benefit. The average wait list for this preventive medicine is 12 weeks. We know from research that people have acquired HIV while waiting to access the drug. That is a significant failure that I hope the new HIV action plan will address, as well as turbocharging access outside sexual health services—the only place where it can currently be accessed. It is entirely wrong that NHS silos are holding back access to PrEP in primary care, including in pharmacy and other settings.

It is also unacceptable that people cannot get a postal test for HIV and sexually transmitted infections in 30% of rural England. It makes no sense that my borough of Hillingdon—not so rural, but on the edge of London—has a completely different postal testing system from the 30 other London boroughs that have their own system. Far too often, the patient is left to navigate complex systems. What test they get will vary depending on where they live. In vast swathes of the country, there is no option to test at home, although sexual health services are often inaccessible and chronically overwhelmed. Far too often, the individual has to fight for an appointment, and only those with the sharpest elbows, or persistence, get access to the sexual health services that they need.

[Lloyd Hatton (South Dorset) (Lab)]

I thank my hon. Friend for making such an eloquent speech. The point he makes is really important: in rural and coastal communities, testing services and public health awareness can often feel particularly remote. Looking at how we use primary care, particularly community hospitals and GP surgeries, will be essential to improving testing and public awareness. Does my hon. Friend agree that pushing this out into communities is essential to ensuring that take-up is just as good in a rural or coastal community as it is in a big town or city?

[Danny Beales]

I completely associate myself with my hon. Friend’s comments. Particularly in rural settings, if getting to a sexual health service means travelling for miles and sometimes for hours, a lot of people, especially on the lowest incomes, will put off getting the test until another day. Unfortunately, we are seeing persistent rates of late diagnosis and of undiagnosed HIV outside major cities. I completely agree with my hon. Friend.

What about those who make it through the complex online systems—the 8 am call queues, only on a Thursday—and actively go out and seek a test, or those who are fortunately now being found in our amazing opt-out testing pilot? If they are diagnosed with HIV, they are not always getting the support that they need to access HIV treatment in the long term.

We have some of the best—if not the best—HIV treatment and specialists in the world. HIV is now a treatable long-term health condition. “U = U. Undetectable = untransmittable.” We need to say that over and over again. In simple terms, it means that when someone is on HIV treatment, they cannot pass HIV on. That is a powerful and life-changing message. Despite the advances, 14,000 people living with HIV in England are essentially lost to the health system. They have been diagnosed with HIV but are not being seen by their clinic because of stigma, poverty and other barriers that are holding them back from getting that life-changing treatment.