Research published by Public Health England last month, confirmed that, in London, not only are 97 per cent of people diagnosed with HIV now receiving treatment, but that treatment is having a direct impact on infection rates. Over the last 12 months, HIV test positivity rates among gay and bisexual men have fallen by 29 per cent.

 

Condoms, screening and early access to treatment

 

“The gains have been thanks to a combination of increased HIV testing, early access to effective HIV treatment, combined with the uptake of preventative measures (like condoms, screening or treatment for STIs) and PrEP (pre-exposure prophylaxis),” says Professor Kevin Fenton, National Director for Health and Wellbeing at Public Health England.

"Promoting greater access and more frequent testing."

Over the past three decades, successive HIV/AIDS strategies in England have  prioritised the importance of combining HIV prevention, testing and treatment as the key to ending the epidemic and vital lessons have been learnt regarding the importance of timely intervention.

More recent efforts to scale up HIV testing by promoting greater access and more frequent testing among men who sleep with men, combined with early access to HIV treatment have been central to the reduction of infection rates, as therapies suppress the virus to a point where it is undetectable in the blood and cannot be passed on.

 

Treatment needs to include psychological support

 

“Another key lesson from our approach to tackling HIV is the importance of providing effective support services to people who are infected with HIV – including, where appropriate, services to address mental health, social care, substance abuse, housing, and managing other sexually-transmitted infections,” says Professor Fenton.

"Mental health, social care, substance abuse and housing: a whole person approach."

“As we rightly focus on getting people on treatment it is also critical to maintain a ‘whole person approach’, identifying and meeting other needs, which – if unaddressed – can significantly worsen a person’s ability to live long and well with HIV.”

Grassroots organsations and charities have played a vital role in connecting people with care; reaching out directly to vulnerable communities, linking them with centralised services, and providing advice and support on a day-to-day basis. As we look to increase access in the most at-risk populations, these community-based groups will be more important than ever. 

 

Minority communities affected by HIV

 

However, beyond the positive headline figures, there are concerning statistics. “In the UK we know black and minority communities are disproportionately affected by HIV, socio-economic disadvantage remains a key determinant of HIV inequalities, and there are regional differences in the progress being made.

"Black and minority communities are disproportionately affected by HIV."

"More work is needed to promote testing and early access to care, and to work with local partners to promote better awareness and enagagement,” says Professor Fenton.

A key barrier that prevents people testing for HIV is stigma. Professor Fenton remains optimistic that the gains we have seen in London will be felt elsewhere in the UK. But, if we are to close the book on AIDS once and for all, we need maintain momentum and commit to tackle HIV stigma, in all its forms, with renewed focus and passion.