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HIV: Stigma

Volume 757: debated on Monday 1 December 2014


Asked by

To ask Her Majesty’s Government what plans they have to develop a campaign to address HIV stigma along the lines of the “Time to Change” campaign on mental health stigma.

My Lords, the Department of Health funds the Terrence Higgins Trust for the HIV Prevention England programme, which helps to tackle stigma by social marketing programmes and by working closely with HIV voluntary organisations. Implementation of the department’s framework for sexual health improvement, 2013, will help reduce the stigma associated with HIV and sexual health issues. Public Health England is supporting the development of the “People Living with HIV Stigma Index” in the UK.

My Lords, maybe I shall not start by asking the question that might be asked, which is: what is the Minister’s secret? I could ask that in the name of Prince Harry, who wants to know what everybody’s secret is, in order to try to encourage people to be able to say, “Yes, I am HIV positive”. But that is not the question I am going ask the Minister.

I thank the noble Earl for his reply, and yes, there are some activities going on—activities which, I have to admit, are not extremely well funded. It seems to me that the success of the Time to Change campaign, which I am delighted by, shows that anti-stigma campaigns can be, and are, very successful. Does the Minister agree that HIV is the other health condition consistently faced with stigma and discrimination? Why has there not been proper resourcing and funding so that we can have a similar anti-stigma campaign, to ensure that there is prevention and a reduction in the number of people who have HIV?

My Lords, there is certainly still too much stigma, although I believe opinion has moved in the right direction generally. The campaigns in the 1980s played a key part in providing information to the general public about AIDS and later HIV, but for some years it has, I think, been widely accepted that campaigns targeting groups at increased risk of HIV are more effective. That is why, for many years, my department has funded the Terrence Higgins Trust for targeted HIV prevention. HIV Prevention England, the unit set up by the Terrence Higgins Trust, is leading that, and is delivering innovative social marketing campaigns, including some mainstream advertising, on things like condom use and testing. There is also a DH-funded national programme, which has been successfully piloted with Public Health England.

My Lords, do we not need to fight stigma and discrimination overseas as well as at home? Around the world, some 18 million people have HIV and are untested, many because of their fear of discrimination. Given that many of them are in Commonwealth countries, should we not use all our influence to persuade such countries to follow policies of equal and fair treatment for all minorities?

My noble friend, with his immense knowledge of this subject, is of course absolutely right. The 2011 UN Political Declaration on HIV and AIDS specifically includes a goal to eliminate by 2015 stigma and discrimination against people living with and affected by HIV through the promotion of laws and policies which ensure that human rights and fundamental freedoms are protected. Progress towards universal access cannot be made unless stigma and discrimination are tackled. They are a particular barrier with regard to the criminalisation of gay men and women, transgender people and sex workers. DfID is a constant champion of these groups internationally.

My Lords, Prince Harry’s brave statement today to declare his secret reminds me of mine. A dear friend died of AIDS three decades ago. I cannot speak his name because to this day his family do not know that he had it. The point made by the noble Lord, Lord Fowler, is important, but we have children and young people in this country who are suffering from HIV and AIDS. What education is planned specifically for young people who are at risk, along with their school friends?

My Lords, sex and relationship education plays an important part in exposing young people to the whole subject. Guidelines are available that schools must follow. They include sections on HIV and sexually transmitted diseases generally. As I say, secondary schools must follow those guidelines.

My Lords, building on the question from the noble Baroness, Lady Brinton, does the noble Earl agree that stigma starts very young? It builds on attitudes that are adopted by young people. The importance of PHSE programmes in schools is therefore very great. In what ways are his department and the Department for Education working together to ensure that these programmes are delivered—not just that they are recommended, but that they are delivered? Does he further agree that it would be a good thing if they were a regular and statutory part of the curriculum?

I shall expand on my previous answer. Sex and relationship education is compulsory in maintained secondary schools, although not in academies. All maintained schools and academies have a statutory requirement to have due regard to the Secretary of State’s sex and relationship education guidance, which dates from 2000, when teaching sex and relationship education. The guidance makes it clear that all such education should be age-appropriate and makes the following points about HIV and sexually transmitted infections:

“information and knowledge about HIV/AIDS is vital; young people need to understand what is risky behaviour and what is not; young people need factual information about safer sex and skills to enable them to negotiate safer sex … Young people need to be aware of the risks of contracting a STI and how to prevent it”.

They also need to know about the diagnosis and treatment of HIV and STIs.

My Lords, is this not the direction in which we need the devolved health commitment in Scotland, Wales and Northern Ireland to go? What co-operation is there between them and the English set-up through television programmes, advertising and in other ways? Is this not one of the areas where it is essential to have effective co-operation?

Yes, indeed, my Lords. I can tell my noble friend that there is such co-operation and constant communication between the public health authorities in England and the devolved Administrations on this, as on many other matters.

My Lords, the noble Earl made it clear in answer to my noble friend that academies are not subject to the core nature of the curriculum as regards sex and relationship education. As he will know, there have recently been a number of inspections by Ofsted that have shown up defects in the approach of schools to sex and relationship education. Surely that gives rise to concern that the issue of stigma is simply not being addressed properly in some schools. Is his department willing to take this up with Ofsted?