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HIV: Late Diagnosis

Volume 757: debated on Monday 1 December 2014


Asked by

To ask Her Majesty’s Government what action they will take in 2015 to support a reduction in late HIV diagnoses in England.

My Lords, late diagnosis of HIV in the UK is declining, but 42% of people were diagnosed late in 2013. This is still too high and that is why we continue to include it in the public health outcomes framework.

Implementation of the sexual health improvement framework in England will help to reduce late diagnosis. The Department of Health funds HIV Prevention England, which continues to promote HIV testing, including leading on National HIV Testing Week and piloting the use of self-sampling tests.

I thank the noble Earl for that reply. Even in areas of high prevalence of infection, research has found that only 30% of patients are being tested for HIV in line with national testing guidelines—for example, when registering with a GP or being admitted via a hospital’s general medical admissions. Will the Minister have discussions with the Local Government Association—the body, as he no doubt knows, which is now responsible for public health—and agree a strategy to increase routine HIV testing in those high-prevalence areas, in line with those guidelines?

My Lords, local authorities have an important part to play in the battle against HIV and AIDS. They are mandated to commission open access sexual health services, and that means that people can self-refer to the service of their choice, regardless of its location. However, as the noble Baroness will know, this is an issue that goes beyond local authorities. The key message from National HIV Testing Week, which was last week, was that we should all take responsibility for reducing HIV transmission, and that those who feel they may be at risk should take an HIV test.

The testing taking place in sexual health clinics in 2013 was up on the year before. We are seeing very good work with, for example, African faith leaders, and we have also piloted national HIV self-sampling services, which undoubtedly have a great utility for those who are too embarrassed to go to a clinic.

My Lords, geographically the highest rates of late diagnosis of HIV were in the Midlands and the east of England with 52%, followed by the north of England with 42%, the south of England with 41% and London with 35%. In light of the announcement that was expected later in the week but which was made at the weekend by the Chancellor of the Exchequer—that there will be an additional £2 billion for the NHS—can my noble friend say whether community testing for HIV will be part of the money being spent?

It is far too early for me to say how the new money will be spent. In any case, that has to be a decision for commissioners weighing up the healthcare priorities that face them. But the new money is excellent news for the NHS, and there will be a Statement later today about that.

My Lords, how many undiagnosed people with HIV does the Minister think there are? Would it not be beneficial to have testing of HIV, TB and hep C all together to save money and to pick up more infections?

I shall have to take advice on the second question posed by the noble Baroness, which I do not know the answer to. But in answer to her first question, an estimated 107,800 people were living with HIV in the UK in 2013, of whom 24% were unaware of their infection, remain at risk of infecting others and are unable to benefit from effective treatment. That is why it is so very important that we target the at-risk communities to urge them to get tested, either in a clinic or through self-testing kits, which are now legal.

My Lords, I wonder if the noble Earl can help me as to what work is being done in relation to women who are suffering from partner violence. Your Lordships will know that 12% of those involved in intimate romantic relationships have HIV through partner violence. Will the noble Earl say what the Government intend to do about that?

The noble and learned Baroness is absolutely right. Those who are at risk of partner violence are of course at greater risk of contracting a sexually transmitted disease. We know this to be true particularly in countries overseas. The work to combat domestic violence, which the noble and learned Baroness is very familiar with, continues. It is vital, not just in this area of work but more generally in the field of mental health, to ensure that women at risk of violence—particularly women—have a place of refuge and a source of advice.

My Lords, I am sure that the new money would be even more welcome if it had not consisted of quite a lot of old money rebadged. The noble Earl referred to the three-year HIV prevention campaign, which promoted testing and condom use. Perhaps I might ask him about how the campaign will go forward. Are the Government going to fund such a campaign and for how long, and can he say what proportion is going to be spent in the future compared with the past?

My Lords, the Terrence Higgins Trust is the vehicle through which we conduct campaigns. Terrence Higgins has a three-year contract, which ends in March next year. We have yet to finalise all our spending commitments from April 2015. We expect that the funding for Terrence Higgins will have to be pared back by some measure because of the current funding constraints, but we are in discussion with Terrence Higgins about that.