Despite this situation, there is no Government strategy for tackling HIV in England. The last national strategy for sexual health and HIV came to an end two years ago and England is the only nation within the UK not to have a strategy – despite over 90% of people with HIV in the UK living in England.

To address this worrying gap, NAT has produced its own ‘shadow’ strategy, ‘HIV – a strategy for success’ which clearly sets out the areas where there is a need for strategic leadership if we are to effectively address HIV as a sexual health issue, a long term condition and an equality issue..

NAT launched this important report at NAT’s 25th birthday Parliamentary Reception which took place on Tuesday 16 October at the House of Lords (photos will be available upon request).

Deborah Jack, Chief Executive of NAT (National AIDS Trust), comments:

‘The Government talks about its ongoing commitment to tackling HIV in the UK but for the last two years it hasn’t been prepared to ‘put its money where its mouth is’ by producing a national strategy for England which will then hold them to account. Not only does this mean we’re in breach of a UN commitment which promised to have a current and comprehensive strategy in place for tackling HIV, it also seems we’ve given up on our strategic approach at a time when we need it most. NAT is hoping to use the occasion of our 25th birthday Parliamentary Reception to draw attention to this important issue and raise support for the need for a national strategy on HIV in England.’

Professor Jane Anderson, Chair of the British HIV Association (BHIVA), comments:

‘HIV remains a serious and life threatening infection, but if diagnosed in time it can be treated and managed for the long term. We remain concerned that with the reorganisation of the NHS underway, fragmentation of HIV prevention and treatment services risks negatively affecting current standards of HIV care in the UK. BHIVA welcomes this new report from NAT and strongly urges a joined-up, strategic approach from the Government to ensure people living with HIV get access to the right treatment and quality of care.’

Pamela Nash, Chair of the All Party Parliamentary Group on HIV and AIDS, comments:

‘With HIV rates rising in the UK, this is not a time for complacency. A national strategy for HIV would help us to focus efforts across Whitehall to tackle the virus, and provide leadership to local authorities in a time of great change. I congratulate NAT for producing this strategy on their 25th anniversary and hope that the Government will seriously consider adopting its recommendations.’

Why is an HIV strategy important?

We saw at the beginning of the epidemic what a difference a planned approach to HIV prevention can have. In the UK we introduced systematic harm reduction measures to prevent infection amongst people who inject drugs – the result is we have one of the lowest rates of HIV in this group compared to many other European countries.

A strategic approach also had an important impact on testing. The last strategy introduced targets, which had a dramatic impact on the number of people offered an HIV test in a sexual health clinic (now 69% of people who go to a sexual health clinic have an HIV test).

A strategy is also important because of the many dimensions of HIV. Whilst HIV is a sexually transmitted virus, HIV is not solely a sexual health issue. HIV is a long-term condition, with health, social care and psychological implications. Many people living with HIV are experiencing poverty or other social pressures such as poor housing, or immigration difficulties. HIV remains a stigmatised condition and HIV-related discrimination still exists.

Why do we need an HIV strategy now?

The need for a national HIV strategy is extremely great at the moment because of the move towards localism. The spread of HIV does not respect local government boundaries and so national leadership is essential in guiding local approaches to effectively tackling the epidemic.

In 2001 the UK signed the United Nations Declaration of Commitment on HIV and AIDS, pledging to take action to tackle HIV both in the UK and internationally (a pledge renewed in 2011). This included a commitment to developing a comprehensive strategy to address all the different aspects of HIV. As other countries take the lead on this issue, with the US, South Africa and France recently launching HIV strategies, we remain behind and in breach of our international commitments.

Amongst the recommendations in the report – NAT highlights a national HIV strategy should ensure that:
Public Health England provides leadership on HIV prevention, taking steps to ensure local authorities invest in appropriate prevention
The national HIV prevention programme targeting gay and bisexual men and Africans continues with a focus on evaluating and improving campaigns
Healthcare workers (especially those in primary care and emergency medicine) are trained to recognise symptoms of HIV infection, including signs of early infection
HIV is recognised as a long-term condition and appropriate support is in place for people living with HIV to maintain good physical and mental health
Further research is carried out into the impact of HIV on ageing and the long-term effects of treatment on both women and men
There is Government leadership across all relevant departments to tackle HIV related stigma and discrimination
HIV is included in wider public education campaigns about sexual health so that people understand how the virus is and is not passed on, how to protect themselves and when to test
There is support and encouragement to secure greater visibility for people living with HIV in public life
Accurate and accessible information about HIV is available to everyone.

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