World Aids Day is an opportunity to remember those who have lost their lives to HIV and AIDS, and today also reminds us that the fight against HIV is not over.
In 2016, we have a range of HIV prevention tools at our disposal – including condoms, promoting early testing and diagnosis, biomedical interventions such as Treatment as Prevention (TASP), Pre Exposure Prophylaxis (PrEP) and Post Exposure Prophylasis (PEP), behavioural campaigns and standards for high quality care.
Yet, while testing and treatment for HIV in the UK is free and available to all, more than 13,000 people living with HIV remain un-diagnosed and at risk of passing on the infection to others.
Our latest edition of Health Matters focuses on ways to increase the uptake of HIV testing and outlines how providers can normalise HIV testing and reduce barriers to uptake.
Two in five diagnoses of HIV are still made at a late stage, with a tenfold risk of mortality within a year and greater potential risk to partners. More than half of those diagnosed at this stage are Black African men and women.
Furthermore the number of new infections among gay, bisexual and other men who have sex with men remain consistently high, with an estimated 2,800 gay/bisexual men acquiring HIV in England in 2015.
There is no doubt that a step change is required in order to reduce the rate of new HIV infections in the UK. Key to this will be exploiting the opportunities that new interventions such as PrEP provide and the potential role they can play in reducing the risk of HIV transmission within most at risk populations.
Making progress towards our ambition to eliminate HIV entirely will require new ideas and ways of working, as well as a more joined-up approach across the system.
An important part of this work is the HIV Prevention Innovation Fund, which PHE has delivered again this year to support local, innovative HIV prevention projects across the country which have the potential to be scaled up or replicated in other areas, if shown to be effective.
After funding seven projects last year the 2016/17 fund received more than 100 applications from across England, demonstrating overwhelming engagement and appetite from local voluntary sector organisations.
Together with representatives from NHS England, local authorities and community groups, we shortlisted and finalised a group of 13 projects, which were chosen for their level of innovation, their ability to be replicated at scale and for their potential impact on the HIV prevention agenda in England.
Alongside the projects there is an evaluation framework to ensure that we are capturing the evidence of impact as well as the learning from the implementation. This year’s projects include:
- Chemsex Open Access Support Team – a project run by Addaction to provide specialised support services for people engaging in ‘chemsex’ in St Helens and Liverpool.
- Love Tenderly, Act Justly II: HIV Prevention and Christian Communities Resource – run by Catholics for AIDS Prevention and support to deliver online training videos addressing HIV prevention from a UK Christian perspective in Hertfordshire and London.
- Trans information project – a trans-led project run by CliniQ in London to develop and deliver HIV prevention and sexual health promotion materials tailored to trans communities across England.
- Laugh Out Loud against Stigma (LOLS) – a project from Kwa Africa in London that will explore the use of comedy to address stigma and late HIV diagnosis among black African communities.
- Reaching Out – a Lifeline project in Stoke-on-Trent to deliver holistic HIV prevention, awareness and testing to substance users who do not ordinarily access treatment services.
- A pilot run by Martin Fisher Foundation to use digital vending technology to distribute HIV self-test kits in a sex-on-premises venue in Brighton.
- Community Conversations: Reshaping the African Dialogue – a project run by NAZ to deliver a web drama series about HIV and sexual health within black African communities in London.
- In the Community – a project from OutREACH Cumbria that will utilise community pharmacists to provide HIV testing in a rural area with high rates of late HIV diagnosis.
- Positive Action will develop a web-chat facility for that will enable HIV prevention support for rural marginalised communities in Hampshire.
- Prison Radio Association will run a sexual health week project dedicating a week of national prison radio programming to HIV prevention and sexual health information for prisoners.
- HIV Prevention for deaf people is a project from SignHealth to deliver HIV prevention workshops in London for young deaf people and online British Sign Language videos for use across the country.
- Friday/Monday – a project from Terrence Higgins Trust and London Friend to create an innovative online support and referral service for gay, bisexual and other men who have sex with men to reduce harms around alcohol and drug use, especially chemsex, in London and nationally.
- Welcome Hear – a project from Yorkshire MESMAC to provide HIV awareness training and testing at a hostel in Wakefield housing migrants who are claiming refugee status in the UK.
You can find out more about innovative ways to increase HIV testing in this latest edition of Health Matters, published today. The resource also includes case studies providing further detail about the Martin Fisher and OUTREACH Cumbria projects.
Importantly, the fund is just one part of a wider national HIV prevention programme, which includes the first national HIV self-sampling service run in collaboration with nearly 90 local authorities, and the national campaign It Starts With Me.
HIV exists within a complex commissioning landscape, and requires collaborative working across the whole system.
These 13 projects are a great example of this and we look forward to working with all of them in the coming months as well as sharing the evaluation reports from the previous cohort of projects.
Importantly the HIV prevention programme is nested as a bridge between our wider programmes of work to improve adult health and wellbeing and health protection.
The teams within Public Health England are actively seeking to link our work on reducing new HIV infections in synergy with our wider programmes on mental health, substance misuse, reducing health inequalities and addressing health related worklessness.
There is no single intervention that will turn the tide of the HIV epidemic and it is fundamentally important that we do not see HIV prevention in a silo for any population.
Ending the epidemic in England will require all of us to play our part, across many different sectors of society and across both the public, private and third sector, working together we can make the dream of no new infections in England a reality within the next five years.
Health Matters is a resource for professionals which brings together the latest data and evidence; makes the case for effective public health interventions and highlights tools and resources that can facilitate local or national action. Visit the Health Matters area of GOV.UK or sign up to receive the latest updates through our e-bulletin. If you found this blog helpful, please view other Health Matters blogs.