HIV charity accuses Scot Gov of 'jeopardising the end of transmission'

A leading HIV charity has accused the Scottish Government of jeopardising the end of transmissions by its failure to recover from the pandemic.

HIV testing rates collapsed in 2020 and have been slowly recovering but the test numbers last year were still almost 9,000 fewer than pre Covid. The numbers of diagnoses also increased 10% on the previous year compared to a 12% reduction in levels in 2019.

The Terrence Higgins Trust warns that this decline in testing is risking Scotland’s goal of ending HIV transmissions by 2030 and is calling for greater investment in HIV testing.

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The numbers of heterosexual diagnoses is continuing to outnumber those of gay, bisexual and men who have sex with men (GBMSM). Of the 126 first ever diagnoses 49% were heterosexually transmitted, 27% in the GBMSM community and fewer than five among those who inject drugs.

The latest Public Health Scotland data also shows a growing number of people who are diagnosed with HIV but are not attending HIV treatment and care. At the end of 2023, of the 6,288 people diagnosed with HIV in Scotland, 18% were no longer engaged with HIV clinical services. There are around 500 people in Scotland who are estimated to be living with undiagnosed HIV.

The new data also showed uptake of HIV prevention pill PrEP has reached near record highs with 1,277 people attending sexual health services in the last six months of 2023 to access it for the first time. The Scottish Government has committed to ending new transmission of HIV in Scotland by 2030.

Alan Eagleson, Head of Scotland Service at Terrence Higgins Trust, said: “Today’s data shows some progress on ending new HIV cases by 2030 with PrEP uptake at near record highs – but the reduction in testing and increase in diagnoses should be a wake-up call. Urgent investment in HIV testing is needed to make the 2030 goal a reality.

“Testing rates from 2023 must serve as a warning that coming out of the COVID-19 pandemic, we remain on the back foot and our vital services are struggling to recover. Testing is at the heart of both prevention and detection, that’s why the reduction puts Scotland’s ambition of ending new transmission of HIV by 2030 at risk.

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“HIV tests must be readily available outside sexual health services. Terrence Higgins Trust’s national online self-test service which is funded by the Scottish Government is a positive example of this but other interventions to promote and expand HIV testing have either yet to come to fruition or have not been actioned by the Scottish Government.”

Eagleson said opt-out testing in England had been a great success, finding nearly 1,000 people in 18 months

He said: “While we were pleased that short pilots of opt-out testing have been rolled-out in three Scottish NHS boards this year, the future of this is in question without confirmation from the Scottish Government on whether they will fund its long-term expansion.

“The absence of a pilot NHS Greater Glasgow and Clyde must also be addressed urgently, with today’s data again demonstrating the prevalence of HIV in this NHS board.”

And he called on the Government to take steps to develop a National HIV Testing Week.

He said: “We have the opportunity to end new cases of HIV by 2030 and we have all the tools we need to get there. We cannot let this moment pass.”

Jackie Baillie, Scottish Labour's health spokeswoman said: "These figures are a reminder that Scotland's progress in tackling HIV is built on years of testing, education and community outreach as well as scientific breakthroughs.

"The 2030 goal of ending new cases of HIV is an important milestone but it's up to the SNP to put in the work needed to reach it.

"There is no room for complacency in the fight against HIV."

Lib-Dem leader Alex Cole-Hamilton commented: “This is a government which presided over an HIV outbreak in 2016 when it cut funding to drugs services and we are still counting the cost of that.

“HIV has not gone away and it is only treatable if people know they have it. The government has to do more to get people into testing.”

Public Health Minister Jenni Minto said: “We welcome this publication, which supports our commitment to eliminate HIV transmission in Scotland by 2030.

“Improving access to HIV testing will continue to play a key role in achieving HIV transmission elimination in Scotland, enabling more people living with HIV to know their status and access appropriate care and treatment.

“While HIV testing rates continue to recover following the pandemic, the Scottish Government is supporting a range of interventions to accelerate progress, including online postal testing across Scotland, piloting opt out testing in A&E departments and funding the Terrence Higgins Trust Scotland to deliver HIV Self-Test Scotland and community-based testing.”