World AIDS Day

Part of the debate – in the Scottish Parliament on 6th December 2018.

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Photo of Ruth Maguire Ruth Maguire Scottish National Party

I thank Emma Harper for securing this important debate on world AIDS day, and for giving us the opportunity to come together across the chamber to show support for people living with HIV and to commemorate those who have died from an AIDS-related illness.

I will use my time to speak about women and HIV, and give particular mention to the excellent report by the Terrence Higgins Trust, “Women and HIV: Invisible No Longer”.

I am grateful to Waverley Care for its briefing on the work of the African health project, which was established in 2003 to meet the needs of Scotland’s growing African population. The African health project provides information, advice and support to Africans living in Scotland. Despite the lack of specific figures for Scotland, we know that HIV disproportionately affects African communities and that late diagnosis, which can lead to health complications, is common for people from those communities. Those inequalities are largely driven by HIV stigma and a lack of awareness about the condition, which can sometimes be reinforced by cultural and religious beliefs. For Africans living with HIV, the stigma can lead to isolation from the community, a breakdown of relationships and negative impacts on their physical and mental health. The project aims to improve health and wellbeing, and to support people to access healthcare services, including HIV treatment and care.

Waverley Care works closely with community groups, businesses and churches to raise awareness of HIV and to promote sexual health. That includes making condoms freely available in community venues in the areas where Waverley Care works, alongside offering testing for HIV, hepatitis B and hepatitis C. Waverley Care also supports people with other issues affecting the African community, including immigration, housing, managing money and employment.

Women make up one third of all people living with HIV, and one quarter of new HIV diagnoses in 2016 were in women. Despite that, it is fair to say that women living with HIV have not been particularly visible in the narrative and the response to HIV in the United Kingdom, and we do not know very much about what it means to be a woman living with HIV in Scotland.

From my constituency work, and as reported in “Women and HIV: Invisible No Longer”, we know that existing HIV services are rarely designed with women in mind. People living with, and affected by, HIV are not a homogeneous group. To treat them as such will result in services that do not meet their needs and, worse, could risk not reaching those for whom the safety net already has massive holes. It is estimated that 1,300 women are living with undiagnosed HIV. It is critical, for both individual and public health, to improve rates of early diagnosis, and HIV testing is key to achieving that. I echo Emma Harper’s call for everybody to know their HIV status.

If they are diagnosed early and receive effective treatments, people with HIV can have a normal life expectancy. If they are diagnosed at a late stage, and if significant damage to the immune system has already occurred, those people will have poorer health outcomes and potentially a much-reduced life expectancy. If someone is unaware of their HIV status and is not on treatment, it is much more likely that they will unknowingly pass on HIV to others.

The HIV prevention drug, PrEP, is currently almost exclusively accessed by men. In the first eight months during which PrEP was available on the NHS in Scotland, only 10 out of the 1,299 people who accessed the drug were women. Waverley Care told me that one in 21 heterosexual African women in Scotland are living with HIV, and we know that a third of all people who are living with HIV are women. Therefore, in closing, I ask the Scottish Government what is being done to redress the imbalance of access to the drug and I offer to bring together interested parties to assist the Government in that work, if it would be helpful.