National HIV Testing Week 2023 — [James Gray in the Chair]

Part of the debate – in Westminster Hall at 2:57 pm on 8 February 2023.

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Photo of Steve Brine Steve Brine Chair, Health and Social Care Committee, Chair, Health and Social Care Committee 2:57, 8 February 2023

The point I was making was that, compared with the hopelessness of 40 years ago, we now have the tools to deal with it, but the hon. Member is right. The all-party group visited the Dean Street clinic last year and heard about the impact that monkeypox has had and is still having on its day-to-day work. Access to PrEP through, say, community pharmacies would move the dial and be a game changer. I would very much support that, and as Chair of the Health and Social Care Committee, I might be able to help.

Some people have mentioned the HIV Commission. I was fortunate to have the proposition for that commission put to me when I was in the Minister’s job. For me and my right hon. Friend Jeremy Hunt and his successor as Health Secretary, my right hon. Friend Sajid Javid, it was an easy proposition to say yes to. When I left Government in 2019, I was asked by Ian Green of the Terrence Higgins Trust to join the commission as a commissioner, which I was delighted to do.

The Terrence Higgins Trust, the National AIDS Trust and the Elton John AIDS Foundation did incredible work to put together the commission’s report. As has been said, on World AIDS Day in 2021, we published our report that developed the evidence-based recommendations that are now the foundations of the HIV action plan, which my right hon. Friend the Member for Bromsgrove published in December 2021. Those recommendations were the foundations of the 2021 report by the all-party parliamentary group on HIV and AIDS, “Increasing and normalising HIV testing across the UK”.

The message from the HIV sector and public health professionals is test, test, test. As was said in the opening speech, late diagnosis remains way too high. There are still far too many people living with undiagnosed HIV who will not be reached through the existing testing strategies alone. If we are to find the estimated 5,000 undiagnosed people living with HIV in the UK, testing must be normalised through the health service and beyond. We have made great strides in doing that, but we will have to roll it out much wider to the high-prevalence areas, as has been said.

Everybody should know their HIV status. There must be equitable and easy access for everyone to that knowledge and to effective treatment, so they can live their full and healthy lives with undetectable HIV. Undiagnosed virus is a major contributor to onward transmission. It is therefore the driver of late presentation, all the impacts on people’s health and people’s lives, and the costs to the national health service; sadly, it also significantly increases the risk of death in the first year after diagnosis.

We know that HIV testing is reliable, cost effective and highly acceptable to patients across a range of settings. As we heard from my hon. Friend the Member for Erewash, HIV opt-out testing was an integral recommendation of the HIV Commission. We know that it works. The latest data available on HIV opt-out in accident and emergency departments in London, Manchester, Brighton and Blackpool shows 238 people newly diagnosed with HIV, and a further 124 people have been returned to care. That proves that it works. We have proved the concept. I will be honest with the House that, as a commissioner, I was concerned that people would opt out, or that they would take offence at the suggestion—that the patient would say, “What are you suggesting?” I was wrong. Routine HIV testing among pregnant women is completely normalised. That convinced me that it was right to make that our key recommendation.

That was our key recommendation, but opt-out testing is done only in London, Blackpool, Brighton and Manchester. I contacted my trust in Winchester today to ask whether we can have a conversation about rolling it out in our area.