HIV and £££

Three contrasting stories around HIV hit our in-tray at BCN this month. Between them they highlight how different health provision is slowly becoming around Britain.

This is something which may become even more marked with the new elected “super-Mayors” in places like Liverpool, Bristol and the West Midlands, as they acquire health policy powers for areas covering millions of people.

England

A series of Freedom of Information requests submitted by the National AIDS Trust have exposed widespread cutting or complete decommissioning of HIV support services across England and Wales.
In England there was an average cut of 28% in expenditure for HIV support services between 2015/16 and 2016/17.
Services for people living with HIV provide support in dealing with issues more likely to affect them than the general population including: poverty, co-morbidities, mental and emotional health problems, and employment and housing problems. For many people living with HIV, these are services giving a rare safe space where they can discuss HIV and its impact.
According to NAT’s figures, 35% of people living with HIV had accessed support services in the past 12 months.
Over a quarter of local authorities in England had cut their spending plans by 50% or more this year.

Scotland

Meanwhile Scotland became the first of the UK nations to approve the provision of PrEP (Pre Exposure Prophylaxis) by the NHS to prevent HIV.
Following a review process the Scottish Medicines Consortium announced that PrEP, the HIV prevention drug, has been deemed a cost-effective treatment to prevent the transmission of HIV and will be made available on the NHS in Scotland.
It has been shown in multiple studies that PrEP works to prevent new HIV infections.
The PrEP4Scotland Coalition (HIV Scotland, Terrence Higgins Trust Scotland, Waverley Care, and NAT (National AIDS Trust)) welcomed the announcement by the SMC approving PrEP on the NHS in Scotland for those who need it. In a joint statement the four groups said, “We applaud the SMC for taking this bold step to tackling HIV in Scotland. PrEP provides opportunities to reinvigorate how people at higher risk of HIV exposure engage with testing and prevention opportunities, and it is a vital opportunity to make a real reduction in the number of new HIV transmissions.”

Wales

Cutting HIV support services is a trend in England, but more straightforward in Wales where expenditure focused on HIV support services has gone from £153,352 in 2015/16 to £0 in 2016/17, according to NAT.
However the Welsh NHS has decided to press ahead with a three-year trial of the Truvada PrEP drug that the health service in Scotland has approved.
The phrase ‘postcode lottery’ barely seems to cover it all.