Richard Angell is the Chief Executive of Terrence Higgins Trust, the UK’s largest HIV charity. It was great catching up with him about the latest developments in HIV and what THT has planned for Pride across the summer.
How are demographics around HIV changing in the UK?
HIV disproportionately affects men who have sex with men (MSM) and those of Black-African heritage and it prays on the health inequalities in our society. As we hopefully near the end of the transmissible element of the epidemic and strive to end new cases by 2030, we are seeing the proportion of newly diagnosed MSM going down. This is because of great advances in testing, the adoption of PrEP and people living with HIV’s adherence to medication, particularly highest among those that are gay and bi. What we have also seen is that reduction not going down in other communities and proportionately they are now playing a much larger part in the newly diagnosed figures. We’ve had some developments in recent years changing how we report new diagnoses in the Latinx community, so we can really make sure we are understanding transmissions. In the last year we’ve seen younger queer people have a slight increase in new diagnoses and queer people that are Black or Asian see a small increase. We need to make sure that this doesn’t become a trend. We’re working hard to put HIV testing where those communities use the NHS. We have been very successful in certain A&E departments.
How can people best access sexual health services?
Sexual health services are funded by the government through the Public Health Grant and commissioned by local authorities, and we’ve seen that access diminishing because the fund is worth significantly less than when it was created (£1.4 billion less). You’re seeing sexual health clinics limit their opening hours, changing their provision and moving to online testing. Those services are capped or limited to certain demographics, different age ranges, or for certain viruses. Mpox further tipped the system over the edge and in truth it has barely recovered.
Can you explain this further?
We had a mystery shopper trying to use sexual health services across the UK and in 51% of instances they were turned away and encouraged to use online and postal services. Particularly those in rural areas, who live furthest from a sexual health clinic, have the longest wait lists and are least likely to be covered by a postal HIV service.
Can you tell us about the Infected Blood Inquiry?
This is the biggest public inquiry to date, looking into the four-decade long scandal where the NHS and the doctors that were looking to protect haemophiliacs and others who needed blood products were given products with viruses in them. From very early on they knew blood products could transmit hepatitis and that heat treatment could prevent the virus living in those products. That advice wasn’t heeded in the late 1970s and 1980s. We’ve seen through testimonies to the Inquiry, that doctors who were there to protect people were often conducting trials on their patients without their consent and that led to the transmission of viruses and people being infected with both hepatitis C and in some cases HIV. Many people have already passed away due to complications with those viruses. We’ve seen at different points the system be complicit in withholding information and not being transparent. We’ve seen remarkable campaigners and brave people continue to raise this issue and seek redress. No more victims or survivors should die before they’ve had justice.
What does THT have planned for the summer in terms of Pride events?
We’ll be at Pride events across the country engaging with our supporters and letting them know that it’s free and easy to test for HIV, that it’s always best to know your status, that being in control of your sexual health is something we can make easy. Also, that we haven’t ended this epidemic yet. Too often people go undiagnosed for too long and when they are diagnosed, they experience stigma in the system and we will not put up with this. Medicine means that the virus does not attack the immune system and that you can’t pass it on to your sexual partners or if you decide to have a baby. That is phenomenal and we must celebrate where we are, but as a country we are not deploying those tools sufficiently. We’ve got about 5,000 people across the country who are undiagnosed and about half of those are queer. It matters to us that everyone has access to testing and treatment. Some of those people may be visiting a Pride festival for the first time.
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