It is essential that people living with HIV are part of the conversations where decisions are made and progress is discussed. Through our Community Panel, we aim to ensure people living with HIV have opportunities to share their experiences and perspectives in these spaces.
Ruth, one of our Community Panel members, shared her experience of attending the recent Fast-Track Cities UK and Ireland Conference, part of a global initiative bringing together cities to accelerate progress towards ending HIV transmission and HIV-related stigma.
Attending the Fast-Track Cities UK and Ireland conference was a valuable opportunity to hear how cities across the UK and Ireland are progressing towards ending HIV transmission. As a member of Waverley Care’s Community Panel, I left feeling encouraged by the progress made so far, while also reminded of the challenges that lie ahead.
Progress has been made, but momentum must be maintained
The day began with an overview of the progress being made across the UK and Ireland. Each nation has now achieved the UNAIDS 90-90-90 targets, meaning that 90% of people living with HIV know their status, 90% of those diagnosed are receiving treatment, and 90% of people on treatment have an undetectable viral load. This represents a major public health achievement.
At the same time, one concern came up repeatedly: how do we maintain momentum? There was agreement that securing long-term funding is becoming increasingly difficult. As HIV transmission falls, there is a growing belief among politicians and the public that HIV is no longer a significant issue and therefore requires less investment. Delegates agreed that this creates a risk of losing the progress that has taken decades to achieve.
HIV stigma and wider barriers to care
One of the discussions that resonated most with me was around HIV related stigma. Although we’ve made enormous progress in treatment, it was clear from every conversation that stigma continues to be one of the biggest barriers preventing people from accessing testing, treatment and support.
There was also considerable discussion about the need to engage communities who experience additional barriers to care, including people who have been lost to follow-up, those experiencing homelessness or housing insecurity, people in prison, asylum seekers, ethnic minority communities, people who use drugs, those experiencing poor mental health, and people living in poverty.
A recurring theme was that services need to be culturally appropriate, accessible and delivered in ways that avoid judgement or stigma.
Pre-Exposure Prophylaxis (PrEP) need and demand
Pre-exposure prophylaxis (PrEP) is medication that prevents someone from acquiring HIV. One discussion I found particularly interesting centred on PrEP awareness. Many participants felt that the biggest challenge is no longer a lack of awareness, but that many people simply do not believe PrEP is relevant to them. Personally, I think both remain important issues, and there is still work to do both to increase awareness and help people understand whether PrEP could benefit them.
Opt-out HIV testing in emergency departments
Hearing examples of how opt-out HIV testing in emergency departments is identifying people who may otherwise have gone undiagnosed was incredibly encouraging.
At the same time, delegates reminded us that diagnosis is only the first step and testing alone is not enough. If people are diagnosed without timely support and clear routes into care, there is a risk that the benefits of identifying these infections will not be fully realised.
Looking ahead to 2030 and beyond
To sustain momentum towards ending new HIV transmissions, delegates agreed that action is needed to tackle HIV related stigma, expand opt-out testing options and improve wider equity across society.
There were a number of interesting ideas about how we could reach more people and improve access to prevention, including expanding access to “digital PrEP”, promoting Zero HIV Stigma Day and the Stigma Charter, and strengthening education about HIV in secondary schools.
One of the strongest messages I took away from the conference was the need to think differently about how we engage people. Delegates spoke about working more closely with local authority public health teams, schools, primary care services and other voluntary organisations to improve education, reduce stigma and make prevention and testing more accessible. Collaboration across sectors will be essential if we are to reach the people who continue to be underserved.
Overall, I found the conference incredibly valuable. It reinforced how far we have come in the fight to end HIV transmission, while also highlighting the significant challenges that remain.
The conference left me feeling optimistic. We have already shown what can be achieved when governments, healthcare services, third sector and communities work together. The challenge now is making sure we do not lose momentum. By continuing to tackle stigma, investing in prevention and ensuing everyone can access the care they need, we can move closer to our shared ambition of ending new HIV transmission and where and everyone living with HIV can live well.
Get involved
People living with HIV must be part of the conversations shaping the future of HIV policy, services and support. Waverley Care’s Community Panel provides opportunities for people living with HIV to have their voices heard, contribute to our policy and influencing work, and hear about opportunities to take part in conferences, events and other discussions like the Fast-Track Cities Conference.
If you are living with HIV in Scotland and would like to get involved, find out more about our Community Panel.
Learn more about Fast-Track Cities and our work across Scotland.