Waverley Care Welcomes HIV Mid-Plan Report from Public Health Scotland

Progress so far

• Fewer new diagnoses – the number of people diagnosed with HIV for the first time in Scotland is going down.
• PrEP pilots – A pilot ePrEP clinic has launched in Glasgow, offering PrEP (pre-exposure prophylaxis) medication, HIV and STI testing, and management through an online platform. Early pilots of other PrEP clinics through general practice have also started, alongside work to improve access for transgender and non-binary people.
• Harm reduction – the opening of The Thistle, Scotland’s first safe drug consumption facility in Glasgow.
• Healthcare knowledge – development of an online HIV information hub for the health and social care workforce.
• Reducing Stigma – ran a “Stigma’s More Harmful Than HIV” campaign in partnership with Terrence Higgins Trust.
• Opt-out testing – following pilots, there is now a commitment to expand HIV and blood-borne virus testing in A&E departments in Greater Glasgow and Clyde and Lothian.

Challenges ahead

However, since the Delivery Plan was published, the HIV landscape has changed in Scotland.

• Changing transmission patterns – Data shows that heterosexual people now make up a growing share of new HIV cases. Prevention efforts must therefore extend beyond gay, bisexual, and other men who have sex with men to reach wider communities, where awareness of HIV and its risks is often lower. Expanding opt-out testing in key settings, including prisons, drug and alcohol services, and specialist sexual health services, will be critical.
• Global pressures – shortages of HIV medication and reduced international funding could increase the number of untreated cases arriving in Scotland.

Key priorities moving forward

Primary prevention

• Tackle stigma – ensure zero HIV stigma in health and social care settings and continue public campaigns.
• Expand PrEP access – create a national ePrEP clinic, roll out injectable PrEP where feasible, and ensure PrEP is available in primary care, pharmacies, and outreach services.

Secondary prevention

• Increase testing – fully fund the rollout of opt-out HIV testing in A&E, prisons, and drug/alcohol services; embed indicator condition testing across the NHS; and launch a Scottish HIV Testing Week.
• Strengthen partner notification – implement new models of partner notification to identify those exposed to HIV and link them into prevention or care.

Tertiary prevention

• Support people living with HIV – expand peer support, tackle isolation, and improve quality of life by acting on the Positive Voices survey findings.
• Re-engage people lost to care – strengthen national systems to reach the estimated 1,100 people in Scotland diagnosed with HIV but not in care.
• Learn from every transmission – investigate all new HIV transmissions to identify missed opportunities for testing, prevention, and re-engagement.

Gaps in Scotland’s HIV response

The report highlights missed opportunities, including:

• Limited rollout of long-acting injectable PrEP (cabotegravir).
• Reduced promotion of condoms.
• Uneven access to at-home postal testing kits.

For a clear, visual breakdown of progress, see the policy scorecard created by Waverley Care and Terrence Higgins Trust.

Grant Sugden, Chief Executive, Waverley Care, said:

“With just five years left, we have a choice: accelerate action and meet our goal or lose the chance to make HIV history in Scotland. This means fully funding opt-out HIV testing in A&E, launching a national HIV Testing Week, making PrEP easier to access through primary care and pharmacies, expanding peer support, and ensuring the health and social care workforce have the knowledge and tools they need.

We know what works — now we need the will, resources, and commitment to achieve zero new HIV transmission in Scotland by 2030.