Despite increasing HIV prevalence, spending on HIV prevention in England has stagnated in the last decade, if not decreased, according to a report commissioned by the National AIDS Trust.
Thanks to potent anti-HIV therapy, the life expectancy of HIV-positive individuals in the UK (and other industrialised countries) has increased dramatically.
This, combined with continuing HIV transmission amongst gay men, migration into the UK by HIV-positive individuals, mainly from Africa, and low-level transmission amongst injecting drug users and UK-born heterosexuals, has resulted in a significant increase in HIV prevalence in the UK since 1996.
But a survey of Primary Care Trusts (PCTs) across England conducted by the National AIDS Trust has found “worrisome” evidence that HIV prevention is being deprioritised by PCTs. The National AIDS Trust sent questionnaires to all 137 English PCTs, and received replies from 80.
In 2005/06, over £38 million was available for HIV prevention in the UK, but the National AIDS Trust estimates that this represents a real-terms cut compared to ten years ago.
Only 55% of PCT’s prioritised HIV prevention and the National AIDS Trust found that PCTs with a high HIV prevalence were no more likely to have HIV prevention as an agreed priority than those with the lowest prevalence. Only 23% of PCTs mentioned gay men as a prevention priority, with 17% prioritising the prevention needs of Africans, even though these are the two groups most at risk of HIV in the UK.
“This survey has revealed shocking complacency”, said Deborah Jack, chief executive of the National AIDS Trust.
PCTs appeared to be making funding decisions about HIV prevention without having a proper understanding of the HIV epidemic locally. The National AIDS Trust found that many PCTs were unable to correctly say how many people were accessing HIV care in their locally, and 57% had not conducted a local health needs assessment relating to HIV prevention.
The National AIDS Trust is now calling for increased investment and resources for HIV prevention, and a clear indication to the PCTs of the amount that should be spent on HIV prevention.