To ask His Majesty’s Government what action they are taking to increase HIV testing rates; and whether they will establish and invest in a programme to engage with the estimated 12,000 people living with HIV who do not receive medical care.
My Lords, HIV testing rates in sexual health services increased last year by 3%. After nearly a decade of cuts, we increased the public health grant to over £3.8 billion in 2025-26, which funds HIV testing and sexual health services. This year we invested £27 million in HIV opt-out A&E testing, identifying undiagnosed and untreated HIV and increasing re-engagement in HIV care. The new HIV action plan, which will be out before the end of the year, will include HIV testing and care actions.
My Lords, while progress is greatly welcome—I applaud the Government’s efforts and commitment in this area—does the Minister agree that, unless we move much more quickly, we have no chance of meeting the target of eliminating new infections by 2030? Last year, there were still over 3,000 new diagnoses—a stubbornly high figure—while HIV rates among black African heterosexual men are, in fact, increasing and there are up to 12,000 individuals lost to care; they are aware that they have the virus but are not accessing life-saving drugs that would stop them passing it on. Will the Government act in two very important areas to try to bring this infection rate down? The first is to make sure that PrEP is available outside sexual health clinics and the second is to ensure there is a dedicated team of caseworkers in every HIV clinic who are laser-focused on finding those who are lost to care and getting them back in treatment.
I will certainly take those very helpful proposals back to the department. As the noble Lord acknowledged, we are developing the plan, which must be ambitious. If it not, exactly as he says, we will not meet what I think is a very correct target. I am sure the noble Lord welcomed the news on 17 October of the NICE publication of a recommendation on the use of cabotegravir, an injectable option for those who cannot have oral PrEP. It is important to look at the reasons why people do not access care and treatment and to find solutions, rather than leaving them as they are.
My Lords, I entirely support the case made by the noble Lord, Lord Black, but I urge the Government to go further. About 9 million people in the world who need HIV treatment are not receiving it at present. That position is being seriously worsened by the American Government’s regrettable decision to cut healthcare provision in so many programmes. Will the Government now lead a new international effort to increase funding to counter this new threat, which is becoming more and more obvious around the world?
As I am sure the noble Lord is aware and welcomes, alongside South Africa, the UK is leading the campaign to raise investment for the Global Fund’s next three-year funding cycle. I assure him that we will, as he does, continue to champion global health and certainly remain committed to UK support for the Global Fund. UN aid also plays a very important role in the response and our funding has contributed towards preventing new cases in key populations. Long may that continue.
My Lords, today, contracting HIV is no longer a death sentence as it once was, unless it is not spotted and treated in time. Testing is freely available, but we need greater awareness among all the communities affected. The currently growing groups tend to be heterosexual communities, and particularly women and ethnic-minority groups. We will not eradicate HIV if we do not spend the money on telling people about it. Are the Government planning to step up to this challenge and finance the eradication of this terrible blight?
We are currently in the process of reviewing existing mechanisms as well as options for improving retention and re-engagement in care for people who live with HIV. This is a crucial part of the new HIV action plan, for which we will not be waiting very long. The noble Baroness makes an important point: there are all sorts of reasons for disengagement from care. It can be due to complex mental and physical needs but also the fear of stigma, as she referred to, particularly in the most vulnerable population groups, which means that they are disproportionately challenged. However, I assure her and your Lordships’ House that the plan will take account of that. Indeed, the 10-year health plan already makes that commitment.
My Lords, does the Minister agree that routine opt-out HIV testing—offering HIV tests to all patients in healthcare settings, such as emergency departments, unless they specifically decline—has proved highly effective, having identified over 1,000 cases of HIV that may well have gone undetected otherwise? Do the Government have any plans to extend this approach beyond the current pilot projects?
I certainly agree that giving people who are attending an emergency department a blood test as part of a routine examination—unless they opt out—has assisted very much in engaging people in care and in identification. We have 79 emergency departments in the programme and they are making a substantial contribution. We will continue to assess where it is successful and how we can extend the success into areas that are not currently benefiting.
My Lords, there has been a decline in the rate of testing of 16 to 24 year-olds, which is deeply concerning. Are the Government going to tackle that as a matter of urgency, recognising the need to target that group in particular?
As I have mentioned, the plan—which is due to be published by the end of this year—will include a focus on HIV testing and will take account of the groups that are less likely to be tested, because that will be key to our success in eradicating new HIV transmissions by 2030.
My Lords, every time we have debated this subject, we have acknowledged the difficulty in identifying at-risk people who do not come forward to be tested for HIV. One such group of people are those who go to pharmacies or GPs to get a prescription for PrEP medication. What information do we give them about the need for getting themselves tested for HIV when they approach pharmacies and other sources for PrEP medication?
Although I cannot answer specifically, I would be very happy to write to the noble Lord about what information is in pharmacies. I know the noble Lord will appreciate, as your Lordships’ House has welcomed, the greater use of pharmacies, not least because they are more accessible for those who otherwise would be disadvantaged.
My Lords, HIV testing rates are vital. When the Minister meets the devolved Ministers for the nations and regions, particularly the Minister for Health in Northern Ireland, I ask that she talks to them about this important area, with particular reference to Positive Life Northern Ireland, which is a voluntary body doing enormously good work with those with HIV. It received a shortage of funding, or did not receive funding, from the department this year.