World AIDS Day

If this vital programme is eventually expanded to all towns and cities with high prevalence, it will be a game- changer. Where London has expanded the programme, it has already been worthwhile financially in areas that do not have very high prevalence. The programme should also be expanded to sexual health clinics to ensure that everyone going to one is tested for HIV. This may be a surprise to many, but that is not always done routinely and it is not an opt-out system. Actually, an HIV test is becoming less, not more common, because more sexual health clinics are moving to online services. Online services have some great advantages, but one downside is that they require people to collect a vial of their blood, which often does not happen, or does not happen effectively, so HIV test rates are lower. We need to ensure that, when people attend a clinic, it is routine and there is an opt-out system. Some clinics do this already, but it is not universal.

I spoke about the HIV prevention drug, PrEP, in 2018. We have a come a long way since the PrEP impact trial. To remind colleagues, PrEP, which is a pill that people take daily, contains two of the three drugs that someone with HIV would have. In fact, I have now been reduced to two because the latest evidence shows that, when someone gets to “undetectable”, the drug load for people who have HIV can be reduced to, effectively, just the PrEP load. The drugs will not be exactly the same as I take for PrEP, but some people can maintain on those as well. So this is also about new interventions that can reduce the costs and the amount of drugs that we are providing.

PrEP prevents HIV and the pill is covered by NHS England, but thousands are still missing out. They are struggling to get PrEP appointments because of under-resourced sexual health services. That is laid bare in the latest report from the National AIDS Trust, the Terrence Higgins Trust, PrEPster, Sophia Forum and One Voice Network. Due to the fragmentation of services in England, the drug PrEP is paid for by NHS England. That is a real milestone for the NHS, and I congratulate the Government on getting that out eventually, after our interventions.

Anyone who is currently sexually active should be tested by sexual health services every three months, and anyone on PrEP should be tested every three months. In theory, therefore, there is no additional resource for sexual health services for someone on PrEP, because the only people on PrEP should be those who are sexually active, or drug-injecting users who should also be tested, and so on—we should not give it to people who do not need it. But our sexual health services in this country rely on balancing the budget through the fact that people do not attend as regularly as they should. Therefore, that limits the places for PrEP appointments and limits the people who can get access to the drug that the NHS is paying for, even though they are entitled to it and should be offered that level of service.

Awareness of PrEP is far too low and it cannot be given out by GPs, pharmacies, community or maternity services. That means that the burden is solely on local government-funded sexual health services. We all know what is happening with local government and probably do not need to go there today—that is a whole other debate.

If we are going to meet our 2030 target, it is vital that everyone who is at risk of acquiring HIV and who wishes to access PrEP can do so as a key tool in completely and effectively preventing new HIV transmissions when it is taken as directed. Over the past two years, the all-party group on HIV and AIDS has published three important reports. We published “Increasing and normalising HIV testing across the UK”—which I just touched on—and “Nothing about us without us”, which addresses the needs of black, Asian and minority ethnic communities in the UK. Those communities are some of the hardest-hit by HIV in this country and are the least likely to have HIV testing done routinely. The roll-out and trial of the saliva HIV testing, which the Terrence Higgins Trust did two years ago and last year, was particularly effective in those communities. It was seen as less invasive, more private, easier to get hold of and possible to do through online and postal services. The Government should consider whether that process should be normalised nationally or provided cheaply and accessibly.

Our other report, “HIV and Quality of Life—What do we mean? How do we achieve it?”, was published today, and my colleagues have been launching that in Brussels with our partners in Europe. Those reports have been made possible only through the evidence provided by the strong HIV sector that we have in the UK. Its continued insights and hard work are appreciated.

The latest data, however, is not quite as positive. There were 2,692 people diagnosed across England in 2021. That is up 0.7%, from 2,673 in 2020. Some might say that is a small amount but, in 2022, there was a fall of 0.2% and, in 2019, there was a fall of 33%. We are clearly plateauing and there is a danger that we are starting to get more diagnoses. That might be positive because we are delving down to the hardest-to-reach areas, but we need more evidence on why that has plateaued and why it is creeping up before we can be sure that that is something to celebrate, rather than to be worried about.

To keep on track, it is vital that we use every lever available to end HIV transmission and to ensure that we do not plateau, as the numbers show. As I said, we can end transmission by 2030 and I strongly believe that the UK will be one of the first countries to do so. We are a world leader. At the beginning of the week, I spoke to our London NHS colleagues, who said that it is the first time in their career that people have been phoning up from around the world to say, “How are you doing the opt-out testing? How are you doing the PrEP roll-out? We want to learn from you.” That is remarkable and we should be deeply proud of that. The head of UNAIDS came to London and Brighton and we showed her the HIV testing vending machines that we have in Brighton. She said, “I thought that I would never learn anything for the developing world from a rich country. I was here as a courtesy visit, but I have seen what you are doing and how we can roll that out to parts of Kenya and Uganda, and community settings around the world, with HIV testing vending machines that run using solar panels”.

One of the inequalities standing in the way of ending AIDS is access to education, particularly for young girls. Six in seven new HIV infections among adolescents in sub-Saharan Africa occur among girls who are outside formal education. Enabling girls to stay in school until they complete secondary education reduces their vulnerability to HIV by more than 50%. All children, including those who have dropped out because of covid and those who were out of school anyway, should get a complete secondary education, including comprehensive sex education.

In some countries, people living with HIV are at risk of being criminalised even when they take precautions with their sexual partners. That opens them up to blackmail and fraudulent claims from former partners. People with HIV in the UK are not immune to that either, as we have seen in some high-profile cases. We have known for at least 20 years that antiretroviral therapy reduces HIV transmission, and for the past few years we have known that it stops it completely, so there should be no doubt that a person with sustained undetectable levels of HIV in their blood cannot transmit HIV to their sexual partner, and laws should not punish them. However, under Canadian criminal law, for example, people living with HIV can be charged and prosecuted if they do not inform their partner about their HIV-positive status before having sex. The law does not follow the science, and it puts people at risk.

Laws requiring disclosure perpetuate the stigma against HIV-positive people. With the advent of PrEP and with “Undetectable = untransmittable”, the law should now reflect the fact that everyone has a role in protecting themselves against HIV and everyone must step up. The criminalisation of drug-injecting users and sex workers has an equally negative effect on HIV prevention and treatment, as I have outlined, in LGBT communities. In all these areas, a health and human rights-based approach must be taken if we truly want to see the end of HIV.

Beating pandemics is a political challenge. We can end HIV and AIDS by 2030 in this country, but only if we are bold in our actions and our investments. We need courageous leadership. We need people worldwide to insist that their leaders be courageous. That is why last month it was so disappointing not to see courageous leadership from this Government. The UK Government were the only donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria to cut their financial settlement—by £400 million. The fund asked donors to raise their pledges by 30% this year, and almost all the G7 nations—which are suffering economic problems that are, in many respects, similar to ours; as the Government often remind us, this is a global crisis, not a crisis of their own making, although in our view it is a bit of both—increased their amounts. For decades the UK was the leader in the global response to these infections and diseases, but that is no longer the case. When our allies met the fund’s request for a 30% increase, the UK went for a 30% cut from their 2019 pledge.

We in the APPG have the political will to meet the targets set by UNAIDS and the action plans for Wales, Scotland, England and, I was pleased to hear, Northern Ireland. We will continue to work with and challenge the Government in ensuring that they do the same, because it is time we stepped up and pushed for that final mile. When you are at the end of the race, you do not slow down; you speed up. This is a prize that we can win, so let us not allow it to slip through our hands. In the words of the former Prime Minister Boris Johnson, let us end the “dither and delay”. Let us end HIV/AIDS today.

I remember, too, the grief that I was given on social media from the ill-educated, ignorant and—to be frank—bigoted people who used that as a stick with which to beat me: “Ooh—why did she need an HIV test?” Why did I need one? First, to know, and secondly, to be a voice for everyone else who felt anxious about getting an HIV test. I wanted to tell them, “There is nothing wrong with it; there is no stigma attached to it; you are doing it for your own wellbeing.” That is why I now act as a champion for all women, telling them how important it is to go and get a test.

The hon. Member for Brighton, Kemptown made a very important point—I dwelt on it a little when I was thinking about what I wanted to say—about the prevalence of online and postal tests. I think that they are great innovations. Earlier this year, however, I received a little package through the post with the message “Give HIV the finger”—which was a wonderful message, but it was hard to get the required amount of blood out of my finger, and I felt slightly concerned about whether it was enough. I thought, “Will this be effective? Who knows?” For me, much of that process was about being photographed proudly holding up the box, having taken an HIV test. However, another part of it was to do with the fact that we need these testing programmes to be effective, we need people to be confident enough to use them, and we need them to be available in all sorts of locations.

That brings me to my next point. We need people to be culturally competent and aware. We know from statistics that a third of the people living with HIV are women, and we know that 25% of the new diagnoses are in women, but we also know of the prevalence of HIV in black African communities. Covid taught us—and I am an absolute advocate of this—that we must learn the lessons of really difficult experiences. We learnt through covid about the importance of speaking to people in languages that they understand, in a way that they can relate to, on the media channels that they instinctively use. It is no good broadcasting our public health messages exclusively on the BBC; we have to find different channels in order to communicate with the audiences who are most at risk, where the prevalence is highest, and where people might not be engaging with the traditional forms of media that you and I, Madam Deputy Speaker, might use. That is a really important message that I would like to give to NHS England and the Department of Health and Social Care. We must keep up the pressure, and talk to communities in which there is high prevalence and where there might be barriers, cultural or otherwise, to getting a test.

I have an important wider point on research. It was crucial that a great deal of the research on HIV and AIDS be done on those who were most likely to be affected by them, so of course, a massive wealth of research has been done on men. I absolutely acknowledge that that was right, but there are knowledge gaps when it comes to women with HIV and which drugs might be most effective for them. There is certainly still a barrier to women accessing PrEP; that is borne out by the numbers. They are simply not using it. We have to understand why that is, and how effective that drug and indeed other HIV drugs may be on women. We have to make sure that the DHSC and NHS England not only have sufficient data, but disaggregate it, so that it can be broken down by gender and ethnicity. Often when I talk about health, I find myself complaining and browbeating others about the lack of data that is relevant exclusively to women, the lack of women coming forward in drug trials, and the lack of research done on women. Those things are true when it comes to HIV.

I turn to what we have been good at. The action plan for HIV talks about the successes on vertical transmission; a tiny number of children are now born with HIV in this country. A big part of that is down to opt-out testing of pregnant women; the take-up has been absolutely enormous. The figures show the result: of the 60 people diagnosed in 2019 who acquired HIV through vertical transmission, only five were born in the UK. That is a huge step forward, and we have done brilliantly on vertical transmission, but it is crucial that we never let up on that, and that we get the message out that effective drugs taken during pregnancy can prevent HIV transmission to a baby. The mother has to be mindful of risks to do with the method of birth, be that natural delivery or via caesarean, and there is a risk factor involved in breastfeeding. All those pieces of information can effectively and easily be communicated to expectant mothers, and they absolutely should and must be.

I am conscious that my knowledge is not as great as that of other Members in the Chamber, so I have deliberately kept my comments relatively brief. We need to keep up the pressure. The hon. Member for Brighton, Kemptown referred to approaching the finish line. When I do anything that involves running, there is definitely a slowdown, usually due to exhaustion, as I approach the finish line, but we cannot afford a slowdown here. We must accelerate to the finish. We can now see a UK without HIV. He made important points about the developing world and the efforts that still need to be made there, but the end is in sight, and it is absolutely crucial that we reach it and see a world that is free of HIV.

STOPAIDS got in contact with my office before the debate. It informed me that the UK, which has provided some £15 million a year to UNAIDS for the last five years, has cut its funding by more than 80% to just £2.5 million this year. I concur with the hon. Member for Brighton, Kemptown that that is a worry, and I think that concern will be expressed by others in the Chamber, too. Even though the Minister does not have direct responsibility for the issue, perhaps he will speak about that. The cut jeopardises work that supports some of the most marginalised. The Government and our Ministers should uplift that funding, even if just slightly, to ensure that charitable organisations are fully funded to do their work.

I want to outline what we are doing in Northern Ireland through the Public Health Agency, which I mentioned in an intervention on the hon. Member for Brighton, Kemptown. I want to mention its achievements, even though there may have been a slight increase in the number of those with HIV; the issue is how we combat that. I think that what it has done is excellent. Its 2022 annual surveillance report on sexually transmitted infections, which is based on data from ’21, showed that there were 76 newly diagnosed cases of HIV in Northern Ireland in 2021. That is a 12% increase from 68 diagnoses in 2020, but—this is the key—more HIV testing was being done. Almost 80,000 HIV tests were carried out in Northern Ireland in ’21, which is a 21% increase on the approximately 66,000 done in 2020. The PHA said:

“We are making great progress towards eliminating HIV transmission by 2030. Frequent HIV testing, the offer of PrEP to those most at risk of HIV, together with prompt treatment among those diagnosed, remains key to achieving this.”

So there is more testing, more contact, and fewer people getting AIDS. That is an example of what we are doing in Northern Ireland, and I commend the PHA for doing that so very well.

In 2019 in Northern Ireland, 40% of those newly diagnosed with HIV were gay and bisexual men. In comparison, 52% of cases involved heterosexual contact. There is a stereotype and an assumption that all people with HIV or AIDS are gay or bisexual, but the stats clearly dispute that. As the right hon. Member for Romsey and Southampton North said—this applies to Northern Ireland as well—there must be greater awareness that not only gay men get AIDS. It has impacted the lives of many women, too. Unfortunately, many of the people represented by those 52% of cases in Northern Ireland are ladies. The right hon. Lady outlined the point exceptionally well. It is good that we have it on record that the disease needs to be tackled head-on, always. The HIV strategy must reflect the fact that more heterosexual people get HIV than gay or bisexual people. A new strategy is clearly needed—one that takes on board the figures, and helps us to understand the issues even better.

In Newtonards in my constituency, the Elim church, which is very active, has had an incredible strategy for Swaziland in southern Africa. It has helped to build hospitals, health clinics, schools and other buildings, which has provided jobs. It has also actively helped to address the AIDS epidemic in Swaziland. Those things need to be done proactively and positively. I commend the Elim church and mission in Newtownards as an example of what can be done where there is the will and understanding, not through their own efforts alone but working collectively with others to reduce the number of people in Swaziland who have AIDS.

There are many orphans in Swaziland whose parents died due to AIDS, and some of them were born with AIDS through no fault of their own, and the Elim church and mission actively works with them. They come to my constituency every year as part of the church’s missionary work, and I have never failed to be moved by their singing and joy. They are receiving treatment and medication, too.

Northern Ireland has only one HIV charity, Positive Life, which I commend for how well it does for us in Northern Ireland. Positive Life attends the Democratic Unionist party conference every year, and I make it my business to thank the charity every year for its tremendous work to promote a positive future for people living with or affected by HIV in Northern Ireland. It provides free rapid testing for those who are concerned that they might have HIV, and it offers support along the way. We are all indebted to Positive Life in Northern Ireland, and to all the other charities that play an invaluable role in battling HIV and making the stereotypes and stigma a thing of the past.

The Public Health Agency has a clear strategy for those in Northern Ireland who have AIDS, whether through transfusions, activities or whatever it may be. I am pleased to say that the positivity not only in Northern Ireland but elsewhere encourages me and gives me great hope. The hon. Member for Brighton, Kemptown is an example of that positivity, for which I commend him. I also commend the Minister in anticipation of his answers, which I hope are along the lines we expect.

The Mayor of the west midlands, Andy Street, has written to the Health Secretary asking for this “invest to save” resource for our region, and I add my voice to his call and ask the Minister if he can help level up the HIV response outside London. With funding for opt-out HIV testing, we can put the west midlands on track to end new HIV cases by 2030.

Andy Street rightly said

“This is not a World AIDS Day stunt but a serious call for action. I don’t want ‘The Ribbons’ to simply be a tribute. It needs to be a reminder that HIV is still happening to many”.

I know my hon. Friend the Member for Birmingham, Northfield (Gary Sambrook) and local councillors in Sandwell, such as Councillor Scott Chapman, join Andy and me in asking for an extension to opt-out testing to cover my West Bromwich East constituency.

We have made such incredible strides. As well as remembering the devastation that HIV has caused for so many around the world, we have to celebrate how far we have come. We have preventive drugs available on the NHS—drugs that stop any trace of HIV so that those who contract it cannot pass it on to others—and we are now seeing the major success of opt-out testing in some of the country’s worst HIV hotspots. In an odd way, the medical question is not really the problem; it is the stigma.

I recently met Harry Whitfield, also known as Charity Kase, who last year made his debut on “RuPaul’s Drag Race UK” to showcase his incredible talents. He talked about how hard it was to deal with his HIV diagnosis. For last year’s World AIDS Day, Harry said:

“The stigma around HIV is far worse than the disease itself. I take one tablet per day to stay healthy and completely undetectable so I can’t pass the disease on. I’m thriving in my life every day, but that’s not the narrative that gets told when talking about HIV.”

Last year, like so many, I was completely engrossed in “It’s A Sin.” Until then, I had not thought that much about HIV. Probably because of my age, I had not properly considered how terrifying that period of time was for so many. When I was sent an HIV test to raise awareness during testing week, I took the test and posted about it on social media. I knew it had the potential to create some odd feedback, but I felt it was important. Some of the comments came from people who thought HIV was a thing of the past, and they accused me of talking about it only as a means to control people now that we are out of the covid pandemic. It showed me the importance of keeping this issue alive.

My experience is similar to that of my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), with people questioning why I thought it was necessary to take a test and what I had been up to. However, one constituent thanked me. He said:

“I’m a victim of this myself. I was fortunate to be born at the right time for effective treatments. But only just. These new tests were not around when I was diagnosed. I just happened to randomly find out through routine MOT as they call it.”

He also said told me that the stigma is the main issue.

In March 2020, the Department of Health and Social Care provided £16 million in funding to local authorities to provide PrEP. I warmly welcome that, but barriers still exist. More than 57% of people waited more than 12 weeks to access PrEP and only 35% who attempted to access PrEP services were successful. It is essential that that changes. PrEP is a game changer for all of us. It is an essential tool if we are to end new infections by the next decade in the UK.

Of course, we know that this is not just a problem here at home. The truth is that covid-19 was the second pandemic of our lifetimes and we are still living through the first; this is a global matter. That is why I am proud that the UK provides funds to UNAIDS, the Robert Carr Fund and the Global Fund to Fight AIDS, Tuberculosis and Malaria. I will join the hon. Member for Brighton, Kemptown in saying that I would have liked to have seen the levels sustained, but my hon. Friend the Member for Totnes (Anthony Mangnall) made the important point that there are other things we can leverage as a country to help other countries in their fight against this disease. The UK is a co-founder of Global Fund and the third largest donor historically—my hon. Friend mentioned the figure of £4.4 billion in that regard—and the Foreign, Commonwealth and Development Office announced on 14 November that the UK will contribute a further £1 billion, so at least we are still in the fight. As with covid, the truth is that none of us is safe until all of us are safe, and we have a role to play in supporting those parts of the world less able to tackle HIV/AIDS than ourselves.

As we aim for our 2030 target, I would also like to draw the Government’s attention to the recommendations of the Terrence Higgins Trust and National AIDS Trust, which are calling for the expansion of opt-out testing to all areas of high prevalence—I cannot stress how important that is—the provision of PrEP to all who could benefit from it, which is very important, and a refocusing of sexual health services that have been displaced by the recent mpox outbreak.

There is a huge amount of work to do if we are to reach our 2030 target, and that will rely on adequate funding, access and information across society. It will need those of us in this place to speak openly and honestly about HIV/AIDS and to be collaborative, working across the piece. I am confident that we can get to that 2030 target and I will continue to support everyone working to that endeavour for as long as I have the privilege to be in this place.

We in Scotland are extremely proud to be the first country in the UK to make PrEP available free of charge to those at a high risk of acquiring HIV. We have made huge progress in detecting and treating HIV, and people with the virus are able to live those long, happy and fulfilling lives. PrEP is free of charge from NHS Scotland for anyone who is more at risk of getting HIV. As we have heard from the hon. Member for Brighton, Kemptown, it is simply an oral medicine, in pill form, comprising two HIV antiretroviral drugs. It is prescribed to HIV-negative people at risk of becoming infected as part of a comprehensive approach to HIV prevention. We know that the drug is highly effective at stopping HIV from being passed on. In clinical trials, PrEP has been shown to reduce the risk of sexually transmitted HIV by between 75% and 86%, so it is hugely successful. Research lead by Glasgow Caledonian University’s Professor Claudia Estcourt shows there has been significant reduction in HIV infections since the implementation of the first PrEP programme in Scotland in July 2017, and that new diagnoses in Scotland have fallen by 20%.

The SNP Scottish Government will continue work to reduce the stigma of HIV, raise awareness of the condition and reduce its transmission. Support is being provided for new research on reducing transmission of the virus, and a separate working group will also look at the clinical utility of PrEP in Scotland.

The SNP Scottish Government have also provided £337,000 to develop a national online service for sexually transmitted infections and blood-borne viruses, which will allow people to request a test online and conduct that home self-sampling that we have heard about today from across the House. Every tool possible will be required in our fight against HIV/AIDS. These are all excellent tools and the Scottish Government remain committed to being on course to reach their target of eliminating HIV transmission in Scotland, and across the rest of the UK, by 2030.

As a fierce defender of minorities in this place, I must also mention the plain fact that many of those living across these nations with HIV are vulnerable. Some experience language, faith and cultural barriers associated with long-standing stigma, while others have complexities, such as mental health and societal issues, that impact their access to health and social care services, leading to poorer health outcomes. As we are all too aware, socio-economic inequalities drive health inequalities. Will the Minister outline the steps being taken by his Government to mitigate the impact of austerity and reduce inequality for all our minority communities?

The Government need to take an intersectional approach to healthcare—an approach that recognises that many people in the United Kingdom will face multiple and often overlapping disadvantages and barriers to accessing good healthcare, and sometimes, as we have heard, a postcode lottery.

Finally, on the matter of funding, the SNP is once again calling on the UK Government to reverse, in effect, the 83% cut to UNAIDS funding, which is a consequence of their decision to cut the aid budget from 0.7% to 0.5% of our GDP. On 31 Oct 2022, the UK Government missed the deadline to donate to the Global Fund to Fight AIDS, Tuberculosis and Malaria. At the time, Mike Podmore, UK Director at STOPAIDS, said:

“The UK is acting as an unreliable partner and preventing the Global Fund from communicating clearly to its grantees about what funding is now available for them to work with, creating uncertainty.”

The consequences of that action could be immeasurable when it comes to the number of lives affected. Although the UK did provide some funding, it was £400 million less than in 2019. Again, we in the SNP call on the UK Government to do the right thing. The aid budget must be restored to its 0.7% level, especially if the UK does not want to be known as an unreliable partner among its counterparts.

This World AIDS Day is not just about recognising and celebrating how far we have come, but about issuing a call to action. There can be no room for complacency in the late stages of this campaign. Today, we stand on the brink of achieving something extraordinary: ending all new HIV transmissions in England by 2030. That goal is ambitious, but achievable, and it is one that Labour is proud to support and to push the Government on to achieving. None the less, too many opportunities are still being missed, and sexual health services are struggling to keep up with demand. A total of 46% of people diagnosed with HIV are still diagnosed too late, and 38% of people attending sexual health services were not offered an HIV test last year. That is not good enough. Some 20% fewer people were tested for HIV in 2021 than in 2019, and research shows that 57% of people have waited more than 12 weeks for PrEP.

Shockingly, in 2021, no local authority in England—not one—reported more than five women accessing PrEP, and there are still stark racial disparities in treatment and in support that must be addressed. I wish to use this debate to press the Minister on what steps the Government are taking to tackle unequal access to sexual health services and, in particular, to PrEP.

In a recent study, 40% of people surveyed reported difficulty in booking a sexual health appointment online; 23% of people were turned away due to a lack of available appointments. With that in mind, what assessment have the Government made of sexual health accessibility levels, and what consideration has the Minister made of making PrEP available beyond sexual health services—for example in GPs, gender clinics, pharmacies and abortion clinics? I assume that that work would be included in the promised PrEP action plan, but that has yet to materialise. Will the Minister commit to an implementation date for this plan today, and if not, why not? Furthermore, what recent assessment has the Minister made of the eligibility criteria for PrEP, and are there any plans to expand it?

PrEP is one side of the coin, but we do not often talk about the other side anymore—partly because of the success of PrEP—and that is access to post-exposure prophylaxis. The publicity has fallen for that, but it is still an important tool in the box for people who are fearing that they may have been inadvertently exposed to the HIV virus. There is a small window for those people who fear that they may have been exposed, or who have been exposed to HIV, to get access to PrEP for it to be successful. What are the Government doing to ensure that there is adequate advice and information on the availability of post-exposure prophylaxis?

Sexual health services are under unprecedented pressure due to mpox. Service displacement means that appointments for PrEP, STI testing and long-active, reversible contraceptives have been cut. That has also led to reported hesitancy by clinics to deliver mpox vaccines. What action will the Minister take to ensure that all those who need the mpox vaccine can access one, and not to the detriment of other vital sexual health services?

Moving to testing, the Minister will no doubt be aware that yesterday, NHS England released its report on HIV and hepatitis opt-out testing in areas of very high prevalence. Labour has been proud to support that for several years. The report shows that because of the tests, more than 800 people living with undiagnosed HIV and hepatitis have been identified in these areas. We have saved an estimated £6 million to £8 million on treatment costs. Put simply, opt-out testing has been a huge success. With that in mind, can the Minister set out whether there are any plans to change the current scope of HIV opt-out testing to include all areas of high prevalence?

Finally, I want to touch on stigma. A study recently published by the Terrence Higgins Trust found that just 38% of people knew that those living with HIV and on effective treatment cannot pass the virus on to partners. Only 30% of people said that they would be comfortable dating somebody with HIV. The HIV epidemic is exacerbated by stigma, ignorance and misinformation. If we want equitable access to HIV treatment, we must proactively tackle the myths and bigotry that still permeate discussions around HIV. I am sure that the Minister will agree wholeheartedly with me about that.

I would be interested to hear the Minister’s assessment of current legislative barriers affecting those living with HIV. A clear example is the fact that LGBT+ people with HIV are still not allowed to access fertility treatment, despite the fact that heterosexual people with HIV are able to do so. That is an out-of-date barrier and it needs scrapping. I am proud that the next Labour Government will equalise access to fertility treatment for LGBT+ people living with HIV. Will the Minister join us in committing to that, and pledge to introduce legislation now—before the general election—to end the restrictions that prevent people with HIV from starting a family?

Labour is committed to the HIV 2030 pledge. It is more than prepared to work on a cross-party basis to make this ambition a reality. But we must address some incredibly concerning trends in HIV treatment and access, and not become complacent because of the progress that has come before us. No new transmissions of HIV by 2030 is still possible. We want to succeed, but there is no time to waste. As my hon. Friend the Member for Brighton, Kemptown said, let us all, together, sprint to that finish line.

The hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) talked about some important lessons that we can learn. We are keen to learn across the UK about the rollout of PrEP in Scotland. On the roll-out of our world-leading vaccination campaign against mpox—one of many issues raised by the hon. Member for Denton and Reddish (Andrew Gwynne) in his speech—we are talking to that relatively small number of clinics that have had to deliver the huge majority of the campaign about its impact financially and on their day-to-day work.

World AIDS Day is an invitation to underline our commitment to tackling HIV, to show our support for people living with HIV and to remember those we have lost to AIDS. I am proud of how far we have come: from the stigma and the sidelining of the past, which a number of Members have mentioned, to where we are today thanks to collaborative efforts and the commitment of the Government, together with HIV patients, their friends and family, campaigners, medics, researchers and the health and care system at all levels.

Today, when diagnosed early and with access to antiretroviral therapy, most people living with HIV in England can expect a near-normal life expectancy. People diagnosed with HIV can expect to receive world-class, free and open-access HIV care. That has been a result of our collective and collaborative partnerships. However, despite successes, HIV has not gone away. There is still more that we should do. That is why last year, this Government published their commitment to end new HIV transmissions in England by 2030 through the HIV action plan. That plan is the cornerstone of our approach in England to drive forward progress and achieve our bold ambitions.

We have come far in the first year since its publication. The UK met the UNAIDS 95-95-95 targets for the first time in 2020: 95% of HIV-positive individuals were diagnosed; 99% of those diagnosed were receiving treatment; and 97% of those receiving treatment were being virally suppressed. I am pleased that the number of people being newly diagnosed with HIV in England continues to fall. The latest data on HIV diagnoses shows that 2,955 people were diagnosed with HIV in England in 2021—a 33% decline compared with 2019, when the Government first made their commitment to end all new HIV transmissions in England by 2030. We are conscious of the need to avoid flatlining or slowing the pace in any way. We are still understanding the impact of the covid pandemic and the things that happened during that period, but there has been progress.

Those successes have been underpinned by clear national leadership and strengthened partnership working. I am grateful to Professor Kevin Fenton, the Government’s chief adviser on HIV, who has been chairing the HIV action plan implementation steering group, involving the key partners in the delivery of the HIV action plan, including local government, the NHS, and our voluntary and community sector. The steering group has met quarterly throughout the year to monitor progress on our commitments and ensure that appropriate action was taken to keep us moving forward with our objectives. Within the remit of the group, they have established specific task and finish groups focusing on key priority areas for action, such as improving equity and access to HIV drug prevention—PrEP—and addressing workforce challenges, among others.

We are also thankful for the work of the UK Health Security Agency, which excels as a world-class leader running high-quality data collection and surveillance systems to help us to better understand and address the challenges on HIV. Those have enabled us to truly understand developments, emerging issues and where we can have the greatest impact with our prevention efforts, and add to our growing repertoire of world-leading British innovation, systems and technology.

Of course, none of this could have been possible without the brilliant efforts of our local government, NHS and voluntary and community sector partners to deliver the highest-quality healthcare tailored to the needs of their local populations. We know through their work that different areas face different challenges, and we remain committed to helping level up outcomes for the whole population across the country.

A key priority, therefore, of the Government’s approach is to ensure that all under-served populations benefit equally from improvements in HIV outcomes. A range of important suggestions have been made in this debate about how to go further. The approach includes scaling up our prevention efforts and increasing access to PrEP. We have already invested £33 million to roll out PrEP access across sexual health services over the past two years. PrEP is now being commissioned as a routine service through the public health grant.

In delivering against these commitments, UKHSA has now developed and published a monitoring and evaluation framework to support local authorities, sexual health services and other key stakeholders to inform continuous service development in PrEP commissioning and delivery, using the existing available data. I am sure many of the people involved in delivery of those services will have followed this debate with great interest and noted some of the challenges posed by different hon. Members.

This approach is important to ensure everyone living with HIV can access testing and rapid linkage to treatment and care, allowing them to live a long and healthy life. Moreover, 325 people were newly identified with hepatitis B and 153 people were newly identified with chronic hepatitis C virus; a further 50 were found who had disengaged from care for both diseases and seven people were identified who had previously cleared the hepatitis C virus.

We will be considering the initial evidence from the first year of testing alongside the data on progress towards our ambitions to decide how and whether we further expand this programme. We are in the very early days of evidence on this, but I must say that evidence is extremely encouraging. I hear what hon. Members across the House are calling for, given the success of that programme in its first 100 days, but we need further evidence as it develops.

We redoubled our efforts to increase HIV testing throughout the country during National HIV Testing Week, which took place in February this year. Results are promising: 30% of the almost 25,000 users who ordered an HIV and syphilis self-sampling kit during the campaign had never tested before, and a majority of the campaign’s target audiences reported having taken some kind of preventative action as a result of the campaign.

We know there is still more we need to do to achieve our ambitions. The HIV action plan monitoring and evaluation framework developed by UKHSA, published today, will explore in detail the inequalities and gaps in HIV prevention, testing and care and other indicators of the progress required to achieve our shared ambitions and will help inform our progress. Our actions continue to be closely monitored by the HIV action plan implementation steering group, which includes key delivery partners such as local government, the NHS and the voluntary and community sector, to ensure we remain on track to meet the 2025 and 2030 objectives. The Secretary of State will report annually to Parliament on progress towards our objectives.

World Aids Day gives us the chance to reflect on progress and challenges, being accountable for what we have done over the past year and where we need to continue improving. But, most importantly, it gives us the possibility of coming together to restate our collective commitment to continue working together to end new HIV transmissions in England by 2030 and to finish the race.

That this House has considered World AIDS Day.