Testing, testing and more testing

Dame Inga Beale

Chair, HIV Commission

The Commission was established by leading HIV charities (Terrence Higgins Trust, National AIDS Trust and Elton John AIDS Foundation).

Over the last 40 years, HIV has killed millions and shattered lives. In many countries the death toll tragically continues to rise today. In England there’s the very real opportunity to be the first in the world to end new cases – why wouldn’t we grab it?

Having lived through the trauma HIV caused in the 1980s, I know there has been real progress in treatment and outcomes since then.

But I didn’t know the sheer extent of the progress. I didn’t know you can test at home and get a result within 15 minutes or there is a pill you can take daily to protect against HIV. I didn’t know a quarter of new HIV diagnoses every year in the UK are among women. I didn’t know that more than four in 10 people are still diagnosed late. I certainly didn’t know that effective treatment supresses the virus to such an extent that it can’t be passed on to partners. 

Ending HIV transmission in England

It has been my privilege to learn this as Chair of the first ever HIV Commission. Just over a year ago, my fellow commissioners and I were tasked with answering one rather daunting question: ‘How can we end HIV transmissions in England by 2030?’. Now, on World AIDS Day, filled with passion and ambition, we’re setting out our vision.

Despite all the laudable progress made, England is not yet on track to meet the 2030 goal. That’s unacceptable when we have the necessary tools to ensure no one else acquires HIV but are under-utilising them. Ultimately that’s what this is all about: the human cost of missing this target.

Increased testing within NHS

The key message from our HIV Commission is testing, testing and more testing, in order to find the estimated 5,900 undiagnosed people living with HIV in England.

When you register with a GP, go to A&E or have blood taken anywhere in the NHS, there must be an offer of an opt-out, not opt-in, HIV test. Failure to make this change is a missed opportunity to diagnose every case of HIV.

Maternity services show how transformative this approach to testing is, with near complete elimination of babies being born with HIV. HIV testing is mainstream in maternity units, where midwives handle the associated issues with care and consideration and, critically, without judgement. The rest of the NHS must follow their example.

Now it’s over to government to ensure England consolidates its place as a leader in the fight against HIV. It must use our recommendations as a springboard for its own HIV action plan to see the country become the first in the world to end new cases by 2030. In a year that’s often felt hopeless, what a message of hope that would be.