London should have free at-home HIV testing, says Assembly

Remarkable progress has been made in London and across the UK in reducing transmission of HIV and improving outcomes for those with the virus.

Today the Assembly agreed a motion asking the Mayor to make more progress to achieve London’s ambitious HIV and AIDS reduction targets.

Krupesh Hirani AM, who proposed the motion said:

“In London we have made significant strides to tackle HIV and AIDS with a view to ending new transmissions by 2030.

“Much hard work has gone into achieving the current high rates of diagnosis and treatment and I fully back the eradication goal, it is achievable.

“However, there is still a way to go, London still has higher than average rates.

“I support opt-out HIV testing in the NHS and I am calling for the GLA to promote the importance of testing and diagnosis. Together, we can end new transmissions in London.“

The full text of the motion is:

The Assembly fully supports World AIDS Day and the objectives of the National HIV Action Plan 2021-25.

The Assembly supports the Mayor’s ambition to eliminate new transmission of HIV in London by 2030. As part of this, we note the remarkable progress which has been made in our city and across the UK in reducing transmission of HIV and improving outcomes for those with the virus.

New diagnoses are decreasing more rapidly in London than in the rest of the UK. Life expectancy for those living with HIV is now near that of the general population. Currently, 95% of people living with HIV infection are diagnosed, 98% of people diagnosed receiving treatment, and 97% of people receiving treatment being virally suppressed. This far exceeds the UN’s 90:90:90 target.

Those lost to the care of a HIV clinic increased by 20% during covid-19 and is yet to decrease significantly. Identifying those lost to care and ensuring they are re-engaged needs to be a priority and commissioners need to ensure they are contracting their work and resourcing it adequately.

However, London still has higher-than-average rates of HIV, accounting for 41.8% of England’s HIV-positive population. There are also large disparities between groups, with gay & bisexual men, and those of Black African ethnicity disproportionately represented among the HIV-positive population. Black Africans are also more likely to be diagnosed late – 47% of diagnoses among this group are made at a late stage versus 39% for white people.

Late diagnoses can result in a ten-year lower life expectancy compared with those diagnosed early.

Therefore, more progress still needs to be done to achieve London’s ambitious targets and we call on the Mayor to take the following actions:

• Work with London boroughs so all Londoners can access free at-home HIV testing;
• Support opt-out HIV testing across the NHS. Many parts of London are areas of high HIV prevalence and HIV testing should be routinely offered to patients in relevant settings, such as GP surgeries, A&E departments and in all sexual health clinics; and
• Use all GLA resources to promote the importance of testing and early diagnosis, particularly among at-risk groups, and to fight HIV stigma; and
• That the Mayor as the Chair of TfL makes free space available on TfL assets for HIV and Aids awareness campaigns from the Terrence Higgins Trust and London Borough led “Do it London”.