This week, to mark HIV Testing Week, Bristol has continued to lobby the Government for more support to continue our work to end new transmissions of HIV by 2030.
With Councillor Ellie King, Cabinet Member for Public Health, I wrote to the Health and Social Care Secretary to call for opt-out testing in hospitals in our city to help diagnose people who unknowingly have HIV.
Read my letter to the Health and Social Care Secretary here, or scroll down for the plain text version.
Dear Secretary of State,
Like the Department of Health and Social Care, Bristol is committed to ending new cases of HIV by 2030 and contributing to the national effort to reach the 4,660 undiagnosed people living with HIV in England. This is why we welcome the Government’s HIV Action Plan and the £20 million being made available by NHS England for opt-out testing in very high prevalence HIV areas.
However, as a local authority with high HIV prevalence, we are concerned that funding opt-out testing only in “very high” prevalence areas is a missed opportunity. To meet the 2030 goal, and the Action Plan’s interim target of an 80 percent reduction in new diagnosis by 2025, the same kind of opt-out testing will be needed in hospitals here in Bristol too.
With those undiagnosed being twice as likely to live outside London, areas like Bristol are the new frontline in the quest for everyone to know their status. We are a Fast Track City, and we have been working with our local NHS partners, and both of our city’s hospitals are supportive of an opt out testing approach. However, we have no identified funding to roll out this approach. It is, therefore, vital that the DHSC and NHS England become a funding partner to make this happen and provide equity across all parts of the country.
Opt-out testing works, is cost effective, has been recommended by the British HIV Association and British Association of HIV and Sexual Health since 2016, and is included within current NICE guidelines on HIV testing. It is proven to find those with traditionally the worst HIV outcomes: people of Black African heritage, women and older people. More than two in five (42%) people diagnosed with HIV in England continue to get their diagnosis at a late stage – this can have serious consequences for their own health and the health of others through unknowingly passing on the virus. These populations experience some of the highest rates of late diagnosis.
Anyone with undiagnosed HIV leaving A&E without knowing their status is a missed opportunity and likely means they will present with a HIV complication at a later date and add additional cost to the system. The HIV Commission – which the government promised to implement – made this its flagship recommendation.
This National HIV Testing Week we are reminded of the need to level up our HIV ambition and testing infrastructure. There is much we can learn from successful HIV interventions in London, but we will only meet the 2030 goal as one country. Just funding opt-out testing in the very highest prevalence areas will not end new HIV transmissions, and we urge the government to consider funding areas like Bristol to reduce stigma, and ensure that we can support everyone living with HIV in Bristol.
Delivering funding by World Aids Day 2022 would help us get opt-out testing in Bristol hospitals up and running as soon as possible. There can be no further delay.
Yours sincerely,
Marvin Rees, Mayor of Bristol
Councillor Ellie King, Cabinet Member for Public Health, Communities and Bristol One City