Introducing the HIV Commission to mark World AIDS Day

Introducing the HIV Commission to mark World AIDS Day: Kat Smithson is director of policy at the National AIDS Trust which worked in partnership with the Terrence Higgins Trust and the Elton John AIDS Foundation to jointly establish the independent HIV Commission.

To mark World AIDS Day, and the release of the HIV Commission’s first report, she outlines the challenges arising from the COVID-19 pandemic and how it has affected their stated goal of ending HIV transmission by 2030.

In many ways the COVID-19 pandemic has changed everything but in some ways it changed nothing. Many of our priorities are the same. The goal of ending HIV transmission by 2030 is just as relevant and important as before, and COVID-19 has exacerbated inequalities in health that already existed and required action. In this context it’s even more important that the Government renews their commitment to ending HIV transmissions in England by 2030 and takes affirmative action. We urge them to respond positively to the new report outtoday. It shouldn’t be COVID-19 or HIV. A lot of inequalities that drive one health issue also drive another. There’s a huge opportunity for the Government now to end the negative impact of HIV on England. They must take it.

The impact of COVID-19 on HIV transmissions is yet to be seen but what we do know is that a lot of people have not been able to access essential services, or access them easily. Many sexual health clinics closed during the lockdown, operated online only, or used a telephone triage service. Staff were redeployed or worked with the limitations of ongoing social distancing measures. There were some walk-ins, but provision was highly limited and varied depending on your area.

It’s important to remember that while some people stopped having sex with people outside of their household in lockdown, or accessed HIV tests online, not everyone is in the position and empowered to do so or to negotiate safer sex. It’s already the case that there’s a lot of stigma for some in accessing sexual health  services, and this was worse in lockdown. As lockdown measures eased, services did not recover anywhere near in line with demand.

Unfortunately, all this may have threatened and even reversed some of our previous success to bring down HIV transmissions and diagnoses. Normally, we would have to wait until November 2021 to get the data from 2020. We hope that some data can be accessed earlier but we need to be careful that the data is full and accurate before drawing conclusions. It may be counterproductive to rush it.

In terms of our future priorities, mental health is going to be very high on the list for those working in HIV. People living with HIV and communities affected by it, for example LGBTQ people and migrants, were already  d disproportionately affected by poor mental health, including from social isolation. We need to ensure access to high quality specialist support services.

As the voluntary sector we also need to face the challenge of how the COVID-19 crisis hasimpacted on fundraising. Many of the usual opportunities we have to raise funds have been cut off and it is difficult for people to give who have their own financial concerns. There are lots of online initiatives but there is only so much you can do, and we thrive best when we can engage in person with our communities. We are working with our supporters to ensure that we can keep meeting the needs of those who need us most, but it will be hard.

There is so much work still to do and there will be a lot of people who live with HIV who will suffer longer lasting psychological and economic impact. Charities like ours are going to have to step up and try to do more with less to support our community and continue to work towards our goal of ending HIV transmissions within a decade.

We can do it. We have already made enormous progress and we know the barriers that remain and have set out through the HIV Commission how to overcome them. It’s achievable, but only with real political leadership and financial commitment.