HIV prevention – underfunded and deprioritised.
Not enough money is being spent on HIV prevention to have any impact on the rate of new HIV infections, a report by the NAT (National AIDS Trust) has found.
NAT estimates in 2014/15 that £15 million was spent nationally on HIV prevention compared with £55 million allocated in 2001/02. In this time the number of people living with HIV has trebled whilst the amount spent on prevention has decreased to less than a third of the original budget.
This estimate is based on information provided to NAT from local authorities in England with a high prevalence of HIV. £10 million was spent in 2014/15 on HIV prevention in these areas – this works out at only 70p per person.
The report found that in local authorities with high prevalence of HIV less than 1% of local authority public health allocation is spent on HIV prevention. In 2013 the NHS spent 55 times more on HIV treatment and care in these areas than local authorities spent on HIV prevention.
The lifetime costs of HIV treatment and care for someone with HIV is £361,000.
Deborah Gold, chief executive of the NAT, said: “Our research found, shockingly, in the 58 areas of highest prevalence of HIV in England, seven local authorities weren’t spending anything on primary HIV prevention or on additional testing services[i]. Worryingly we also found no correlation between level of HIV prevalence in an area and how much was being spent on prevention. There are massive inconstancies between regions and areas, creating a postcode lottery of HIV provision.”
"Testing for HIV is an important prevention intervention as we know that up to 80% of people get HIV from someone who doesn’t know they have it. Worryingly 35 out of 58 local authorities were not investing anything in HIV testing outside sexual health clinics in 2014-15. This is despite NICE guidelines clearly stating they should be offering tests in GPs surgeries, hospitals and community settings in order to have any hope of reducing the number of people with undiagnosed HIV, and further transmissions, in their areas.”
The HIV charity is also concerned that more problems are on the horizon when the ring-fencing for the public health budget is removed. Currently, local authorities are given money to provide basic services such as sexual health clinics. In April 2016 they will be able to spend this money on anything. Gold continues: ”In the current climate of cuts and pressure on budgets we are extremely worried this money will be used to shore up other areas of council spend. This would be a disaster for public health in this country.”
The National AIDS Trust is now calling on local and national government to address this funding gap, maintain the public health ring-fencing and prioritise HIV prevention and testing services.
[i] Four of these local authorities were in London and contributed to the London-wide programme.