Wales has made strides in the HIV response, with significant drops in new diagnoses and a bold commitment to end new transmissions by 2030. However, supporting people living with HIV to live well is an ongoing challenge. Dr Alessandro Ceccarelli, one of the co-founders of the Fast Track Cymru initiative and a Trustee at National AIDS Trust, reflects on the progress made so far - and the crucial steps needed to ensure all individuals living with HIV can thrive.

The Living Well with HIV in Wales report highlights areas where action is still needed. What inspired you and your colleagues to focus on these three areas?

The Welsh Government has made great progress with its HIV Action Plan for Wales, but as we approach the mid-point of the delivery window, we are aware that some priorities, particularly those relating to the quality of life for people living with HIV, are in need of further attention. Mental health services are a huge gap - almost two in five people living with HIV say that they are also living with at least one mental health condition, and many still don’t receive the right support. The same goes for ageing - half of the people living with HIV in the UK are over 50, and services haven’t adapted to meet their often more complex needs. Tackling health inequalities and discrimination, especially for under-served communities, is also key to ensuring no one is left behind.

Mental health and wellbeing seem to be a significant focus of the report. Why do you think this area is so critical to address in Wales?

Investing resources in mental health is fundamental. If we don't address the psychological, social, and emotional needs of people living with HIV, it affects everything - from ensuring people continue their treatment, to their overall quality of life. For example, we need sustainable funding for peer support networks, which have proven to be life-changing for many. But we also need to ensure HIV services meet the highest standards, like those set by the British HIV Association. This will create a holistic care approach that prioritises community support and mental health just as much as physical health.

Let’s talk about ageing with HIV. The report mentions that over half of those living with HIV in the UK are now over 50. What are the unique challenges this community faces?

Ageing with HIV presents new challenges, often because people are dealing with multiple health conditions - HIV being just one of them. We hear stories of loneliness, as older people living with HIV often feel isolated. Our services need to catch up with these realities. For example, expanding training for NHS staff is essential, so they’re equipped to deliver person-centred care. Sexual Health Wales recently published some educational videos and animations for GPs and healthcare professionals, which I highly recommend watching and sharing. Initiatives like the HIV GP Champion programme have been successful, but we need to scale up these efforts across regions and health board areas to support older people properly.

Inequalities in HIV prevention and treatment have been a long-standing issue. How does this report address these barriers?

It’s unacceptable that some communities in Wales still struggle to access HIV care due to factors like living in a rural area, socio-economic barriers, or discrimination based on their background or characteristics. The report is clear: we need to involve community-led organisations based in Wales in the development of HIV services. They have a deep understanding of the barriers some people face and can offer tailored support that resonates with those under-served populations. For example, the Welsh Government could prioritise forms of support towards initiatives and interventions that combat HIV stigma, such as the Stop HIV Stigma campaign promoted by Fast Track Cymru - this is fundamental to ensuring equal access to prevention and treatment services for all. Another great example is the HIV Confident Charter, that is helping employers and organisations become more inclusive and welcoming, including in Wales.

What do you hope to see from the Welsh Government in the next year following this report?

I hope to see a commitment to continue to deliver the goals of the HIV Action Plan for Wales beyond the end of this Senedd term in 2026. That would offer a more realistic approach to delivery timelines and funding. And I hope to see a renewed commitment to the Living Well with HIV priority. There needs to be stronger investment in mental health services, expanded support for ageing communities, and concrete actions to end health inequalities. By addressing these issues, we can create an environment where people living with HIV in Wales don’t just survive - they thrive. I’m optimistic that with continued collaboration between organisations like Fast Track Cymru and the National AIDS Trust, alongside bold leadership from the Welsh Government, we will achieve this.

It’s clear that with the right support, we can make lasting changes to HIV care and outcomes. Any final thoughts you’d like to share?

As Wales continues its journey towards ending new HIV transmissions by 2030, initiatives like HIV Outcomes and reports like Living Well with HIV in Wales serve as crucial reminders that care doesn’t stop at prevention. Medical advancements are crucial to ending HIV, but the strength of communities, peer support, and mental health services will also be key to saving lives. With a person-centred approach, all people living with HIV in Wales can lead even more fulfilling lives.