• ‘Beyond the Virus’ report released today
• Report by HIV Outcomes UK, a partnership convened by National AIDS Trust
• Highlights critical actions the Scottish Government can take to address the mental health needs of people living with HIV and advance its HIV and mental health strategies
• Government ministers, MSPs and leaders in the Scottish HIV response coming together in Edinburgh on 6 November to discuss action

A new report, ‘Beyond the Virus: Prioritising mental health for people living with HIV in Scotland’, has uncovered critical gaps in mental health care for people living with HIV across Scotland, and highlights urgent actions needed by the Scottish Government. 

Two in five people living with HIV in the UK have a diagnosed mental health condition, and all too many are still being left without adequate support. Current gaps in psychological support are getting in the way of Scotland’s goal to end new HIV transmissions by 2030. It is estimated that mental health issues are believed to cost Scotland at least £8.8 billion a year, and studies have shown that each pound invested in mental health services will yield up to a fourfold return. Investment in mental health services is highly cost-effective but despite this, the Scottish Government’s August emergency budget saw a further £19 million cut from national mental health spending. The Royal College of Psychiatrists has warned that mental health services in Scotland are at breaking point. 

People living with HIV face elevated risk of mental ill health, so strengthening mental health services for people living with HIV must be a public health priority. Investing in services can help to reduce overall healthcare costs, improve treatment adherence, prevent HIV transmissions, and enhance the quality of life for people living with HIV.

‘Beyond the Virus’ shows why it is vital for Government and NHS Board action to prioritise mental health for people living with HIV. It presents a cost-effective, actionable framework for the Scottish Government to deliver integrated HIV and mental health care, aligning with its commitment to world-leading mental health services. 

Impactful case studies, such as NHS Lothian’s integrated HIV psychology services and Terrence Higgins Trust (THT)’s Peer Support Scotland initiative, give a powerful insight into the positive impact that a holistic, person-centred approach to HIV care can make.

The report is being launched in Edinburgh on 6 November, at an event bringing together key leaders in the Scottish HIV response, including Jenni Minto MSP (Minister for Public Health), Paul O’Kane MSP (Scottish Labour Spokesperson on Equalities), Dr Sandesh Gulhane MSP (Shadow Cabinet Secretary for Health and Social Care), Dr. Bridie Howe (HIV Lead, NHS Highland), Grant Sugden (CEO, Waverley Care) and Stephen Duffy (HIV activist and musician). The report highlights three key areas that need further action:

1: Ensure access to mental health and wellbeing services for people living with HIV

The availability of comprehensive mental health support and treatment for people living with HIV in Scotland is a postcode lottery, with particular barriers to care in remote and rural communities. The Scottish Government must better integrate mental health into its HIV strategy and services. The Government should work to ensure services meet the British HIV Association Standards on psychological support for adults living with HIV, including embedding specialist mental health care in HIV clinics, and optimising pathways for referral between HIV clinics and mental health services

2: Tackle stigma and discrimination

HIV stigma significantly impacts the mental health for people living with the virus and contributes to reduced healthcare access. The Scottish Parliament’s Equalities Committee recently highlighted that discrimination is still prevalent across Scotland’s healthcare settings, and intersecting inequalities that communities face. The Scottish Government must work to improve HIV literacy in health sectors and support laws, policies, public education campaigns and services that tackle HIV stigma discrimination

3: Increase access to HIV peer support

Voluntary sector HIV support services are a lifeline to many people with HIV. Peer support - delivered by trained people living with HIV - is a cost-effective approach to improving mental health and reducing stigma. Scotland has several successful peer-support services but the voluntary sector is facing significant resource constraints. To fully unlock the benefits that HIV peer support can have, the Government must ensure people can access peer support, wherever they live in Scotland.

James Cole, Senior Policy, Research and Influencing Manager at National AIDS Trust, says:

“To achieve Scotland’s 2030 HIV targets, the Scottish Government should integrate mental health into every aspect of its HIV response. People living with HIV experience mental health challenges at higher rates, yet too many face a postcode lottery for support. Scotland can achieve its vision of world-leading mental health support with the right leadership, investments and partnerships in place.

“The ‘Beyond the Virus’ report highlights a clear, cost-effective path forward: ensure people living with HIV can access to mental health services, expand peer support, and tackle HIV stigma head-on. With these investment, Scotland can support people to live well with HIV and drive action to end new HIV cases.”

Dr Nicoletta Policek co-chair HIV Outcomes UK, adds:

“The ‘postcode lottery’ for mental health support, care and treatment for people in Scotland living with HIV is a significant barrier, which compounds societal inequalities that already exist, affecting marginalised communities. By addressing this, and the intersecting inequalities faced by communities living with HIV, that compound the discrimination which is sadly still present in Scottish healthcare provision, we can make sure that Scotland can achieve its vision of world-leading mental health support, which is so important for people living with HIV.

Grant Sugden, Chief Executive, Waverley Care, continues:

“This report shines a much-needed light on the pressing gaps in mental health support for people living with HIV across Scotland.

“To bridge these gaps, it's essential that services such as peer support, where individuals with lived experience can share guidance and understanding, are accessible to all who need them.

“At Waverley Care, we have seen firsthand the transformative impact of peer support on mental health and wellbeing. However, without sustained government funding for these vital services, there is a real risk that people living with HIV will continue to experience disproportionately high rates of mental health problems.”

Commenting Scottish Labour MSP for West Scotland Region Paul O’Kane says:

“This report is an important piece of work that lays bare the great need for investment in mental health support for people living with HIV and of course the need to tackle stigma surrounding HIV.

“I am looking forward to speaking at the HIV Outcomes event in the Scottish Parliament where the priorities of getting to zero transmissions, improving investment in mental health services and eradicating HIV stigma will be discussed and raised in front of the Minister for Public Health.”