Cuts to sexual health clinics across England are raising concerns about the possibility of meeting the national goal to eliminate new HIV cases by 2030. A recent report by the London Assembly Health Committee highlights a significant rise in new HIV diagnoses, with 6,008 new cases reported in 2023—nearly double the 3,859 cases recorded in 2019. This increase marks a reversal of previous downward trends in new HIV infections.
Much of the rise is attributed to expanded HIV testing in emergency departments; however, even excluding these figures, new cases have still increased. The report underscores the critical role that publicly funded health services and targeted outreach programmes play in identifying and supporting at-risk populations.
Krupesh Hirani, chair of the London Assembly Health Committee and Labour politician, told The Independent that protecting public health budgets is essential for reaching the 2030 target. He stated: “The importance of testing with HIV is well documented and well evidenced and the obvious outcome and benefit of testing is to make sure we identify people who may be living with HIV but also it will help if people know what their status is in terms of what action they can take.”
Richard Angell, chief executive of the Terrence Higgins Trust, a leading HIV charity, emphasised the severity of funding cuts on services. “The committee’s findings are clear: we are not currently on track to end new HIV cases in London - or in fact anywhere in the UK. Years of real-terms cuts to public health has meant long waiting lists to access pre-exposure prophylaxis (the treatment drug PrEP) in many places and intense pressure on sexual health services,” he said.
The report makes several recommendations aimed at addressing these challenges. These include urging London Mayor Sadiq Khan to petition the health secretary, Wes Streeting, for an increase in the public health grant to 2015 levels by 2029, adjusted for inflation. It also recommends expanding HIV testing services to other healthcare settings such as GP surgeries, and calls for the Department of Health and Social Care to enable the distribution of PrEP medication through pharmacies.
Kat Smithson, chief executive of the British Association for Sexual Health and HIV, reiterated the interconnected nature of HIV and broader sexual health services, warning of increasing sexual health issues and overstretched clinics. She told the committee: “When you look at the situation with sexual health and you consider that you cannot completely separate sexual health and HIV, and you look at rising STIs and you look at the pressure on sexual health services, I think it is impossible to say that we are on track to reach 2030.”
Alison Brown, a consultant scientist at the UK Health Security Agency, noted that another government target to reduce new HIV infections in England by 80 per cent by 2025 also appears unlikely to be met.
Personal testimonies included that of Joe Mejia, 39, who was diagnosed with HIV in Colombia in 2008 and later moved to the UK. Now serving as a London HIV Ambassador for the Terrence Higgins Trust, Mr Mejia highlighted the importance of testing and culturally sensitive services. “A lot of us [living with HIV] probably wouldn’t know their status if it weren’t because of a testing effort put somewhere. In my case, it was a primary care setting, and to this day, I’m really thankful for that test because if I hadn’t had it, I probably wouldn’t know my status, I probably wouldn’t be alive,” he said.
Mr Mejia further expressed concern over the erosion of specialised services catering to specific ethnic communities. “When I came here there were a couple of services for Latin American communities—many of them don’t exist anymore, and many of them don’t exist anymore not because the community isn’t there or the diagnosis rate changed but they don’t exist because there is no particular funding for those services,” he explained. He added that services for Black African and Caribbean communities are similarly underfunded and operating at minimal capacity.
A spokesperson for Mayor Sadiq Khan said, “The current government has committed to commissioning a new HIV action plan, and the mayor looks forward to working closely with ministers to help end HIV cases by 2030, as we build a fairer and healthier London for everyone. The mayor will respond to the Assembly’s report in due course.”
The Independent is reporting on the ongoing challenges faced by public health services in their efforts to reduce HIV transmission, highlighting concerns that continued budget cuts could undermine national targets for HIV elimination.
Source: Noah Wire Services