Here’s a summary of what we achieved in 2018:
- We launched a major report on women and HIV with Sophia Forum.
- We stepped up our campaigns to ensure more people can access PrEP, both through the capped trial in England, resulting in an additional 3,000 places, and by working to increase uptake of the uncapped PrEP study in Wales.
- In Wales, we have kept up the pressure to ensure that progress is made on the recommendations of the national review of sexual health.
- We helped shape the first guidance on sex education in nearly 20 years, ensuring compulsory lessons in England are LGBT-inclusive and have a strong focus on HIV and sexual health. In Wales, we secured a win with the Welsh Government confirming Relationships and Sexuality Education will be a mandatory part of the new curriculum.
- We had two big wins on HPV vaccines, for boys and the roll-out of a programme for gay and bisexual men in England.
Access to PrEP
PrEP was a big part of our work throughout 2018.
In England, we marked one year since the start of the PrEP Impact Trial. We campaigned with other HIV and sexual health organisations to increase the number of places on the trial from the original 10,000. In September we had a small victory when the trial added an additional 3,000 places to help meet the demand there had been among gay and bisexual men.
We knew that this small uplift would simply not meet demand. That’s why in the summer we worked to bring together over 30 organisations to call on NHS England and local authorities to make PrEP routinely available by April 2019 [PDF].
n December, we worked with a cross-party group of MPs and Peers to send an open letter to the UK Government urging immediate action to avoid a cliff-edge scenario with places for gay and bisexual men likely to be full by early 2019.
It’s a different story in Wales where an uncapped study has been running since June 2017, allowing anyone who is eligible to access PrEP. This doesn’t mean, however, that there aren’t issues.
We learned this year that an alarming proportion of people who are eligible for PrEP decline it. Many state that they don’t see themselves as being at risk, while others give no reason at all. This urgently needs to be addressed and, as part of the PrEP steering group, we will contribute to a forthcoming research study into this.
There are also gaps in demographic data that mean we can’t be certain if the study is reaching everyone who could benefit from PrEP. This year, we have been pushing for better data collection and continuing to argue for a targeted promotion campaign to ensure that the message about PrEP reaches groups who might not otherwise engage with sexual health services.
Road to compulsory Relationships and Sex Education
2018 was a real milestone on sex education in England and Wales.
After nearly 20 years, new guidance was published that will be used by schools to deliver new compulsory Relationships & Sex Education lessons in England from 2020. As we always have done, we put the voices of young people at the heart of our response to the guidance by training three young peer researchers to lead on engagement workshops.
The young people we spoke to said they want lessons to be LGBT-inclusive, have a strong focus on sexual health and have a regular fixed slot in the school timetable. We fed this back to the Department in our consultation response [PDF], as well as criticising the weak focus on HIV and that no funding had been agreed for teacher training and resources.
In May, the Welsh Government confirmed that LGBT-inclusive Relationships and Sexuality Education will be a compulsory part of the new curriculum, due to be rolled out from 2020. There will be training for teachers and in the longer term a new professional pathway for RSE will be developed. In the meantime, guidance for existing RSE provision will be updated.
We contributed to draft lesson plans to be used within the current curriculum and will ensure that we contribute fully to the process for developing content for the new curriculum.
HPV vaccine campaign victory
After years of campaigning, the UK and Welsh Governments finally announced they would extend the HPV vaccine to boys from September 2019.
However, the Department for Health and Social Care has stated it will not be introducing a catch-up vaccine programme for boys up to 18 years old – despite girls having access to the vaccine up to this age. Instead, only boys aged 12 and 13 will get the vaccine. The Welsh Government has not yet confirmed its position on this.
We will continue to press the UK and Welsh governments to agree to a catch-up programme as a matter of urgency.
April also saw the start of a HPV vaccine programme for gay and bisexual men in England, following a year-long pilot. Roll-out of the vaccine has been slow and uptake has been variable, with more work needing to be done to guarantee access and encourage uptake among gay and bisexual men to this potentially life-saving vaccine.
Funding for sexual health services
Sexual health services across England continue to face cuts to public health spending, with demand already outstripping supply. There have also been reports of people who have symptomatic sexually transmitted infections (STIs) being turned away from clinics.
Throughout 2018, we have worked in partnership with the wider HIV and sexual health sector and with local authorities, to make the case on why investment in sexual health [PDF] is so important. We engaged Parliamentarians and Ministers on the impact of these cuts and held events and meetings in Parliament to raise our concerns.
Properly funded sexual health services form the backbone of HIV prevention and are therefore absolutely crucial if we are to achieve the ambition of zero new HIV infections and tackle the spiralling rates of STIs including gonorrhoea and syphilis, which have increased by 20% in a year.
Championing HIV and sexual health in Parliament
Working with Parliamentarians and Welsh Assembly Members is a crucial way for us to create real change in HIV and sexual health policies. We attended the major party conferences and hosted events throughout the year in Parliament and the Assembly.
During National HIV Testing Week, Matt Hancock MP, Secretary of State for Health & Social Care, became the first Health Secretary in a long time to have an HIV test.
2018 also saw a first: Lloyd Russell Moyle made history and helped to change attitudes across the entire country as the first MP to disclose their HIV status in the House of Commons Chamber.
2018 will be remembered as a key juncture in the work to end new HIV transmissions, with the UK as a whole meeting the UNAIDS 90-90-90 targets.
Wales became the first part of the UK to commit to zero new infections by 2030, with the Health Secretary announcing the target at our World AIDS Day event. The UK Government has yet to step up to the plate, but Ministers have made encouraging comments in Parliament, recognising the need to reach zero new infections. We continue to pressure them for both a commitment and a timetable.
Despite a backdrop of spending pressures and a turbulent political environment, we have made some real progress in both HIV and sexual health.
We would like to thank all of the individuals and organisations that have helped us to make this happen. We will start 2019 as we did in 2018, ready to demand more and secure greater progress.
- Liam Beattie is Campaigns & Parliamentary Officer at Terrence Higgins Trust.
- Ceri Dunstan is Campaigns & Policy Officer at Terrence Higgins Trust.