World AIDS Day

15 December 2009

Following a series of meetings which Gavin Strang attended this month focussed on World AIDS Day (1 December), he has called for more determined action to tackle the epidemic in the UK.

Gavin Strang, who was the architect of the AIDS (Control) Act, said:

Sex is now the most common route of HIV transmission in Scotland.  

If you become infected in Scotland, it is most likely that you are a man who has been exposed to the virus through sex with another man.   There is also a significant number of people who have been infected through heterosexual sex, most often abroad, and there is evidence of growing transmission amongst a small number of Africans in Scotland.  

In the 1980s, we had a terrible epidemic among people who injected drugs.   By 1988, around two thirds of Edinburgh’s drug users were HIV positive.   A great deal was done to stop the spread of the virus, and the number of new diagnoses among drug users has been low for many years now.   But the risk to Scotland’s drug users has by no means disappeared - more than one in eight are injecting with used needles and syringes.

Just as Scotland’s epidemic has changed, living with HIV has also been revolutionised.   A positive HIV test was once a death sentence.   Successful treatment means that nowadays, people diagnosed with HIV can go on to live normal lives.  

There is still no vaccine, however, and nor is there a cure.   People who are on HIV treatment are on it for the rest of their lives.  

There is a lot to be done.

We must step up our prevention work.   We know that many gay men are putting themselves at great risk of infection.   Prevention efforts must be effectively targeted – at the groups most at risk, and at people with HIV.   The Health Protection Agency estimates that preventing the 3,550 HIV infections probably acquired in the UK that were diagnosed last year would have saved more than £1.1 billion.  

We must also make it easy and normal for people to take an HIV test.   Across the UK, more than a quarter of people infected with HIV have not been diagnosed.    A Scottish Executive policy change in 2005 led to a welcome increase in testing, but many people remain unaware that they are infected.  

This is important.   The sooner people are diagnosed and start treatment, the more successful the therapy is likely to be.   A third of new HIV diagnoses in the UK last year were made so late that the individuals had a significant risk of developing an AIDS-defining illness.

And the sooner individuals are diagnosed, the sooner they can prevent any HIV risk to other people – by avoiding risky behaviour, and through treatment which lowers the amount of the virus they carry.

Finally, we must tackle the stigma which blights the lives of people living with HIV and hinders prevention efforts.

It is just not good enough that hundreds of people are still being diagnosed HIV positive in Scotland every year.