Jason Warriner: Don't lose the momentum against HIV

To mark World AIDS Day, HIV nursing expert Jason Warriner celebrates the remarkable progress that's been achieved in the UK since the 1980s. The end of the HIV epidemic in sight - but only if we keep investing in prevention, testing and treatment

To mark World AIDS Day, HIV nursing expert Jason Warriner celebrates the remarkable progress that's been achieved in the UK since the 1980s. The end of the HIV epidemic is in sight - but only if we keep investing in prevention, testing and treatment

An HIV home screening test kit. Picture: Science Photo Library

The first global health day took place on 1 December 1988 with the launch of World AIDS Day. At a time when people were dying from AIDS-related illnesses and no effective treatment against HIV was available, the future looked bleak.

HIV was a death sentence for hundreds of people diagnosed with the virus, and fear and anxiety were high around the globe. Raising awareness of the epidemic was one way of combatting the virus and allaying public fear.

Changed beyond recognition

Almost 30 years later, the world of HIV has changed beyond recognition. The theme for this year’s World AIDS Day is Let’s end it – end isolation, end stigma, end transmission.

From the early days of the epidemic in the 1980s to the present, it is hard to think of any other medical condition that has progressed and changed so much in such a short time.

The difference in nurses’ attitudes towards HIV/AIDS today compared with the 1980s and 1990s is remarkable, but there is still a long way to reach the point where all healthcare workers see HIV as a long-term condition.

No longer a death sentence

Many nurses coming through the ranks today do not know HIV as the death sentence it once was, and many do not know the history of HIV.

Due to advances in treatment and care and effective medicines, nurses who have joined the specialism in the past decade will not have seen the large numbers of young men dying, the high levels of fear and anxiety, and the patients with multiple health problems due to AIDS-related illnesses.

In countries where people do not have access to healthcare services and treatment, people are still dying because of it.

Key to reducing infections

Today, there are 36.7 million men, women and children with HIV globally, including more than 100,000 in the UK. Around 6,000 people are newly diagnosed in the UK every year, but we are starting to see a significant reduction in HIV diagnoses in gay men in London and other cities.

This reduction is down to regular testing, access to treatment and pre-exposure prophylaxis (PrEP), with research showing that people on effective HIV treatment – taking treatment as prescribed for at least six months and having an undetectable HIV viral load – cannot pass the virus on.

Developments in HIV testing are key to reducing infections. Around 13% of people with HIV in the UK do not know they are infected, and enabling people at risk to have access to a range of testing opportunities is a key part of prevention and reducing onward transmission.

Free self-testing

The Selphi study taking place in England and Wales will help decide if the NHS should provide free HIV self-testing. At least 10,000 people are also being recruited to the Impact trial. Co-ordinated by NHS England and the St Stephen’s AIDS Trust, this builds on the research base demonstrating the effectiveness of PrEP.

At a time when NHS services are under increasing pressure, and many HIV charities have closed or are experiencing severe funding reductions, it is essential that we do not lose momentum in the battle against the epidemic.

HIV treatment is working. If progress continues, by 2030 we could end the HIV epidemic in the UK.

Jason Warriner is chair of the RCN Public Health Forum and a nursing expert in HIV 

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