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2020 Vision – Making England’s HIV Prevention the best in the world Paul Ward Acting Chief Executive, THT 20 February 2014. The story so far. Increasing HIV testing World class HIV treatment & care HIV transmission levelled off Sustained condom use But Levels of undiagnosed HIV

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slide1
2020 Vision – Making England’s HIV

Prevention the best in the world

Paul Ward

Acting Chief Executive, THT

20 February 2014

the story so far
The story so far
  • Increasing HIV testing
  • World class HIV treatment & care
  • HIV transmission levelled off
  • Sustained condom use

But

  • Levels of undiagnosed HIV
  • High sexual risk taking amongst some groups
  • Little city wide or programme planning
  • Major investment risk
2020 vision 50 reduction in undiagnosed hiv
2020 Vision – 50% reduction in undiagnosed HIV
  • Reduce by 10,000 the number of people undiagnosed
  • Full usage of integrated testing approach
2020 vision 50 reduction in undiagnosed hiv1
2020 Vision – 50% reduction in undiagnosed HIV
  • Embed recall/reminder process within local HIV testing Programmes and service
  • Overhaul of partner notification – traditional and digital
  • Exploration of use of Viral Load HIV testing with highest risk groups
2020 vision 250 000 more hiv tests1
2020 Vision – 250,000 more HIV tests
  • A 125% increase in tests with high risk groups needed
  • £20m annual investment to achieve lifetime cost savings of at least £250m pa
  • Rebalance HIV testing so that more occurs in low cost settings
  • Major shift in testing culture through advocacy & community engagement
  • Get public health value from 98% of HIV testing resources spent on people without HIV
2020 vision 75 of pwhiv uninfectious
2020 Vision -75% of PWHIV uninfectious
  • Although UK performance is amongst best in world, there are still too few people retained on treatment & uninfectious
  • Expansion in community & clinical advocacy for treatment
  • New approaches to case management & case finding to reduce people lost to care
  • New Positive Prevention care pathway to help people living with HIV to optimise their health
  • Explore reducing threshold for HIV treatment
2020 vision increasing condom use harm reduction
2020 Vision – Increasing condom use & harm reduction
  • 80,000 infections prevented by condoms to date
  • Societal challenge re condom use
  • Community & clinical advocacy for condom use, backed up by free/low cost availability
  • Full access to behaviour change services for those in highest need
  • Increased access to PEP and PREP
  • Active encouragement of a range of harm reduction approaches
  • Twin track approach to HIV & STI/HCV harm reduction
2020 vision healthy communities healthy people
2020 Vision – Healthy communities, healthy people
  • Mandatory SRE in schools
  • Integration across Sexual health, Mental health & Substance use services
  • Specialist drug services focusing on recreational drug use
  • Step change in Corporate Social Responsibility expectations from community businesses
  • Community involvement & engagement to increase our collective HIV Prevention capacity
making it happen leadership
Making It Happen Leadership
  • Strong Local Authority & NHS leadership, political and officer
  • Active community leadership & involvement holding to account
  • Fully co-ordinated local HIV testing & prevention programmes
  • Redirection of less than 1% of Public Health resources
  • Operation of effective surveillance and monitoring systems
  • Continual improvement by local and national comparison
  • London is pivotal to this, with nearly 50% of undiagnosed HIV in the capital
making it happen signs of optimism
Making It Happen – signs of optimism
  • UK Brighton – 50%+ HIV diagnoses now out of hospital
  • UK HIV Home Sampling – 6,000+ tests in first year, 1.7% positivity diagnosed
  • UK – falling levels of undiagnosed HIV
  • US – 4,000 home HIV testing kits sold per week
  • US – strong reductions in undiagnosed HIV in some cities
  • US – first fully engaged urban testing programmes
achieving success

100%

90%

89%

84%

80%

78%

70%

75%

60%

78

%

73

%

6

9

%

61

%

50%

2020 ambition

2012

actual

40%

30%

20%

10%

0%

HIV infected

HIV diagnosed

Retained in care

On treatment

Undetectable VL

(n=98,400)

(n=7

6,8

00)

(n=72,840)

(n=6

7

,

600

)

(n=59

,

900

)

Achieving success

Fall in HIV transmission

  • Crucially achieving this, will together with condom use, help England reduce HIV transmission – the overall aim
together
Together…..

Thank you!

For further information:

Paul.ward@tht.org.uk

0207 812 1850