Will a new generation die of ignorance?
Pointing to rising HIV rates, the politics.co.uk editor asks whether the “don’t die of ignorance” message has been forgotten, with the government under pressure to refocus on HIV education.
Political discussion on HIV and Aids tends to assume the disease is a problem for Sub-Saharan Africa and Gordon Brown has repeatedly spoken of the need to improve access to HIV treatment in developing countries. Yet the prime minister has been markedly more silent on HIV in the UK, despite the latest figures showing the UK can be far from complacent about its homegrown HIV problem.
Figures from UNAID show the UK is bucking the global trend for a fall in the number of new HIV infections, with a global levelling off of HIV prevalence. Data from the European Centre for Disease Prevention and Control show the UK has the third highest rate of new infections, with only Estonia and Portugal reporting worse sexual health. The Terence Higgins Trust warns the UK is now lagging behind in the global fight against HIV.
Deborah Jack, chief executive of the National Aids Trust (NAT), said: “While global figures show some countries are making progress, the UK is consistently failing. Gordon Brown needs to match his commitment to tackling HIV internationally with real action at home.”
Awareness of HIV and Aids in the UK has been high since the mid-1980s, yet the prevalence of the disease does not show a corresponding decline. Figures released by the Health Protection Agency (HPA) in November show the number of new cases of HIV continues to rise. It now annually exceeds the number of yearly diagnoses seen throughout the 1980s and 1990s.
Transmission among heterosexuals, although a small proportion of overall cases, has been steadily increasing, with new diagnoses up 50 per cent since 2003. New cases among gay men also hit a record high in 2006, with 2,700 new diagnoses, compared to 750 for heterosexual patients. The NAT predicts that if present trends continue, there will be 100,000 people living with HIV in the UK by 2010.
The government regards rising numbers of HIV sufferers as an indication more high-risk people are coming forward for testing, motivated in part by the improved life expectancy afforded by new drugs. The HPA agrees high diagnoses can be the result of increased testing, but says there is no suggestion the underlying rate of HIV transmission, especially among gay men, is falling.
Despite the continued prevalence of HIV since the 1980s, it has declined as a high-profile concern, increasingly replaced by obesity and smoking in public health debates. Young adults persistently tell surveys they are not actively concerned about contracting HIV, despite making up 11 per cent of new HIV diagnoses each year.
In November 2007 the Queen was pictured for the first time shaking hands with an Aids patient in Uganda. For many, this marked the final death knell to the stigma surrounding Aids. Yet perversely, as people become increasingly aware of the myths surrounding HIV, they have become more inclined to participate in the high-risk behaviour that does in fact increase the risk of contracting the virus.
Campaigners have argued the government needs to dramatically increase HIV awareness education. In 1986, Margaret Thatcher’s government launched a groundbreaking public health initiative with the “Don’t Die of Ignorance” campaign. Every household in Britain was targeted with a leaflet and a public information film told viewers: “The virus can be passed during sexual intercourse with an infected person.if you ignore Aids it could be the death of you – so don’t die of ignorance”.
The campaign was credited with greatly raising awareness of Aids and HIV and spreading the message about the importance of condoms. Yet it has not been followed up with a similar drive and concerns have been raised that its message has been forgotten; every young adult questioned by politics.co.uk admitted they had no recollection of the campaign.
Public health campaigners have called on the government to refocus on education. The NAT told politics.co.uk the government needs to urgently improve comprehensive sex and relationship education in schools. The NAT argues sex education lessons must be made compulsory, with teachers given guidance to ensure young people leave school fully equipped with the facts.
The NAT has also called for Gordon Brown to use World Aids Day on December 1st to make a keynote speech on Aids, reaffirming it as a health and human rights priority for the government. The Terence Higgins Trust (THT) has agreed there is too little national attention on HIV and has called for a renewed focus.
The THT argues HIV policy needs to focus on prevention, or the costs of treatment will spiral as more people are diagnosed with the virus. But with 73,000 adults now living with HIV in the UK, public health policy cannot focus solely on prevention.
A significant barrier to effective treatment of HIV is the high number of undiagnosed cases. It is estimated 33 per cent of HIV sufferers are not aware of their condition, with the latest figures from the HPA suggesting 21,600 people could unknowingly pass on the disease.
The THT has launched a campaign to reduce the proportion of hidden cases to 25 per cent. To enable this, testing will need to be increased. Professor Pete Borriello, director of HPA’s centre for infections, said testing for all sexually transmitted infections must be increased further. He argues all gay men should have regular HIV tests and anyone attending an STI clinic should be screen for HIV.
The NAT advocates an ‘opt-out’ policy, where GUM clinic attendees are offered an HIV test as standard but not obliged to submit to testing. Proposals for home testing for HIV have been met with resistance because of concerns sufferers will not be able to access adequate counselling.
To improve treatment, the NAT has called for ring fenced funding for sexual health treatment. Ms Jack said: “Instead of allowing public health funding, that vital investment in our future health, to be lost to budget deficits and acute care, the government must ring fence these resources and insist they are spent on what was intended, health promotion.”
The Department of Health says the UK is a relatively low prevalence country for HIV compared to global trends. In terms of total sufferers, this is correct but as seen by the persistent rise in new cases suggests the government must remain far from complacent.
