Transcript Grays Inn Road - HIV Prevention England

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
• High sexual risk taking amongst some groups
• Little city wide or programme planning
• Major investment risk
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 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 tests
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
• 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
• 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
• 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
• 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: Urban Responses
San Francisco / Washington DC / London
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%
50%
69%
61%
2020 ambition
2012 actual
40%
30%
20%
Fall in HIV
transmissio
n
10%
0%
HIV infected
(n=98,400)
HIV diagnosed
(n=76,800)
Retained in care
(n=72,840)
On treatment
(n=67,600)
Undetectable VL
(n=59,900)
• Crucially achieving this, will together with condom use,
help England reduce HIV transmission – the overall aim
Together…..
Thank you!
For further information:
[email protected]
0207 812 1850