HIV & AIDS in the UK - What needs to be done?

Earlier in the course of the epidemic, the media played a role in warning the public of the dangers of HIV. The Health Education Authority used to have a £30 million budget, some of which was spent on television and billboard advertising, warning the public about the dangers of HIV. Since the abolition of the HEA in 2000, funding now comes from a variety of different government departments and goes to a number of different organisations. It is difficult to get a clear picture of current levels of funding, but it seems clear that it has dropped. Certainly, such high-profile education campaigns are no longer carried out.

Clearly, there needs to be a new governmental commitment to health education, part of which needs to be focused on preventing the transmission of HIV. Currently, there is no emphasis on health education and awareness as part of governmental domestic policy.

Years of underfunding have resulted in a situation where the HIV epidemic in the UK has been allowed to get out of control - due to the government's fear of talking about sex and fear of spending money on anything other than war or high-profile donations to the third world. Certainly, it is ironic that the UK is more likely to pay for AIDS medication for a positive person in Africa than they would if that African person were in the UK.

GUM clinics are unable to cope with the strain of testing people for STIs and treating them, and they lack the resources necessary to address the spread of HIV. More than a quarter of HIV+ people in England remain undiagnosed, and half of HIV+ men who have sex with men had been positive for more than six years before diagnosis - a time gap which allows the infection to be spread to many others. GUM clinics need to offer - and to have the resources to carry out - HIV tests to everyone who attends them, and their waiting times need to be markedly reduced.

According to the national strategy for sexual health the lifetime treatment cost of caring for someone who is HIV positive is estimated to be between £135,000 and £181,000, and that the monetary value of preventing a single onward transmission estimated at between £0.5 million and £1 million, it is clear that money spent on preventing the transmission of HIV would be well spent. More funding is clearly needed for education and early detection, and it is crucial that politicians take this matter into their hands to prevent a worsening of the situation. Health education is often not a popular funding area, because it produces long term, rather than immediate results. Ultimately, however, it can be very cost-effective.

HIV is not other people's problem, it's everyone's problem. But there is now no Health Education Authority, and when was the last time you saw an advertisement warning people of the dangers of HIV? The only real sources of information these days are the often-skewed reporting in the media, which focuses on the problems in Africa and Asia.
The UK government, with its obsession with trying to play a major role on the international stage, is very keen to tell other countries what to do about their own HIV problems. However, in this area as in a number of others, domestic policy suffers at the expense of foreign policy. The UK government spends its time making high-profile moves on the world stage, while people become infected with HIV, and ultimately die, at home. More political leadership is needed from the UK government, and more awareness of the needs of the UK population.

As regards care and treatment for people with HIV, the UK does better than many other countries. It can be faulted for its unwillingness to treat people with HIV / AIDS who are not UK nationals and fall outside the asylum system. The ability of the NHS and its staff to treat people on the basis of their needs is put at risk by legislation concerning their legal status. This is a politically rather than financially motivated decision, as treatment for people who are from outside the UK are who are HIV positive would place a comparatively tiny burden on the Health Service. For example, if a pregnant woman who is not from the UK requires an emergency caesarean section operation, the NHS will happily provide it. If, however, she is HIV positive, it is unclear if she will be given the inexpensive medication which will stop her baby being born HIV positive.

If more effort were put into sexual health education and HIV prevention, there wouldn't be so many HIV positive people requiring care. It seems that sexual health education is still too sensitive a topic to be given the serious national debate it deserves.