On the first of December, we marked World AIDS Day. A time to remember all those we have tragically lost to HIV over more than four decades, to reflect on remarkable progress made, and to commit to the work ahead to reach our shared goal to end new HIV cases in Scotland by 2030.
Scientific advances have been significant since the first cases of HIV more than forty years ago. As little as one tablet a day can mean that someone living with HIV in Scotland today will be unable to pass it on to their sexual partners and can live as long and healthy a life as anyone else. What is more, we can say with confidence that we have all the tools we need to end onward transmission of HIV, without a vaccine and without a cure.
However, success is not a foregone conclusion, and we have much work still to do. Stark HIV related health inequalities persist. and third sector organisations play an ongoing vital role in supporting people living with HIV, amplifying their voices, challenging outdated beliefs, and influencing decision-makers to effect positive change.
HIV related health inequalities are complex and multifaceted. They stem from a variety of factors, including socioeconomic status, gender, ethnicity, and sexual orientation. People from marginalised communities are disproportionately affected by HIV, often facing stigma, discrimination, and multiple barriers to accessing healthcare.
The third sector plays a crucial role in addressing these inequalities. Organisations like Terrence Higgins Trust Scotland provide essential services for people living with or at risk of HIV, including counselling, peer support, education, and testing. Also advocating for policies that promote equity of access to HIV prevention, treatment, and care, ensuring that no community is left behind.
One of the most significant contributions of Scotland’s HIV third sector organisations is amplifying the voices of people living with HIV. By sharing their stories and experiences, people living with HIV can challenge stigma, educate the public, and influence decision-makers, ultimately leading to more effective, compassionate, and person-centred policies and services.
For example, Terrence Higgins Trust Scotland, alongside other third sector partners such as Waverley Care, were instrumental in advocating for the introduction of free access to PrEP (pre-exposure prophylaxis) in Scotland, a game changing medication that can prevent HIV transmission. By working with people living with and affected by HIV, charities were able to highlight the need for PrEP and encourage the Scottish Government to lead the way in the UK in becoming the first nation to make it freely available through the NHS.
However, despite the significant contributions of the third sector in shaping Scotland’s HIV response, there are still challenges to overcome. Perhaps unsurprisingly, one of the most significant being an increasingly precarious funding landscape. Public funding for HIV has been declining in recent years, making charities increasingly reliant on donations to maintain essential services.
Another challenge is the ongoing stigma and discrimination associated with HIV. This can lead to people living with HIV being reluctant to seek testing, treatment, and support, which in turn can contribute to onward transmission. To address these challenges, it is essential that the third sector is able to continue to work together with stakeholders across government, healthcare, academia, and people with lived experience of HIV.
As we approach our 2030 target for ending new HIV transmissions in Scotland, it is clear that we have much work to do. However, by continuing our partnership approach and leveraging the powerful combined voice of the third sector, Scotland can and should be one of the first countries in the world to achieve this ambitious goal.
Alan Eagleson is Head of Services (Scotland and Northern England) at Terrence Higgins Trust Scotland and a VHS Board Member.
