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Written Statement - HIV /AIDS rates, prevention and treatment services in Wales

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Lesley Griffiths, Minister for Health and Social Services 

Following Mark Isherwood AM’s question during Plenary on 4 December, I am providing a statement on the burden of HIV/AIDS in Welsh residents, together with an overview of prevention and treatment services.

To date, approximately 120,000 people have been diagnosed with HIV in the UK, of whom 27,000 have developed AIDS and more than 20,000 have died. The availability of highly active anti-retroviral therapy (HAART) has resulted in a rapid decline in AIDS diagnoses and deaths since the early 1990s and those with HIV, who are stable on therapy, are maintained in services for life.

Surveillance of HIV/AIDS in the UK is undertaken by the Health Protection Agency (HPA) with the collaboration of Public Health Wales (PHW). From the first diagnosis in the early eighties until the end of June 2012, there have been 2128 individuals diagnosed with HIV infection in Wales. In 2011 there were 169 new diagnoses of HIV infection in Wales which is an increase when compared to 2009 (141) and 2010 (151). Data for 2012 is available up to June 2012 and shows 63 people have been diagnosed (it is expected this number will rise as further reports are received). A year on year variation in numbers of new diagnoses is to be expected. Whilst the total for 2011 is higher than the previous 2 years, to set it in context, the highest annual total of new diagnoses was recorded in 2007 at 176. Fifteen new AIDS diagnoses and 11 deaths in HIV-diagnosed individuals were reported from Wales in 2011. In 2010, 20 individuals were diagnosed with AIDS and 12 deaths in HIV-diagnosed individuals were reported.

Data from the HPA’s SOPHID survey which collects annual data on diagnosed HIV-infected individuals resident in Wales and accessing HIV-related care indicates the number of people living in Wales and accessing HIV-related care was 1471 in 2011, giving a prevalence rate for HIV/AIDS in Wales of 49 per 100,000 population. There was an 11% increase in the number of Welsh residents seen for HIV care in 2011 (from 1320 people seen in 2009). The number of individuals accessing care increases year on year because of the effectiveness of HAART and the low mortality rate. However, there continues to be transmission of HIV in Wales, particularly in men who have sex with men. In 2011, over half of those accessing services (783) most likely acquired the infection through sex between men, a 14% increase in the number reported in 2010.

586 (40%) of those diagnosed with HIV and accessing services in Wales in 2011 most likely acquired their infection through heterosexual sex. Of these, a proportion will have acquired their infection in high prevalence countries or through sexual intercourse with individuals from countries of high prevalence. Table 1 describes in more detail most likely route of infection.

The Welsh Government’s Sexual Health and Well-being Action Plan for Wales 2010 – 2015 is committed to improving the sexual health and wellbeing of the population and to reducing inequalities in relation to sexual health. One of the key objectives of the Plan is to focus on HIV prevention and protection to reduce the spread of infection. To coincide with World AIDS Day, PHW launched the HIV awareness campaign on 26 November 2012 (the campaign will run until 1 December 2013).  Many campaigns undertaken in the UK have targeted specific population groups, particularly men who have sex with men and those of African origin. This campaign has been designed to raise awareness in all population groups with the aim of encouraging testing in those who may not self-identify with the two previously identified risk groups. Since its launch, the www.friskywales.org / www.cymruchwareus.org website has had 19,000 hits.

Health Boards also undertake a number of local initiatives to address HIV/AIDS and PHW are delivering the HIV Prevention Programme. In addition to the HIV awareness campaign, the key elements of this Programme are:

  • annual HIV testing for injecting drug users;
  • piloting an initiative in North Wales to provide testing for asylum seekers from countries with high prevalence rates;
  • providing support and funds towards a GP training programme to help improve testing for those at risk in the general population; and 
  • ongoing antenatal screening (with almost 100% of women tested).

To improve NHS services for people with HIV, the Welsh Government published Providing for the needs of people with HIV/AIDS in Wales: National Pathways and Service Specification for testing, diagnosis, treatment and supportive care in 2009. This document provides the recommended models of care for patients with HIV/AIDS, including specialist clinical services, social care and services for families affected by HIV.

I am also planning to consult on an amendment to the Overseas Visitor Charging Regulations 1989 to exempt overseas visitors from charges for HIV treatment.   Current advice is this would be a common sense step in our efforts to ensure people come forward for treatment. However, I will await the responses to the consultation before making a final decision.  At present, overseas visitors are only entitled to free NHS treatment for diagnostic testing for evidence of infection with the HIV virus and counselling associated with that test or its result.  

Following the decision by its trustees to wind up Tyddyn Bach Trust earlier this year, the Welsh Government’s legal advisors are now handling this issue on our behalf. The grant made to Tyddyn Bach in 2003 was used to fund the purchase of the Trust’s premises. In the event of the premises being sold, disposed of, or ceasing to be used for the approved purposes for which the funding was granted, the terms and conditions of the grant provide the Welsh Government with the discretion to demand repayment of the full grant, or a proportion of the market value at time of disposal.  

The grant represents a substantial sum of public money which, if recovered, could be reused to benefit a large number of people. Our expectation, therefore, is to recover the full grant and to consider recovering a proportion of any additional proceeds following the sale of the property.

This statement is being issued during recess in order to keep members informed.  Should members wish me to make a further statement or to answer questions on this when the Assembly returns I would be happy to do so.