Written Statement: HIV Action Plan for Wales 2023-26: Annual Progress Statement

At the start of Wales HIV Testing Week and as we look towards World AIDS Day next month, I am providing Members with an update about HIV in Wales and our progress in delivering the HIV Action Plan.

Thanks to the hard work of our NHS, volunteers and campaigners, the latest data on trends in the prevention, diagnosis and treatment of HIV in Wales show Wales is making encouraging progress towards our goal of zero new transmissions of HIV by 2030:

• Screening levels continue to increase and in 2023 they surpassed the numbers seen in 2019 before the pandemic. This is the result of services working together to provide wider access to testing, including through our free and confidential online testing service, which supports testing outside the clinic setting and also allows clinical staff to focus on treatment.
• Uptake of pre-exposure prophylaxis (PrEP), a medicine which when taken as prescribed reduces the risk of contracting HIV through sex by 99%, is increasing year-on-year and is at its highest level since it was introduced in Wales in 2017. 
• Rates of treatment have been maintained and treatment continues to be highly effective – 97% of people on treatment have an undetectable viral load, which means the infection has been reduced to such low levels it cannot be passed to others.

While all this is very encouraging, we know there are still challenges which we need to address, including having better data to monitor trends, assess the success of interventions and plan service provision. 

Although the use of PrEP continues to grow, we can make access even easier. PrEP is predominantly used by gay, bisexual and other men who have sex with men but much less so by those in other at-risk groups. Making improvements to access will help address this.

We continue to see people being diagnosed with HIV at a late stage and there is more to be done to ensure people with HIV are living well, including ensuring they do not experience negative attitudes, beliefs and behaviours directed towards them. 

Our HIV Action Plan contains a number of actions to help address these challenges:

• The Welsh Government, health boards, local authorities and other partners continue to work closely with the HIV voluntary and community sector. Fast Track Cymru is well established and is supporting the delivery of our aspiration to be a Fast Track nation. We now have four health board areas signed up to the Paris Declaration, with the remaining three health board areas (Cwm Taf Morgannwg, Hywel Dda and Powys) on course to sign by the end of the current financial year. 
• A business case for an all-Wales sexual health case management system is being developed and we are strengthening data on the quality of life and healthcare needs of people living with HIV by introducing an annual wellbeing survey in 2025. 
• Earlier this year, health boards provided their first annual return evidencing their care pathways. Health boards will provide annual updates on progress in ensuring they are equipped with the necessary resources, staffing and pathways to fully implement the British HIV Association (BHIVA) Standards of Care.
• The Terrence Higgins Trust has agreed funding for an online peer support service dedicated to Wales. In addition, Education Programmes for Patients Cymru will soon be launching a six-week pilot programme to help develop an online HIV self-management programme. This is open to people living with HIV and those supporting someone living with HIV. Further work is underway to agree sustainable funding for peer support networks both at regional and national levels, incorporating in-community, in-clinic and online methods. 
• A model providing more convenient access to PrEP in the community will be piloted and an awareness-raising campaign will run in the spring so all those at risk know about PrEP and how to access it.
• Health board late diagnosis cohort review meetings take place every six months so clinicians can identify missed opportunities and implement improvements. 
• Zero tolerance to stigma is woven throughout the action plan. An initial awareness campaign has been run. A short animation for health care professionals and for the public have been produced. An overarching guide will also be produced for teachers to help schools consider and teach developmentally-appropriate learning about HIV, PrEP and stigma.

I will continue to keep Members updated about progress towards our goal of zero new transmissions of HIV in Wales by 2030 and our zero-tolerance approach. 

I would like to reiterate my sincere thanks to our NHS, volunteers and campaigners, who are all pivotal in delivering these commitments.