National HIV Testing Week runs from 18 to 24 November, with World AIDS Day on 1 December. As an HIV activist this is my favourite time of the year. The main call to action around National HIV Testing Week is encouraging people to test for HIV, but we are also seeking to raise awareness and challenge HIV stigma.
I was diagnosed with HIV in January 2010. Over the last seven years there have been massive changes in the way in which HIV is treated in the UK. When I was diagnosed with HIV, NHS policy was to delay a patient’s HIV treatment until their CD4 count, which measures the number of white blood cells and is the main indicator used to measure the health of an HIV positive person, had fallen to between 350 and 500.
At the end of 2012, my CD4 count suddenly plunged. In June 2012, my CD4 count was over 800, then by September it had suddenly fallen to just over 500. The rate of the fall in my CD4 count frightened both myself and my specialist. He recommended that I commence HIV treatment. I started HIV treatment three years after my diagnosis. Today, when someone is diagnosed with HIV, they start treatment straight away. The NHS changed its policy around 2015. Factors in this decision included that antiretroviral medication is almost side effect free now and can involve taking only one pill a day, new research that people who wait to start treatment are more likely to develop AIDS-related illnesses such as cancer, but also an ambition to reduce HIV transmissions.
Once an HIV positive person is on treatment they can no longer pass the virus on. That’s because HIV treatment works by reducing the amount of virus in the blood to undetectable levels, which both protects the immune system from damage and means HIV can’t be passed on. Testing, diagnosis and treatment are key to ending the HIV epidemic. This was demonstrated decisively by the PARTNER study, the results of which were released in 2016. The study monitored couples where one partner is HIV negative and the other HIV positive (serodiscordant). Frequent and rapid testing enables HIV positive people to get the treatment they need, keeping them healthy and reducing onward transmission of HIV. There is also an increasing uptake of Pre-Exposure Prophylaxis (PrEP), a course of HIV drugs taken before sex by HIV negative people to stop them getting HIV. For PrEP to work effectively, those taking the prophylactic need to be tested regularly.
I first visited an STI clinic when I was 16 and still at school. At this stage I was exploring my sexuality on Glasgow’s gay scene after experiencing intense LGBT bullying and repression at school. I was enjoying my new found freedom and the nurse recommended that, if I did not have a regular partner, I should attend the STI clinic at least once every six months for a full STI screen. The recommendation now is that gay men should get tested at least once a year, and every three months if having sex with new or casual partners. From STI clinics, GP services, to the comfort of your own home with a self-testing kit, HIV testing is more accessible than ever. You can order a free self-sampling HIV test kit or find where to get tested near you via startswithme.org.uk.
Around two-fifths of people diagnosed with HIV are still being diagnosed late, once the virus has started to impact the immune system. Across the UK we are now seeing falling HIV diagnoses. In 2015 there were 6095 new HIV diagnoses, this figure decreasing to 5164 in 2016. This is a fall of 18 %. HIV testing is central to the reduction in HIV transmissions. HIV positive people can only receive the treatment they need once they have been diagnosed. The new tools and knowledge we have in the fight against HIV makes HIV testing even more important.
Nationwide, London is leading the way in terms of falling HIV transmissions and testing. At 56 Dean Street incredible progress has been made in terms of new HIV diagnoses. In 2015, 56 Dean Street recorded 626 new HIV diagnoses, with a 40 % fall to 373 new diagnoses in 2016. The trend has continued into 2017, with 56 Dean Street recording 136 new diagnoses between January and July of this year. 56 Dean Street has been very innovative around PrEP, but has also maintained its focus on testing. Once someone is newly diagnosed, they are encouraged to start treatment straight away. Getting HIV testing right provides the foundation for effective HIV care.
We can win the fight against HIV. This is increasingly within our grasp, as demonstrated by the falling number of HIV diagnoses. To do this though, people must get tested. This National HIV Testing Week make sure that you get tested for HIV. And take an STI test not just this November, but build regular STI testing into your annual routine.