Efforts to curb Covid-19 virus could also help us finally escape the shadow of Aids
Today is World Aids Day. Globally, there are 38 million people living with HIV, more than 6,000 of them in Scotland. While there is no cure, scientific progress in HIV is one of the greatest triumphs in modern medicine.
Today there will be online fundraisers and virtual vigils taking place in memory of millions of lives cut short.
The 32nd World Aids Day falls in a year that has seen health become the number one priority for everyone. Testing is now our frontline of defence in the Covid-19 response. Previously, testing for viruses and illnesses has been carried out with a targeted approach, now it’s a blanket one. Public health messages on our televisions, radios and on billboards are a daily occurrence; they urge us to play our part and get tested, not just for our own health but for the health of others.
Collective responsibility is something HIV activists and health professionals have been campaigning for over the last five decades. However, widespread fear and stigma means this message isn’t being heard by everyone, whether they are at risk of HIV or not.
In the 1980s, the UK government launched it’s “Don’t die of ignorance” campaign in a bid to tackle the rising numbers of people testing positive for HIV/AIDS. At the time, Edinburgh was dubbed the “Aids capital of Europe”, owing to spiralling cases of HIV among injecting drug users in some of the city’s most deprived housing estates.
It was the largest public health campaign of its day and it was also targeted to the entire population, with leaflets landing on every doorstep. The accompanying advert still sends shivers down my spine. During the advertisement, the word “Aids” is hammered into a falling tombstone, lilies are thrown on a grave and an admonishing voice warns that “there is now a deadly disease with no known cure”.
This is a far cry from the adverts we see about Covid-19. Warm scenes of separated friends and family having conversations over phones, and people wearing masks continuing to go about their daily lives in good spirits. All this is packaged in a message that is overwhelmingly positive, and crucially, supportive.
Despite the devastation caused, uptake for testing for Covid-19 remains high. Tens of thousands of tests are processed each day. People aren't shying away from getting a Covid-19 test, in fact, there is an outcry for more. There is a sense of civic duty attached to our health, the likes of which I’ve never seen before.
In contrast to attitudes towards Covid, many people continue to be scared about getting an HIV test. There are still over 500 people – approximately eight per cent of the total population living with HIV in Scotland – who are believed to have the virus but are undiagnosed. This not only impacts the health of the person who is living with HIV, it means they could unknowingly pass on the virus.
Unlike the flurry of social media posts and well-known figures, such as the Prime Minister, talking about their experiences of testing for Covid-19, there isn’t the same level of enthusiasm when it comes to testing for HIV. HIV testing is still taboo and scaremongering public health messaging have cast a long shadow.
There’s still plenty of misinformation about HIV. Research by HIV Scotland found nearly half (46 per cent) of Scots think that HIV is transmitted through biting, spitting or kissing. This gross misinformation results in barriers to testing by perpetuating stigma.
This reluctance to test continues in spite of huge advances in HIV treatment which now means the 5,484 Scots living with HIV can enjoy normal, healthy lives. What’s even more remarkable is that 95 per cent of people on this life-saving treatment cannot pass on the virus.
Across Scotland, new cases of HIV have fallen in gay and bisexual men and in heterosexual populations to their lowest in over a decade. Yet 29 per cent of all new cases of HIV in 2019 were diagnosed at a late stage and rates among injecting drug users continue to climb.
Unexpectedly, 2020's lockdown restrictions have given opportunities to step up the fight against HIV and for Scotland to meet the global target of ending new cases by 2030.
When restrictions were first introduced, the rules had an immediate impact on the sex lives of many Scots. People were banned from meeting others outside their own household, even if they were in a relationship. A survey by HIV charity the Terrence Higgins Trust, and London sexual health clinic 56 Dean Street revealed that 84 per cent of UK adults followed the rules during the initial lockdown.
Abstaining from sex during lockdown means people who have been tested will have received an accurate result, because HIV can take up to a month to be detected in the blood after exposure. Knowing your status means you can access life-saving HIV treatment if you get a positive result, therefore stopping the onward transmission of the virus.
It’s too early to say how much of an impact this has had but encouraging more people to get tested can only be positive.
The public is now attuned to the fact there are lots of ways to test for Covid-19, such as a walk-in centre or at home. The same is true for testing for HIV. Gone are the days of having to sit in the basement of a hospital, then wait weeks for your result. You can now test at home and get a result in just 15 minutes.
The expected mass Covid vaccine programme in 2021 will mean people who have not engaged with the NHS in years will be face-to-face with it. This could provide a oncein-a-generation chance to engage people in a conversation about their wider health, including HIV status. This might mean that the efforts to cure the Covid-19 virus might not just help to beat one virus but two.