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Equity must be a priority in the HIV Action Plan

Equity must be a priority in the HIV Action Plan

Mercy Shibemba

Mercy Shibemba

Mercy Shibemba

3 min read

Black communities in Britain still face barriers to access testing, treatment and care

In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) set its 90-90-90 targets: by 2020, they wanted 90 per cent of all people living with HIV to be diagnosed, 90 per cent of those diagnosed to receive treatment and 90 per cent of those receiving treatment to reach viral suppression.

In 2020, the United Kingdom surpassed this target for the fourth consecutive year – 95 per cent know their status, 99 per cent who know their status are on antiretroviral therapy and 97 per cent of those living with HIV are virally suppressed. Living with HIV has changed. People are living longer, fuller and healthier lives. 

However, Black communities in Britain still face barriers to access testing, treatment and care. The latest figures indicate that 47 per cent of Black Africans diagnosed with HIV within the past year were diagnosed late. Black Africans are more likely to experience late diagnoses than other ethnic groups.

Decades of inequitable responses to HIV have left cracks in the positive picture of progress

Rates of HIV testing have fallen by 30 per cent across the board. Just 1.5 per cent of participants in the PrEP impact trial, set up to better understand usage of PrEP among people with HIV, were Black African. Black women across Britain have reported limited knowledge about PrEP’s benefits and effectiveness, and data suggests that Black communities are less likely to be engaged in HIV care. There was no mention of these issues in the government’s Commission on Race and Ethnic Disparities Report.  

Campaigners have long proposed that a fourth “90” be added to the 90-90-90 targets, that 90 per cent of those who have reached viral suppression have a good quality of life. Achieving this cannot happen without a commitment to ending barriers that Black communities in Britain face, which are exacerbated by broader health, social, economic and structural inequalities. 

The healthcare system is still a postcode lottery. Dwindling access to holistic interventions in communities is a reminder that investment is needed to ensure that people living with HIV can thrive, not just survive. Ending stigma and discrimination must be a priority, particularly in healthcare settings. Research published last year showed that public knowledge and attitudes of HIV lag behind reality. 

Decades of inequitable responses to HIV have left cracks in the positive picture of progress made. Ensuring equity is a priority in the HIV action plan roll-out is paramount. 

Mercy Shibemba is an award-winning HIV activist, working in clinical trials, research and with charities supporting young people living with HIV

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