On the Agenda: Ending new cases of HIV in Wales

In less than a week, electors in Wales will head to the polls to vote for who they want to represent them in the Senedd. Whoever wins the election, this new generation of parliamentarians will have the opportunity to end the HIV epidemic in Wales by 2030 and do so without a vaccine or a cure.

In the run up to the Senedd election on 7 May, we have been engaging with political parties to ensure ending HIV transmission stays on the agenda. Over the past few weeks, political parties in Wales have been publishing their manifestos and putting forward their priorities for the next parliament. We have seen manifesto commitments related to ending HIV transmission from Plaid Cymru, Welsh Labour and the Welsh Green Party.

These manifesto pledges are the first step to the action required to end new transmissions of HIV for good and support everyone living with HIV to live well, free of stigma. Our shared goal is only achievable if these commitments are translated into urgent action by the next Welsh Government.

Testing

Finding and supporting everyone living with undiagnosed HIV and those not engaged in care is vital for their health and ending new transmissions of HIV by 2030. In 2024, nearly half (45.1%) of new diagnoses in Wales were at a late stage, meaning the virus had caused greater damage to a patient’s immune system and increased risk of severe ill health. We must take bold action to diagnose people living with HIV earlier and support them to access the care and treatment they need so they can live healthily and not pass the virus on. This means trialling new and innovative approaches in our health system.

Emergency department opt-out HIV testing has been a game-changer elsewhere in the UK in finding new cases of HIV and re-engaging those who are no longer accessing treatment and care. The testing programme in England has already found 719 new HIV diagnoses, 831 new Hepatitis C diagnoses and 3,667 Hepatitis B diagnoses. A significant majority (73.4%) of people newly diagnosed had no record of a previous test for blood borne viruses, highlighting the success of the opt-out programme in accessing populations who would not normally interact with traditional settings where a blood borne virus test may take place. The success of this programme in England has led to the roll-out of A&E opt-out blood borne virus testing in Scotland’s largest urban areas, including in NHS Grampian where new diagnoses of HIV in 2024 were less than in NHS Cardiff and Vale and NHS Aneurin Bevan

It is therefore welcome that Plaid Cymru have committed in their manifesto to expanding screening programmes for conditions like HIV. 

Prevention

Prevention must be one of the central pillars of our work to end the onward transmission of HIV in Wales by 2030. The national Sexual Health Test and Post Service is at the heart of this, allowing everyone across the country to access free and fast HIV and STI testing.

We must build upon the successes of this service, which now accounts for nearly 20% of HIV tests taken in Wales every year, and use this as a tool to initiate people onto PrEP. Currently, it is only possible to get PrEP through specialist sexual health services in Wales, meaning there is a lack of awareness of the prevention tool and people who don’t go to sexual health services can’t access it, which is further compounded by rurality. Moving PrEP online as part of a wider Online HIV Prevention Service will help in breaking down barriers to prevention services and ensure access is as easy as possible for those who want to use these tools.

In their manifesto Welsh Labour highlighted PrEP as a key success of theirs in government and it is encouraging that the Plaid Cymru manifesto commits to ensuring that more people who need PrEP can access it.

Stigma

Stigma continues to seriously impact the lives of people living with HIV and is preventing people from accessing testing, treatment and support. The 2022 Positive Voices survey of people living with HIV across the UK found that almost half (45.1%) of those surveyed reported feeling ashamed about their diagnosis and that 1 in 7 people worried about being treated differently to other patients by healthcare staff. It is crucial that the next Welsh Government doubles down on efforts to combat HIV stigma, learning from campaigns like ‘Stigma is more harmful than HIV’ in Scotland.

That’s why the Welsh Green Party’s pledge to strengthen work on healthy relationships and sexual health is so vital, allowing the opportunity to develop campaigns and educational materials to challenge common misconceptions about HIV and update everyone about the realities of living with HIV in Wales in 2026, including that people living with HIV and on effective treatment can’s pass the virus on.
 

A refreshed Action Plan

With less than five years until 2030, it is integral that action continues at pace to end new transmissions of HIV by 2030. With the current iteration of the HIV Action Plan for Wales expiring this year, we need a refreshed plan which sets out a whole-system approach on how we succeed in ending new cases by 2030 and a funding package that meets the scale of this ambition. 

A new plan must commit to improving data collecting and reporting, delivering on the long-promised Sexual Health Case Management System, and pledge action to ensure the evolving care needs of everyone living with HIV in Wales are met through investment in vital third sector support services and a national audit to identify those lost to HIV care. Plaid Cymru’s commitment to renewing the HIV Action Plan is therefore encouraging. Welsh Labour have also committed to refreshing the LGBTQ+ Action Plan, which currently commits to ending new transmissions of HIV in Wales by 2030.

As we approach the election, it is worth celebrating that ending HIV cases by 2030 and tackling stigma is firmly on the agenda, but there is no room for complacency.

The leader of Reform UK, Nigel Farage, recently said he would ban asylum seekers with HIV from receiving treatment on the NHS. This is wrong and we called it out. With access to treatment, people living with HIV can live a normal, healthy life and can't pass it on. Withholding HIV treatment from anyone in the UK means more people living with HIV because there is a chance it could be passed on and means more people ill in the NHS. I have offered to meet with Nigel Farage to discuss the realities of HIV in the UK and how Reform UK can support the cross-party effort to end the HIV epidemic for good.

At Terrence Higgins Trust, with our partners from across the HIV sector, we’ve published our own manifesto for the election, with five clear calls for action. Together we have set out what is needed for Wales to end new HIV transmissions by 2030, and we are ready to support any new government of any party to make that happen.

It’s going to be up to all of us. So whether it’s through writing to your parliamentary candidate or donating to support our work, please stand with us on this next phase of the journey.