New HIV Report Addresses Black, Asian and Minority Ethnic Communities’ Needs

The All Party Parliamentary Group HIV and AIDS launched its latest report “Nothing about us without us.” This report looks specifically at addressing the needs of Black, Asian and Minority Ethnic communities in relation to HIV in the UK. 

By looking exclusively at HIV, the APPG Report report addresses how inequalities affect a patient population in which Black, Asian and Minority Ethnic vulnerable groups are disproportionately represented.

Diagnoses among gay and bisexual men nearly halved:

HIV emerged 40 years ago this month and created an epidemic that still devastates the communities it affects today, however there has been significant progress in the fight against HIV since height of the epidemic.

“The voices, experiences and needs of Black, Asian and Minority Ethnic communities must be given specific focus and support”

All Party Parliamentary Group HIV and AIDS Vice Chair, Florence Eshalomi MP

In the UK, new cases of HIV have fallen by over a third in the last five years, with diagnoses among gay and bisexual men nearly halved.

Advances in HIV treatment now mean most people living with HIV have a normal life expectancy and, even more remarkably, cannot pass on the virus to their sexual partners. 

Research found that 21% of Black people 30% of Asian people believe that people with HIV will always go on to develop AIDS. 

Still more to do for women diagnoses:

However, that same progress in reducing transmissions isn’t being experienced across all groups. Diagnoses among women – who account for a third of all people living with HIV in the UK, and more than half globally – fell by only 4% in 2019, compared to 10% across the general population.

Almost half of new HIV diagnoses among heterosexuals in the UK are among Black African men and women, despite this group making up less than 2% of the British population.

These communities are less likely to access the anti-HIV drug, PrEP, which finally became routinely available on the NHS in April 2020 after continuing delays by the government. 

Report Recommendations:

The report makes the following key recommendations:  

1. Opt-out HIV testing across all health care settings across the UK; 
2. More tailored and targeted HIV interventions are needed to reach out to Black, Asian and Minority Ethnic communities; 
3. A UK wide campaign to educate the general population with good Black, Asian and Minority Ethnic representation on the benefits of PrEP needs to be formed and implemented; 
4. Anti-stigma campaigns and interventions to increase understanding, dispel myths and change attitudes towards HIV and HIV testing are needed to engage with under-served ethnic minority groups; 
5. Progress on addressing current inequalities that disproportionately impact these communities should be detailed in annual reporting.  

HIV Action Plan:

In the Government’s HIV Action Plan, they promised more progress for black Africans as they remain the ethnic group with the highest rate of HIV, making them a priority for HIV prevention and testing.

In December last year, Health Minister, Maggie Throup, said: “Our unwavering commitment to prevention and public health campaigns have helped significantly reduce new HIV infections by tackling stigma and urging more people to get tested, as well as accessing life-saving treatment.”

Creating consensus:

The APPG has urged the four governments to work with a diverse range of racial and ethnic communities and organisations, using the principles of co-production and meaningful involvement, to create a consensus around more acceptable terminology to be used by the HIV sector and with communities directly. 

Commenting on the report, Vice Chair of the Party Parliamentary Group HIV and AIDS, Florence Eshalomi MP said: “The history of HIV has been largely seen through a white lens, as an illness drawing attention largely for ravaging white men and highlighted by cultural touchstones like the film Philadelphia, about a gay white man who had AIDS. 

“If we are to meet the target of halting new HIV transmissions by 2030 the voices, experiences and needs of Black, Asian and Minority Ethnic communities must be given specific focus and support as part of the action plan. We cannot end transmissions whilst leaving any group behind.  

“I represent Vauxhall an area that has a large Black population and one of the highest rates of HIV prevalence in the country.  I have seen first-hand the inequalities they face day to day. If we are to end HIV in the UK then we must tackle those inequalities and ensure there is equitable and easy access for all to HIV testing, prevention and care. 

“Nothing about us without us” is not just a phrase, it is a request.  Only meaningful involvement of the diverse communities of the UK will end new transmissions of HIV by 2030, combat stigma and ensure that all people living with HIV enjoy real quality of life.” 

Contributing to the report, Director of The Love Tank, Marc Thompson said: “Since the beginning of the global HIV pandemic over 40 years ago, people from racially minoritised communities – particularly people of Black African descent – have been disproportionately impacted by HIV worldwide.  

“The COVID-19 pandemic has highlighted existing health inequalities, across almost every health condition. Therefore, it should be no surprise that these same inequalities will exist across HIV.  

“I’ve been working in HIV and sexual health for over three decades and have witnessed the impact of this exclusion. If we are to ever really make progress and meet the ambitious target by 2030, these lives must really matter, their voices must be heard, and their needs must be acknowledged and recognised.” 

Consultant in HIV Medicine at Barts Health NHS Trust and Honorary Senior Lecturer at Queen Mary University of London Dr Rageshri Dhairyawan said: “In my day-to-day clinical practice I still see people who are not benefitting from the many advances that we have seen in HIV. People continue to suffer life-changing disability or die from AIDS-related conditions. These are often people diagnosed late, or not on medication or engaged in HIV care. These are often people from communities which have been marginalised, including racially minoritised groups.”  

“Ethnic health inequalities in HIV and beyond reduce life expectancy and quality of life for people from racially minoritised groups. This is a matter of human rights and social justice, as well as about meeting targets to end the AIDS epidemic.  

“I therefore welcome this timely and important report, which sets out the evidence regarding ethnic inequalities in HIV, looks at the gaps and suggests actions at multiple levels to tackle them. It is only through intersectoral working that effective change can be realised.” 

Final Thought:

The APPG report provides evidence to back up what many of us in the sector have thought for several years, Black, Asian and Minority Ethnic communities are being left behind in respect of HIV care and treatment.

The simple fact is that even before the pandemic, HIV care pathways were not delivering the desired outcomes for Black, Asian and Minority Ethnic communities. Therefore, we must ask what more can be done in terms of implementing change at every level of the system.

The UK has signed up to a series of international agreements and without government action to support hard-to-reach communities, these targets will be missed. Therefore, implementation of the HIV Action Plan is critical, especially for Black, Asian and Minority Ethnic communities.