World AIDS Day: In Loving Memory of All Bright Lights Lost
An article by Liam McClelland, Learning and Devolved Nations Officer
“In loving memory of all the bright lights we lost to AIDS” appears on the screen above Madonna during her Celebration World Tour as she dedicates “Live to Tell” to the victims of the HIV/AIDS epidemic. Madonna’s story is personal, her best friend Martin Burgoyne was a victim of the silence and stigma that surrounded this period of denial.
For many it’s moments like this, It’s A Sin, Pose, or Queen and Freddie Mercury are the closest we come to HIV/AIDS. It is something that happened, we talk about it using the past tense. Some may consider it to be geographically distant too, something that was happening in sub-Saharan Africa. Occasionally it has been used to sell newspapers, The Sun spent a week titillating its readers with which Hollywood star they were going to expose as living with HIV.
I share my experience with the estimated 106,890 other people living with HIV in the UK. I take a one tablet once a day that contains 4 different drugs, known as a fixed dose combination. I have taken this tablet daily since 2013 and next year will be a decade of living with an undetectable viral load, having an undetectable viral load also means that the virus is untransmittable. U=U is the abbreviation used for Undetectable = Untransmittable. Someone who is on effective HIV treatment will achieve a viral load within their bloodstream that does not register when a blood test is administered, hence ‘undetectable’. Medically a person with a viral load suppression below 200 copies per ml of blood will also mean a person cannot transmit the virus.
A number of global long-term studies has led our UK Government to adopt the undetectable = untrasmittable (or U=U) global 95/95/95 aim. Something that England has achieved and is maintaining and Scotland is due to achieve in 2025. In England, 95% of those living with HIV have been diagnosed. Of that 95%, 99% are on HIV treatment and 98% of those on treatment have an undetectable viral load. Whilst in Scotland, 92% of people living with HIV are diagnosed; 97% of those people attending specialist services are accessing antiretroviral treatment, and; 94% of people accessing treatment have an undetectable viral load.
A continuing barrier that exist globally for the UN 95/95/95 aim is stigma. Stigma abounds in both the LGBTQ+ community and outside. There is a need to combat this in order for people to test frequently, to take better care of their health (such as by using PrEP) and to communicate with their sexual partners. Terrance Higgins Trust and the Scottish Government are working together to tackle stigma in Scotland. For the first time in 40 years a national television campaign will be viewed by thousands of Scots, many of whom will remember the tomb stone advert of the 1980s with its tagline “don’t die of ignorance”.
The Scottish Government has a proud history of taking steps to support public health. Scotland was the first to abolish the homophobic legislation Section 28, ensuring generations of young people would receive adequate age appropriate sex and relationship education. Scotland launched the world’s first online HIV prevention service. The use of this will enable those in rural areas to access services, many of which are located within larger cities as primary care still remains a postcode lottery across much of the U.K. for many health conditions. And last year Scotland introduced the first safe injection rooms, treating drug use as a public health issue and helping to eradicate the crisis of HIV transmission through shared needles that gripped many Scottish cities in the 1980s.
Whilst previously we have seen the government and NHS taken to court for a failure to fully fund PrEP in England, it is my hope that future governments of the U.K. (both devolved and Westminster) continue to use this evidence based and person centric approach to health issues. Rather than stigmatising people we should be providing spaces for them to seek support and information to live healthier lives.
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