Is London set for a new HIV epidemic?

© Ed Marshall
Posted: Thu May 5 2011

Will a cut in the HIV prevention budget lead to a rise in infections?

Latest figures suggest that one in every 200 people in London is living with HIV. For gay men in the capital, that figure rises to one in ten.So it's rather alarming to discover that funding for HIV prevention in London has just been cut by a whopping 42 per cent.

A spokesperson for NHS North West London confirmed this, saying, 'In planning for 2011/12 eight PCTs [Primary Care Trusts] decided to reduce their financial input and ten PCTs withdrew funding completely. The impact of this was the reduction of the pan-London HIV prevention financial funding envelope by 42 per cent from that of 2010/11.'

Time Out has previously raised questions about the effectiveness of some prevention campaigns. But a cut of 42 per cent will have a massive impact on efforts to reduce the number of people testing positive for HIV, and could well lead to a rise in infections. We asked people working in the HIV sector for their reaction.

Deborah Jack chief executive of National Aids Trust
'Targeted HIV-prevention strategies are vital, especially for those most at risk, such as gay men, and without them it could lead to infection rates going up and awareness of HIV going down. HIV prevention should not be regarded as an easy target for short-term cost cutting.Any savings made now are likely to result in increased costs in treatment and care in the longer term.'

Ben Tunstall head of health improvement for the Terrence Higgins Trust
'Prevention initiatives are vital in educating people about HIV and keeping infection rates down, so we're worried about the potential effects of any cuts to this area of funding. Our priority at THT is to continue to support people with HIV and those at risk across London so we're concentrating on making the most of the prevention funding that is currently available and trying to maximise its impact across the capital. We're also working to make the strongest possible case, to local and national government, for prevention services to be maintained. It would be a dangerous mistake to reduce the funding which supports these vital services.'

Matthew Hodson of gay men's health charity GMFA
'Every year HIV prevention work is given less funding and expected to deliver more. Just in economic terms, prevention is far cheaper than treatment. If these cuts result in even a handful of men becoming infected with HIV, then the cost of treatment would mean that PCTs won't have saved the taxpayer a single penny. And the human cost of these cuts is that fewer men are able to access information and, as a result, more men become infected and have to live with the virus.London has the largest gay population in the UK and the highest number of people living with HIV. This round of cuts is just the latest in a long series in HIV-prevention funding. Best estimates suggest £19.2 million was spent on HIV prevention in London in 2001. By 2008 that had been cut to around £4 million and now it looks likely that the funding will be cut almost in half again. The HIV-prevention budget isn't slowly being eroded, it's being swept away.'

Peter Scott of new HIV prevention group Status
'At a time when new HIV infection among gay men is far too high and rising it would be a costly mistake to cut HIV-prevention funding. However, much of what passes for HIV prevention is irrelevant, ineffective and a waste of public money. That is why 42 per cent cutsacross the boardmake no sense: they punish some prevention projects that are efficient and effective and reward those that have wasted precious funds. This should act as a wake-up call. The cash envelope needs to be preserved but it needs to be spent more wisely. There is an opportunity in this funding dispute to thoroughly review HIV prevention in London and develop a truly effective programme. It's no bad thing if money is taken away from the failing organisations, so long as that money is spent on HIV prevention that actually works. From now on there has to be proper accountability for how the money is spent and what exactly it has achieved.'