here - United Kingdom Parliament

301WH
HIV
1 DECEMBER 2010
HIV
302WH
The first issue that I mentioned was prevention. In
the early days of the epidemic, not much was known
about the virus. There were no drugs and no effective
treatment. Messaging was, by necessity, extensive and
untargeted. Those of us old enough will remember the
adverts with the collapsing tombstones and the gravelly
voice telling us about the new virus—AIDS—and how
dangerous it was. We remember the posters and the
radio adverts, which were essentially blanket advertising
for the whole UK. People debate the relative impact of
those messages, but we remember that campaign many
years after it happened, so it did have some impact.
The situation of those who have HIV in the UK
today means that that type of mass media advertising is
not perhaps the best way of getting a message to those
most at risk. That point was made in the foreword to the
“Halve It” document, by Lord Fowler, about which I
will speak shortly. Lord Fowler was a distinguished
former Secretary of State for Health and Social Security,
and he is remembered very fondly by people who work
on behalf of and alongside those with HIV and AIDS
for the forward-looking approach that he took. As he
acknowledges, such mass communication messages are
no longer relevant, and the campaign must be more
targeted.
Will the Minister tell us whether the Government’s
strategies on sexual health and HIV propose to target
messages on specific, at-risk communities, and particularly
but not exclusively on younger gay men, for whom some
of the safe sex messages may have been lost in time, and
the African community? Those communities are not
mutually exclusive, of course, but the messaging to each
will have to be different. Particularly now that more
heterosexual people are contracting the virus, many of
whom are in the African community, there is a pressing
need to develop messaging that speaks to that community
and to its values and structures, whether through Church
or faith networks or whatever, so that we can overcome
some of the ignorance and stigma in the black African
community in this country. I would be grateful for the
Minister’s comments on what she proposes to do about
that.
Pauline Latham (Mid Derbyshire) (Con) rose—
David Cairns: I am happy to give way to a vice-chair
of the all-party group on HIV and AIDS.
Pauline Latham: Does the hon. Gentleman accept
that, in addition, white heterosexual people who perhaps
have got divorced recently, after having had a monogamous
relationship for many years, are now going out into the
world of single dating and getting into a mess because
they do not realise that HIV/AIDS is out there in the
heterosexual community? Is that not an expanding area
that we should also be targeting?
David Cairns: The hon. Lady is right. I was saying
that the messaging should not go exclusively to gay men
and to people in the African community. There must be
a message for everyone, but the messaging needs to be
differentiated. There will need to be different messages
to different people, within relative constraints. I hope
that the Minister will deal with her point.
There is concern. I am of the generation that came to
maturity at the time when the AIDS epidemic—well, I
might not have come to maturity yet; it is probably up
for debate whether I have reached maturity.
Mr Thomas: Don’t do yourself down.
David Cairns: Yes, I am doing myself down here. I am
of the generation that came to adulthood when the
virus was making its first big impact, so those messages
really stayed with me. I wonder whether that is the same
today, particularly, although not exclusively, for young
gay men of 17, 18 or 19. We cannot be squeamish about
this issue. We must speak a language that they hear and
will listen and respond to. I do not expect the Minister
necessarily to go into that in detail today, but I want an
assurance from her in that regard. I know, particularly
given her former career, that she is not squeamish about
these things, and we cannot be squeamish when people’s
lives are at stake.
Of course, one way to prevent the spread of the virus
is to ensure that everyone who is HIV-positive knows
that they are HIV-positive—knows their status—and is
receiving the correct drug treatment. It is not widely
appreciated that when someone who is HIV-positive is
on the correct level of antiretroviral drug treatment,
they become significantly less infectious. I had not
appreciated that—I must confess that that was ignorance
on my part—until fairly recently. It means that treatment
for one person is prevention for another.
When an individual is on ARVs and is less infectious,
that helps to constrain the spread of the epidemic and
when people know their HIV status, it alters their
sexual practices. Most of the evidence and studies show
that. The more people we can test and the more HIVpositive
people who know their status and are receiving
the right treatment, the more we will do to prevent the
spread of the virus.
Jenny Willott (Cardiff Central) (LD) rose—
David Cairns: I am happy to give way to another
vice-chair of the all-party group.
Jenny Willott: I have just had a baby and I was tested
automatically for HIV during my pregnancy. Does the
hon. Gentleman agree that extending such automatic
testing could play a valuable role in identifying cases
very early so that people can receive the treatment that,
as he said, will not only help them with their own
medical needs, but prevent them from spreading the
condition?
David Cairns: The hon. Lady makes an excellent
point. I think that it was my right hon. Friend the
Member for Holborn and St Pancras (Frank Dobson),
when he was Secretary of State for Health, who introduced
automatic testing in pregnancy. If we look at the graph,
we see that the tail-off is quite astonishing: once opt-out
testing was introduced for pregnant women, the numbers
of babies being born HIV-positive plummeted.
Of course, the issue is not just about babies. Quite
often when we are talking about the prevention of
mother-to-child transmission, we focus on the baby, but
a woman is involved as well. As the hon. Lady rightly
says, if a woman’s own HIV-positive status has been
diagnosed at the beginning of pregnancy, she can be
put on the correct course of ARVs. That is why, in
the northern world, mother-to-child transmission has
been, if not completely eliminated, massively reduced—
because not only ARVs but the correct education about