Meeting of the Parliament

Meeting date: Tuesday, November 28, 2023

Official Report 903KB pdf

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World AIDS Day 2023

The final item of business is a members’ business debate on motion S6M-11334, in the name of Clare Haughey, on world AIDS day 2023. The debate will be concluded without any question being put.

Motion debated,

That the Parliament recognises World AIDS Day, which falls on 1 December 2023; recognises that millions of people around the world live with HIV, which continues to have a profound impact on the health and wellbeing of people globally; believes that, thanks to scientific developments, if on the right treatment, a person living with HIV in Scotland today can live a long, happy and healthy life and cannot pass the virus on to others; notes what it sees as the impact that inequalities in accessing treatment, and stigma surrounding HIV, continue to have across Scotland, including in the Rutherglen constituency; commends the recent Terrence Higgins Trust advertising campaign that aired on STV, which aims to tackle the stigma of HIV; understands that this is the UK's first major public health campaign regarding HIV/AIDS in four decades; welcomes the Scottish Government’s goal of ending HIV transmission in Scotland by 2030; further welcomes the Scottish Government’s ongoing work to realise this goal, including the development of a pilot online HIV prevention service, to make it easier for people to get pills to prevent infection; considers that Scotland has been a recognised leader in real-world implementation of HIV pre-exposure prophylaxis (PrEP) since the introduction of its NHS-delivered programme in 2017; welcomes what it sees as the continued progress being made in the decline of HIV diagnoses in Scotland; further welcomes increases in the uptake of PrEP, with the latest statistics reportedly showing the highest number of people accessing PrEP in any six-month period since the implementation of the programme in July 2017, and notes the belief that, while welcome progress is being made, substantial work remains to be done to meet the ambition to end HIV transmission in Scotland, and to tackle the inequalities that it considers are holding back progress.

17:01  

I thank colleagues across the chamber for signing my motion marking world AIDS day, which falls on Friday 1 December. I look forward to hearing speeches from other members throughout the debate.

HIV remains a condition that has a profound impact on the health and wellbeing of people globally. However, with early diagnosis and effective therapy, HIV is, in many nations, no longer the terminal illness that it was in the 1980s. It is now established that, with effective treatment, the virus cannot be transmitted to others.

Of course, adverse impacts on physical and mental health remain, together with the requirement for lifelong healthcare and treatment. Living with HIV can worsen existing inequalities, and people might experience additional HIV-related stigma and discrimination. Therefore, there is a real opportunity and a real need to prevent HIV from being passed on in the first place.

By the end of 2021, 6,415 people were known to be living with HIV in Scotland following a diagnosis. That compares with 5,617 people in 2019. HIV can and does affect anyone—people of any age, sexuality, ethnicity or gender. However, we know that rates of access to HIV specialist treatment and care are relatively high in Scotland. Based on 2019 data, 90 per cent of people who had been diagnosed were attending specialist HIV services, 98 per cent of those attending were receiving antiretroviral therapy and 95 per cent of people treated had achieved an undetectable HIV blood level.

Over the past decade, the annual number of people in Scotland diagnosed with HIV for the first time has declined. The number reduced by 37 per cent between 2010 and 2019, and by a further 54 per cent in 2021. Thanks to scientific and pharmacological developments and the expertise of our leading sexual and reproductive health services, if they are on the right treatment, a person with HIV in Scotland can live a long, happy and healthy life.

However, we can go further. The goal of eliminating HIV transmission is now in sight. On world AIDS day three years ago, the then public health minister, Joe FitzPatrick, set the goal of ending HIV transmission in Scotland by 2030. To make good on that commitment, excellent work has been undertaken to examine what is working well in driving down the number of new transmissions and how those successes can be further capitalised on, and people are investigating what more we can do.

Back in 2020, the Scottish Government commissioned the Scottish health protection network to develop a proposal on how elimination could be achieved. That led to the establishment of the HIV transmission elimination oversight group, which published its report on world AIDS day last year with a set of recommendations to inform the Scottish Government on how the elimination target can be met. That report set out a total of 22 proposed actions within five key pillars of intervention. Those pillars are testing; education, including awareness raising and stigma reduction; combination therapy; entry into and retention in specialist HIV care; and contact tracing.

One of the specific asks is for the Scottish Government to commit to piloting opt-out HIV blood-borne virus—BBV—testing in accident and emergency departments in areas of the highest HIV prevalence. A similar opt-out testing scheme was launched in England and proved to be successful in identifying cases of HIV and other blood-borne viruses. There are estimated to be 500 people living with undiagnosed HIV in Scotland, and it is vital that we invest in ways to find all of them if we are to meet the 2030 goals.

I wrote to the Minister for Public Health and Women’s Health about that earlier this year. In her response, she advised that there would be an

“element of prioritisation for the recommendations, and this will be based on a number of factors, such as available capacity within services, likely relative impact, and timescales for delivery.”

Identifying undiagnosed and unknown HIV and blood-borne viruses should be a key public health priority. I ask the minister to consider the recommendation for opt-out testing as a matter of urgency. That action could save lives. I also look forward to hearing more from the minister in her closing speech about the actions that the Scottish Government will take to drive forward the recommendations to ensure that the 2030 goal becomes a reality.

World AIDS day affords us the opportunity to come together to stand in solidarity with all people who live with HIV. It allows us to remember those who have lost their lives to HIV and AIDS-related illnesses over the decades, as well as to celebrate activists and charities who have refused to let HIV stigma stand in the way of progress. As charities such as the Terence Higgins Trust say, nowadays, stigma is more harmful than HIV itself.

The stigma around HIV is not what it once was, but much more needs to be done to educate people about the virus, as a lack of knowledge about the medical progress over the years still fuels stigma. Research by the Terence Higgins Trust and the Scottish Government has laid bare attitudes to HIV in Scotland today. According to the study, only 35 per cent of people would be happy to kiss someone with HIV, 25 per cent would feel worried about receiving medical treatment from a doctor or nurse who has HIV and nearly half of the people in Scotland would feel ashamed to tell others if they were diagnosed with HIV.

Last month, I was pleased to lodge another motion in the Parliament, as well as to ask a question to the First Minister regarding the launch of the new national HIV anti-stigma campaign, led by the Terence Higgins Trust and funded by the Scottish Government. Aired on television in Scotland, the new advert provides an overdue update on the huge medical progress in the fight against HIV. It is the first TV advert on HIV since the UK Government’s infamous “Don’t die of ignorance” campaign, which featured falling tombstones, 40 years ago. I am sure that any of us who is old enough to remember that campaign does so.

Alongside providing up-to-date information about HIV, the new 60-second TV advert aims to tackle the stigma that still surrounds the virus, which usually results from misconceptions about how HIV has changed since the 1980s and 1990s. We still have a way to go in tackling stigma, but public information campaigns such as that one can make a difference and that, in turn, will save lives.

I remind members of the photo call to mark world AIDS day, which my colleague Karen Adam is sponsoring, after First Minister’s questions on Thursday. I encourage all members to join and show their support. Across the parties, we all share the same commitment to do what we can to eradicate new HIV transmissions by 2030. It is a visionary and ambitious target, and one that we can and must achieve.

17:09  

I refer Parliament to my entry in the register of members’ interests, which states that I am a practising national health service general practitioner. I thank Clare Haughey for securing the debate.

On world AIDS day last year, the Scottish Government announced the laudable goal to end HIV transmission in Scotland by 2030. For those living with HIV, it is a lifelong infection that can be managed successfully through antiretroviral therapy, or ART. There is no vaccine or cure for HIV, but if tablets are taken daily, the virus will not replicate and progress to acquired immune deficiency syndrome, which we know as AIDS.

We now have drugs that reduce the likelihood of becoming infected in the first place. For those who think that they have been exposed to the virus, we have PEP, or post-exposure prophylaxis medicine. For those who are HIV negative but at high risk of HIV infection, we have PrEP—pre-exposure prophylaxis medicine—which reduces the risk significantly. The three groups with the highest rates of HIV are gay and bisexual men; people from countries with high HIV prevalence, especially sub-Saharan African countries; and drug users who share drug-injecting tools and people who have sex partners who inject drugs. Thirty years ago, HIV/AIDS was a death sentence. Now, the medical profession considers HIV as a chronic disease. In fact, the prognosis and life expectancy for a person living with HIV is actually better than those for someone with type 2 diabetes.

Let us return to the Scottish Government’s goal to end transmission within seven years. Yes, we have PrEP for those at high risk of contracting the virus, but the Scottish Government has yet to add another key weapon to its armoury: namely, testing for HIV, in particular opt-out testing when someone presents at an A and E department. Opt out means that an individual who is seeking other health services can be tested for HIV/AIDS without the need for pre-test counselling, unless the individual opts out of such testing.

Let us consider best practices. England launched its HIV/AIDS opt-out testing two years ago, and the one-year statistics have been phenomenal. Tangible progress has been made in tackling health inequalities and in reaching population groups who could be less likely to access HIV testing through traditional routes. In the first 12 months of the programme alone, nearly 2,000 new diagnoses of HIV, hepatitis B and hep C were found, including 343 new HIV diagnoses. Additionally, 209 people were found to have been previously diagnosed with HIV, but they were not receiving life-changing treatment—which we refer to as “loss to care”. The intervention also assists with tackling late diagnosis, which in 2022 made up 22 per cent of first diagnoses here in Scotland.

Early diagnosis not only reduces morbidity and mortality; it results in savings across health and social care. In the context of England, the first 100 days of testing cost around £2 million, but an estimated £6 million was saved in long-term care costs. Opt-out testing is not a new concept and has been a National Institute for Health and Care Excellence testing guideline since 2016.

An estimated 500 people are living with undiagnosed HIV in Scotland but, every day, opt-out testing is not on offer. Opportunities to test for HIV and other blood-borne viruses are being missed across our country. It is key to introduce such testing into Scotland’s emergency departments as a matter of urgency.

Ahead of 2023 world AIDS day, while there is much to welcome regarding our knowledge of the disease and advancements in diagnosis, treatment and management, there is still so much to do to reach the goal of zero transmission by 2030. With too many people going undiagnosed, opt-out testing is key.

17:14  

I thank my colleague Clare Haughey for securing the debate.

Forty years ago this year, a team of doctors at the Pasteur Institute in France reported that they had isolated a new virus that they believed was the cause of AIDS. The World Health Organization estimates that, since the beginning of the pandemic, as many as 113 million people worldwide have been infected with the virus, and as many as 51.3 million people worldwide have died as a result of HIV.

Four decades on, too many people across society are unaware of the basics of the transmission of blood-borne viruses or of the great scientific advances in treatment and prevention. Far too many are unable to say what the H in HIV stands for.

Like my colleague Clare Haughey, I welcome this year’s new public health campaign against HIV and AIDS, which was created in partnership with the Scottish Government. I vividly remember being a child in the 1980s and seeing the “Don’t die of ignorance” campaign, which was shocking and fearful. I am sure that it did nothing to help alleviate the stigma at the time. Ignorance, fear and misunderstanding about HIV and AIDS were at their peak, and the school playground was not immune to it. I remember children tagging each other in mock horror, claiming, “Now you have AIDS”. Those children, and many adults, did not know then that HIV could not be passed on through touch.

In 2023, sadly, stigma continues to take its toll. As Clare Haughey said—it is worth repeating—according to research funded by the Scottish Government, only 35 per cent of people in Scotland would be happy to kiss someone who is living with HIV, despite it having been known since the 1980s that the virus cannot be passed on through saliva. I found that quite sad to read. It also found that almost half of the people in Scotland who are HIV positive would be ashamed to tell other people that they are HIV positive, and only a third of Scots are aware that those living with HIV on effective treatment cannot pass it on, or that undetectable equals untransmittable.

The Princess of Wales played her part in dispelling HIV myths on a visit to the UK’s first specialist HIV and AIDS unit, where she shook hands with and hugged patients. That was in 1987.

This week, however, my office spoke with a number of people who are living with HIV about the stigma that they face day to day, and I wish to share some of their testimonies with members. A 47-year-old woman who is living with HIV told my office that she went into hospital for a routine bladder examination. Upon informing the doctor of her HIV status and treatment, she was told to wait in the waiting room in her medical gown. Her examination was then cancelled as a result of concern about the use of equipment for later patients. When she went to get her Covid jab, upon telling the nurse that she has HIV, which is under control, the practitioner pulled her hands away abruptly and walked away, saying that she needed to go and get gloves. This week, I have heard of doctors and nurses putting on two or even three pairs of gloves when dealing with patients who are living with HIV.

The importance of tackling stigma is twofold. It is about making the lives of people who are living with HIV better, and that is reason enough. However, the myths about HIV and the stigma surrounding the virus ultimately discourage testing, which delays or prevents treatment and, in turn, results in further transmission.

We must do all that we can to eradicate ignorance. The new campaign is a good start, but we have to go further. Scotland can be the first country in the world to end new cases of HIV, but if we are to do so, we must tackle the stigma wherever it rears its ugly head. Let us never forget what the H in HIV stands for; let us never forget that, behind every diagnosis and every disclosure, there is a human.

17:18  

I am pleased to have the opportunity to contribute to this annual debate as we mark world AIDS day 2023. I congratulate Clare Haughey on her speech and on securing the debate. It is important that the Parliament continues to shine a light on HIV in Scotland and on-going efforts to reduce and eliminate transmission.

World AIDS day each year presents us with an opportunity to do a number of different things. It gives us the opportunity to recall and remember those who have lost their lives over many decades—as we have heard from colleagues—and also to renew our support and the fight for the living, particularly for those who are managing their condition, as well as those who are living in a situation in which they can take action to prevent transmission. It also gives us the opportunity to move forward in our ambition to reach zero transmissions by 2030.

Tonight, we stand with those in Scotland and around the world who are living with HIV. As we have heard from colleagues, we know that an HIV diagnosis still carries with it far too much stigma, along with fear and uncertainty. In that context, it is imperative that the Parliament and public figures continue to call out stigma and offer support to people who have received a diagnosis.

Estimates from Public Health Scotland show that, as of the end of the last calendar year, around 6,600 people in Scotland were living with HIV. The statistics around diagnosis and treatment are encouraging: 93 per cent of people living with HIV have been diagnosed, and 93 per cent of people receiving antiretroviral treatment had an undetectable viral load. There are positive developments, as we hear year on year when we gather in the chamber to debate these issues.

Every year, there is a theme for world AIDS day. This year, the theme that we are focusing on is “let communities lead”. That is particularly important in the context of the excellent work that is being done in communities across Scotland in partnership with third sector organisations and charities in order to drive forward our ambition for 2030. I highlight the work of organisations such as the Terrence Higgins Trust, which we have heard about already this evening. In particular, I will say something about Waverley Care and the work that it has done in continuing to focus on the journey towards zero new transmissions in 2030.

In the past year, I have been pleased to host a number of events focusing on that work. I held a round-table event in Parliament—which some colleagues in the chamber attended—where we heard about some of the lived experience to which Karen Adam referred in her speech, and about the stigma and the challenges that still exist for so many people in Scotland who are living with HIV.

During the summer, I was pleased to host the launch of the #GetToZero campaign by Waverley Care at an evening reception in the Parliament, which was very well attended. Once again, we were able to hear about the ambitious target for 2030, and we heard clearly from Waverley Care and others that the Government must continue to keep pace, do more and continue to take action to drive us towards that deadline. None of us wants to be standing in the chamber in 2030—if, of course, we are successful in still being here—talking about a missed target. We want to be talking about the target that we have achieved, and how we have moved Scotland to a position where there are no new transmissions.

In reflecting on the theme of communities coming together, we still have more to do to tackle stigma and to ensure that we support people who are living with HIV. The Government has more to do, with the support of all members in Parliament, to achieve the 2030 target. I look forward to hearing the minister’s update in that regard, and I am very grateful to have the time to share my views this evening.

17:22  

I welcome the debate and congratulate my colleague Clare Haughey on bringing it to the chamber.

I led the world AIDS day debate in 2020, in the previous session of Parliament, and I am pleased to continue my support for world AIDS day and the opportunity that it presents to raise awareness of HIV and AIDS. I thank the Terrence Higgins Trust, Waverley Care and HIV Scotland for their briefings and for the invaluable work that they do to support those who are living with HIV.

I start by emphasising that, thanks to scientific developments, a person in Scotland who is living with HIV today can, if they are on the right treatment, live a long, happy and healthy life, and—as we have heard colleagues mention already—they cannot pass the virus on to others. Once a person has received a diagnosis, receives the appropriate treatment, and HIV becomes undetectable in their viral load, they cannot pass on the virus through sexual transmission.

Waverley Care, along with NHS boards across Scotland, including NHS Dumfries and Galloway, continues its important work to promote the need for people to know their HIV status. It is also promoting the undetectable equals untransmittable, or U=U, message.

In preparation for the debate, I reflected on my time at Cedars-Sinai Medical Center in the heart of west Hollywood, in Los Angeles, where I worked as an operating nurse in the early 1990s. That was when combination antiretroviral drugs were just starting to be used. The stigma associated with HIV and AIDS was absolutely rife back then, including from professional colleagues.

I am glad that we have moved on and that Scotland is leading the way in reducing stigma about HIV and AIDS. I note the work of LGBT Youth Scotland on its recent report on life in rural areas, which demonstrated that stigma about HIV and AIDS is more prevalent in rural areas. We must pay attention to that and ensure that rural Scotland is targeted to achieve stigma reduction.

When I led our world AIDS day debate in 2019, I spoke about the progress that was being made in Scotland to meet the United Nations 90-90-90 targets. The aim was that, by 2020, 90 per cent of people living with HIV would be diagnosed, 90 per cent of those diagnosed would be receiving treatment, and 90 per cent of those being treated would have an undetectable viral load. Despite the Covid-19 pandemic, Scotland has met those targets. Ninety-two per cent of those with HIV are now diagnosed, 98 per cent of those are receiving treatment, and 94 per cent of those in treatment have an undetectable viral load. That is good news.

I pay tribute to NHS Scotland staff, such as NHS Dumfries and Galloway’s sexual health and blood-borne virus nurse consultant Marie Murray, for the trailblazing work that they do to support those living with HIV and AIDS. Marie in particular has broken down many of the barriers to people coming forward for screening and treatment, and she has been fundamental in helping to reduce stigma around HIV and AIDS, particularly among her colleagues in Dumfries and Galloway.

We have already heard that, today in Scotland, HIV is considered to be a manageable long-term health condition, with treatments such as PrEP and PEP that allow people to live long and healthy lives. I caught up with the Terrence Higgins Trust at our conference in September, and I was pleased to hear about its new joint campaign with the Scottish Government, which says that stigma is more harmful than HIV. That landmark campaign, which is the first on TV for 36 years, takes the topic of HIV to the Scottish public and provides an insight into the stigma that people living with HIV in Scotland face today. It also provides important messages about HIV transmission, treatment and care. I encourage all members to engage with that campaign, share it on their social media, and promote the importance of people knowing their HIV status through testing. Testing has a central role to play in reducing the number of new infections, and it is as simple as giving a wee finger prick blood sample.

I ask the Scottish Government not to take its foot off the pedal but to continue public awareness campaigns on the importance of sexual health testing, including for HIV and AIDS, and to keep showing that stigma about HIV and AIDS has no place in Scotland.

17:27  

I thank Clare Haughey for securing this important debate to mark world AIDS day on 1 December. I also express my condolences to everyone who has lost someone whom they love to HIV and AIDS, and I thank all the activists and organisations that have championed the issue for decades and have campaigned for better treatment, awareness and diagnosis of HIV. Organisations such as the Terrence Higgins Trust, the National AIDS Trust and Waverley Care have undertaken amazing work to support people living with HIV and AIDS. I thank them for the work that they do in keeping the campaigns alive in the public sphere and in the minds of politicians at Holyrood.

I welcome the Scottish Government’s pledge to end HIV transmission in Scotland by 2030. That must be our ambition for public health policy, but we still have much progress to make to achieve that deadline. I welcome the new sexual health and blood-borne virus action plan, and I look forward to engaging with the minister on how we put that into practice.

It is heartening that Scotland is moving towards the UN AIDS goals that were set out for 2025. Public Health Scotland currently estimates that, of the 6,600 people who are presumed to be living with HIV, 93 per cent have been diagnosed. Despite that progress, we must acknowledge the ultimate aim of getting to zero transmissions, and we must expand education about and awareness of testing to ensure that individuals who are or may be at risk of contracting the disease are aware of the testing that is available in Scotland, so that they can receive the necessary treatment. Increased and accurate diagnosis also means that public health responses can be swifter and more targeted, which is vital to mitigating any inequalities that may exist.

Trends in diagnosis are also changing. For the first time since 2007, heterosexually acquired diagnoses in Scotland have exceeded, in both number and proportion, those among gay and bisexual men and other men who have sex with men. Trends in diagnosis need to be treated with caution, but the point remains that, in order to ensure equality across society, we must be vigilant, and we must repeat the message that anyone could be at risk of contracting HIV.

HIV treatment is an area that has seen significant medical advancement over recent decades. I draw attention to PrEP medicines specifically. As we have heard, PrEP is a medicine that reduces someone’s chances of getting HIV from sex or injection drug use. When taken as prescribed, PrEP is highly effective for preventing HIV.

It is important to draw attention to PrEP as a life-saving drug that is available for free in Scotland from NHS sexual health clinics. It will have already saved lives.

In December 2022, the Scottish Government announced that it was developing an online e-PrEP clinic to make it possible for participants to order medication without needing to attend a specialist clinic. That is vital to enabling wider access to healthcare, including for people in rural areas, where access to sexual health clinics is limited by distance and availability. Beyond online clinics, pharmacies and other community health services might also offer accessible opportunities in communities in which access to sexual health clinics is difficult.

Action is needed to explore current provision and the combination of delivery that would make PrEP more accessible to all who need it. That work should ensure that education and awareness go hand in hand with equitable provision.

We also need to ensure, as many others have said, that stigma in the area is continually tackled. We should all know our HIV status, and I doubt that many of us in the chamber do for certain. We all agree that we should have opt-out testing. That would not only tackle stigma but accelerate our progress towards zero transmission.

HIV does not discriminate; attitudes do. That needs to end if we are going to get to zero transmissions.

I call Kevin Stewart, who is the final speaker in the open debate.

17:31  

I thank Clare Haughey for securing the debate, and I express my gratitude to the Terrence Higgins Trust and Waverley Care for sending comprehensive briefings to members and, of course, for the work that they do day in and day out, campaigning for and supporting people living with HIV.

Today, we remember the lives lost to AIDS, celebrate the resilience of those living with HIV and renew our commitment to ending the pandemic. HIV has had a devastating impact worldwide and has claimed the lives of millions, but, despite the immense challenges, progress has been made in the fight against HIV. Antiretroviral treatments have transformed the virus from a death sentence into a manageable condition, allowing people with HIV to live long and healthy lives.

I am sure that all of us in the chamber fully support our national mission for Scotland to get to zero new HIV transmissions by 2030. I recognise the efforts of the Scottish Government over the years, but we have a way to go to reach that 2030 goal.

I fully support campaigners’ three main asks: that the Scottish Government introduce a pilot of opt-out blood-borne virus testing, launch a Scottish national HIV testing week and ensure that people in Scotland have easy access to PrEP. I am keen to hear the minister’s views, but I hope that the Government’s attitude is, “Just let’s do this.”

I turn to tackling stigma, which we have heard much about today. Like many colleagues, I remember the AIDS advertising campaign of the 1980s, which filled a young me with dread and fear. That campaign, without a doubt, bred stigma. Times have changed, but, unfortunately, stigma still exists.

In The Press and Journal on world AIDS day in 2021, my fellow Aberdonian and friend Paul Robertson, who is living with HIV, wrote:

“All too often, people living with HIV still experience stigma linked to discrimination and judgement about their personal lives. Public attitudes and understanding of HIV have not kept pace with the advances that have been made in medical care ... Ending stigma matters, because it is one of the biggest barriers to people accessing HIV testing and care.”

I am sure that many members in the chamber will agree with Paul’s words.

Another person who is living with HIV spoke to the anti-stigma focus group in May 2023, saying, “Stigma kills. HIV doesn’t.” It is the job of all of us here to help to end such stigma by blowing up the myths, listening to the voices of people with lived experience and acting on what they have to tell us. Together, we can end stigma, improve lives and get to zero.

I invite Jenni Minto to respond to the debate.

17:35  

I, too, am grateful to Clare Haughey for securing this important debate, and I thank colleagues for their thoughtful contributions. I welcome everyone who has joined us tonight by sitting in the public gallery.

As Paul O’Kane said, we should let communities lead. They certainly did at the event that he held in Parliament, which I was privileged to attend.

As other members have reflected, in the past four decades, far too many people have lost their lives to HIV and AIDS-related illness, leaving behind families and friends who continue to feel the pain of their loss. We must keep them in our hearts and minds today.

I reflect on the contributions of Emma Harper and Gillian Mackay, who described the position for people who live in rural Scotland. I attended this year’s Oban pride, where I heard about the impacts for them of living in a rural community. I am really interested to hear more about the work that is happening in Dumfries and Galloway.

On world AIDS day last year, my predecessor, Maree Todd, announced the publication of Scotland’s HIV transmission elimination proposal and committed to providing Parliament with an annual progress report. It is my pleasure now to provide an update on the significant work that has been undertaken over the past year and to announce the further actions that the Scottish Government is taking to achieve our transmission elimination goal.

Members will know that our ambitious goal is to end new cases of HIV in Scotland by 2030, with an interim target of achieving and maintaining the goals of the 95-95-95 strategy of the joint United Nations programme on HIV and AIDS—UNAIDS—by 2025. That will mean that 95 per cent of individuals with HIV will have been diagnosed, 95 per cent of those diagnosed will be on treatment, and 95 per cent of those on treatment will have a suppressed viral load.

It is estimated that 6,600 people in Scotland currently live with HIV, of whom 93 per cent have been diagnosed. Of those who have engaged with HIV services, 98 per cent are receiving treatment and, of those, 93 per cent have been recorded as having an undetectable viral load. Those are reassuring figures, but we are not there yet. As Kevin Stewart eloquently said, there is more work to be done.

The proposal that was published on world AIDS day last year contained recommendations that were wide ranging and, rightly, ambitious. Over the past 12 months, an expert implementation group has been working to prioritise those recommendations to ensure that they can be progressed in the most effective way possible, to give us the best chance of achieving the results that we all desire. The establishment of the implementation group was an important commitment that Ms Todd made last year. I am delighted to say that the outcome of the group’s hard work will be seen shortly through the publication of the Scottish Government’s HIV transmission elimination delivery plan, which we intend to publish in the coming weeks.

I am happy to provide an update on two other commitments that the Scottish Government made on last year’s world AIDS day. The first was to fund a marketing campaign to address the fear and stigma around HIV that, sadly, persist and which, as other members have said, can be more harmful than HIV itself. As others have done in the debate, I commend the work of the Terrence Higgins Trust and thank it and our other partners who have contributed to delivering that outstanding campaign, which, throughout, has been informed by people with lived experience of HIV.

Reflecting on the speeches of Karen Adam, Clare Haughey, Paul O’Kane and Kevin Stewart, I, too, remember the horrendous and heartbreaking advert from the 1980s of the falling tombstones and reflect on the contrast with the current advert that we have worked with our colleagues to produce. I do not know how many colleagues are avid soap fans, but if members missed the launch of the campaign in a primetime slot between “Emmerdale” and “Coronation Street” last month, I hope that they will now have seen the campaign, whether that is through television, social media, billboards or the fantastic news and media coverage that it has generated. As Emma Harper said, please share it. To see the reality of living with HIV and the harm of HIV stigma portrayed so powerfully and discussed so widely felt like a landmark moment, and it is one that I hope will make a real difference to the lives of people affected by HIV.

Last year’s other major announcement was on funding for a pilot of ePrEP clinics. In 2017, Scotland led the way in offering free PrEP—a medication that prevents HIV infection—to those at the highest risk of acquiring HIV. Since then, we have seen a significant reduction in new HIV diagnoses among gay and bisexual men. However, it is essential that we expand access to PrEP to reach a wider range of communities in Scotland. The e-PrEP pilot will support that.

Recently, I met the team at Glasgow Caledonian University and was delighted to hear about the excellent progress that they are making on the three-year project. The team is currently undertaking the vital development work that is necessary for the next stages of a safe and successful pilot.

I am pleased to announce today that we are working with national health service boards to carry out three pilots of BBV opt-out testing in accident and emergency units. Those pilots will help us to better understand the undiagnosed population of HIV and viral hepatitis, as well as the acceptability of such an initiative in Scotland.

Those projects are fantastic examples of the groundbreaking work that is already under way to achieve our transmission elimination goals, but there is a great deal more besides. I am pleased to announce that our new sexual health and blood-borne virus action plan was published today. The action plan is supported by £1.7 million of funding a year, of which £800,000 has already been allocated to a range of projects that support the actions in the plan. Along with actions to improve sexual health and wellbeing, the plan includes a recommitment to our HIV transmission elimination goals, and funding has been allocated to projects that support that.

I do not have enough time today to do justice to all those projects, but they include investment in research, developing education and training, improving access to information and resources, strengthening our data and digital capabilities, exploring the feasibility of providing PrEP in primary care and delivering community-based testing initiatives. Those projects are outlined in detail in the sexual health and blood-borne virus action plan that was published today and in the HIV transmission elimination delivery plan, which will follow in the coming weeks.

I know that the Parliament will be unified in its will to end HIV transmission in Scotland by 2030 and to improve the lives of people living with HIV in Scotland. As Karen Adam reminds us all, the H is for human.

Meeting closed at 17:43.