Chamber and committees

To ask the Scottish Government whether it has taken a decision regarding the extension of the temporary provisions in the Coronavirus (Recovery and Reform) (Scotland) Act 2022. (S6O-01676)

The 2022 act gave the Scottish Government the power to release prisoners prematurely at the stroke of a ministerial pen. That power was used to disastrous effect during the pandemic, when at least 40 per cent of those who were released early by this Government went on to reoffend. Will the cabinet secretary at the very least rule out extending the power to release prisoners early, given how disastrously that power was used the first time?

You have said that palliative and end-of-life care is a big omission, and you have argued that people approaching the end of life are, by far, the biggest single group of people who receive social care. It would be helpful if you could comment further on that.

That is alarming.

I have just one key question, which is for Mark Hazelwood. The SPPC has said that the bill’s principles do not take into account people who still need care but who have no hope or expectation of a cure. If the issue is not addressed, what consequences will that, in your opinion, have for those patients?

I have a question for Dr Manji and Cathie Russell. Is there a lack of ambition in the implementation of Anne’s law? Are you satisfied with the pace of change?

My question is for Andy Miller. The SCLD has said that some areas of the bill

“are within the scope for co-design, while other areas are not.”

What areas do you feel are not subject to co-design?

It may have been my interpretation, so that is really helpful; thank you.

It is a privilege to close the debate for the Scottish Conservatives. I remember the early 1980s, when the first cases of AIDS were discovered. I was a teenager at the time and around 16 years old. Looking back, I do not think I fully grasped the gravity of what was happening. I could not possibly have imagined in 1981 that an estimated 40 million people would lose their lives to AIDS-related illnesses in the decades following the first diagnosis.

Paul O’Kane said that we stand in solidarity with those who are living with AIDS, but, as Claire Baker pointed out, we cannot be satisfied with our progress.

Brian Whittle highlighted some heroes: Magic Johnson, Freddie Mercury and Gareth Thomas.

To have lost so many lives is heartbreaking, but so, too, is the awful truth that many were stigmatised and shamed before they died because of their illness and—all too often—because of whom they chose to love. Sadly, as my colleague Jamie Greene pointed out, there are still parts of the world where the number of infections is rising because people are afraid to go for a test or seek treatment, for fear of retribution.

Whether Richard Leonard likes it or not, Gilead developed 11 antiretrovirals that treated more than 16 million people. I say to him that, without Gilead funding, many HIV charities would not now exist and many lives would have been lost.

For many years, HIV and AIDS were vectors of social prejudice and lightning rods for bigotry, homophobia and discrimination. Although attitudes have changed over time, they have not changed enough. Shaming and fear-inducing tactics are often used to change behaviour, and the HIV stigma of the 1980s and 1990s still looms large. Data released earlier this year by the Terrence Higgins Trust shows that public attitudes to HIV are still stuck in the 1980s. That terrible stigma was the main theme of Joe FitzPatrick’s speech.

As we know, stigma can prevent people from getting tested. According to the National Aids Trust, roughly one in 16 people living with HIV in the UK do not know that they have the virus. Gillian Martin quoted alarming statistics showing that there is still huge stigma and hurtful stereotyping. As we have heard today, testing is pivotal, as is addressing the barriers that prevent people from getting tested.

My colleague Jamie Greene stressed the message, “When in doubt, test,” and I commend him for his courage in posting the testing video. Gillian Mackay highlighted underlying issues of division, disparity and disregard. It is a huge issue when it comes to eradicating barriers to progress, as she said.

As the Scottish Conservatives’ amendment emphasises, “timely access” to sexual health services is so important. Dr Sandesh Gulhane stressed the importance of a well-functioning sexual health service, Paul O’Kane cautioned about a postcode lottery and Alex Cole-Hamilton, Jamie Greene and Emma Roddick made calls to improve access to treatment services in rural areas, including in the Highlands.

If someone does get tested and receives a positive diagnosis, HIV stigma means that they can feel isolated and alone when they are most vulnerable. I was struck by a comment made by Nathaniel J Hall, who starred in the television series that has been highlighted today—“It’s A Sin”—and who was diagnosed with AIDS at just 16. He said:

“There was a lot of working through all that shame of being gay and trying to unpick all that homophobia”.

He had internalised that, and then came the other thing:

“I’d contracted this virus. I didn’t tell anyone, I didn’t tell my family and my friends—I told very few friends—until about 2017.”

Imagine being 16 years old, being given a life-shortening diagnosis, which is what it was at the time, and trying to cope with it alone. Imagine trying to do that while dealing with decades of bigotry that makes you believe that, because you are gay, there is something wrong with you.

We need to keep working towards the goal of zero transmission by 2030. We also need to aim for zero stigma, which was so rightly pointed out by Emma Roddick. We need to provide mental health support to people with a diagnosis of HIV and AIDS, if they need it. With early diagnosis and treatment, people with HIV can lead a normal life, so I welcome the announcement by the minister of a public awareness campaign. No one should feel that they must go through it alone. It is about emotional health as well as physical health.

Many of us in the chamber are wearing our red AIDS ribbons. They were first introduced 30 years ago, at the height of the AIDS crisis, by the Visual AIDS artists’ caucus in the United States. In 1992, actress Elizabeth Taylor wore a red ribbon to the Oscars and it became an internationally renowned symbol of compassion, support, awareness and hope. She dedicated so much of her life to AIDS activism, even though she was warned that it was one of her lame-duck causes that could hurt her professionally. She stuck her head above the parapet over and over again as Governments the world over scrambled to come up with a coherent public health response.

As Maree Todd and Dr Sandesh Gulhane emphasised, with advancements in medical treatment, a diagnosis is no longer a death sentence. Antiretroviral medicines can effectively reduce the viral load to undetectable levels, and PrEP can prevent HIV if taken properly. We have come so far since the red ribbon first became embedded in our collective consciousness as a symbol of solidarity and hope. The UK has met and surpassed the UN’s 1990 target. There has been a huge reduction in HIV transmission in the UK and in Scotland, but the fight to end AIDS is not over yet.

No.