The Health Protection (Coronavirus) (Requirements) (Scotland) Amendment Regulations 2022 and The Health Protection (Coronavirus) (Requirements) (Scotland) Amendment (No. 2) Regulations 2022: equality impact assessment

Sexual Orientation

Background

In 2018, 2% of people in Scotland identified as lesbian, gay, or bisexual (LGB).^[202]

During the pandemic, loneliness and isolation has strongly impacted LGB people of all ages. A survey of 2,934 secondary school pupils (1,140 of whom identified as LGBT+) by Just Like Us found that LGBT+ young people are twice as likely as their non-LGBT peers (52% vs 27%) to have felt lonely and separated from the people they are closest to on a daily basis during lockdown. 68% of LGBT+ young people survey also reported their mental health has worsened since the pandemic began, compared with half (49%) of non-LGBT+ young people.^[203] Age UK also reported that older LGBT people are especially at risk of loneliness, as they are more likely to be single, live alone, and have less contact with relatives.^[204]

While data from 2019 suggests that only 0.3% more men in the UK contracted HIV through sex with other men than with women,^[205] HIV still has a strong historical and cultural connection with the LGB community. A study from England in December 2020 showed that the risk of dying from Covid-19 for people with HIV was more than double that of the rest of the population, even after adjusting for factors such as deprivation, ethnicity, smoking and obesity.^[206] In comparison, a systematic review found those living with well-controlled HIV were are no greater risk of poorer COVID-19 disease outcomes than the general population^[207]. A note in the Lancet stated that, while clinicians should treat the findings as important, conclusions should be taken with caution until we have more specific controlled data to assess the effects of HIV on Covid-19 outcomes.^[208]

Differential impacts

Positive impacts

If the policy objective to reduce the risk of transmission is achieved, Covid Status Certification could positively impact people living with HIV, as they are at a higher risk of poorer health outcomes if they contract the virus. It may also support them to feel safer and more confident participating in society if they know that those around them have been vaccinated.

If the policy objective of allowing higher risk settings to continue to operate as an alternative to closure or more restrictive measures is achieved, Covid Status Certification could positively impact LGB people as it facilitates their ability to socialise. This is particularly important for older people within the gay community who report higher rates of loneliness.^[209]

Negative impacts

Despite their higher risk of death from Covid-19, stakeholders have informed us that some HIV positive people feel hesitant about the vaccine due to fears about side effects and that it may interact poorly with their HIV medication.^{[210] [211]}

Therefore, if HIV positive people are less likely to be vaccinated, Covid Status Certification could have a negative impact if they are denied access to the settings in scope. This will be mitigated by the addition of testing as a negative test results can be used as an alternative to proof of vaccination.

As detailed in the Gender Reassignment section, LGBT people are less likely to have ID than the general population, and so they may be slightly more likely to face difficulties registering for the App and more likely to use the paper Certificate.