Sexual health and blood borne virus action plan: 2023 to 2026

HIV Transmission Elimination

Our vision is to end HIV transmission in Scotland by achieving a target of zero people contracting HIV within Scotland by 2030. This aligns with wider global strategic aims and is detailed in the HIV Transmission Elimination proposal⁷ published in Scotland by an expert group of community representatives, clinicians, academics and other stakeholders in December 2022. The World Health Organization (WHO) refers to a goal "to end the AIDS epidemic as a public health threat by 2030"

A publicly stated commitment to eliminate HIV transmission in Scotland by 2030 is an ambitious but not an impossible target. The most recent data, published by PHS reports 108 'first ever' diagnoses of HIV in Scotland in 2022 (these may not all be cases acquired in Scotland). With commitment and effort, Scotland could be among the first counties in the world to achieve HIV Transmission Elimination. Reducing the number of infections acquired within Scotland requires further improvements to , access and uptake of HIV testing, pathways into care, retention within care for those who are HIV positive, support with stigma and disclosure to partners, and access to HIV Pre-exposure prophylaxis (PrEP) for those who are negative but are at increased risk of acquiring HIV.

The most recent data, showed that in 31 December 2022, there were an estimated 6,600 individuals living with HIV in Scotland²⁶. Of those receiving specialist care 98% were receiving antiretroviral therapy (ART) and, of those, 93% were recorded as having an undetectable viral load. Following the introduction and prescribing of HIV PrEP in Scotland in July 2017. By 2019 a significant decrease in HIV incidence was observed amongst gay, bisexual and other men who have sex with men, who had been prescribed PrEP. With a continued high uptake of PrEP there has also been a reduction in first ever HIV diagnoses in this population in Scotland.

To further highlight our ambition in this area, the Scottish Government commits to achieving the WHO 95:95:95 target by 2025. This measure aims for 95% of people living with HIV to know their status, 95% of people diagnosed with HIV to received sustained antiretroviral therapy, and 95% of people receiving antiretroviral therapy to have achieved viral suppression.

During 2023, a Scoping Group worked to identify the priorities within the HIV Transmission Elimination proposal and to develop a Delivery Plan detailing the first phase of elimination to 2025. A Delivery Implementation short-life working group will be convened under the Scottish Health Protection Network to undertake the co-ordination and monitoring of actions to be taken forward by a range of statutory and third sector agencies.

As with HCV elimination, the ongoing sustainability of our HIV transmission elimination is vital. We must consider how we evidence continued elimination and ensure that beyond the 2030 goal we continue to ensure that we maintain a HIV transmission free Scotland.

Action 15 : HIV Transmission Elimination Scoping Group to identify priorities within HIV Transmission Elimination Proposal, and establish an HIV Transmission Elimination Implementation SLWG to oversee delivery of the actions.

Action 16: Scottish Government to publish a HIV Transmission Elimination delivery plan outlining prioritisation of the recommendations.