Not enough money is being spent on HIV prevention to have any impact on the rate of new HIV infections, according to the NAT (National AIDS Trust).

The trust found that in 2014/15 £15 million was spent across England on HIV prevention, compared with £55 million in 2001/02. In this time the number of people living with HIV has trebled, while the amount spent on prevention has decreased to less than a third of the original budget.

This estimate is based on information provided to NAT from local authorities in England with a high prevalence of HIV. £10 million was spent in 2014/15 on HIV prevention in these areas – just 70p per person.

The report also highlighted that in local authorities with high prevalence of HIV, only 0.1 per cent of local authority public health allocation is spent on HIV prevention; yet in 2013 the NHS spent 55 times more on HIV treatment and care in these areas than on HIV prevention.

HIV treatment v prevention

The lifetime costs of HIV treatment and care for someone with HIV is £361,000.

Deborah Gold, chief executive of the NAT, said: ‘Our research found, shockingly, in the 58 areas of highest prevalence of HIV in England, seven local authorities weren’t spending anything on primary HIV prevention or on additional testing services. Worryingly we also found no correlation between level of HIV prevalence in an area and how much was being spent on prevention. There are massive inconstancies between regions and areas, creating a postcode lottery of HIV provision.

‘Testing for HIV is an important prevention intervention as we know that up to 80 per cent of people get HIV from someone who doesn’t know they have it. Worryingly 35 out of 58 local authorities were not investing anything in HIV testing outside sexual health clinics in 2014-15. This is despite NICE guidelines clearly stating they should be offering tests in GP surgeries, hospitals and community settings in order to have any hope of reducing the number of people with undiagnosed HIV, and further transmissions, in their areas.’

The HIV charity is also concerned that more problems are on the horizon when the ring-fencing for the public health budget is removed. Currently, local authorities are given money to provide basic services such as sexual health clinics. In April 2016 they will be able to spend this money on anything. Gold continues: ‘In the current climate of cuts and pressure on budgets we are extremely worried this money will be used to shore up other areas of council spend. This would be a disaster for public health in this country.’