Original Article: ind.pn/1AoZL3w
Last November the government touted a 50% cut to HIV Prevention England’s budget, a decision it reversed and denied altogether days later after the tumultuous political fallout left it little room to do anything but. It was a victory for health campaigners, but a small one in the wider context of the wholesale cuts to prevention which have taken place over the last decade. In 2001/02 £55 million was allocated to local authorities for HIV prevention services. Last year that figure stood at just over £10 million. It should come as no surprise that the number of new diagnoses recorded each year is now significantly higher.
It’s textbook short-termism. In high prevalence areas – where two in every 1,000 people is diagnosed with HIV – the NHS spends 55 times more on treatment than it does on prevention. The estimated lifetime cost of treating one person living with HIV lies between £280,000 and £340,000. There were 6,000 new diagnoses recorded in England and Wales in 2013, more than double the figure in 1998 (2,901). Treating them alone will likely cost over £1.6 billion.
“We’re surviving, but the bit of the work that isn’t supporting itself financially is the HIV prevention work. That’s the work that we’re most known for,” says Hodson. “All the money we spend on HIV prevention every year is less than it costs for the treatment of one person living with HIV. Although the eighties were obviously the worst times in terms of death we’re looking at a higher prevalence now than we ever had at that time. Each year the prevalence has increased within the gay community. It’s complicated by the fact we’re dealing with an evolving situation.”
With a third of people with HIV living in London spending per capita is higher compared with outside. The emergence of dating apps has made registering a high turnover of sexual partners much easier, while increasing numbers of gay men are engaging in chemsex (sexualised drug use), where inhibitions are removed and the ability to evaluate potential health risks is severely reduced. The dynamic of sexual relationships isn’t static and if the rising transmissions rates among young gay men are to be curbed then the approach to prevention should be similarly fluid. In the austerity era it’s a tough sell.
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