New HIV figures put us within sight of #ZEROHIV target by 2030 The beginning of May brings with it the spring sunshine, the countdown to summer holidays, and the annual HIV Scotland analysis of Health Protection Scotland’s surveillance report of HIV diagnoses. The figures for 2018 published last week reflect a significant decline in new HIV diagnoses in Scotland. It is the lowest figure recorded in the 10-year history of the report and continues the downward trend over the past decade. A keen eye might have also spotted that this is the first report in a new style for Health Protection Scotland, focusing on two different figures – First Time Reports and Total Reports. This splits out the figures of people who are newly diagnosed, and it is the first time this diagnosis is being reported alongside Total Reports, which includes people who may have moved to Scotland, or back to Scotland, where their HIV has previously been diagnosed and reported elsewhere. Using this information, we can get a better picture of how effective our prevention strategies are working in Scotland. I wrote previously about being sceptical of celebrating 2016’s drop in new diagnoses rates too much, but I think we can be safe in the knowledge that the tools available in Scotland to prevent or diagnose HIV are working. The overall 14% decline in new HIV diagnoses is incredibly good news, and worth celebrating. The figures show that the significant decline comes from diagnoses among gay, bisexual and other men who have sex with men, and people who inject drugs. This means we’ve seen the first significant decline in new diagnoses among people who inject drugs since the outbreak in Glasgow was recorded in 2015. That means that our strategies to contain the outbreak, prevent HIV, and decrease community viral load are working. Some of these measures included community-based prescribing through pharmacies and outreach nurses, as well as third-sector services, such as Waverley Care’s outreach team. The U=U (Undetectable = Untransmittable) message seems to have embedded itself into clinics and among people living with HIV. The success of this message, the scientific fact that people living with HIV on effective treatment with an undetectable viral load can’t pass the virus on to others, is challenging the stigma that was so structurally embedded in the everyday lives of people living with HIV. We can celebrate the science behind the U=U message as a tool that puts people in charge of their treatment choices and removes the fear and to encourage testing. And, of course, there’s PrEP. This data could be the first sign that PrEP is working – with a significant decline in new diagnoses amongst men who have sex with men, and fewer recent transmissions too. PrEP has been bringing more people into the clinic, many who have never been or not been tested in over 2 years. It is important to continue promoting positive sexual health messaging alongside this vital HIV prevention tool. The figures are certainly something to be celebrated. A 14% year-on-year reduction would take us within sight of reaching our #ZEROHIV targets. We’re off to a good start, but we cannot become too complacent. There’s still much work to be done. Let’s keep up the work, spread the message about U=U, PrEP and Testing, and together we can set a course for a Scotland where HIV becomes a thing of the past. Let’s get to work.