Monday 29th October 2018

Results released today from a Europe-wide survey including over 500 people in Scotland demonstrate that, despite significant progress over almost four decades, HIV-related stigma persists as a major challenge for people living with HIV (PLHIV). 

Negative societal attitudes towards PLHIV pose a barrier to achieving the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 treatment targets by 2020, as stigma discourages testing and can impede PLHIV’s access to and engagement and retention in HIV care. Early diagnosis and successful treatment of HIV can reduce AIDS-related deaths, lead to a near normal lifespan, and prevent HIV transmission. , 

“Across Scotland, we have seen a great deal of positive changes in addressing HIV management and care over the years, particularly with respect to the UNAIDS 90-90-90 targets for testing, treatment and viral suppression,” said George Valiotis, CEO, HIV Scotland. “However, as these results show, there is still much work to be done amongst the general public to further tackle the issue of HIV-related stigma and misconceptions about HIV and PLHIV, which can be a key barrier to achieving the target of 90% of PLHIV knowing their status. We need to evaluate and increase our efforts and ensure that we adopt the right approach to address these issues and achieve 90-90-90 by 2020.”

Results for Scotland from the Is HIV Sorted? survey, jointly conducted by the International Association of Providers of AIDS Care (IAPAC), the core technical partner of the Fast-Track Cities initiative, and Gilead Sciences, were presented today at HIV Scotland’s ‘Fast Tracking Scotland to End the HIV Epidemic’ event at the Glasgow Science Centre.

  • Across Scotland, a significant proportion of respondents (69%) would not feel comfortable dating someone who is living with HIV (68% in Glasgow)
  • Just over one-fifth (22%) of respondents would not feel comfortable working with a person living with HIV; however, significantly more respondents (42%) believe that PLHIV should not be allowed to work as healthcare professionals
  • Only 43% of respondents across Scotland agreed or strongly agreed that HIV-related stigma is ‘a thing of the past’ in the United Kingdom

The survey results also demonstrated a significant lack of awareness about the realities of HIV treatment and secondary transmission. Successful HIV treatment that yields an undetectable level of HIV in the blood (viral suppression) over a six-month period means that the risk of transmitting the virus from HIV-positive to -negative sexual partners is negligible to non-existent (the premise of the Undetectable=Untransmittable [U=U] message). However:

  • Only around one in 10 respondents (11%) understood the meaning of ‘undetectable,’ with approximately one third (33%) believing that being undetectable means that you can still transmit HIV to someone else
  • 44% of respondents believed that it would still be possible to transmit HIV to others, even if HIV treatment was having the best effect possible (viral suppression)
  • Less than a third (28%) of respondents were aware that it is possible for women living with HIV who are undetectable to conceive HIV-negative children

HIV testing rates among Scottish respondents was also worryingly low. One fifth of respondents have had an HIV test (19%) in their lifetime – however half of these tests (51%) were completed more than 5 years ago. In addition, the survey found worrying levels of complacency across Scotland with respect to HIV prevention. Almost a quarter of respondents said they had a new sexual partner in the last year but, of these respondents, only 37% always used a condom, and a quarter rarely or never used a condom with a new sexual partner. These results contrast with a majority view among respondents in Scotland (78%) that condoms can protect people from HIV infection, though very few respondents (5%) are aware that taking certain HIV treatments before sex (5%) can reduce HIV acquisition.

“HIV Scotland’s commitment to fast-track the country’s AIDS response is aligned with the Fast-Track Cities initiative’s objective of attaining the 90-90-90 and zero stigma targets to achieve impact on national HIV epidemics. The Is HIV Sorted? survey results for Scotland demonstrate a need for greater collaboration and coordination to increase HIV literacy among the general public, address complacency regarding HIV testing and prevention, and correct misperceptions that exacerbate stigma against PLHIV,” said Dr. José M. Zuniga, President/CEO, International Association of Providers of AIDS Care (IAPAC). “We firmly believe that for Glasgow and other Scottish cities, an initiative such as Fast-Track Cities can provide a platform to support this holistic approach, with the opportunity to leverage wider global partnerships and share positive learnings and best practices on the world stage.”