Ending HIV transmission in Scotland by 2030
The HIV transmission elimination proposal has been developed by Professor Rak Nandwani and an expert group made up of clinicians, academia and third sector partners. The proposal contains 22 recommendations to ensure progress is made to meet our goal of zero transmissions in Scotland by 2030.
Monitoring and evaluation
Public Health Scotland is the lead national agency for improving and protecting health and well-being. After some years of planning and a desire to work in new ways, Public Health Scotland was launched in April 2020, jointly sponsored by the Scottish Government and the Convention of Scottish Local Authorities (COSLA). The Scottish Health Protection Network (SHPN) which includes national SHBBV leadership is co-ordinated by Public Health Scotland.
As highlighted previously, robust, dedicated monitoring and collection of data is an essential prerequisite to deliver the ambition of ending HIV transmission by 2030. In turn, the information requires interpretation and expertise to evaluate progress and inform future interventions. Many of the recommendations require analysis of Scotland-wide baseline data followed by robust monitoring arrangements. Scotland has an excellent past record of publishing official statistics on HIV including new diagnoses, attendance and uptake of specialist care and prevention interventions, which have guided policy and strategy on this topic [Ref 39].
The COVID-19 pandemic adversely impacted on the capacity of Public Health Scotland to monitor blood borne virus and sexually transmitted infections (BBV/STI). However, in support of this HIV transmission elimination proposal, Public Health Scotland have reaffirmed their commitment to prevent ill-health and early death associated with BBV/STI in their 2021-24 delivery plan, as part of their wider workplan to reduce health harms within communities and place that communities are exposed to [Ref 40].
To progress the aim of eliminating HIV transmission in Scotland, we recommend that Public Health Scotland takes the lead role to deliver the following actions:
PHS 1: To re-mobilise the BBV/STI team to provide timely surveillance data on HIV epidemiology, including the development of estimates of HIV incidence and prevalence in Scotland.
PHS 2: To collaborate with other national agencies to agree shared definitions of HIV transmission elimination metrics, and to develop monitoring and evaluation initiatives for delivery.
PHS 3: To utilise administrative and clinical information systems (including NaSH data) to support the publication of national HIV data for Scotland.
PHS 4: To review and refine methods to estimate the number of individuals confirmed as living in Scotland aware of their HIV status but not currently engaged in HIV care.
PHS 5: To work with partners to monitor the extent of BBV (and other harms) in people who inject drugs and to evaluate interventions to prevent BBV transmission, including the continuation of national bio-behavioural surveillance systems.
PHS 6: To work with partners to support the monitoring and evaluation of sexual health and harm reduction services in relation to HIV transmission elimination.
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