The number of new HIV infections in the UK continues to rise. By the end of 2013, an estimated 107,800 people were living with HIV in the UK, approximately one quarter (26,100 people) of whom were undiagnosed. 33,863 Londoners are living with diagnosed HIV and 32 of the 33 London boroughs are deemed to have a high prevalance of HIV against the national standard (2 people per 1,000 aged 15-59). Over one third of those with new HIV diagnoses in the UK in 2013 were Londoners (2,122 of 6,000).
Diagnosed HIV prevalence per 1,000 residents aged 15-59 by council in London, 2013 (Source: PHE)
From 1 April 2013 a range of public health responsibilities, including the commissioning of HIV prevention services, transferred from the NHS to local authorities. A Pan-London HIV Prevention Programme had been jointly commissioned by the London Primary Care Trusts, but was due to come to an end in March 2013.
In February 2013, our Leaders' Committee commissioned a needs assessment and options appraisal to consider the case for future pan-London commissioning.
In the light of this work, in November 2013, our Leaders' Committee agreed a new three-year £3.4 million London HIV Prevention Programme would be commissioned to deliver a limited number of key HIV prevention services.
The services are aimed at men who have sex with men and black African communities (the groups at highest risk of contracting HIV) and will include media campaigns, condom distribution and some outreach work.
Boroughs remain responsible for any additional HIV prevention commissioning required to meet the needs of their communities. Two case studies of local HIV prevention work are The ChemSex Study and C-Card Scheme.
The London Borough of Lambeth is hosting the London HIV Prevention Programme. It is overseen by a Steering Group, chaired by Julie Billett, Director of Public Health for Camden and Islington. Queries about the programme should be addressed to Paul Steinberg, the Programme Manager (email@example.com).
Three contracts have been let under the programme:
- Condom distribution and personal/digital outreach to men who have sex with men
A new contract worth £950,000 over 2 years started on 1 April 2015. It will secure distribution of 1.5 million condoms and lubricant sachets to a minimum of 80 MSM venues across London and deliver 76,000 face to face outreach contacts per year at 22 priority venues, as well as at 6 key events a year (eg Gay Pride).
- Black African condom distribution - review
There was found to be a lack of robust evidence about how to target condom distribution to black African communities effectively, so a review of existing schemes has been commissioned to inform the further development of this part of the programme.
- Communications and media
The LHPP has secured £250,000 from the National Institure for Health Research to contribute to the evaluation of the progrmame that will be undertaken by University College London (UCL) in conjunction with Public Health England.
The LHPP features in a June 2015 publication of case studies of sexual health commissioning in local government (link to an external website).
The HIV Prevention Needs Assessment for London - Nov 2013
The HIV Prevention Needs Assessment for London was published in November 2013. Six underpinning work streams fed into the needs assessment:
- Epidemiological review
- Evidence review update
- Call for evidence
- Stakeholder engagement
- Segmented insight research
- Mapping of current HIV prevention
A Health Equity Assessment was also produced.
A new evaluation work stream in the London HIV Prevention Programme will ensure that we continue to learn about what works best and build the body of evidence to inform future commissioning.