In a year of news about COVID-19, it is easy for a genuinely exciting development like the topic of this month's editorial to get lost in the relentless news cycle of late. I don't think I myself have written an editorial that wasn't about the pandemic in about a year now, that's how consumed our lives have become with this ongoing pandemic (though hopefully it is now nearing its end).
The exciting news is that the latest research from the University of Cambridge and Public Health England, published in The Lancet HIV (Brizzi et al, 2021) has shown that HIV is on track to be eliminated by 2030.
The management of the HIV epidemic among men who have sex with men (MSM) in England was scaled up in 2011, and from 2015 was supplemented by pre-exposure prophylaxis (PrEP). Examining the results of this study, Brizzi et al (2021) found that the targets set by the United Nations for HIV control and elimination of HIV transmission could be within reach by 2030 among MSM in England.
The peak in the number of new HIV infections in MSM in England is estimated to have occurred between 2012 and 2013, followed by a steep decrease from 2770 new infections in 2013 to 1740 in 2015 and a further decrease in 2016, down to 854. The drop was consistent across all age groups but was particularly marked in MSM aged 25–34 years, and slowest in those aged 45 years or older. It is impressive to note that this decrease began even before the widespread rollout of PrEP in 2016, showing the effectiveness of the testing and treatment system put in place in England.
June this year was Pride month, a time to reflect the many accomplishments of the LGBTQ+ community, as well look at the work that still needs to be done around the world. Here in the UK, we are lucky enough to have practitioners like yourselves who are well versed in the treatment of LGBTQ+ people and offer a number of services that not only protect their sexual health but also their mental wellbeing. Of course, this is not to say we are perfect. The trans community still face perplexingly long wait times when beginning the medical process of transitioning, with many still opting to commit their savings to see a private doctor, rather than waiting for their referral to a gender identity clinic. I have no doubt this is a complex and often intimidating area for practitioners. With the discourse constantly evolving and an ongoing discussion regarding such issues in the media, the care and treatment of the LGBTQ+ community often requires not only a broad knowledge but also a stigma-free mindset. I am sure many members of the LGBTQ+ community, including myself, at times, have felt that the language used by the medical community during consultations and treatment could have been better considered; but these are learning steps, and it is important to access your own behaviours and practices at every turn.
I hope you joined me in celebrating Pride month this June, and continue to forward the work the NHS can do for the LGBTQ+ community.