• Responsibility for sexual health services transferred to councils in 2013
  • Fall particularly notable among gay and bisexual men

A large fall in HIV transmission among gay and bisexual men has occurred since responsibility for providing sexual health services moved from the NHS to local government, data from Public Health England has revealed.

report, published on Thursday, said in the UK there were 2,300 HIV transmissions for this group in 2014 compared to 800 in 2018.

Directors of public health have been responsible for sexual health services, including testing for sexually transmitted infections, contraception and advice, since they transferred to councils in 2013.

The figures, which were reported by LGC, also showed a drop in people being diagnosed with HIV.

Following a peak in people being diagnosed in 2014 of 6,278, there was a “rapid decline” to 4,453 in 2018. For gay and bisexual men, the reduction was 35 per cent over the period.

Commenting on the report, Noel Gill, head of STIs and HIV at PHE, described testing as “a key part of the UK’s success”, adding: “We are well on our way to reaching the goal of eliminating HIV transmission by 2030, with the rapid fall in HIV transmission continuing in 2018, and nearly all of those diagnosed receiving treatment that prevents onward transmission.”

However, Dame Inga Beale, chair of the HIV Commission, said that while the figures showed “real progress” is being made in the fight against HIV, they also showed “the significant challenges that remain if we’re to achieve the ambitious goal of ending transmissions by 2030”.

She highlighted the need to look at what is working “as well as thoroughly investigating how to tackle persistently high rates of late diagnosis and ensure the decline in new diagnoses is felt across all groups impacted by the epidemic”.

The report said pre-exposure prophylaxis, which sees HIV-negative people taking antiretroviral medicine either daily or before and after sex, “is highly effective at protecting people who are at a high risk of acquiring HIV” when taken consistently.

A three-year PrEP impact trial in England, launched in October 2017, has twice been expanded after demand exceeded original expectations, and, last October, health and social care secretary Matt Hancock said the “rollout from a trial to routine commissioning will happen in April (2020)”.

The Local Government Association has earlier called on the government to ensure adequate funding is in place to support a future nationwide expansion of PrEP, accompanied by “a firm guarantee that any unforeseen costs do not fall on already under pressure local authorities”.

However, although the government has said the public health grant for 2020-21 will be increased in real terms, it has yet to confirm details, including any additional responsibilities it may include about the roll out of PrEP around the country.