In EastEnders this week, Zack Hudson has been struggling with how to tell his past sexual partners and drug-injecting partners about his HIV diagnosis. As we follow Zack’s journey to realising that his HIV isn’t a life sentence for him or his baby, we're also seeing one of our most important tools for ending new HIV transmissions in action – partner notification.
In the episode on 19 January, Zack gave names and numbers to his clinic of his former partners. He is visibly daunted, but he doesn’t have to be. Trained health professionals will take over and contact them by call or text and let them know to test. It’s anonymous, voluntary and can’t be linked back to you – and if they test positive, they too can access the effective treatment that means they can live a long, healthy life and can’t pass on the virus.
Millions of us have been on one or other end of a similar experience recently, through the NHS COVID-19 Test and Trace programme. But long before Test and Trace, this type of 'partner notification' was standard in the sexual health world – and it still is.
The HIV testing that follows is the most likely of any testing to find someone with undiagnosed HIV. Only 4% of these tests come back positive, but that’s higher than any other standard testing that takes place in sexual health services, in emergency departments or through postal tests. This makes it a really efficient, cost-effective way of diagnosing people with HIV.
The Government’s target to end new HIV transmissions by 2030 relies on us finding the 4,400 people with undiagnosed HIV in England. To do this, every type of HIV testing has to become normal and de-stigmatised – including partner notification. As we get closer to 2030 and if numbers continues to fall, partner notification will only become more valuable. If new cases of HIV become less common, finding people who may have had contact with HIV will be harder, but even more important.
However, acute staff shortages and funding pressures in sexual health clinics is making partner notification harder for services to prioritise. The budget allocated to local authorities for public health – which funds sexual health services – has fallen dramatically for over a decade now. Actual spending on sexually transmitted infection (STI) testing, contraception and treatment has dropped by more than £110 million over the last seven years.
On top of this, councils are still waiting to hear what their public health funding allocations will be for the year 2023/2024. This uncertainty holds back their planning. Proactive public health work like partner notification is often the first thing which takes the hit – but we can’t afford to continue to let that happen.
We’ve been proud to work with the BBC to make sure that Zack’s HIV storyline is as true to life as possible. It's brilliant that Zack’s clinic in Walford can support him to notify others to take an HIV test and know their status, but the sad reality is partner notification is increasingly less common.
We hope this is a reminder to Government, commissioners and service providers that we must prioritise partner notification in the real world too.
