SONAR – World AIDS Day, 1 December 2023

The discovery of new and better treatment for HIV / AIDS is one of the great health service successes of the last forty years. Clinicians and scientists have discovered how to diagnose the disease quickly and to treat it with new drug therapies (diagnosis of patients as HIV positive can be carried out by a simple test costing £20, with 100 per cent reliability).

As a result, the number of new HIV diagnoses among men has fallen from 4,155 in 2013 to 2,430 in 2022. At the same time, the number of people who are able to live with the disease has risen. The most recent survey showed that an estimated 105,200 people were estimated to be living with HIV infection in the UK in 2019, 94 per cent of which were diagnosed.

There is more to do: the rates of transmissions among heterosexual men and among women have not fallen as fast as those for gay men, for example. Leading AIDS charities are campaigning for routine tests for patients attending A&E across the country, following a successful pilot in London, Manchester, Brighton and Blackpool.

The overall goal, as set out by government, is to end new transmissions of HIV in England by 2030. Providers of health information systems in prisons and other settings, such as SONAR, can help to achieve it.

The cohort of users that SONAR supports is at high risk of contracting the virus. Drug users are heavily over-represented in prisons. Nearly 30,000 adults received treatment for drug problems in prisons in 2020-21.

In 2018, the Health Select Committee received evidence that prevalence of HIV and hepatitis C was higher among male prisoners than in the whole population, and substantially higher among female prisoners.

SONAR’s specialized interface for health staff aims to make it easy for health professionals to input data on, for example, HIV testing and treatment. Because of the ability to connect to health data in other settings, and in the NHS, prison staff will have full knowledge of prisoners’ medical history and medication needs.

It will prevent examples where individuals have suffered harm due to failure act on a person’s medical status, as in the case of Thoko Shiri who died as a prisoner at HMP Chelmsford having failed to receive HIV medication. Through the SONAR Release Portal, it will ensure that health authorities are aware of an individual’s full medical history post-release.

SONAR aims to provide the right information at the right time. In the case of HIV / AIDS, it will contribute to an historic and ongoing improvement in people’s lives through better healthcare.

References:

• HIV diagnoses: New HIV diagnoses, AIDS, deaths and people in care in England data tables, UK Health Security Agency, October 2023

• People living with HIV: House of Commons library, July 2023

• Department of Health AIDS action plan (December 2021) and update (June 2023).

• People receiving drug treatment in prison: Alcohol and drug treatment in secure settings 2020-21, Office for Health Improvement and Disparities, 27 January 2022

• Evidence to Health Select Committee: Revolving Doors Agency, 2019

• Case of Thoko Shiri, Leigh Day solicitors, June 2022