HIV treatment and care

In England, government regulations list a number of treatments and services which are always free of charge, regardless of a person’s residence or immigration status. Since October 1st 2012, HIV treatment has been included on this list, alongside treatment for other sexually transmitted infections.

No patient should receive a bill for anti-HIV drugs or HIV clinical care in an NHS hospital.¹

Nonetheless, an HIV-positive individual who also needs treatment for another health condition (e.g. pregnancy, diabetes, cancer, etc.) may be charged for that treatment. For this reason, NHS overseas visitors managers are permitted to assess the circumstances and health needs of people with HIV.

Department of Health guidance makes it clear that HIV treatment should be provided to individuals who are currently staying in the UK, with drugs made available while they remain in the UK. Treatment should not be prescribed for use outside the UK and individuals should not travel to the UK to access treatment.

Guidance states that treatment will be provided to undocumented migrants living with HIV and to individuals diagnosed during a visit to the UK. While short-term visitors to the UK who have diagnosed HIV are expected to bring the medication they need with them, in the event of unforeseen circumstances (loss of medication, change of travel plans, etc.) the NHS should provide limited emergency access until alternative arrangements can be made.

Due to the possibility that an individual will leave the UK, first prescriptions should be for a maximum duration of one month.¹

The removal of charges for HIV treatment was a significant victory for HIV advocates who persuaded government officials that charging for HIV care discourages migrants from testing for HIV, leads to undiagnosed individuals unwittingly passing their infection on, and means that when people are eventually diagnosed, the treatment they need is unusually expensive. Government officials took particular note of the impact that HIV treatment has on onward transmission and justified the politically controversial change on the grounds of public health.

The 2012 amendment is only relevant in England.

In Scotland, Wales and Northern Ireland, the legislation still states that HIV treatment may be chargeable. Nonetheless, charges for HIV treatment have not been levied or actively pursued in recent years. The National AIDS Trust (NAT) has called for a formal change in the law in these countries, to ensure that free universal access to HIV treatment is guaranteed for all across the UK.