1. Will the Cabinet Secretary make a statement on increasing the opportunities for people to test for HIV, including within community settings, through self-testing and home-sampling? OAQ52963

Thank you for the question. I recently announced a number of interventions to improve sexual health in Wales, including a pilot for online testing in the Hywel Dda university health board area, and a project to provide self-sampling HIV tests to those attending pre-exposure prophylaxis clinics. This work will inform future developments in service provision across Wales.

I'm really pleased, Cabinet Secretary, and I welcome your commitment to this, because we all know that early diagnosis of HIV is crucial to ensuring that any individual who has a positive test can start treatment as soon as possible, and having a range of opportunities for testing is indeed vital to improving that early diagnosis and to maintaining the health and well-being of those people who are living, or might be living, with HIV. Late diagnosis of HIV does cause serious implications for the individual's health and can lead to serious and life-threatening complications. Unfortunately, late diagnosis for HIV is still high, with 43 per cent of all new cases being diagnosed late. So, Cabinet Secretary, beyond the ones that you have just outlined—and they are indeed very welcome—what other actions might the Welsh Government take to improve even further the take-up of early diagnostic testing in HIV?

Well, I'm genuinely encouraged both by the work we're doing on PrEP, but also in the new pilot that I've announced. The work on PrEP is important, because, if you recall, when I gave a statement to this Chamber previously, we had picked up a number of people in the pre-testing, before providing PrEP—a number of people undiagnosed with HIV—so they were able to actually begin treatment for that at that point, as well as the preventative point about PrEP, and I expect that we will learn much more about how to make sure PrEP is properly available to prevent HIV taking place in the first place. The roll-out that I've announced of the self-testing and sampling at home is important, because other parts of the UK have a variation of that. We've actually got an easier test that we're actually rolling out here in Wales. The initial focus is on chlamydia and gonorrhoea, but that will then roll out into looking at HIV testing as well. We provide nearly 100,000 HIV tests in Wales each year, so there's a significant amount of testing going on. It's not about what we should do; it's how we should do it, and how we should improve what we're doing, and, actually, on this point, we're leading the way across the UK.

Cabinet Secretary, you recently highlighted the importance of understanding the real levels of HIV in Wales, and I think, as you added, the number of people living with HIV here is probably underestimated. The Terrence Higgins Trust have produced statistics that relate to the UK as a whole, with a breakdown, but there's very little data in their statistics relating to Wales specifically. Aside from looking at providing testing in communities and self-testing kits, will you be carrying out further Wales-focused research to understand how many people in Wales are HIV positive and, importantly, if there any parts of Wales with a higher number of people suffering than elsewhere?

We expect to learn an awful lot from the PrEP study we're engaged in—not just people presenting themselves, because it is a genuinely nationwide point, but the broader engagement with sexual health services. So, the point about making testing easier—it's all part of trying to reduce stigma as well. There's a challenge about people coming forward to take advantage of the testing that is already available, so the easier we make that, the more we talk about it, frankly, the more likely we are to have people come forward. And we can of course be confident that there are people living in Wales undiagnosed with HIV, because we discovered some of them by accident in the PrEP testing. We thought we would discover some, because we're actually getting to people who have riskier sexual health behaviours than others. That's why, even the people who have undertaken PrEP, we know that nearly a fifth of those people have actually got other sexually transmitted infections. So, we're actually dealing with the right population of people, and I look forward to addressing the Terrence Higgins World AIDS Day event here in the Senedd at the end of this month, while speaking about this Government's commitment to eliminating HIV here in Wales.