THE hit television series It’s a Sin is a timely reminder of the dangers of stigmatising HIV and Aids, according to a Scottish academic.

While there’s been a significant fall in the number of new HIV infections in Scotland following a ground-breaking prevention programme, sexual health expert Professor Claudia Estcourt warns there’s more work to be done to break down the stigma that prevents people seeking help.

“When I was watching It’s a Sin it took me right back to the 1990s, when I worked with beautiful young people who were dying from Aids right into the 2000s because of the stigma and ignorance around the disease,” said Ms Estcourt, Professor of Sexual Health and HIV at Glasgow Caledonian University.

She was referring to the critically acclaimed Russell T Davis drama currently on Channel 4 that follows the lives of young gay men arriving in London in 1981, when rumours started circulating of a mysterious, deadly flu attacking only gay men.

The slogan for the UK public health campaign that began in 1986 when the Government believed millions of people could become infected was “Don’t die of ignorance”, but today, 35 years later, Ms Estcourt says that there are still dangerous misconceptions that hamper the fight against this treatable disease.

Her concerns come as a result of a report that she and her fellow researchers have published into the success of the Scottish HIV Pre-Exposure Prophylaxis (PrEP) programme. Scotland was one of the first countries in the world to implement a national PrEP programme to help eliminate HIV transmission by the UK target of 2030.

Professor Estcourt’s report found that there’s been a huge fall in Scotland in new HIV infections following the rollout in 2017 of PrEP, which involves taking anti-HIV pills daily or around the time of sex and is available free from NHS sexual health clinics.

New HIV diagnoses in gay and bisexual men fell by 20 per cent after the implementation of the publicly funded PrEP programme in Scotland, while HIV incidence in a large cohort of men attending sexual health clinics fell by 43%.

Among the 3,256 gay and bisexual men who attended Scottish sexual health clinics between 2017 and 2019 and were prescribed PrEP at least once, incidence of HIV infection fell by 75%. Incidence also fell by 32% among men who had never taken PrEP, suggesting that PrEP users remaining HIV negative have benefits for their sexual partners too.

But the more worrying finding is that the programme is not reaching people from other groups who could benefit, including women, heterosexual men, people from some African communities, transgender people and people who inject drugs. Only 2% of the people who have taken PrEP so far are not gay and bisexual men.

“We show that it is possible to achieve important reductions in HIV incidence in men who have sex with men when PrEP is implemented within routine care,” said Professor Estcourt. “Our findings suggest that PrEP can make a wider contribution, alongside other prevention interventions, in reducing population level risk of HIV for those not on PrEP.”

The next challenge will be to bring these benefits to a wider and more diverse cross section of the population. Before PrEP, approximately half of Scotland’s HIV diagnoses were in gay and bisexual men, 30% in heterosexual men and women, and 15% in people who inject drugs.

“Our research findings are important and exciting because they show us where the gaps are, so we know we have to work harder at raising awareness in all groups who may benefit, try and make it more acceptable to attend sexual health clinics, and think how best to provide PrEP in other settings,” said Professor Estcourt.

“There’s still a lot of shame around sex and talking about it is taboo in some families. If you don’t know about sexual health and you’re in an environment where sex is not talked about, even attending a sexual health clinic can be seen as a slur on your character,” she added.

“All you have to do is watch It’s a Sin to see the damage caused by sexual taboos – it’s gutting and chilling. For me, there’s no such thing as a taboo subject. HIV is simply an infection that is treatable today, with a normal life expectancy if medication is taken and you attend regular medical check-ups, but there’s still so much stigma around it.

“PrEP has been a great success in Scotland with 1,000 people benefiting from its use in the first year, and around 4,500 over the last three years. Now we want to extend these benefits to a greater proportion of the population. We want to normalise the use of PrEP so people realise that it’s one of a number of tools that they can use to have healthy sex lives.”