 The next item of business is members' business debate on motion 2404, in the name of Kezia Dugdale, on World AIDS Day 2016. The debate will be concluded without any questions being put. Would those members who wish to speak in the debate please press the request to speak buttons as soon as possible? I call on Kezia Dugdale to open the debate. Around seven minutes please Mr Dugdale. Thank you, Presiding Officer. Can I start by drawing the chamber's attention to my register of interests where it's listed that I am a member of the Terence Higgins Trust, which is of course named after Terence Higgins, who was the first person to die of AIDS, so coming to the disease in London's St Thomas's hospital aged just 37. I'm very grateful to all the members who have decided to stay in the chamber to listen or to participate in this debate, designed to mark World AIDS Day tomorrow. I'm particularly grateful to HIV Scotland for all the work that they have done ahead of tonight's debate and indeed ahead of tomorrow's lunchtime reception in Hema, which members are most welcome to attend. Having cornered several friends across the chamber and encouraged them to speak tonight, I know that we are in for an excellent debate. For Labour's part, Nassarwa will pick up the global and international development dimension of the battle against HIV and AIDS. Monica Lennon will discuss issues around HIV services for drug users, whilst Daniel Johnson will talk a little bit about Waverly Care here in Edinburgh and some of the work that Edinburgh University is doing to find a cure for the disease. That leaves me with plenty scope to reflect on how we got here. I've had a long-standing interest in HIV AIDS, an interest predating the experience of knowing dear friends who are HIV positive, an interest that predates being at ease with my own sexuality and understanding the history of the LGBT community's relationship with the disease, and an interest that predates all the fundraising efforts on our TV screens to tackle the spread of AIDS as it did and continues to savage sub-Saharan Africa. I am very much a child of the 1980s, born in 1981. The year that AIDS was first clinically observed, it wasn't called that at first. The working title, so to speak, was 4H, named after the four groups most likely to get it—heroin users, homosexuals, hemophiliacs and Haitians. That was replaced with grid, which stood for a gay-related immune deficiency, a name that, fortunately, had a very short lifespan. We are all aware of the UK Government TV campaign of the time, which warned of a disease that was spreading—a disease for which there was no cure—a terrifying advert that started with an explosion and ended with a giant tombstone with the word AIDS engraved on it, and the slogan, Don't Die of Ignorance, a leaflet version of which was posted through every letter box on Margaret Thatcher's command. I personally recall watching Mark Fowler try and tell his mum and dad in these tenders that he had a virus, that it was just one of those things, that it didn't mean that he was ill, just that he could get ill, but all he could hear was AIDS, and all he could think of was the death sentence that came with it. What I didn't and couldn't appreciate, though, was how HIV-AIDS was affecting this dear city that I now have the great privilege to represent, because, of course, we can't and shouldn't forget that Edinburgh was during the 80s the AIDS capital of Europe, and if Edinburgh was the capital, Muir House was the epicentre—a community with deep-rooted poverty, appalling houses and mass unemployment was exploited by drugs, and the heroin brought HIV. A study of around 230 drug users from Muir House in the 1980s showed that 52 per cent of them were HIV-positive, 52 per cent. Sharing needles was literally a game of Russian roulette, a game brought vividly to life for all of us who have seen Irvine Welsh's train spotting. Such a density of cases forced the Scottish AIDS monitor into existence, and soon support services, which we now know as Waverly Care, were established. Milestone House was opened as a hospice for people dying of AIDS in 1991, and on Friday night I attended a Waverly Care event to raise funds to keep it going 25 years on. Difference now, of course, is that it's evolved from caring for those who are dying to assisting so many more people to live their lives positively. In preparing for tonight's debate, I took some time out to look properly at some of the press cuttings from the 1980s. It's hard now to grasp the absolute outrage that was sparked when Princess Diana was photographed holding the hand of a man dying of AIDS in Canada. How brave and groundbreaking it was of her to say in 1986, HIV does not make people dangerous to know. You can shake their hands and give them a hug. Heaven knows they need it. She seemed to know instinctively that what was needed was compassion and understanding, not fear and ignorance. How applicable that is to so many of the problems that we face in the world today. The first debate on HIV AIDS in the House of Commons took place in November 1986, sent dipotysli almost 30 years ago to this very day. Having read the full Hansard report, I'd like to share some of the excerpts with the chamber. The Secretary of State for Social Services Norman Fowler was the first to speak. He told the chamber that AIDS was a serious threat, that there were 565 cases in the United Kingdom and 284 people had died. He said and I quote, the likelihood is that it will be a problem for the next 10 years, probably for the rest of the century. Even if no one else becomes infected tomorrow, there are still an estimated 30,000 carriers. Little did he know that just 5 years later there would be 10 million people living with HIV, a figure that stands today at 36.7 million people. Sir David Price MP rose to ask for some clarification from the Minister. Could the disease be transmitted through saliva or tears? What about breast milk? Was it safe to hug, to kiss, cry or shake hands? Before concluding, there is no evidence to treat them as lepers, although some elementary precautions should be taken. Anna McCurley, the Tory MP for Inverclyde, no less, suggested that homosexual surgeons, dentists and even people working in the food handling industry should withdraw from their jobs and be compensated by the Government for doing so to reduce the risk of transmission. My dear friend Gavin Strang, who served as the Labour MP from Edinburgh East for 40 years, was the first to demand specific help for prostitutes, counselling, alternative work, free condoms, dedicated healthcare, just four of his demands, which he saw as necessary having watched the disease take hold of Edinburgh first hand. Frank Dobson warned that the threat facing the heterosexual community was underplayed. He said that that is partly because of the presentation of The Sun and other newspapers of AIDS as a gay plague. The people responsible for that sort of reporting, he said, must bear a great deal of the blame for helping heterosexuals to believe that AIDS was no threat to them. I could read from this all night, Presiding Officer, but I suspect you are keen for me to conclude at some point soon, not least to let other members have a go. Safe to say I'll tweet the link to the full debate so folk can read it for themselves. Fast forward 30 years to today, and we've made vast progress. HIV is now one of the most scrutinised viruses in the world. We probably know more about its transmission, its spread, management treatment and prevention than any other, yet we have no vaccine and no cure, but we're close. Medical advances have given us antiretroviral therapy, which has transformed the lives and life chances of people living with HIV. Testing is absolutely critical because early detection, combined with early adoption of antiretroviral medication, means happy, healthy lives. In fact, someone on antiretroviral meds can now have a viral load so low that the disease becomes undetectable again, and the risk of transmission to others so small is to be statistically unquantifiable. A HIV infection is no longer a death sentence. People living with HIV today say that it's not the infection that's the hardest thing to live with. It's the stigma, the fear of how people will treat them, fear and ignorance, two concepts that were the drivers behind how this country spoke about and dealt with HIV and AIDS in the 1980s and which still exist today, but two concepts that we know can be defeated by education, whether that's formal education from schools to pupils or the information given to those working in saunas, or through informal conversation, compassion and understanding, and through nights like this and days like tomorrow. In marking world day today this year, I conclude that, while there is so much being done to tackle HIV, there is so much more to do. I pay tribute to all those individuals in HIV Scotland, THT and Waverly Care who have made this their life's work. I move the motion. I now move to speeches of around four minutes please, and I call first of all Emma Harper to be followed by Donald Cameron. Thank you, Presiding Officer. Today is world AIDS day. December 1, 1998, was the first day to raise awareness of HIV, the first world AIDS day. While working in the USA in 1990 in the surgical environment, I learned a lot about the harm that HIV virus could cause to my patients. I learned about the presenting symptoms of the opportunist infections called caposi sarcoma and pneumocystis carinae pneumonia. Nobody talks about them anymore. Working in trauma theatre, where emergency surgery often meant the potential to be exposed to blood, it meant that the wearing of personal protective equipment, gowns, gloves, masks, face shields or goggles, and safely handling scalples and sharps meant that healthcare workers were able to be protected from exposure and reduce any risk for us. People who had the virus were stigmatised. It was easier to avoid them than care for them. Many of the doctors and staff I worked with avoided the operating theatres or even speaking to the patients without suiting up. This was daft because HIV transmission was already known to be transmitted via blood and not airborne. The people were fat. The disease is no cure, but my best friend Jackie Pitt worked as an HIV research nurse in Los Angeles. She helped me to understand about the disease and how I could use my knowledge to care for the human beings in the best way I could. In 1991, Irvin Magic Johnson was a famous basketball player for the L.A. Lakers. He announced that he was HIV positive. He wasn't gay. He was heterosexual. He had a wife and wanes. This highlighted that HIV and AIDS were not just a gay man's disease. For me, this highlighted the need to address the disease and not judge the person and not stigmatise the person. Magic sought treatment, and in 1995 announced he had zero viral load. The media grabbed this and said, we have a cure. It wasn't a cure. However, the treatment has advanced, and we now have anti-retroviral drugs, post-exposure therapies and even pre-exposure treatments for those deemed at high risk. HIV Scotland says that HIV stigma is one of the biggest barriers to testing, treatment, care and support. Earlier today, I spoke with one of the NHS of Freeson Galloway blood-borne virus nurses, Liz Kent. As well as doing great work for all their patients in a WeHealth Board with the resources that they have, Liz said that there was still stigma attached to persons with HIV. Those people cannot be discriminated against. She said that we need to continue to help to raise awareness of many young people today who don't have the history of HIV evolution. Today's theme for World AIDS Day is asking us to focus on losing the stigma that is associated with HIV. I am grateful to my harper for taking intervention. Given the sorts of communities that she is talking about in Dumfries and Galloway, it can be quite intimate and where the issues of stigma perhaps more pronounced as a result. Does she think that there is a case for increasing the availability of home testing to avoid the situation where people present at clinics for testing against a wide variety of people that are known to them and who are aware of the reasons why they might be in that clinic? Emma Harper Thank you for that intervention. The issue of addressing stigma is quite interesting. If there are home tests available, that is an idea that could be pursued. Other home tests and point-of-care testing can be achieved by other devices that are already on the market that I have used when cardiac surgery was one of the areas that I worked in. I think that pursuing anything that would help to address the stigma would be something that I would be interested in hearing more about. Again, today, most people with HIV live healthy lives. This is World AIDS Day. I want to thank the specialist nurses and the blood-borne virus and infectious disease doctors, as well as all the other healthcare providers for their selfless work. Let us remember the people who have lost their lives and their families and continue to support the people who are living with this disease and not stigmatise them. Those are our fellow human beings. Donald Cameron, followed by Anna Sarwar Thank you, Deputy Presiding Officer. I would like to start by thanking Kezia Dugdale for bringing forward this motion for debate and note the significance of the fact that tomorrow is World AIDS Day. As a child of the late 1970s, slightly older than Kezia Dugdale, but not much, I also well remember growing up with AIDS in the news, the photos of Princess Diana, etc. Even at that age, it was impossible not to be aware of the high-profile, hard-hitting AIDS advertising campaigns and the growing public knowledge and understanding, albeit sometimes slow and cautious of the condition. But perhaps we thought we had done enough. Perhaps we thought we had won the battle. Perhaps no need three decades later to continue to talk about this. Of course not. It's more important than ever. The National AIDS Trust have chosen the theme of this year's awareness day to focus on stigma and the stigma that continues to surround this issue and I'd like to talk about stigma tonight. Whilst many things have improved since the initial outbreak of the condition in the late 1970s, such as the way we talk about it, the ease by which most people can be tested for it, and the way we manage and treat the condition, one thing that remains a problem is the way in which people view HIV AIDS and the way that people who have the condition are treated by society at large, and one statistic that the National AIDS Trust produced particularly surprised me, two out of five people in Britain believe that their manager should tell them if a colleague is living with HIV. Attitudes like that are archaic and ill-informed, but we can't just rely on simple condemnation to bring an end to views such as the one I've just mentioned. Education is fundamental to this. The Terence Higgins Trust reported that three out of five receive no information at all about HIV in school and there is clearly a need to improve the way in which we communicate on this issue, but beyond that there are issues with how we approach sexual health education in schools. For many parents it can be a taboo subject, I understand that as a parent myself. I would always support a collaborative approach in our schools between parents, young people and teachers, not only about sexual health but also about relationships so that by the time my children are of a certain age they don't fear about talking about these subjects openly. I had the pleasure of meeting with HIV Scotland last month to discuss a variety of issues relating to HIV AIDS and in particular their positive persons manifesto 2016 and we also had a discussion about HIV prevention and what we in this parliament can do to help fight HIV AIDS. Tackling stigma is fundamentally linked with prevention. As HIV Scotland notes around 17% of people living with HIV don't know they are living with it. They add and I quote that one of the biggest barriers in getting people to get tested is HIV stigma. There is also a greater need to increase access to safe testing. Public awareness campaigns are now significantly better in comparison to the somber and off-putting adverts of the 80s which I recall growing up with and it is incumbent upon the government to ensure these preventative methods continue to be supported. I would like to end on one final issue that can be missed in this debate. Today we tend to focus more on the sexual aspect of HIV AIDS and we often forget to discuss the continuing problem of HIV infection as a result of drug use. Jamie Greene and I visited Inverclyde Royal Hospital on Monday and we met NHS staff who worked in treating drug addicts. They talked of the fact that the cohort of drug users who are at risk of infection are aging. They also demonstrated the various methods they use in facilitating safe injecting as well as mental health and they spoke of the particular problem in the greater Glasgow area of a recent alarming spike in cases. Let me end on an optimistic note. We have travelled far and there is more to do but people with HIV are living longer lives and healthier lives and with treatment have full life expectancy. That is a world away from the world of the late 1970s and early 80s. Let's keep talking about it and let's keep campaigning. I'm delighted to both support this motion and have participated in the debate and I commend Kezia Dugdale for driving the issue forward. I must start by saying that I think that the tone and the content of this debate today has demonstrated the very best of our Parliament. I think that they have all been fantastic contributions and I'm sure that it sends a very strong message to the people of Scotland. I want to put on record my thanks to HIV Scotland who have been doing so much tremendous work in the run-up to this debate but in actual fact for years on this very, very important issue. I was particularly struck by what Kezia Dugdale was saying in her opening remarks. I thank her for bringing forward this debate. I vividly remember that EastEnders storyline or the message that she had about trainspotting that Princess Diana photograph and I even remember it was when we were at school it was the one thing that people would tease on would be about all AIDS or HIV or making silly remarks about you can't shake someone's hand, you can't kiss someone and all the rest of it. I'm proud that we've come away from that but I don't think that we should be complacent about the stigma that still exists in so many parts of Scotland in the UK but actually the stigma that exists in many parts of the world because we have made great progress and I think the way that we have dealt with HIV is an example to campaigners and to charity organisations and international development organisations right around the world but we can't be as I say complacent. We've had a leading role here in the United Kingdom. I'm proud that it was a Labour Government that in 2002 supported actively the global fund, funded primarily through the Department for International Development. I'm also pleased that the current UK Government has donated to the replenishment of that global fund and pledged some £1 billion over the course of this Parliament to try and tackle the issue of HIV and AIDS right around the world because it's important to recognise that through that global fund we have been able to support 20 million people right around the world, 20 million people having a diet intervention because of the support of taxpayers here in the UK putting money in towards the global fund and caring for others in other parts of the world too. In a previous role, when I was a member of Parliament, I served on the international development select committee. I had the honour of being a shadow international development minister too and through that time I had the privilege of working with campaigners and charities here in the UK by actually making visits to many countries, particularly in Africa and speaking directly to patients who have had issues around HIV and learning from them about what different actions we can take in terms of shaping our own international development response. That's something that we can't lose sight of because across the world there are 17 million people living with HIV who are on treatment and over half have received treatment directly because of the global fund. Will that not be complacent about what's happening in Scotland? We have been successful in having 94 per cent of those diagnosed on treatment and 95 per cent of those having an undedictable viral load, but we've got a long way to go, particularly in diagnosis. In Scotland there are one in six people who are living with HIV who are yet undiagnosed and across the world that is an estimated half of the 37 million people living with HIV unaware of their own status and what that means for their own health, and it means that it's a potential for them to unwittingly pass the virus on to others too, and I think we have a human responsibility to try and do something about that. So we have made great strides, but I want to mention just in closing two very specific cases, one both relating to Glasgow, one we've had a spike in the last year in incidents and cases in Glasgow. I think that there will be some research into why that has been the case in Glasgow and what perhaps we need to do differently to avoid that happening over a longer period of time, but I also want to pay tribute to Glasgow Caledonian University, whose School of Health and Life Sciences has been doing particular research and work on the issue of stigma and discrimination around HIV, and they have published a follow-up report on that today. We haven't mentioned PREP and the opportunities of PREP, but I hope that someone in the chamber will bring up that issue, but what I want to say is that I think that we have a commitment from all parties across this chamber, and I hope that all levels of government across the UK, but hopefully international agencies too, that we can tackle HIV in home but also tackle it right around the world, because that is our global human obligation. Patrick Harvie, followed by Monica Lennon. Thanks very much, Deputy Presiding Officer, and can I, as others have, thank and congratulate Kez Dugdale for bringing this motion to the chamber. Kez began by talking about those advertising campaigns in the 80s, and I am just that. We're tiny bit older, just a modest little bit older. I was about 12 or 13 when those iceberg adverts came out, and I think the principal impact that they had was to accentuate the fears that people had while doing nothing at all to demystify and destigmatise the illness and the virus, and this at a time when a huge amount of vitriol and prejudice was being promoted by the tabloid press. A few years later, I went to university in Manchester and the odious man, James Anderton, God's cop, as he was called, chief constable of Greater Manchester Police, had been describing people swirling around in a human cesspool of their own making. That was his description of issues like HIV, and when I was a student in Manchester enjoying the dubious delights of the gay village in Manchester, he was sending cops in to raid gay clubs, sending them in wearing biohazard gear. That was the level of the prejudice and the stigma that he was happy to promote rather than to challenge. However, as a student activist, I did have many opportunities to get involved in sexual health promotion on campus, and later in life I had the chance to do that as a professional within Face Scotland, Face West, as it was at the time. That's PHACE for the point of the official report, their project for HIV, aged care and education based in Glasgow. Like many people doing youth work in that field, I can't be alone at all in remembering moments when, despite the successes that you had and the positive work that you did, somebody you were working with would tell you that they'd got a positive diagnosis, and you wonder for a long time—it's not the kind of thing that you leave at your desk at five o'clock—you wonder for a long time whether you could have done more, and that kind of memory stays very much with you. At that time, when I was working in the HIV field, that was the beginnings of something new called PEP, post-exposure proper access. Initially, the idea was that people working in clinical settings—for example, if someone had got a stab injury, a needle stick or something like that, as was mentioned earlier—could be given a dose of existing antiretroviral drugs in order to limit their chance of becoming HIV positive. That was the beginning of the thought about applying that in sexual health settings, so that people who had been exposed to the risk of HIV infection through unprotected sex might also use post-exposure proper access to prevent them from becoming HIV positive. While that has had hugely positive impact, it was accompanied by hugely negative stigmatising portrayals in the press. It might have been desirable to think as we stand here now that we have overcome that. However, as we begin to debate pre-exposure proper access, using existing antiretroviral drugs to protect somebody who is at an existing high risk of infection, as we start to debate the use of PEP, we see this kind of stigmatising treatment through the likes of the Daily Mail, who had a big banner headline not so long ago describing a skewed sense of values for the fact that the NHS might consider funding prep and contrasting it with other conditions that would go without treatment—notably conditions around children going without treatment, of course, because that was the simple trade-off. I know that the decision ultimately lies with the Scottish Medicines Consortium on the point of an application, but all of us are going to have a responsibility if that decision does come to be made to openly and vocally challenge the kind of prejudices that do still exist amongst those who would seek to misrepresent PEP and the opportunities to use it. Last point, Deputy Presiding Officer, is that as we have seen HIV move into the field of being something closer to a chronic manageable condition in the wealthy west, we must be committed to ensuring that that is achieved throughout the world. Countries that have that intention are going to have to step into the breach when the Trump-Pence regime takes over in America and begins to withdraw funding for sexual and reproductive health as part of international development work, so we must all commit ourselves to that as well. There is so much that people want to say in this debate today, and there are still a few speakers who would like to come. I would be happy to accept a motion without notice under rule 8.14.3, and that would extend the debate by up to 30 minutes. I invite Kezia Dugdale to move that motion. Do members agree to extend the debate this evening? Thank you very much. I now call Monica Lennon to be followed by Tom Arthur. Thank you, Deputy Presiding Officer. I, too, welcome this evening's members' business motion in the name of Kezia Dugdale ahead of World AIDS Day tomorrow, and for this chance to highlight some of the important issues around HIV and AIDS. The situation, treatment and care for those living with HIV in Scotland today is much improved from even a couple of decades ago. However, despite those changes, HIV policy solutions need to be further improved upon to help to stop the spread of HIV in Scotland and to achieve the ambitious 1990 UN goals by the year 2020. We have heard from the opening speeches and other speakers that there are approximately 6,150 people living with HIV in Scotland, and there have been 217 people diagnosed with HIV this year so far. However, as Anas Sarwar has said, around one in six of those with HIV in Scotland are thought to be living undiagnosed, so the actual figure is likely to be a lot higher. It is important that these new cases of HIV are given greater or given particular attention, and that focus is given to how we prevent new cases from occurring. As Anas Sarwar also highlighted, there is currently an ongoing outbreak of HIV infection in people who inject drugs in Glasgow, and that is very concerning. In the Glasgow NHS health board area, there have been 72 new diagnoses of HIV related to drug use over the last 18 months. In the first six months of this year alone, there were 18 new cases of HIV in Glasgow found to be transmitted by injected drugs, which was more than the new cases discovered to be transmitted sexually. I would like to pay particular thanks to David Liddle of the Scottish Drugs Forum for his work in highlighting this issue and for the recommendations that his team has brought forward in respect to some of the actions that need to be taken. Any rise in the number of people contracting HIV is concerning, and this rise among intravenous drug users is a serious public health concern. The risk of similar outbreaks in other areas of the country and the risk of spread to other populations through patterns of imprisonment, involvement and prostitution and homelessness resettlement must be taken seriously. Reducing cases of HIV in Scotland starts with improving education and awareness of the disease. On the rise in cases of HIV contracted through drug use, I echoed the calls of the Scottish Drug Forum that an education campaign for drug users and staff in front-line services would be beneficial. As co-convener of the cross-party group on drugs and alcohol misuse, I am keen to explore how we can continue to reduce the stigma directed at substance users and to increase the uptake of regular HIV testing. Early detection and treatment is key to the reduction of infection and better outcomes for patients. Last week was HIV testing, which I was happy to support that. It is important that any education or awareness-raising campaign focuses on the importance of regular testing for those involved in drug misuse. We must do better in raising awareness about HIV through improvements in equipping young people with the knowledge that they need to prevent risk of infection. Current Scottish Government guidance on sex education and sexual health and blood-borne virus framework from 2015 acknowledged the importance of relationships, sexual health and parenting education to ensure that all young people have the information that they need to make healthy choices. HIV Scotland has been involved in great work on that topic. The positive persons manifesto from last year has consistently highlighted sexual health education or rather the lack of, as a key factor in preventing the spread and contraction of HIV. Given the acknowledgement that sexual health education is vitally important, I would welcome moves by the Scottish Government to further consult on the matter of making sexual health education a compulsory component within the Scottish curriculum. As I said at the beginning of my speech, the situation for people living with HIV in Scotland today is much better than it was a couple of decades ago. Despite the stigma of HIV, there is no tool to live with it that persists. In conclusion, improving education about HIV is, I believe, the way to ensure that the transition rates continue to reduce and that those with infection will be able to receive early treatment. You are all taking terrible advantage of me now. I have Tom Arthur to be followed by Jamie Greene. Thank you, Presiding Officer. I would like to begin by thanking Kerry Dugdale for securing this member's debate on the eve of the 28th World AIDS Day. As has already been alluded to by Donald Cameron, one of the key messages of world AIDS day this year is HIV stigma, not retro just wrong. This is unfortunately an all too necessary campaign as ignorance and misconceptions of HIV AIDS are still far too prevalent in our society. This debate provides an opportunity to debunk some of the myths and stand up to HIV stigma. Just under six months ago at the beginning of June, as Kerry Dugdale alluded to, passed the 35th anniversary of the first public reporting of what would later be termed AIDS. Next year will mark the 30th anniversary of when human immunodeficiency virus HIV was confirmed by the International Committee on Taxonomy of Viruses. Most importantly, however, July 2016 this year marked the 20th anniversary of the 1996 international AIDS conference in Vancouver, where the successful development of the first effective antiretroviral therapies was announced. Since then there has been significant progress with new and less toxic drugs developed and, importantly, the pill burden reduced. Presiding Officer, I bring these dates to the attention of the chamber to illustrate a very simple point. For the majority of time that we have been aware of HIV AIDS, we have also been able to treat it to turn it into, as Patrick Harvie said, a manageable chronic condition. While both a vaccine and a cure have so far proved elusive, we are getting closer. Only last month we learned of encouraging early results from the kicking kill strategy. When HIV is still within the blood but at undetectable levels, perhaps due to the blood brain barrier, etc., this new method is actually getting in there and removing those last vestiges of HIV when it is hidden from detection. In the last few days it was announced that the biggest ever HIV vaccine trial has begun in South Africa. The reality is that for the vast majority of people who receive ART, HIV is no longer a death sentence. The reality is that successful ART is, in the words of the British HIV Association, as effective and consistent as using a condom in limiting transmission. Presiding Officer, the reality is that, in the developed world, we are winning the fight against HIV. However, we cannot be complacent. Of the approximately 6,150 people living with HIV in Scotland, as was mentioned earlier, it is estimated that 17 per cent are unaware of their status. HIV-positive individuals who do not know their status are, of course, at risk of inadvertently passing the infection on and left untreated. HIV will, for the majority of those infected, progress to AIDS. In tackling HIV, prevention is still exceptionally important in our first line and our first line of defence. That is why it is vital that our young people are equipped, as Monica Lennon was discussing, with the skills to talk confidently about relationships, sexual health and parenthood. Additionally, the development of PrEP represents a significant advancement and have abilities to prevent transmission. I have been very encouraged by the Scottish Government's approach and I urge the manufacturer to make a submission to the SNP at a fair price as soon as possible. We must also continue to be alert to developments and remember that new challenges may emerge. Last year it was reported that the most aggressive strain of HIV ever studied had been found in Cuba. Of the admittedly small 73 patients initially studied, all progressed to AIDS within three years, with a median latency period of only 1.4 years compared to the median time of 9.8 years for the average HIV strain. So far, this variant has been limited to relatively small numbers, but it serves to the minders of the challenges that may emerge in the future, and we need to keep HIV AIDS at the top of the political agenda. In closing, I would like to reaffirm my support for the continued fight against HIV AIDS and welcome the plans to deform the cross-party group on sexual health. Together, we can end HIV stigma, continue to create a supportive and inclusive society for HIV positive people and take another step towards a world where AIDS is something found only in the history books. Jamie Greene, followed by Daniel Johnson Presiding Officer, first of all I thank Kizzy Dugdale for bringing this debate to the chamber this evening. There has been some excellent contributions from all parties. Earlier this month, I was really honoured to speak at the youth stop AIDS big weekend in Glasgow. The youth, the young volunteers, had come from across the UK and given up their weekend to support each other on a peer to peer basis. At that event, we heard some really moving and inspiring speeches. One specifically from a young man called Robbie Lola, who shared his own experiences on how he tested positive in Ireland. He told about the relative lack of support that was available to him after his diagnosis. That is something that I took away and thought a lot of after. I think that we can all be thankful that anti-retroviral therapy means that today people living with HIV live longer, healthier lives than 20 or 30 years ago. Being diagnosed with HIV today means something very different from what it did in those days. But we are very mistaken and we think that it's a problem of the past, which is why one of the hashtags for world AIDS day this year is hashtag HIV not retro. Like Kizzy Dugdale I2, I'm a child of the 80s, and I remember many of those campaigns that we've spoken about on television and in print and in a lot of the gay media at the time as well that really made the public aware of the importance of taking charge of their sexual health. I think admittedly it was a fear campaign, but there's a generation of young sexual active people today who do not have those images ingrained in their brains in the way that I do and some of my friends do. In Greater Glasgow and Clyde alone there's been reported 77 new cases this year and specifically I think young men in particular need to be made aware that the risks are still very real today. At the meeting in the Clyde hospital that Donald Cameron mentioned, I wanted to add some further thoughts that we were told about, some other rises in blood-borne viruses among certain other groups such as young professionals who were social drug users and snorting drugs for example, men who were steroid users and gymgoers and I think we shouldn't ignore the growing epidemic and intravenous drug use during sex which is becoming an epidemic in certain parts of the world among the MSM group. So it's not just that idea of people who are living in depravity and injecting drugs that there's a whole other bunch of people out there who are at risk who maybe we don't talk about that as much when we talk about this issue. It's important to note that of HIV positive individuals reported in 2016 81% are male and 60% are aged between 25 and 44. This is really an issue that strikes a very personal note with me. I have many friends who are HIV positive and I know their very personal stories and experiences. I know many who as a result of their diagnosis have found it really difficult to cope with that and have turned to alcohol or drugs to cope. Many suffer from depression and anxiety and in some cases were suicidal and in one case unfortunately successfully. So I think particular attention should be given to how we help people who have recently been diagnosed. As we know that Scotland around 17% of people living with HIV do not know their status. Stigma is a big part to play in that but also I think is fear and I can only talk from my personal experiences that the fear of going for a test is a fear of what the result might be. It's a fear about who you might have to tell if that's a positive answer and it's a fear about how yourself how you might deal with that internally and how do I think I have the mental strength to deal with a positive result. So that is something we need to address is how do we help people get over that fear. HIV Scotland are producing a draft strategy on stigma and in the brevity of time I'll just say that I hope the Scottish Government take heed to any recommendations that come out of that. I'm also very pleased to be alongside Kezia Dugdale, Patrick Harvie and Ben Macpherson co-convener of the LGBTI cross-party group. I hope that we can work with other cross-party groups and find mutually interesting areas where we can discuss and help each other. I think that World AIDS Day is still very important because it reminds the public and governments that this problem has not gone away. It's still important that we raise money, that we increase awareness, fight prejudice and improve health and education services and I think it's our duty as legislators to make sure that we do everything in our power to take the lead on prevention treatment and awareness. Tomorrow I will remember those who sadly have passed and I'll remember them with sorrow that medicine couldn't help them in their day but I'll also remember tomorrow with a hope that debates like this bring this issue to the forefront of people's mind and the hard work continues. Thank you. The last of the open speeches is Daniel Johnson. Thank you Deputy Presiding Officer. I'm hugely pleased to be speaking in this debate this evening not just because it's always a good idea to be supporting the debate that your leader puts in front of the Parliament but actually because like so many people here I think AIDS has been something that people of my generation have grown up with and it's one of the things that's been very interesting about this evening. So many people have brought up the same experiences remembering those TV ads and I must have been nine or ten when they came on and they scared the you know the living whatever from me. I hope that's parliamentary language and the AIDS HIV AIDS I think has been defined by that fear. It has haunted this subject and I think the thing that I find remarkable is how far we have come but how far we still have to go because yes it's absolutely right that we have moved on from the world where HIV AIDS was a playground taunt and I think you can tell much about society's prejudices from the names that the children tell each other or call each other in the playground. We've moved on from that and people are living and surviving an HIV positive status but there's still so much more to go because as I was discussing with people from HIV Scotland when I was going along to the photo call earlier and I was remarking about the fact that HIV AIDS was a defining issue for people of my generation they said well that that's true and that's interesting but it's also a fact that it's people of my age my demographic who are most likely to actually acquire an HIV infection. Now I think it says something about where we are because this is as many people said it is a condition that is defined by marginalisation and stigma and it's understandable why. The primary vectors through which people acquire HIV are sex and injecting drug use these are subjects one of which we are very sensitive about and one which is by definition about a group of people who are very marginalised but what's increasingly becoming true or I'm certainly in terms of the conversation I had today that it's also an issue of complacency and we can't have any complacency because this is a condition I think that that preys upon the marginalisation stigma and complacency. So as Kezia Dugdale pointed out in her earlier remarks I want to just highlight the work of two organisations based on my constituency in Edinburgh Southern one is Waverly Care an organisation set up when Edinburgh was acquiring the title of AIDS capital of Europe it was indeed the organisation that set up the very first AIDS hospice in 1991 the milestone house opened by Princess Diana who did so much to directly and actually a very direct human physical way to break down the barriers of HIV AIDS and I'm very pleased to be visiting it on Monday and indeed its story is one which tracks that of HIV AIDS it's gone from being an organisation focused on end of life to one that's focused on outreach support respite and helping those with HIV and AIDS to live well it's also working very hard in terms of speeding up discharges from NHS but it's also doing much to work around the issues of stigma that so many people have raised working with marginalised communities focusing on the damaging effects both to the individual who live with the fear of judgment that an HIV status might bring with it and then the ensuing damaging effects that that that fear drives infection by not talking about it not talking to other people not acquiring the information that you get you're scared to be tested leading to later diagnosis and promoting spread of HIV so they have two projects in particular I'd like to highlight one is the hallways here project working with church groups and schools so that people have information about HIV likewise caring conversations works with GPs and other healthcare professionals so that best practice and understanding about the healthcare implications of HIV AIDS are well shared and well understood but I'd also like to briefly mention the work of Henry diversity and specifically the HIV human rights development network and indeed it was my predecessor Jim Eadie who hosted the first seminar here in this parliament in 2013 and this is the UK's first network of academics bringing together professionals focused on looking at the intersection of HIV and the conditions of powerless poverty inequality and exploitation looking at the social political and cultural elements that lead to HIV spread and also how those issues can be used to tackle those to tackle the spread of this virus so in summary I think many people have talked about the marginalisation stigma and indeed I would add complacency in terms of the issues that we need to look at examine and tackle and what I would say is that to tackle marginalisation we need to understand this is a this is a something that affects people and understanding that that is a way of breeding better understanding which in turn must be reliant on better information and communication so that we demystify HIV AIDS and they take away the fear and the stigma which contributes so damagingly to this condition thank you and I call it alien Campbell to close this debate around seven minutes please minister thank you Presiding Officer and I sincerely also want to thank Kezia Dugdale not just for securing today's debate but also for the very informed passionate and emotional way in which she addresses us and that was the way that was echoed by every speaker tonight who contributed to this debate. Kezia Dugdale also reminded us that Terence Higgins died I think at the age I think she said at the age of 37 and that's the age I'll be next year and Terence Higgins age is a reminder of the tragedy of a life cut shirt and of potential unfulfilled but his impact has been profound and the improvements made in his name have been huge and like many speakers tonight I too remember as I was born in 1980 to add to that long list of 80s children the images that Kezia Dugdale describes the adverts and of seeing princess Diana's work it illustrates how far we have come and thankfully though I think the awful language and tone that was used in that debate in Westminster in 1986 of seeking homosexual dentists and doctors to give up their work and that general lack of awareness of the condition within that debate is as far removed from tonight's informed eloquent and heartfelt debate as it is possible. Now but no matter how far we've travelled over the last 20 years since the first world age day or in terms of social attitudes or treatment world's age day is important because HIV is still important and it's not just here in Scotland but around the world. It also provides a moment to reflect on the task that lies ahead. World age day presents a valuable opportunity to raise awareness of HIV and I'm sure that many of us will be taking opportunities tomorrow to demonstrate our support for work to raise awareness of HIV and demonstrate our commitment to stand against HIV stigma and I've been really pleased to hear of so many local events and also hear from many members this evening about local initiatives in their own constituencies. In Scotland we do have very good access to treatment for HIV as many today have outlined but it is vital people who are infected but remain undiagnosed are tested not for treatment. The Scottish Government's sexual health and bloodborne virus framework updated last year is clear that normalising testing and expanding provision of testing is key to this and while treatment is highly effective public and individual health in Scotland is best improved by preventing infections and this must continue to be a priority. Kezia Dugdale. Thank you minister for giving me a way. I wonder if she might address Liam McArthur's point about how it's difficult for some people in more rural communities to access the sexual health whether it's treatment or testing required and whether the Scottish Government might look further at whether home testing kits using the postal service is a possibility. Aileen Campbell. I listen to the point that Liam McArthur made and of course take on board the points that Kezia Dugdale made and certainly it's something that I've been asking my officials to look into around the postal testing kits and to see what progress can be made if any but certainly it's something genuinely that we have been and I have been asking my officials to look into. The NHS does of course have a crucial role to play in diagnosis and preventing infection but I would also like to recognise the important contribution that the third sector makes. Their innovative hands-on and targeted work to prevent transmission and their holistic caring and supportive approach with patients does not go unnoticed and it's that compassion caring and caring that has been such a big theme of tonight's debate which has been far removed from the talk of cess pits of their own making which I think was the language that Patrick had mentioned during his remarks that he had heard during his time in Manchester but while there is no silver bullet when it comes to HIV prevention many members across the chamber have discussed the contribution that pre-exposure prophylaxis or PREP might make to reducing the number of new cases of HIV in Scotland in the future and we do well to be heed to the parallels that Patrick Harvey drew between the negative narrative around post and pre-exposure prophylaxis and I think from today's debate and across all parties that we are all very much up for the challenge set by Patrick Harvey to stand up to that negativity. Across all medicines we remain committed to ensuring the patients in Scotland get access to new innovative treatments they need and this is why following the granting of the licence for Travada for PrEP by the European Medicines Agency earlier this year the chief pharmaceutical officer has written to its manufacturer urging them to make a submission to the Scottish Medicines Consortium at a fair price so its routine use in Scotland can be considered as quickly as possible but stigma was undoubtedly one of the big themes tonight during this debate and all of us want to live in communities that have positive non-stigmatising and supportive attitudes towards people living with or affected by HIV and that's why our sexual health and bloodborne virus framework addresses stigma as one of its five outcomes and it's why I'm sure that we all agree with the theme of world AIDS day this year that stigma is not retro it's just wrong there's no place for HIV stigma in Scotland today but as Tom Arthur mentioned campaigning on stigma is still an unfortunate necessity education is undoubtedly a big part of that effort to reduce stigma because we all want children and young people to learn tolerance to learn respect equality and good citizenship to address and prevent prejudice as well as to learn about healthy relationships. Relationship sexual health and parenthood education is already an integral part of the health and wellbeing element of the school curriculum and we're supporting improvements and we strive to always do more in terms of equipping our young people with the ability to cope and emerge into their adulthood with the tools they need to make informed and confident choices and ensuring resources are there for Scottish schools so Presiding Officer tomorrow is world health world AIDS day and I'm sure that we all will all take a moment to pause and reflect on those that we know have lost or have been affected by HIV but I am proud after listening to everybody's contributions this evening that 28 years from now those who read our Parliament's official report will read a debate of compassion of tolerance and of understanding our job though in here is to ensure that that's felt widely across our society that we make the medical improvements we need and that we challenge the stigma felt by too many too often because we don't want in 28 years from now is to still be grappling with those issues we must do better than that so thank you to everybody who's contributed this evening it's been an informed emotional and compassionate debate and I very much enjoyed everyone's contributions and thank Kezia Dugdale once again for bringing this to the floor of the chamber thank you