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As I said earlier, I represent one of Scotland’s rural constituencies. I have had conversations that are similar to some of the evidence that you heard.

I always think that there is an interesting balance to take in rural communities. Because of the stigma, some people are happier travelling to a larger population centre for their treatment. We have to bear that in mind when we are looking at the situation.

In the committee’s previous evidence session, Dr Howe gave strong anecdotal evidence about how she operates and how things operate in Highland. It is important to recognise that, alongside the delivery plan, we have done some work to look at rural inequalities and how we can ensure that the service that people in those areas get is the same as we would expect in the larger centres and is person centred. I think that that work will be published later this week.

The committee also heard from Professor Estcourt about the amazing work that is being doing with regard to ePrEP. Again, that could work well to support people in rural communities.

Have I covered everything, Rebekah Carton?

I appreciate that we published the plan just this morning. If the committee has any further questions about it and wants to write to us, we would be very happy to have a dialogue in that way.

On resources, we have set aside £1.7 million for the whole HIV plan within this element of Government. The committee heard very clear evidence that resources are tight for this. I am reflecting on that. That is why it is so important that we get the spending on this right. There will be more information coming out on how we decide to spend the money, but we appreciate that we have a tight budget.

I put on record the amazing collaboration that happens among the third sector, academics, health boards and the Government. That came across really strongly in your two evidence sessions in the previous meeting. I like to say that they are our critical friends, and I think that we work very well together. I really appreciate their hard work. They know their community so well. Dr Clutterbuck reflected on that in his evidence.

We must remember that the pilots are happening in busy A and E departments. We do not want to introduce, for long periods of time, additional stresses in areas that are already very stressed. We felt that we could get the answers from the time periods that we set.

It is important that we recognise that pilots are also happening in England. The data that comes out of those, as well as the data that comes out of Scotland, will be considered so that we can see the bigger picture.

That is one of the things that we are looking at. If I am correct—Rebekah Carton will correct me if I am wrong—currently, clinics have to prescribe PrEP. We are taking forward work on how we can widen the prescribing of PrEP so that GPs can do it. We are doing scoping work in NHS Grampian with GPs to find out how open they are to doing that and how we can make it work in the best way possible for them and for the people who will be prescribed PrEP.

I acknowledge and have reflected on the evidence that was given to us about the gaps in specific areas. The plan that we have launched today supports the need to find ways to increase data gathering.

We also need to recognise—I might refer to rural communities, but this can also be across other sections of the population—that, because the numbers in Scotland are so small, we need to make sure that we gather and report that data in the best way so that people cannot be identified and we do not create a knock-on effect on stigma.

Dr Kirsty Roy talked about the work that Public Health Scotland is doing to create a dashboard to ensure that we get the best information, and I am fully behind that. Paul O’Kane is right about how different health boards have different pockets of information and we need to pool that, so part of the plan is a national Scotland-wide audit of HIV contact tracing, which I hope will help to feed into that.

The plan specifically includes work to support data gathering, as well as working closely with Public Health Scotland to ensure that we get the right information and that it is produced in the right way.

That is a helpful question. It gets to the nub of stigma, in that we cannot account for where it will happen. We hope that training will ensure that people deal with people in the way that they would expect to be dealt with, whatever their circumstances. I will take that question away and come back to the committee with a much clearer response.

I will also reflect on what I was saying about the issue’s importance in education settings. In some respects, you might find that teachers are learning from their pupils and that different conversations are now happening. The work regarding health boards that we highlighted could be replicated in local authority areas. For example, a couple of months ago, I was at an event about breastfeeding and heard how the local council—I think that it was North Lanarkshire Council; I sometimes get my Lanarkshires mixed up—had spent a lot of time working internally and with the health board to understand the best way to give training so as to provide a breastfeeding-friendly environment. We can certainly learn from such initiatives.

All education and learning has to be continuous. I do not think that, in any profession or walk of life, you hit a door where you stop learning. I can speak personally to that experience in my previous career and in this role. Education and learning are important, which is why it is important that we see how the work that is being done in Grampian on e-learning can be rolled out.

Thank you for inviting me and for considering the important issue of HIV stigma.

HIV stigma remains a barrier to accessing treatment and care and it puts people at risk, but, ultimately, we aim to build a Scotland in which everyone is treated with kindness, dignity and respect.

This is about real people who lead real lives. The Terrence Higgins Trust anti-stigma campaign showed some of the harms that can be caused by stigma. Although it was a proud moment to fund and support such a hard-hitting campaign, I am not proud that HIV stigma remains. We are committed to working to tackle that. We must continue to remember that the “H” in HIV stands for “human”, and put people at the centre of everything that we do.

In 2021, we committed to eliminating the transmission of HIV in Scotland by 2030, and I am pleased to announce that our HIV transmission elimination delivery plan was published today. It focuses the actions that we will take to deliver on the 22 recommendations that were presented to us on 1 December 2022 as part of the HIV transmission elimination proposal.

We worked with a wide range of stakeholders to develop the plan, and many of the actions in it are already well under way. We have taken the time to ensure that the plan that we have published today has the support of the sector, is deliverable and achievable and will take us closer to our transmission elimination goal.

The plan takes us up to 2026, at which point it will be important to take stock again and adjust our focus as we aim toward 2030. The delivery plan focuses on preventing new cases of HIV and reducing stigma is an important part of that. However, it is also important that we continue to support those who are living with HIV. Although we aim to eliminate HIV transmission by 2030, we will continue to care for those who are living with the virus long after that.

The delivery plan complements the wider aims of the “Sexual health and blood borne virus action plan” that was published in November 2023, which aims to eliminate new HIV transmissions and to support people who are living with HIV to

“lead longer, healthier lives, with a good quality of life”

in

“a society where the attitudes of individuals, the public, professionals and the media in Scotland towards sexual health and blood borne viruses are positive, non-stigmatising and supportive.”

Both those outcomes have remained a key focus of our blood-borne virus work in the past 10 years and it is right they continue to be the anchor points for our work. However, the Scottish Government alone cannot deliver them; it takes the support and co-operation of our national health service partners, third sector colleagues, academia, industry and the general public. We continue to work with our partners to break down barriers to testing and treatment, including by funding opt-out testing pilots in three accident and emergency departments, funding Terrence Higgins Trust to offer postal and community-based HIV testing and working with Public Health Scotland to develop online postal self-sampling for all sexually transmitted infections, including HIV.

We continue to fund Waverley Care to deliver fast-track cities—an intervention that ensures that the voices of people living with HIV are engaged so that they have a say in shaping local and national priorities.

It is important that we reflect what Professor Claudia Estcourt said at the committee’s meeting on 12 March:

“Scotland is not England-lite”—[Official Report, Equalities, Human Rights and Civil Justice Committee, 12 March 2023; c12]

It is therefore vital that our interventions and actions address the needs of our population, our demographic and our epidemic. Considerable progress has been made in reducing the number new cases of HIV in Scotland. As we move towards our transmission elimination goal, we must do what is right for those who are living with HIV or those who contract HIV in Scotland.

That is an important area. As I said, we do not stand still. We must keep learning and refreshing. The other important area that was brought out in the evidence is that the education should be wider than just HIV. It is much more about people’s sexual health. In one of the schools in my constituency, some of the fifth and sixth year girls have taken that on board. They are looking at the best way for them to get educated, whether it is in a school environment or at their general practice. There is a real buy-in for this, not only from teachers but from pupils.

The monitoring of the plan is incredibly important. There are many different groups and acronyms. We now have a group that is called HIV-TEDI.