The Foundation, Lambeth Council, The National Lottery Community Fund, ViiV Healthcare, Comic Relief, and Big Issue have come together to implement the world’s first Social Impact Bond (SIB) focused on HIV treatment and care. The Zero HIV SIB is based in the South London boroughs of Lambeth, Southwark, and Lewisham (LSL) due to disproportionately high HIV prevalence, with an estimated 1,000 residents living with HIV that are unaware of their status in these boroughs. To reach patients in these boroughs, the Zero HIV SIB operates across three settings: in hospitals, in GP surgeries and in the community. In all settings, the SIB is focused on bringing individuals with HIV into care.
In the first 18 months of the three-year social impact bond, more than 120,000 people received HIV testing, over 180 South Londoners living with HIV entered HIV treatment, with 114 people receiving a new diagnosis of HIV and attending their first treatment and 68 others returning to treatment after previously leaving treatment. Hospitals, primary care, and community organisations all have conducted distinct activities through the SIB to find these patients and link them to care. The model places greater focus on patients themselves and utilises a bespoke approach to engage individuals in HIV services.
Hospitals in the programme have set up universal HIV testing in their A&E departments, so that all adults with blood drawn have the option to be tested for HIV. If a patient is HIV-positive, the clinic follows up with them and brings them in for specialist care. GP Federations are helping their practices implement a range of activities, including computerized notifications prompting screening patients for HIV, wide screening during universal HIV testing week, and targeted work with HIV-positive patients not in care. Community organisations go into public spaces, build trust and respect, test for HIV, and then provide supportive services to those who are diagnosed with HIV, which encourages those patients to seek specialist HIV treatment. This project has, in its first year of implementation, proved that diverse stakeholders can come together to develop varied but connected HIV activities across a complex health system.
This project has proved that diverse stakeholders can come together to develop varied but connected HIV activities across a complex health system. We are eternally grateful for all our partners in this work, including the clinicians, operational staff, and healthcare advisors.
A special thank you goes out to the fantastic pro bono legal team at Freshfields Bruckhaus Deringer who have made all partnership and provider agreements possible.
Anne Aslett, Chief Executive Officer of the Elton John AIDS Foundation, spoke with Doctor Grace Bottoni about her work on the Social Impact Bond and the effects that COVID-19 has had.