Consultant Editors Lynda Sibson, Ian Peate, Pete Gregory Editor Aysha Mendes jpp@markallengroup.com Commercial Manager Frankie Bramble frankie.bramble@markallengroup.com Group Classified Manager Daniel Doherty daniel.doherty@markallengroup.com Production Manager Kyri Apostolou Production Assistant Jamie Hodgskin Content Development Director Tom Pollard Editorial Director Sophie Gardner Managing Director Anthony Kerr anthony.kerr@markallengroup.com Associate Publisher Mike Shallcross Publisher Anthony Kerr Chief Executive Officer Ben Allen

Editorial Board Guillaume Alinier Director of Research, Hamad Medical Corporation Ambulance Service, Doha, Qatar; Professor, Simulation in Healthcare Education, University of Hertfordshire, UK Ayesha Bal Paramedic, West Midlands Ambulance Service Trust, UK Aidan Baron Paramedic Researcher, Sydney, Australia; Visiting Researcher in Emergency, Cardiovascular and Critical Care, Kingston University and St George’s, University of London Tony Bleetman Consultant in Emergency Medicine; Honorary Associate Professor, University of Warwick Medical School, Coventry, UK Malcolm Boyle Senior Lecturer, Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia Dr Mike Brooke Doctor and Advanced Paramedic, Tameside Hospital NHS Trust/North West Ambulance Service NHS Trust UK Tanoh Asamoah-Danso Paramedic, East of England Ambulance Service Trust, UK David Davis Clinical Lead, Integrated Urgent Care Workforce Development Programme, NHS England; Fellow and Mental Health Spokesperson, College of Paramedics; Founding Fellow, Faculty of Clinical Informatics, UK Robert Deighton Senior Lecturer in Paramedic Science & Prehospital Care, Edge Hill University, Manchester, UK John Donaghy Senior Lecturer, Paramedic Science, Anglia Ruskin University, UK Georgette Eaton Clinical Practice Development Manager, Advanced Paramedic Practitioners (Urgent Care), London Ambulance Service NHS Trust, UK Kerry Gaskin Principle Lecturer, Advancing Clinical Practice; Academic Lead, CPD and Paramedic Science, Allied Health and Social Sciences Academic Unit, University of Worcester, UK Pete Gregory Head of Allied Health Professions, University of Wolverhampton, Wolverhampton, UK Sigurd Haveland HCPC Paramedic; Resilience and Special Operations Officer, Ambulance Service, Gibraltar Health Authority

Andrew Kirk Associate Head, Allied Health Professions Education, Edge Hill University, UK Joanne Mildenhall Paramedic Team Leader, South Central Ambulance Service NHS Trust, UK Dr Tom Mallinson Prehospital Doctor, BASICS Scotland, UK Ian Mursell Consultant Paramedic, East Midlands Ambulance Service NHS Trust, UK Ian Peate Head of School, School of Health Studies, Gibraltar Health Authority, Gibraltar Nigel Rees Senior Research Lead, Welsh Ambulance Services NHS Trust, UK John Renshaw Senior Lecturer in Paramedic Science, Wolverhampton University, UK Alan Rice Associate Professor, Paramedic Practice, Department of Paramedic Science, Kingston University and St George’s, University of London, UK Lynda Sibson Telemedicine Manager, East of England Stroke Telemedicine Service, Addenbrookes Hospital, Cambridge, UK Ceri Sudron Senior Lecturer and Paramedic Science Course Lead, University of Wolverhampton, UK Kacper Sumera Deputy Head of Education, East Midlands Ambulance Service NHS Trust, Nottingham, UK Sammer Tang Public Health Registrar, Gloucestershire Hospital NHS Foundation Trust, UK James Taylor Locality Manager, Yorkshire Ambulance Service NHS Trust, UK Mark Woolcock Consultant Paramedic; Lead Clinician, Cornwall Health Out-of-Hours Aimee Yarrington FCPara, Clinical Team Mentor and Midwife, West Midlands Ambulance Service NHS University Foundation Trust, Shropshire, UK

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Journal of Paramedic Practice is published by MA Healthcare Ltd, St Jude’s Church, Dulwich Road, London SE24 0PB Tel: +44 (0)20 7738 5454 Website: www.paramedicpractice.com lthcare Ltd

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© MA Healthcare Ltd, 2023. All rights reserved. No part of the Journal of Paramedic Practice may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, photocopying, recording, or otherwise without prior written permission of the Publishing Director. The views expressed do not necessarily represent those of the editor or the Journal of Paramedic Practice. Advertisements in the journal do not imply endorsement of the products or services advertised. Please read our privacy policy, by visiting http://privacypolicy.markallengroup.com. This will explain how we process, use & safeguard your data

ISSN 1759-1376 Printed by Pensord Press Ltd, Blackwood, NP12 2YA

EditorialEditorial

World AIDS Day

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023 marks the 35th year where nations celebrate World AIDS Day. This year, it is commemorated with the theme ‘World AIDS Day 35: Remember and Commit’. Since 1988, communities locally, nationally and internationally have stood together on this day to show solidarity against stigma and remember those lives lost.

The world has witnessed significant progress in addressing HIV/AIDS thanks to advances in medical research, increased access to treatment and prevention, and a broader understanding of the virus. During this time, there has also been a tremendous global advocacy community which has united to take on challenges and hold institutions to account for ensuring access to these advances.

The number of HIV diagnoses in England increased by 22% from 3118 in 2021 to 3805 in 2022. Most of this increase is attributed to people previously diagnosed abroad, a 69% increase from 805 in 2021 to 1361 in 2022. These infections were likely acquired abroad and therefore do not reflect a rise in transmission in England. In the UK, there were 688 deaths and 167 cases of AIDS at diagnoses in people with HIV in 2022. This marked a decrease in recorded deaths from 826 in 2021, and a decrease from the 187 cases of AIDS at diagnoses in 2021 (UK Health Security Agency, 2023).

Prevention remains key in the ongoing effort to end the HIV epidemic. We must continue to promote education, support safe practices that includes syringe services and overdose prevention programmes, as well as access to pre-exposure prophylaxis (PrEP) and post exposure prophylaxis (PEP) to reduce new infections.

Increased awareness and education have contributed to a reduction in new HIV infections globally. Disseminating accurate information about HIV, and promoting prevention and testing, are crucial steps in increasing awareness and ending stigma and discrimination. Paramedics are ideally placed to make an effective contribution to the ongoing quest to end HIV and AIDS. Stigma and discrimination remain formidable barriers to effective HIV testing, prevention and care. Collaborative efforts have led to improved access to testing, treatment and support services; yet, in underserved communities, disparities persist in access to healthcare.

Programmes and initiatives responsive to local needs do best when driven by the voices of the most impacted communities. Paramedics can advocate for and participate in community-based initiatives aimed at reducing risky behaviours and promoting safe practices. It is imperative that care providers, commissioners and policymakers listen to what people with lived experience tell us about what works and what does not. Advocacy for inclusivity and sensitivity within the paramedic community is crucial to combating stigma, aligning with the Health and Care Professions Council’s (HCPC) changes to be made to the standards of conduct performance and ethics: to promote an active approach to ensuring that registrants’ practice supports equality, diversity and inclusion.

Advances in antiretroviral therapy have transformed HIV from a once-debilitating illness to a manageable chronic condition. Research and innovation play a pivotal role in the progress made in 40 years of the HIV epidemic. Committing to ongoing research is essential for developing new treatments and prevention methods, with the aim of finding a cure.

The challenges HIV brings are far from over. As we celebrate progress made, we must also acknowledge the challenges that persist and renew our commitment to a world where the stigma surrounding HIV is eradicated, and individuals living with the virus receive the care, respect and support they deserve. Paramedics, with their unique position in the healthcare continuum, are integral to achieving this vision. JPP

UK Health Security Agency. HIV Testing, PrEP, New HIV Diagnoses and Care Outcomes for People

Accessing HIV Services: 2023 Report. 2023. https://tinyurl.com/yjdxnfm5 (accessed 21 November 2023)

Ian Peate is Consultant Editor of Journal of Paramedic Practice

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