"As a young, gay activist, living with HIV, I am proud to be a member of the Conservative Party. This is a progressive party which is helping people like me feel that they have nothing to hide. David Cameron and George Osborne have done much to modernise and welcome voters from all walks of life. There is a forceful progressive and dynamic impulse, which is having a tangible effect on the LGBT community. I applaud the bravery with which the Conservative Party advocated same-sex marriage. They share my energy for equality and diversity. For many of us living with HIV there is still much stigma to face. Let's not hide from it. As Conservative Party members, let's tackle it together."
Let's Not Hide was a fringe event which was held at the Conservative Party Conference on 4 October 2015. LGBTory and myself organised this, with Shaun Griffin from the Terrence Higgins Trust, David Bridle from Boyz Magazine and Stuart Andrew MP on the panel.
My speech, the closing paragraph of which is quoted above, discussed how the audience of councillors could improve HIV testing, prevention and challenge stigma. From 2013 a range of public health responsibilities, including the commissioning of HIV prevention services, was transferred from the NHS to local authorities. A key concern is the large number of late HIV diagnoses and the implications this has for public health. In 2012, 47 % of new HIV diagnoses were made after treatment should have commenced and 28 % were severely immunocompromised. Investing in sexual health services now will protect people and bring savings in the future. We need to get more people tested and diagnosed.
I narrated my own journey with HIV, including my diagnosis:
"My clothing had been soaked on the way to the clinic and I felt cold. The room was large and empty, except for some seating and bland posters. The blinds were down and the room was already darkened with afternoon shadows. I sat in a chair with my back to the wall and the nurse sat opposite. She was in her mid-forties, with streaks of grey around her temples, and her eyes were full of concern.
"I'm sorry to tell you that the test has come back positive."
The diagnosis came like a punch to the stomach. I was 24 years old-this wasn't supposed to happen to me. I struggled to breathe and was overcome by anxiety. I turned my head to one side and looked at the floor. My hands felt sweaty against the vinyl surface of the chair. The nurse tried to engage me in conversation, asking me what I was thinking. I tried to take in what I could. She gave me some basic information on HIV and informed me of the next steps. The nurse left the room. And I was alone. That's just the beginning of how lonely I would feel."
The event emphasised the importance of prioritising sexual health and, in particular, HIV. Councils must increase spending on public health. HIV funding routes are fragmented. It can be hard for councils to understand what to commission, both in terms of projects that will be most effective and provide value for money. Current investment by local authorities is inadequate. Spending must also be clearly recorded. Of the 58 local authorities surveyed by the National AIDS Trust, seven are spending nothing on HIV prevention or on additional testing services, five are spending less than £500,000 and 13 less than £250,000 per year. Funding needs to be increased and better coordinated.
Services must be tailored to local needs. An understanding of HIV, the groups affected and the long-term benefits of both early diagnosis and support is crucial. HIV is now a long term condition in the UK. HIV disproportionately impacts upon black and minority ethnic communities, the gay community, people with poor mental health and people in poverty, groups identified in any equality impact assessment. Targeted campaigns can yield impressive results. This requires better data collection at local level. Each area has a Health and Wellbeing Board, which is a forum where clinical commissioning groups and councils can engage to create a cohesive framework for local health needs in a Joint Strategic Needs Assessment (JSNA). The JSNA should incorporate an evaluation of local sexual health requirements.
Importantly, we also need properly funded peer support. This encompasses group support, face to face support with one person, support via email or over the telephone. Establishing community forums for people living with HIV, where they can provide feedback and voice their concerns in a safe and confidential space is also highly effective.
Each council needs an HIV champion, to raise the profile and advocate for the needs of people living with HIV in local authorities. The HIV champion can also engage with initiatives such as the Halve It Campaign, which seeks to halve the number of people diagnosed late with HIV, including their local Halve It group, which will consist of local agencies and HIV specialists. This also provides an opportunity to understand what approaches other areas are taking and identify good practice both locally and nationally.
"No patient should miss out. No patient should feel alone. No patient should feel they need to hide."