As new data shows rising numbers of people diagnosed with HIV in the UK we need to ask if we are truly doing enough to tackle this issue.
This week Public Health England (PHE) published their annual report into HIV in the UK. The report makes for some stark reading:
- For the first time the number of people living with HIV in the UK has reached over 100,000
- A quarter of those living with HIV, some 26,000 people, are as yet undiagnosed and don't know they are HIV positive
- 6,000 people were newly diagnosed HIV positive in the last year
- 1 in 26 gay men are living with HIV in the UK, rising to 1 in 8 in London
What do we need to do to tackle this to best protect and HIV and support people's health?
Prevention
People are complex, life is confusing, add sex into the equation and we've got a heady mix. A one-size-fit- all approach to sexual health just doesn't work. We need a toolkit of prevention that ranges from sex and reproductive education at schools, condom distribution, psychological and social support, to treatment as prevention. If people living with HIV are on anti-HIV medications they are less likely to pass it on to partners during sexual intercourse. A new component in this toolkit is PrEP (Pre-Exposure Prohylaxis) a treatment for HIV, that if taken by people who are HIV negative can prevent them becoming HIV positive. UK trials for PrEP are in the early stages but showing good results amongst gay men and it's already available in the US - albeit through private insurance of course. However existing approaches to prevention haven't stopped the rise in HIV in the UK and we need to secure the resources for new approaches such as PrEP to change this.
Testing
Next week, 22 - 30 November, is National HIV Testing Week. Taking action, getting tested and knowing your status is the only way to stay healthy by accessing medical care, treatments and support. It also has implications on prevention. Two thirds of HIV transmissions are those who do not know their HIV status, and don't think they are HIV positive. Those who are tested are more likely to consider their approach to sexual health and be on treatments, which suppress the amount of HIV in the body, meaning they are less likely to pass it on, even through unprotected sex. We need encourage testing, not just at the local GUM/sexual health clinics, but at GPs, hospitals and Accident & Emergency. For this to happen healthcare practitioners across the board need to be able to identify the signs of HIV infection and be aware of the groups most likely to be affected.
Stigma
Of course we also need to encourage people to come forward and get tested for HIV, and the biggest barrier to this is discrimination. It is sometimes unfathomable that a medical condition, one that can be diagnosed and treated, can carry so much stigma in the UK in the 21st Century that you'd think we were living in medieval times. In our work at Positively UK stigma is the single biggest issue that people raise and one of the main reasons people don't test. Every year 500 people in the UK die from HIV related conditions and despite having access to the best care in the world. This number has remained static over the last decade. People of African origin are most affected by this. The majority of these are deaths are due to late diagnosis and people not receiving lifesaving medications in time. To get people tested we need to do more to challenge the stigma and misconceptions around HIV. Next week to coincide with World AIDS Day Positively UK will launch the new social media campaign #wearepositive to challenge HIV stigma, I urge to sign up and take part.
Support
They say "the measure of society is how it treats its weakest members". At a conference yesterday I was reminded that receiving any long-term condition is devastating and that people feel out of control of their lives. This is certainly true of HIV where a new diagnosis comes with it the feat of stigma, being turned away by family and friends and not knowing who to turn to. Providing the right support for people who are diagnosed with HIV is crucial. However, due to austerity, we're seeing core services provided by patient groups cut and charities struggling to survive. In 2013 Positively UK saw a 25% increase in people accessing services, yet over the next 12 months we're likely to be subject to a cut of over 50% in the government funding. We are not alone and all patient groups are facing the same pressures. This is unsustainable.
If we are serious about tackling HIV we need to prevent, we need to test, we need to treat and we need to care. This requires the input of our communities, political will, co-operation and the resources to make it happen.
To read the full Health Protection Agency Report https://www.gov.uk/government/statistics/hiv-in-the-united-kingdom
#wearepositive launches on 27 November at http://www.positivelyuk.org/wearepositive