Tag Archives: hiv

It’s 2018 and we still have HIV/AIDS denialism from “professionals”.

Kelly Brogan (Photo: Bryan Bedder)

This weekend, Lululemon-clad wellness aficionados descended on New York for the In Goop Health summit, where they learned about trendy workouts, nibbled on Instagram-worthy organic food, and heard from a doctor who doesn’t think HIV causes AIDS, despite conclusive science saying it does.

Article via Fast Company

As Jezebel reports, one of the featured speakers at the one-day conference was Dr. Kelly Brogan, a “holistic health psychiatrist,”who said back in 2014 that the idea that “HIV causes AIDS is a ‘meme’ brought upon us by the ‘medical-scientific-industrial marriage,’ and that ‘drug toxicity associated with AIDS treatment may very well be what accounts for the majority of deaths.’”

When Newsweek asked Brogan about it recently, she called the link between HIV and AIDS an “assumption.” Brogan also brought the world the article headlined, “Why you should stop taking your antidepressants” and pretty much argues against taking any and all medicine.

In short, she’s basically the medical world equivalent of a climate change denier, ignoring overwhelming research that HIV does cause AIDS.

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A gay man’s experience of using PEP (Emergency HIV medication)

In recent months I experienced something I never thought I’d have to deal with when I faced the possibility that I might have contracted HIV.

I have been sexually responsible for my entire adult life and have always been heavily influenced by warnings of the past regarding HIV and AIDS, however all it takes is one moment of passion to let your guard down and you can find yourself in a situation similar to mine which resulted in me taking the HIV emergency medication known as PEP. The days leading up to my 28-day treatment were possibly some of the scariest of my life. Experiencing this drug first hand and the people I encountered along the way brought on a variety of conflicting emotions and an understanding of sexual health I never thought I’d have to comprehend.

Story via Metro

What is PEP?

Post-exposure prophylaxis (PEP) is a month-long course of medication which aims to prevent HIV infection after the virus has potentially entered a person’s body. The drug is used as an emergency measure on a person who may have been exposed to the virus, either through infection or sexual transmission. Although PEP is not 100% guaranteed to always work, the success rate is very high. It’s very important to make clear that PEP should not be considered an alternative to using condoms as prevention for contracting HIV. Using condoms is the most effective method of preventing HIV transmission as well as other sexually transmitted diseases.

The drug should also not be viewed as some form of a morning after pill either – PEP is a powerful drug and users like me risk side effects, not to mention the fact PEP isn’t taken on just one occasion like with morning after pills. I myself am lucky enough to have not experienced any side-effects of PEP, but the potential side-effects include prolonged headaches, diarrhoea, nausea and vomiting. If you experience any of these side effects you should not stop taking the medication as once stopped, PEP will not be effective. Contact your doctor to discuss any issues you may be encountering on the drug to get an informed decision on what to do next. Timing is also crucial when it comes to PEP. If the course of drugs has not started within 72 hours of potential infection, the drug will no longer be effective.

Why I took PEP

My reasoning for using this often misunderstood drug was down to one thing: paranoia. The partner I had engaged in potentially risky sexual activity with was someone I know to be practising safe sex, and although we weren’t in a relationship we were very open with one another about our fears of HIV risks in the gay community and HIV tests we had previously taken. Nonetheless, I couldn’t shake the feeling of ‘what if?’ after this particular sexual encounter.

After two days of endless overthinking, excessive Googling and sheer panic I decided to bite the bullet and visit my nearest sexual health clinic. On this particular evening the clinic stated upon my entrance that the session was for appointment-only patients – my heart sank as this was my final chance to obtain PEP before the 72 hour window had closed. However, after quietly asking if I could speak to a nurse in private I was humbled to learn how genuinely concerned and helpful the staff at the clinic were. I was ushered into a private room where I explained my situation and within five minutes the nurse had made space for me and I was on the waiting list.

After a short wait I was seen by the doctor who carefully took note of my situation, perfectly explained what PEP was and reassured me that coming to the clinic after potentially being exposed to HIV was the right thing to do. Hearing that my decision to take PEP was the right one was all I wanted to hear from a medical professional at that time. The doctor agreed with my sentiment that if you’re asking yourself ‘what if?’ then you should absolutely take no risks when it comes to HIV, because, ultimately, the only sexual health status you can be 100% sure of is your own. After taking a few blood samples and a quick HIV test, which is something I had done many times over the past few years, I was given my PEP medication.

The instructions were to take one tablet in the morning and two at night, taken exactly 12 hours apart at the same time every day. I was however only given a three day supply of the drug. The doctor informed me that this is normal practice and it’s up to the patient to pick up the remainder of their 28 day supply from their pharmacy. It is absolutely imperative that users of PEP plan ahead to make sure their supply of pills does not run out before retrieving the full medication.

The future

My experience with PEP, which I am currently still using until my 28 days are up, has been both fearful and insightful. In the short amount of time between considering starting a course of the drug and actually taking it I learned more about HIV and the treatments available than ever before. I also came to appreciate the services we have available in this country – if I wasn’t lucky enough to live in such a privileged part of the world who knows how I would be forced to handle a situation like this. Life after PEP will most likely enhance my sexual health paranoia, however I believe that being overly careful is always better than being slack when it comes to an issue such as this. Although I’m confident my treatment will be successful, I am currently still in my PEP bubble which involves a daily routine of taking pills with an alarm reminder at either end of my days. In the end, whether I actually needed the drug or not in the first place, it was most definitely worth it.

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Life on London’s first Aids ward

In 1993, Gideon Mendel spent a number of weeks photographing the Broderip and Charles Bell wards in London’s Middlesex Hospital.

The Broderip was the first AIDS ward in London and was opened by Diana, Princess of Wales in 1987.  This was the era before antiretroviral medications had become available, a very distinct and tragic time. All of the patients on the wards, many of whom were young, gay men, were having to face the terrifying prospect of an early and painful death.

During his time at the hospital Gideon followed the stories of four patients in particular – John, Steven, Ian and Andre. These two wards at The Middlesex Hospital were some of the few dedicated AIDS wards that existed in London, and even more unusual for their decision to open themselves to being photographed.

Considering the high levels of stigma and fear that existed at the time, the decision of these four patients to allow themselves, alongside their families, lovers and friends to be photographed was an act of considerable bravery.

During his time at the hospital, he photographed their treatment and many other aspects of ward life, including the intimate way in which the staff, patients and their families related to one another.

Treatment was not a passive process, but rather an active engagement on the part of the patients, who were often extremely knowledgeable about their condition. The staff too became far more attached to their patients than was commonplace in hospitals at the time.

All of the patients in these photographs died soon after the pictures were taken. They were the unlucky ones, who became sick just before treatment became available.

The Ward poignantly reminds us of a different time, how it felt to live with HIV when it was considered a veritable death sentence, and how the wards at the Middlesex Hospital became unique and special places full of love.

Mendel’s project aimed to move away from the representations in the popular media at the time, which he believes tended to show the horror of the illness.

“The work is gentle and compassionate and loving, and the intention was to try and move away of images of people living with HIV as being emaciated, dying skeletons,” he says.

“I was trying to show relationships and show the love.”

“The Ward” Photo Book is available to buy from World AIDS Day, 1st December 2017 – ISBN: 1907112561 

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From HIV to trafficking: shifting frames for sex work in India

Hijras in a train in Rajasthan in 2012. Giannis Papanikos/Demotix.

Hijras in a train in Rajasthan in 2012. Giannis Papanikos/Demotix.

The conflation of trafficking and prostitution in anti trafficking discourses not only frames all sex workers as victims in need of rescue, but elides the reasons many include sex work as part of their complex livelihood strategies.

NGOs focusing specifically on ‘sex work’ and ‘trafficking’ (where ‘trafficking’ is conflated with prostitution) in India have only been around since the mid and late 1990s. There has been a steep rise in their numbers in the last decade. Previously, if organizations addressed the needs of sex workers, they did so within the rubric of HIV/AIDS. Indian HIV/AIDS organizations were spurred into existence by the flow of international aid dollars that increasingly became available to organisations working in Asia, Africa, and Latin America during the first decade of the AIDS pandemic (1985-1995). Funds for HIV-related work in India came from the European Union, Sweden, Norway, and Canada into then relatively new entities like India’s National AIDS Control Organization (NACO). This money provided the infrastructural support for both governmental and nongovernmental efforts to surveil, control, and eventually treat HIV and AIDS. Local organisations also emerged as a result of this new funding to provide HIV-related services to sex workers, men who have sex with men, andhijras (people assigned male sex at birth who live as a ‘third sex’ in the feminine range of the gender spectrum).

By the late 1990s, thanks to feminist debates on pornography and prostitution, an antitrafficking framework—composed of laws, policies, and theories that used prostitution as an allegory for women’s oppression by men—was taking hold within some national governments and segments of the international policy-making community as a primary lens for understanding sexual commerce. This framework now largely dominates the discussion, having become the ‘common sense’ of sexual commerce and even, to a degree, migration among poor and working class people. This is despite the fact that the trafficking framework has been repeatedly criticised for conflating human trafficking with prostitution, and for failing to provide clear parameters for tracking the phenomena it aims to describe. It remains, for the moment, a significant but contested lens on sexual commerce for international policy, especially with respect to interventions crafted for countries in the Global South.

The rise in the explanatory power of the anti trafficking framework for understanding phenomena like migration and the exchange of sex and money in the Global South paralleled an increase in the significance of prostitution in the global image and imaginary of India, usually as the dark foil of India’s buoyant economic growth rates. By 2007, ‘prostitution in India’ had become a categorical focus for charitable organizations, an object of study for filmmakers, a worthy cause for politicians and celebrities, and a Wikipedia entry. This was not due to the discourse on HIV per se, nor was it due to an increase in the proliferation of HIV in India (the national rate of new infections decreased by half between 2000 and 2009). Rather, the increased significance of prostitution to the idea of India itself was linked with the increased global significance of the anti trafficking framework.

While this framework is far from being unequivocally dominant in managing and understanding prostitution, its increased significance in the halls of international policy formulation has helped position prostitution as particularly important to understandings of women in the Global South. This conflation of trafficking and prostitution is contextualised by a number of historical trends, including the ways in which discourses of venereal disease have figured female sex workers as infectious vectors since the nineteenth century. It is also contextualized by the altered conditions for labour migration brought about in the late 1980s and early 1990s due to the adoption of neoliberal economic policies in many parts of the world; the well-rehearsed histories of feminist pornography debates in the United States; and the confluence of interests between governments and some segments of women’s movements in seeking to eliminate illegal and undocumented cross-border migration. While migrancy has changed dramatically in the era of neoliberalism, such that economic migrants are vulnerable to wage theft, debt bondage, exploitation, and abuse in new and unprecedented ways, we may ask whether the frame of ‘trafficking’ accurately tracks and addresses these vulnerabilities, or whether it is more effective in protecting states’ interests in securing and monitoring borders?

At worst, the rise in the explanatory power of ‘trafficking’ for prostitution consists of an elision of political economy within discourses of sexuality, contributing to the reproduction of the idea that sexual freedom, autonomy, expression, and even sexual subjectivity are all luxury goods, available only to those whose access to food and shelter is secure. This form of depoliticisation within sexuality politics in the United States and elsewhere has attracted much scholarly and activist attention, as well as criticism from both the mainstream left and the LGBTQ left. In my view, a sustained scholarly engagement with sexual commerce in the Global South would not only offer a way to critique prostitution per se. It would also demonstrate the kind of discussion of sexuality, politics, and power that is possible when sexuality is not primarily or exclusively understood as a form of individuated, innate human expression.

The result of this depoliticisation in understandings of sexual commerce has been the subjection of women and girls selling sexual services to a discourse in which prostitution is a state of being from which they must simply be rescued. In this discursive trajectory, sexual commerce is never figured as a livelihood strategy that is part of a complex set of negotiations for daily survival that include, but cannot be reduced to, violence and precarity. Just as identitarianism marginalises questions of political economy with respect to LGBTQ politics, the conflation of selling sexual services with human trafficking deprioritises and, in some spaces, erases the question of survival with respect to sexual commerce. This individuated frame reinforces and reifies the idea of origins, on the moment in which an individual subject knew, came out, was forced, was called into being, within a fixed subjective matrix.

_Street Corner Secrets _takes up this critique by asking what an analysis of sexual commerce would be if it were to use a framework other than trafficking, one that focuses instead, for example, on the relationship between sexuality and livelihood? How would such an analysis account for violence, without conflating the exchange of sex and money with violence? The book does this by emphasizing the idiosyncratic and extremely local ways in which laws and criminality are interpreted and enforced as part of a larger focus on migration and daily economic survival. This emphasis is able to account for the relationship between sexual commerce and the profoundly uneven and inadequate access to water and land among poor migrants living in Mumbai. Here, the difference between living in a brothel and a slum is, among another things, the relatively higher access to municipal services like water and government-run schools among brothel-based sex workers, compared with those eking out a living in the slums at the edge of the city.

The emphasis in the book on livelihood, economic informality, housing and the liminal legal zones migrants must navigate in the city opens up a number of questions that are subsumed, or unasked, when abolitionism imbricated with trafficking serves as the primary interpretive frame for sexual commerce. What, for example, could a critical examination of sexual commerce reveal about the politics of day wage labour? What would it show about the exercise of state power on the urban street? What could it reveal about economic survival, in the Indian context, or in any other? Addressing these questions brings us closer to discursively repositioning violence, such that we may account for violence as it is meted out in myriad forms by police, housing authorities, and clients against people selling sexual services, while also explaining why sexual commerce endures as a livelihood strategy among people who are extracting survival from an shrinking field of economic options.

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We have the ability to end HIV in our lifetime!

Image by NIAID (CC BY 2.0)

London’s largest sexual health clinic, Dean Street is on track to record a huge drop in new HIV cases for a second successive year. In light of this, Dean Street has set itself a target of zero new infections after  witnessing a two-thirds fall in the number of new diagnoses since 2015.

So what’s happened? – PrEP has happened.  PrEP is a HIV prevention, once a day pill which you take regularly, or semi regular (depending on your circumstances).  For more information on PrEP please visit Prepster or The Terrence Higgins Trust

The reduction in new HIV diagnosis attributed to intensive testing of high-risk gay men, quick access to antiretroviral therapy and trials of PrEP which will be offered free on the NHS to 10,000 people from next month.

Dean Street diagnosed 136 people with HIV between January and July, putting it on course for a total of 233 by the end of the year.  If achieved, this would be the second successive fall in excess of 40 per cent, down from 679 in 2015 and 393 last year, when clinicians first raised the possibility of defeating HIV.

Dean Street’s figures are notable as it is also the largest HIV clinic in Europe and typically accounts for one in nine of all new cases in the UK.

Lead clinician Dr Alan McOwan said the latest figures were “great but not good enough” and told the Standard: “It’s a very exciting time. Everyone is so motivated to make this work. In 2015 we were diagnosing about 60 to 70 people positive a month. It dropped dramatically last year, and it’s still dropping. Over the last few months it’s between 15 to 20 people a month.”

Public Health England figures show that the total number of HIV diagnoses in London has fallen steadily from more than 3,000 in 2006 to 2,603 in 2015. It has risen within the highest-risk group of “men who have sex with men”, who now account for more than half the cases. One in seven gay and bisexual men in the capital has HIV.

Figures published earlier this summer for London’s five busiest clinics, including Dean Street and Mortimer Market, also in Soho, showed a 32 per cent fall in new HIV cases, from 880 to 595, in the year to last September.

Dr McOwan said the initial fall in infections diagnosed at Dean Street since 2015 had been concentrated among “very well-informed, assertive people” who bought PrEP online and followed medical advice.

The clinic’s Plan Zero initiative, unveiled this week, will provide tailored advice online to “harder to reach” gay and bisexual men on how to reduce the risk of contracting HIV, and preventing onward transmission. “Shockingly, there are still groups of people who have very, very little awareness of even the basics of HIV,” Dr McOwan said. Participants are asked to answer five questions about their lifestyle, adapting the answers depending on whether they are HIV positive or negative, have sex with multiple partners, use condoms, or take PrEP.

“We finally have the tools to end HIV,” Dr McOwan said. “Plan Zero brings them together into one package. We will beat HIV if we all act together.”

Dean Street, part of the Chelsea and Westminster Hospital NHS trust, will be among the first London clinics to offer PrEP before it becomes available country-wide by next April.

The drug, previously available to about 1,000 gay men via the Proud clinical trial, cuts the risk of contracting HIV from unprotected sex by about 86 per cent.

NHS England decided to make it available under a £10 million three-year trial after being told by the Court of Appeal last year that funding PrEP fell within the health service’s remit. The trial will be the biggest of its kind in the world.

It is not yet known how Leicester & Leicestershire will be involved in the trial.

The introduction of anti-retroviral therapy two decades ago was credited with transforming HIV from a fatal infection into a chronic manageable condition. However, there were 594 deaths of people with HIV in the UK last year.

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There’s currently an outbreak of Hepatitis A affecting gay and bisexual men.

Hepatitis A outbreak in England under investigation

Public Health England is investigating a hepatitis A outbreak predominantly affecting men who have sex with men. Between July 2016 and 2 April 2017, 266 cases associated with the outbreak had been identified in England. At least 74% of these were among MSM, and 63% of cases were in London. There is evidence that there have been some cases in the wider population linked to the outbreak.

A high proportion of cases likely acquired the infection abroad at the beginning of the outbreak, but transmission now mainly occurs in England. The outbreak comprises three concurrently-circulating genotype Ia strains, previously not seen in England. Hepatitis A outbreaks caused by the same strains are concurrently occurring in 12 European countries and elsewhere in the UK outside of England [1,2].

As part of the outbreak response, PHE together with the British Association for Sexual health and HIV have recommended that MSM with one or more new or casual partner in the last three months are opportunistically vaccinated in GUM clinics at their next appointment. In addition, pop-up vaccination clinics have been set up around gay venues in London. PHE is considering wider vaccination strategies to respond this outbreak, which is occurring in the context of a global shortage of hepatitis A vaccine.

See the PDF version of this report for the epidemiological curve depicting the outbreak.

References:

  1. ECDC (December 2016). Rapid risk assessment: hepatitis A outbreaks in the EU/EEA mostly affecting men who have sex with men.
  2. Beebeejaun K, Degala S, Balogun K, Simms I, Woodhall SC, Heinsbroek E, et al (2017). Outbreak of hepatitis A associated with men who have sex with men (MSM), England, July 2016 to January 2017. Euro. Surveill. 22(5), 2 February.

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National HIV Manifesto & Leicester Halve It Pledge

Join us in challenging local candidates to pledge their support for people living with and affected by hiv. The general election is a crucial opportunity to raise the profile of HIV; please add your voice to our campaign.

We have come a long way since the 1980s. While stigma and discrimination remain, HIV is now a long term condition and individuals are living with HIV into old age. HIV affects individuals of all ages with 95% of people living with HIV of working age. HIV treatment in the UK is excellent, but not everyone living with HIV is doing well. The number of people diagnosed with HIV each year remains high and far too many people are diagnosed late.  Services which help people living with HIV manage their condition are facing continued funding cuts.

We have come so far. We cannot stop now.

WE ARE CALLING ON THE NEXT GOVERNMENT TO:

  1. Commit to tackling the stigma and discrimination faced by people living with HIV.
  2. Fully fund HIV and sexual health services to meet the needs of local communities.
  3. Recognise the importance of prevention to a sustainable health and social care system by increasing investment in public health services.
  4. Equip schools with the resources they need to ensure that high-quality, age-appropriate, lesbian, gay, bisexual and trans (LGBT)-inclusive sex and relationships education is taught to all young people in all schools.
  5. Make PrEP available to all individuals at risk of HIV in the UK.
  6. Develop a fair benefits system that meets the needs of people living with HIV whether in or out of work.
  7. Ensure that the health and social care system is equipped to meet the needs of a population ageing with HIV.

TAKE ACTION NOW

It’s time to pile on the pressure; will your local candidates stand with people affected by HIV? There are some easy ways you can help put HIV on the agenda in this election.  Click here to write to your local candidates, asking them to support our manifesto.

Leicester

Tom Robson holding the Halve It Pledge which Leicester City council and Leicester City MPs signed in 2015.

Late HIV diagnosis in Leicester is 13.8% higher than average in England and Leicester has the 6th highest rate of late diagnosis of HIV in the country.  As a city with these statistics, we are responsible for doing everything we can to ensure these late diagnoses come down and to ensure that people know their HIV status.

In 2015 and as part of the ‘Halve It pledge’, Leicester City Council together with local MPs; Liz Kendall, Jon Ashworth and Keith Vaz united with LASS, Trade and other voluntary sector partners to sign the ‘Halve It pledge’.  The national pledge commits Leicestershire to halve late HIV diagnoses by 2020.

Here you can see, our local MP’s together with our council have actually penned their names to the Halve It Pledge, we hope with your support they will remember to put HIV back on the agenda.

#HIVMANIFESTO

You can Tweet the manifesto to spread the word about our demands – use the hashtag #HIVmanifesto. You can also take a photo of yourself holding our HIV pledge. Download here.

Take it offline: meet with your candidates face-to-face to discuss the points in the manifesto. Go to any local hustings events to do the same, ask questions to see how committed they are to the HIV manifesto. Take a look at this toolkit with details and tips on what questions to ask.

Suggested Tweets

I’ve challenged my local MP candidates to support people living with HIV. Join me by sharing the #HIVmanifesto

HIV is misunderstood and under-funded. Put it back on the agenda this election with the #HIVmanifesto

I pledge to stand with people affected by HIV this general election – do you? #HIVManifesto

I’m calling on the next government to stand with people affected by HIV. #HIVManifesto

Download the full HIV Manifesto

Download the HIV Manifesto pledge board

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