Tag Archives: HIV/AIDS

Nine ways funding for the global HIV response could go further

 A young girl living with Aids takes her drugs at her home in Ndiwa, western Kenya. Photograph: Simon Maina/AFP/Getty Images

A young girl living with AIDS takes her drugs at her home in Ndiwa, western Kenya. Photograph: Simon Maina/AFP/Getty Images

Story via The Guardian

1 | Protect and promote human rights

Public resources are wasted on enforcing laws that criminalise HIV transmission and dehumanise at-risk populations. By contrast, laws that protect at-risk populations are powerful, low-cost tools that help ensure that financial and scientific investments for HIV are not wasted. Enacting laws based on sound public health and human rights will ensure new prevention and treatment tools – such as PrEP [pre-exposure prophylaxis], male circumcision and microbicides – reach those who need them. Changes in the legal and policy environment, along with other interventions, could lower new adult HIV infections to an estimated 1.2 million by 2031 (compared to 2.1 million if current efforts continue unchanged). Mandeep Dhaliwal, UNDP

2 | Make drugs cheaper

One way to make limited funds go further is to challenge drug companies on the high price of life-saving drugs. The use of unmerited patents by pharmaceutical companies to secure monopolies on their products must stop. Make Medicines Affordable is working with civil society to challenge unmerited patents and useTrips agreement flexibilities. Julia Powell, International Treatment Preparedness Coalition

In lower middle-income countries, the average antiretroviral (ARV) treatment cost for a new adult patient is around $350 [£283]. Of that, just 40% is the cost of the ARV – 35% is non-ARV recurrent costs (clinical salaries, laboratory etc) and then 25% is programme management. We really need to dissect non-drug costs and find ways to reduce costs with regard to generic licensing and optimising manufacturing costs. Anand Reddi, Gilead Sciences

3 | Support LGBT groups

There are some great new global funds supporting funding for local and national LGBT groups so that they can gather data on access to medicines for their community, in a way that ensures their confidentiality and safety. The Rapid Response Fund, funded by the Elton John Aids Foundation (EJAF), the President’s Emergency Plan for Aids Relief (Pepfar) and UNAids, will support civil society organisations that are led by, or work closely with, MSM [men who have sex with men] and LGBT people and communities, to implement rapid responses to situations or events that threaten their access to HIV services. Grants of up to $20,000 [£16,000] are available. Mike Podmore, STOPAIDS

4 | Support adherence to ARVs

Drug resistance is a huge issue and one to which we are only just waking up. The World Health Organisation has produced a 2017-21 action plan which, I think, underlines that we have neglected to focus on adherence and support people not just to access ARVs, but to stay on them. Mike Podmore

5 | Integrate HIV into health sectors

Finance ministers tend to think in terms of sectors (eg health) or a clusters of sectors (eg the social sectors – education, health, social welfare), rather than in terms of individual issues like HIV. We need to integrate Aids financing into domestic health financing and make the argument to finance ministers that they need to increase investment in the social sectors, and health in particular. We need to underscore why this is an important investment in human capital and, therefore, in economic development. David Wilson, World Bank

6 | Collect and spend taxes on health

Some countries with major HIV epidemics have actually progressively reduced the share of the government budget they allocate to health, and many African countries with major HIV challenges collect a smaller share of GDP as revenue – and spend more collecting that small share – than comparable economies elsewhere. We must ensure that a significant share of the greater revenue collected is allocated to health, and spent as efficiently as possible. David Wilson

7 | Integrate HIV and water and sanitation programmes

Safe water can make an enormous difference to the health and wellbeing of people living with HIV. It can increase drug effectiveness by reducing diarrhoea and collaboration between HIV specialists at Safaids and in the water and sanitation sector have identified ways to integrate water and HIV programming more effectively in southern Africa to streamline investments. In addition, arecent systematic review showed that water and sanitation interventions to reduce morbidity among people living with HIV were cost-effective, particularly when incorporated into complementary programmes. Louisa Gosling, WaterAid

8 | Coordinate responses

In the HIV/Aids space, we can work with others focusing on health to share costs. In Malawi, for example, our mobile clinic teams test and treat for malaria and TB even though our core focus is HIV. Also, in our door-to-door testing pilot – where a team of eight canvases a village over a week to perform HIV tests – that same team will check for bed nets. If they do not have one, our HIV testing team will leave one and teach the family how to use it. One team, but two major health issues covered. Joel Goldman, The Elizabeth Taylor AIDS Foundation

9 | Push for more funding

We must reject the assumption that we will/can have less money and, instead, make it clear that less money, or even maintaining the same levels of funding, will lead to an increase in infections and deaths globally. Many organisations working on the global HIV and TB responses are shouting loudly about the funding alarm. It became even more urgent when the Kaiser Family Foundation found that global donor financing had reduced by 13% from 2014 to 2015. Our only way forward is to increase general public awareness and demand for donors and INGOs to increase HIV and TB funding up to 2020, and make it possible to end the epidemics by 2030. If not, we risk a terrifying rebound of the epidemics that we will struggle to get a grip on again. Mike Podmore

Read the full Q&A here.

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Pregnant and diagnosed with HIV: the group providing support for mothers

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Thirteen years ago, when Babalwa Mbono was eight months pregnant with her second child, she went to her clinic in Cape Town, South Africa, to have a routine HIV test.

Article via The Guardian
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“I went with confidence because my first child was negative and I was negative then,” she says. When the test came back positive, Mbono couldn’t believe it. “When the counsellor who tested me showed me the results I thought, ‘you’re joking!’ I even asked her if she was sure.”

Mbono left the clinic in a daze and went home to reflect on the news, still in denial. She looked healthy and well, unlike her sister who had died three years previously from Aids-related tuberculosis. “For me, [the result] was something that was not real,” Mbono adds.

Nowadays many people in South Africa know about HIV. The country has the biggest and most high-profile epidemic in the world, with an estimated 7 million people living with the condition, according to UNAids figures. But in 2003 it was not a big topic, and discussions usually revolved around death, says Mbono. The fear of what having HIV might mean for her unborn child started to creep in, and she worried that she would not live long enough to care for a baby who might be infected.

When Mbono found out that she had HIV, South Africa’s government was still deciding whether to make antiretroviral treatment (ARVs) available to all, despite a third of pregnant women testing positive. Today, 48% of infected South African adults are on ARVs.

Back at the clinic, Mbono was linked up to a mentor mother through Johnson & Johnson’s mothers2mothers (M2M) programme. The scheme started in 2001 and has helped 1.4 million HIV-positive mothers in nine sub-Saharan African countries. It currently operates in Kenya, South Africa, Malawi, Lesotho, Uganda, Swaziland and Zambia – seven countries where it has virtually eliminated mother-to-child transmission (MTCT) among its patients, with a 2.1% transmission rate (the UN classifies virtual elimination as less than 5%).

Mbono’s HIV-positive mentor allayed her fears about death and her anger towards her husband, whom she blamed for giving her HIV after he tested positive with a much higher viral load. Through M2M, Mbono learned about taking ARVs to reduce the risk of MTCT in the womb and during breastfeeding, and about how to change her lifestyle to live a long and happy life with her children.

Last year, South Africa was one of six priority countries (all in sub-Saharan Africa) to meet a Global Plan target of reducing MTCT by 90%, with 95% of pregnant women with HIV on ARVs and an 84% reduction in new HIV infections among children.

Over the past year, Cuba, Belarus, Armenia and Thailand – non-priority countries – managed to eliminate MTCT altogether. In South Africa, mother-to-child transmission of HIV has fallen to 3.5%, putting the country within reach of eliminating paediatric infections, although maternal mortality remains high.

The M2M programme “makes the person feel supported”, Mbono says. “It’s a sisterhood, and it makes you feel like you have a family to cry on.” Through counselling, which helps to breaks down the stigma still attached to HIV/Aids in South Africa despite its high prevalence, Mbono also found the courage to confide in her parents and siblings.

And six months ago, she decided to disclose her HIV status to her daughter Anathi, who had just turned 13. “It really felt shocking,” says Anathi, who feared that there would be no one to look after her seven-year-old brother, who was born HIV negative. “I was afraid that she would leave us.”

Mbono reassured her daughter that she had tested negative when she was 18 months old, but Anathi decided to go alone to the clinic and be tested anyway, where she also accessed free counselling from health workers.

“I was so, so scared, but eventually they just sat with me and told me to not freak out and to not think negative things about my mum,” Anathi says. Over the two days she waited for her results, she spent time with her mother and learned more about M2M, even reading her mentoring books.

Mbono’s experience with M2M made her give up unhealthy habits, such as not eating properly and drinking alcohol, and inspired her to become a mentor mother in 2003. “The [programme] gave me the strength to go out there and tell people about HIV and correct the mistakes that people are making and [that] I also made when I didn’t have any information.”

She has gone from counselling others on HIV/Aids and family planning, to training other mentors and seeing them become nurses, social workers and students.

“What makes me most happy [is] when I see a woman who had broken up in pieces when she was told about HIV … and when you see her on the next visit she is much better than the day she left.”

Some 95% of babies in M2M’s South Africa programme test negative for HIV at 18 months, and that also makes Mbono proud. “That makes me feel that I’ve done my job, because 18 months is a long time for the mother to be supported and to be educated. There are so many challenges that they come across, and we are there [for them].”

Anathi set up a counselling group at school to discuss HIV and sex with 18 girls and five teachers, as well as a drama group to perform plays to parents and pupils that discuss staying HIV negative and breaking down stigma.

“Most people don’t talk about it … Young people are not getting enough information about HIV,” she says. Anathi has a friend who she says became a recluse after she found out she is positive, and she knows two girls who have gone off the rails since their mothers recently died of Aids.

But for Anathi, dealing with her mother’s HIV has made them stronger and brought them closer together.

She still worries about how well her mother has slept or eaten when they are apart, even though learning about ARVs has lessened her fears of her mother falling ill and not recovering. “I just worry too much and I call,” she says. “She is like my daughter.”

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HIV DOES NOT EXIST!!

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Did that grab your attention??  We hope so!

Many of our readers are fluent in ‘HIV speak’, our service users, volunteers, partner agencies and the many people who subscribe to our blog and follow us on twitter.  We don’t need to be told that HIV doesn’t exist because we know it does and have first-hand experience of the condition.

You could argue that within our industry, we have blinkers on, we see people infected and affected by HIV on a daily basis, we support people and we advocate.  We assist when people are victim to prejudice and stigma.  We offer emotional support to people when they need it most and we research the condition.

Yet for some people, it’s hard to believe that HIV is a real condition.  Some people believe that the HIV virus and its associated medical paraphernalia is a fabrication by pharmaceutical companies to create expensive drugs and keep people using them.

Others believe that HIV already has a cure, but this is being kept secret in order to keep the drug companies (i.e. Big Pharma) in business.

HIV/AIDS denialism is the belief, contradicted by conclusive medical and scientific evidence HIV does not cause AIDS.  Some denialists reject the existence of HIV, while others accept that HIV exists but say that it is a harmless passenger virus and not the cause of AIDS.  Insofar as denialists acknowledge AIDS as a real syndrome, they attribute it to some combination of sexual behaviour, recreational drugs, malnutrition, poor sanitation, haemophilia, or the effects of the drugs used to treat HIV infection in the first place.

The scientific consensus is that the evidence showing HIV to be the cause of AIDS is conclusive and that AIDS-denialist claims are pseudoscience based on conspiracy theories, faulty reasoning, cherry picking, and misrepresentation of mainly outdated scientific data.  With the rejection of these arguments by the scientific community, AIDS-denialist material is now targeted at less scientifically sophisticated audiences and spread mainly through the Internet.

Despite its lack of scientific acceptance, HIV/AIDS denialism has had a significant political impact, especially in South Africa under the presidency of Thabo Mbeki.  Scientists and physicians have raised alarm at the human cost of HIV/AIDS denialism, which discourages HIV-positive people from using proven treatments.

What do you think about this? – Fancy a chat with the Skeptics?

“Skeptics in the Pub” are a group of people in Leicester who like getting together in a pub to have a few beers and talk about ‘nonsense’.

Each month, they find a speaker – typically a scientist or prominent sceptic who will speak for around 40 minutes.  The subjects of the talks vary, but they will typically be about a common belief that either cannot be justified by the available evidence, or that can actually be demonstrated to be false by the available evidence.

Examples of these subjects are:

  • Alternative Medicine
  • Psychics & Mediums
  • Religious Beliefs
  • Holocaust Denial
  • Pseudoscience
  • Creationism

The talk is followed by an informal discussion by all who attend and their next talk is about “AIDS Denialism” with Myles Power.

In the early days of the AIDS epidemic many bizarre and dangerous ideas were advanced regarding the origin of the disease and its cause. Since the discovery of the Human Immunodeficiency Virus (HIV) these conspiracy theories, which once filled the void left by the lack of information, have all but vanished. Over the past three decades HIV has been the subject of intense scientific research which has resulted in effective treatments, rapid HIV tests, and promising cures. Yet unbelievably there are a small number of people who are sceptical of the “official story”. Although these people are small in numbers they are extremely well funded and can pose a very real threat to public health.

In this talk Myles discusses some examples of the dangerous assertions in the documentary ‘House of Numbers’ and explains how they have led to the death and suffering of hundreds of thousands of people. He will also talk about the failure of the DMCA and how it can be exploited by the proponents of pseudoscience.

The talk is at 7:30pm on Tuesday, 19th August at The Font (52 Gateway Street, Leicester)

So if you fancy the debate, why not pop along it’s sure to be interesting!

 

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Don’t Ever Wipe Tears Without Gloves

Beginning on Monday 2nd December to mark World AIDS Day and continuing on the following two Monday evenings, BBC Four is to screen the multi-award winning Swedish drama Don’t Ever Wipe Tears Without Gloves, telling the story of the AIDS crisis as it hit Stockholm’s gay community in the 1980s.

The series gripped Sweden, united the LGBT community and is credited with an increase in awareness about HIV and AIDS. The programme was named as Sweden’s Best Drama at the Kristallen Awards. This year, its author, Johan Gardell was named Sweden’s LGBT person of the year and was presented an award by Swedish Crown Princess Victoria.

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Don’t Ever Wipe Tears Without Gloves is a 3 part drama series about love in the shadow of AIDS, set in Stockholm in the 1980s.

When Rasmus and Benjamin meet at a party they fall instantly and deeply in love. For a short time their happiness continues until suddenly young men start to get sick, fade away and die. AIDS has come to Stockholm and nothing will ever be the same.

The series has been acquired for BBC Four by BBC’s Head of Acquisitions, Sue Deeks, who says: “This is a beautifully realised drama about the early years of the AIDS epidemic which has a poignant and affecting love story at its heart – we are so pleased to be able to bring it to BBC Four viewers.”

Set in Sweden, the series was a huge public and critical success when aired and it recently won the Kristallen (Swedish Emmy) for Best Television Drama. Don’t Ever Wipe Tears Without Gloves also won the Audience Award at the Series Mania Festival in Paris last April, in competition with American TV dramas such as Game Of Thrones and House Of Cards.

It is directed by Simon Kaijser and written by renowned author Jonas Gardell, after his series of books with the same title. It is an in-house SVT production with Maria Nordenberg as executive producer.

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A special message from our international patron, Desmond Tutu on World AIDS Day

Archbishop Desmond Tutu, LASS’s International Patron has sent a special video message from Cape Town to mark 1st December, World AIDS Day, for LASS.

“God, you love us all especially those of your children who suffer. We think at this time on Worlds AIDS Day of those who have HIV/AIDS. Help them not to despair, help those who work to combat this pandemic. Thank you that it is reducing. May those who are ill take their treatment regularly”

-Arch Bishop Desmond Tutu (November 2013)

LASS is a service user and volunteer charitable agency which works to prevent the spread of HIV and to promote positive sexual health through education, training, and community initiatives. By working together with other agencies, we play a major part in developing a coordinated response to the challenges of HIV/AIDS. We provide support for HIV positive people and HIV education and awareness across the communities.

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Missed, HIV Testing Week? – Don’t worry we do it all year round :-)

We are pleased publish our advert to promote HIV testing, this advert speaks with 15 languages internationally.

Our message is clear, it is better to know your own HIV status and you can get a HIV test at LASS, and have the result within a minute!

Our team of volunteers have specialist training to provide a free and confidential test, we also have a fantastic support team to provide after-care and further information if required.  We also have established network links so we can refer to more specialist agencies so you can be sure to get expert advice for your needs.

We hope you like our advert and hope that you’ll feel comfortable to contact us if you would like a free and confidential test. (0116 2559995)

Working with HIV: A Fading Taboo?

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Three months ago, the government lifted the ban that stopped medical staff with HIV performing certain dental and surgical procedures. The move was the latest step towards stamping out discrimination against people with HIV. But how far are we from HIV in the workplace being a forgotten taboo?

Under new rules announced by the Department of Health in August, healthcare workers with HIV will be allowed to undertake all procedures if they are on an effective combination of anti-retroviral drug therapy.

Professor Dame Sally Davies, England’s chief medical officer, celebrated the news. For her, many of the UK’s HIV policies were designed in the 1980s and had been left behind by scientific advances and effective treatments. According to her, “the risk to patients is ‘negligible’ now and HIV positive people will be able to partake in a number of tasks, including dentistry and surgery”.

The recent announcement is just one positive development in the many battles against discrimination that people living with HIV and organisations and individuals supporting them have fought over the years. For many, working in a fair, non-discriminatory environment, or even finding a job, has not been easy.

Employers’ responsibilities
Nearly a decade ago, Malcolm Bryant, who now works as a lawyer in the Ministry of Justice, was applying for new jobs. He had been diagnosed HIV positive a few months earlier and felt somewhat uncomfortable coming out in the open about his condition. When one of his applications required him to be specific about any medical conditions he might have, he decided to reveal he was HIV positive.

The recruiters asked him for a face to face meeting and then to bring a doctor’s letter providing more information about his condition. Three weeks later they offered him the job. “There seemed to be a delay in my start date compared to other new recruits with whom I had the interview; that always made me feel a bit behind. That was the first time I felt I was treated slightly differently,” he remembers.

Malcolm’s anecdote is just one among many. Although HIV stories are not as frequent in the media as they were decades ago and awareness campaigns do not seem to be as visible as they used to be, it does not mean that people living with HIV do not face day-to-day challenges when it comes to discrimination in their workplaces. Lack of knowledge, prejudices and uneasiness with the stigma that was associated with HIV in the 80s are some of the factors that can still lead to discriminatory practices.

In 2009, the National Aids Trust (NAT) carried out research in partnership with City University, which included a survey of over 18,000 HIV positive gay men in employment. Over half of the respondents, employed across a diverse range of sectors, testified that HIV had no impact on their working life.

The most recent development in UK national legislation regarding disabled people and people with AIDS is the Equality Act 2010, which replaced the Disability Discrimination Act 1995 and 2005. Under the Equality Act, it is now illegal for employers to ask people to disclose their health status before they have been offered a job.

Furthermore, the act protects anyone who has, or has had, a disability, along with anyone being treated less favourably because they are linked or associated with a disabled person. The act defines a disabled person as “someone who has a physical or mental impairment, which has substantial and long-term adverse effect on their ability to carry out normal day-to-day activities”.

An additional development concerns the ban on direct discrimination; the previous law protected disabled people when the discrimination was taking place in the workplace. Now, the ban on discrimination applies to other areas such as access to goods and services.

Discrimination comes in many forms
Jackie Redding, spokesperson for the Terrence Higgins Trust (THT), a charity providing HIV and sexual health services in the UK since the 80s, explained to Safety Management the various types of discrimination that may occur in working life. “Direct discrimination is when someone treats a person less favourably than others on the grounds of their medical status. Indirect discrimination occurs when someone, for example an employer, has a generic policy in place, which is applied to everyone, but in fact restricts a disabled person from undertaking a particular task.” She clarifies: “If there was a rule banning people from wearing something on their head, then this would be indirect discrimination against Muslim women.”

Jackie defines associate discrimination as “a situation where an employer treats someone unfavourably because they are associated with someone who is protected under the Equality Act 2010. For example, if his or her son is homosexual or if people think he is. ”The act protects people from every form of discrimination by rendering unfavourable treatment of any sort as unlawful.”

Suzi Price, communications manager at NAT, refers to two other forms of discrimination, less known but equally significant. “It is illegal if a management practice or workplace policy results in unfavourable treatment of an individual member of staff living with someone with HIV for a reason connected to their HIV status; this is discrimination arising from disability.” As she clarifies, “this type of discrimination is similar to indirect discrimination but legally distinct from it; discrimination arising from disability only applies if the employer knows about the employee’s HIV status, and the policy deliberately aims at their unfavourable treatment”.

Suzi describes perceptive discrimination as a situation where “the employer treats someone differently assuming it is HIV positive, because, for instance, he or she is homosexual or coming from a country with a high HIV prevalence”.

The 11ft tall ‘Tay’, the UK’s first AIDS memorial in Brighton. Photograph: Dominic Alves

Employers’ duties

There are some actions that employers need to implement in order to create a discrimination-free working environment, when there are HIV positive people among the staff. The employer needs to ensure that the workplace provides a supportive environment for people living with disability, and especially with AIDS.

Therefore, the first step for the employer is to familiarise themselves, if they have not done so, with the Equality Act 2010. Furthermore, an employer has to make some ‘reasonable adjustments’ to accommodate HIV positive people. NAT describes reasonable adjustments as “those changes to the workplaces or the work practices, which remove a substantial disadvantage that a disabled person might experience because of their disability”.

Malcolm explains that people with HIV need to take some time off work for hospital visits and medication treatments, so employers need to give allowances and make adjustments, such as flexible hours or some leave for a clinic appointment. “Surely that is a better way of managing staff, rather than having people taking time off sick due to stress or due to their face blotches after a medication treatment,” he says. Malcolm would urge all employers to check their procedures and also make sure that during the recruitment process they do not put off applicants by being too intrusive with questions about their health.

But he also thinks it is convenient for colleagues and members of staff to be aware of HIV positive employees’ health condition. “People are not as obsessive now and they understand the implications of one’s condition,” he says. “If your colleagues are not aware then you keep wondering ‘What if I cut myself and someone comes to help me?’ It is very relieving to know that people know.”

Side effects of medication is another aspect that employers need to take into account when they manage HIV-positive people. Side effects can include fatigue, nausea, sleep disturbance and diarrhoea, which sometime require additional reasonable adjustments at work.

Actual risk of transmission
According to the NHS, the body fluids that contain enough HIV to infect someone are semen, vaginal fluids, breast milk, blood and lining inside the anus. HIV cannot be transmitted through spitting, contact with unbroken, healthy skin, being sneezed on, sharing towels or crockery or mouth-to-mouth resuscitation.

THT explains that the actual risk of transmitting HIV in the workplace is minimal. This is because HIV is very fragile outside of the body and dies very quickly in the air. The infected bodily fluid would need to get into an open and bleeding wound in order to infect a person. If the wound is not bleeding, it is sealed; nothing can get into it. Also, if the wound is bleeding out then it’s very hard for any fluid to get in.

HIV cannot be transmitted via anything other than bodily fluid, so there is no risk around food preparation or sharing cups or crockery.

Employers working on awareness and prevention
In 2001, L’Oréal Group, in partnership with UNESCO, initiated a preventive education programme, called ‘Hairdressers against AIDS’. The programme has spread over 36 countries and reached out to more than 1.5m hairdressers so far. The programme was born in South Africa, where AIDS is a prevalent issue and a safety risk for the industry. The official launch of the campaign was in 2005, when UNESCO put together a questionnaire and a film to be incorporated into all education and training of potential hairdressers. The Group paid for part of the course.

L’Oréal has also created an activity-based day on 1 December and has developed a fund, the profits of which go to charities such as the NAT and Children with AIDS. The group also uses the red ribbon (universal symbol of AIDS awareness) as its badge and distributes it to all staff, in all events.

Naomi Scroggins, communications director, L’Oréal Professional Products (UK), feels proud of the work done by the group worldwide: “If we could just touch people and remind them that HIV is still around, that would be good for us, it is our way of helping to create awareness and accordingly help those who live with AIDS.”

Employers’ duties (guidelines from Terrence Higgins Trust)

  • Ensure there is a robust policy for supporting people who have chronic conditions, including HIV
  • Ensure that all staff have information and training around HIV
  • Support staff who have HIV if they choose to disclose it, and deal with inappropriate behaviour and comments robustly
  • Respect people’s right not to disclose
  • Help end stigma and discrimination by supporting World AIDS Day (1 December).

HSE guidance on managing incidences of blood-borne viruses at work can be found at the HSE Website.

With thanks to The British Safety Council

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