Tag Archives: nat

NHS England reconsiders decision over HIV PrEP drug


The HIV virus. Pre-Exposure Prophylaxis is a new way of using antiretroviral drugs that has been proven to stop HIV transmission in almost every case Photograph: GeoStock/Getty Images

NHS bosses in England will reconsider whether it is their responsibility to fund a new treatment that can prevent the spread of HIV.

Pre-Exposure Prophylaxis (PrEP) is a new way of using antiretroviral drugs that has been proven to stop HIV transmission in almost every case.

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Last month NHS England said HIV prevention responsibilities lay with local councils as it announced it would no longer consider whether to offer the treatment, the National Aids Trust (NAT) said.

There was public outcry when NHS England said it was not their decision to make and the NAT threatened the health body with legal action.

However, NHS England said on Tuesday that its specialised commissioning committee will consider whether to put PrEP back into the NHS decision-making process.

“NHS England had previously told us that it was impossible for them to reconsider their decision. Faced with legal action, they have now changed their mind. We trust that NHS England, when it re-evaluates its position, will come back with a resounding yes.

“PrEP is one of the most exciting prevention options to emerge since the HIV epidemic began and offers the prospect of real success in combating this virus. To deny the proper process to decide whether to commission PrEP, when 17 people are being diagnosed with HIV every day, is not only morally wrong but legally wrong also.”

An NHS England spokesman said: “Final decisions on PrEP have not yet been taken, and we have agreed to consider representations from some stakeholders before deciding on next steps on the appropriate way forward.”

Local Government Association community wellbeing spokeswoman, Izzi Seccombe, said it was pleased and encouraged by the NHS England’s decision.

“Councils are keen to work with NHS England and the Department of Health to find a solution which can enable this ground-breaking prevention method to be delivered throughout our communities,” she said.

“Councils have invested millions in providing sexual health services since taking over responsibility for public health three years ago, and this treatment could help reduce levels of HIV in the community. However, our position has always been that responsibility for funding PrEP should lie within the NHS rather than councils.

“We look forward to working with NHS England to find an agreeable way forward that will resolve this issue.”


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Portrayal of HIV in the media & The Leveson Inquiry

The Prime Minister announced a two-part inquiry investigating the role of the press and police in the phone-hacking scandal, on 13 July 2011.

Lord Justice Leveson was appointed as Chairman of the Inquiry.  The first part will examine the culture, practices and ethics of the media. In particular, Lord Justice Leveson will examine the relationship of the press with the public, police and politicians.  He is assisted by a panel of six independent assessors with expertise in key issues being considered by the Inquiry.

The Inquiry will make recommendations on the future of press regulation and governance consistent with maintaining freedom of the press and ensuring the highest ethical and professional standards.

Lord Justice Leveson opened the hearings on Monday 14 November 2011, saying: “The press provides an essential check on all aspects of public life. That is why any failure within the media affects all of us. At the heart of this Inquiry, therefore, may be one simple question: who guards the guardians?”

A major concern for people living with HIV in the UK and the organisations that support them is the number of articles in the media that sensationalise and stigmatise HIV and unfairly represent individuals living with the virus.

Stories in the media can have a positive effect in increasing people’s awareness of HIV and what it means to live with HIV. However media reports about HIV are often stigmatising or inaccurate. Many stories contribute to a culture of blame about HIV transmission, focusing on so-called irresponsible sexual activity, use judgmental language and stereotype people living with HIV.

Improving the media’s coverage of HIV issues is vital to tackle discrimination experienced by people living with HIV, improve people’s knowledge and help prevent the spread of the virus.

Portrayal of HIV in the media

There are very few public figures who are open about their HIV status, and currently no established characters living with HIV in mainstream soaps or television dramas.   NAT are calling for proactive initiatives to portray realistic HIV stories in the media, with the BBC and Channel 4 taking the lead as part of their statutory duty to promote disability equality.

As well as in the media, NAT would like to see greater, and supportive, visibility for people living with HIV both in cultural representation and public life.

NAT recently made a submission to the Leveson Inquiry, which is examining the culture, practices and ethics of the media, and made the case for the need to tackle the frequent inaccuracies still written about HIV in the press and the use of stigmatising and prejudicial language.  You can read NAT’s submission to the Leveson Inquiry here.

Guidelines on Reporting HIV

NAT and the National Union of Journalists have jointly produced Guidelines on Reporting HIV to help journalists make sure that the articles that they write are not misleading and do not encourage negative perceptions about HIV.

You can read what NAT is saying to editors and journalists to improve reporting on HIV here.

Press Gang

Press Gang is an online group of people living with HIV who are interested in challenging stigmatising coverage in the media and making their voices heard. The National AIDS Trust keep Press Gang members informed of any stigmatising or inaccurate coverage and give them advice on how to challenge it.

Every day they scan many newspapers online and check other media for mentions of HIV and AIDS. Any articles that are identified as stigmatising or inaccurate are sent to Press Gang members via email as a ‘stigma alert’.

Members are then encouraged to write a letter to the editor or add a comment online pointing out why this article is stigmatising or inaccurate and informing readers about the realities of living with HIVin the UK.

If you’re living with HIV and are interested in challenging stigma in the media then you can find out more about find out more about joining ‘Press Gang’ here.

What’s in the news?

NAT scans the media in the UK and worldwide daily for stories relating to HIV and produces a summary of the main stories of the week, with online links to the original article. You can read the latest news here.  Where they identify inaccurate reporting of HIV, they always challenge it.

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NICE supports expansion of HIV testing at GP’s and in hospital settings

In its first ever guidance related to HIV, the health watchdog NICE recommends that health services not concerned with sexual health take a greater role in offering HIV tests to black African people and to men who have sex with men.

NICE also encourages outreach testing projects for gay men in venues such as saunas and cruising grounds, using rapid point-of-care tests.

The National Institute for Health and Clinical Excellence (NICE) issues recommendations to the NHS about the most effective and cost-effective treatments and public health interventions to provide. In some cases, NHS bodies are legally required to fund medicines and treatments which are recommended by NICE.

Guidelines on HIV testing have been previously issued by organisations representing specialist clinicians such as the British HIV Association (BHIVA) and the British Association for Sexual Health and HIV (BASHH). Their most recent guidelines recommended that HIV testing should be offered to patients in a wide range of healthcare settings, including GP surgeries and most hospital departments.

Implementation of that part of the guidelines has generally been limited, although pilot projects have established that widespread HIV testing is feasible, acceptable to patients and effective in identifying a substantial number of people with undiagnosed HIV.

But with NICE today endorsing large parts of the BHIVA / BASHH guidelines, there may be more hope that non-specialist clinicians will take further steps to promote HIV testing.

NICE have produced public health guidance on increasing the uptake of HIV testing in two related documents.  One concerns interventions for men who have sex with men, the other work with black African communities.

The document concerning black African communities repeats a number of the key recommendations in the BHIVA / BASHH guidelines. In all healthcare settings (including general practice, outpatient and emergency departments), an HIV test should be routinely offered and recommended to all patients who come from high prevalence countries, patients who have had sexual contact abroad and patients who have symptoms that may be related to HIV.

In addition, everybody attending a sexual health, antenatal, termination of pregnancy, drug dependency, tuberculosis, hepatitis B, hepatitis C or lymphoma services should be offered an HIV test.

At health services in areas of relatively high HIV prevalence, healthcare workers ‘should consider’ recommending HIV testing when registering and admitting new patients. In addition, an HIV test should be offered and recommended to all patients who are having another blood test anyway.

Areas of high HIV prevalence are those in which more than two in 1000 have diagnosed HIV. This is the case in most parts of London as well as in places such as Brighton & Hove, Manchester, Blackpool, Salford, Bournemouth and Eastbourne that have historically had high HIV prevalence. Areas which have experienced more recent increases in HIV prevalence such as Luton, Watford, Harlow, Southend-on-Sea, Reading, Slough and Crawley are also included, with around a fifth of the English population living in areas touched by these recommendations.

The wording of the document on testing men who have sex with men is somewhat different, but the implications are similar. In all healthcare settings, male patients who are known to be gay or bisexual should be offered and recommended an HIV test. General practitioners should repeat the offer on an annual basis.

At health services in areas of high HIV prevalence, all male patients (whether they are known to have sex with men or not) should be offered and recommended a test.

For both population groups, NICE recommends that directors of public health and commissioners develop a local strategy for increasing testing rates. The strategy should lead to more health professionals offering HIV testing and more individuals accepting the offer. The strategy should be developed in consultation with local voluntary organisations and community members and should pay particular attention to groups who are less likely to access services.

Community engagement and involvement is seen as particularly important in relation to black African communities. NICE recommends that community members should be recruited and trained to act as champions and role models. Programmes need to address misconceptions about HIV testing and treatment, promote the benefits of early diagnosis and tackle HIV-related stigma.

Health promotion interventions promoting testing to men who have sex with men should be encountered in venues, such as saunas or websites, which facilitate sex between men.

Moreover, the guidance supports outreach testing programmes in high-prevalence areas and also in venues where high-risk sexual behaviour between men occurs. This could include saunas and cruising areas. NICE appears to be more enthusiastic than BHIVA / BASHH about such projects, although they do note that testing will not be appropriate in all such venues. In such settings, rapid tests (using mouth swabs or fingerprick blood samples) should be provided by trained staff, in a secluded or private area.

All testing services (including community testing) need to have clear referral pathways to confirmatory HIV testing, HIV treatment services and support groups. Moreover people who test negative may need referral to counselling and safer sex interventions, as well as repeat testing (for example, if a risk has been taken during a test’s window period). Men who have sex with men are recommended to test annually, or more frequently if their sexual behaviour suggests that they may be at higher risk.

Dr Clare Gerada, chair of the Royal College of General Practitioners commented: “It is important that all health professionals do everything possible to encourage HIV testing amongst high risk groups. The RCGP welcomes the new NICE guidelines and we are sure that GPs will help patients come forward for testing.”

Deborah Jack, Chief Executive of NAT (National AIDS Trust) said: “It is crucial that HIV testing becomes ‘normalised’ in our society, not just among gay men and African communities, but also amongst health professionals. Many people with HIV attend NHS services for years without being offered an HIV test and this neglect needs to be addressed and stopped.” She called for late HIV diagnosis to be used a key outcome indicator in public health monitoring and for the new government body, Public Health England, to ensure that NICE’s recommendations are “consistently implemented across the whole of the NHS and public health system”.

Source: http://www.aidsmap.com/NICE-supports-expansion-of-HIV-testing-at-GPs-and-in-hospital-settings/page/1735227/

LASS offer a completly free and confidential rapid HIV test and you’ll get the results within 60 seconds from a simple finger prick test.  We use the Insti HIV test produced by BioLytical laboratories.  The test is 99.96% accurate from 90 days post contact for detecting HIV 1 and 2 antibodies.

Appointments are not always necessary, if you would like a test, please contact us on 0116 2559995

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