Tag Archives: National AIDS Trust

NHS England reconsiders decision over HIV PrEP drug

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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.

Story via
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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.”

TWB  FBB

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HIV and the general election – what we should be talking about!

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Press Release via NAM (@aidsmap)

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NAM is an award-winning, community-based organisation, which works from the UK. They deliver reliable and accurate HIV information across the world to HIV-positive people and to the professionals who treat, support and care for them.

The National AIDS Trust and HIV Scotland have joined together to identify the key priorities for the new Parliament which will reduce HIV transmission and improve the lives of people living with HIV across the UK. They are calling on the next UK Government to commit to the following:

1. Retain the protections set out in the Human Rights Act, which acts as a safeguard to ensure people living with HIV can live a meaningful, safe and fulfilled life.

2. Introduce compulsory Sex and Relationships Education for all schools, which is inclusive of young people of all sexual orientations and gender identities and has appropriate sexual health and HIV content – in the first session of the new Parliament.*

3. Make HIV prevention a national public health priority, with effective funding, more varied testing options and access to the full range of prevention information and choices for all who need them.*

4. End HIV stigma in the NHS and social care through the training of all NHS and care staff.*

5. Ensure that people affected by HIV-related sickness or disability have the support they need by committing to the Disability Benefits Consortium’s Five Things You And Your Party Can Do For Disabled People.

Deborah Gold, chief executive of NAT (National AIDS Trust), said: ”HIV has already been talked about during the general election but now we need to focus on how we can decrease the number of people getting HIV in the UK, how we can reduce the shocking levels of stigma and ignorance around the disease, and how we can ensure people living with HIV are treated with respect and dignity.”

George Valiotis, chief executive of HIV Scotland, said: “The responsibility for many of the decisions that affect HIV are devolved in Scotland – sex and relationships education, HIV prevention and the training of NHS and care staff. Despite this, the new UK Government has a key role to play north of the border. Chiefly retaining a commitment to the Human Rights Act and ensuring dependable, fair access to welfare support for those who need it.”

The charities are asking voters to raise these issues when talking to candidates and to share the five HIV asks.  This is part of a cross-sector campaign, with Terrence Higgins Trust joining the call for the new Government to take action on sex and relationships education, HIV prevention for England and a stigma-free NHS. 

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The Criminalisation of HIV Transmission

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Recently, LASS ran a workshop to provide up to date information about HIV & the Law.  The law relating to the transmission of HIV is based on case law, as courts have responded to new situations by expanding the scope of existing legislation and setting precedents. This case law can only be created through contested trials or appeals.

The law used in England and Wales to prosecute people for HIV transmission is the Offences Against the Person Act 1861 (OAPA 1861), under the sections relating to ‘grievous bodily harm’ (GBH). Proving GBH originally depended on physical evidence – the existence of a mark, but in the 1990s, in the context of concern about the ineffectiveness of the law to deal with high profile cases of stalking, courts succeeded in broadening the definition to include psychological harm. This subsequently meant that the transmission of disease could be defined as a crime. For a detailed timeline of legal developments, visit AIDSMAP for for more information.

Our recent workshop provided participants with up to date information about HIV and the law, using recent research by Sigma Research, updates from the National AIDS Trust (NAT) and policy statements by the British HIV Association and the Expert Advisory Group on AIDS. The workshop consisted of a presentation by Birkbeck lecturer Robert James, group work analysis of case studies, and action planning.

Presented here, is a summary record of the workshop which can also be used as a general briefing on the issues relating to HIV transmission and the law. This document will be of particular interest to people in the health profession, legal profession, police and CPS who may be involved with possible prosecutions. It is highly relevant for health workers and other support workers for clients who may have a blood borne virus or may be vulnerable to other transmitted infections.

Obtain your copy of the report by clicking here.

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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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LASS Annual General Meeting 2013

Leicestershire AIDS Support Services (LASS) are holding our Annual General Meeting on 10th October 2012 at Warning Zone, 30 Frog Island (Off North Bridge Place), Leicester, LE3 5AG. (Map)

Our AGM is a public meeting where our Trustees report back on the management & finances of the organisation for the previous year. Trustees are elected & re-elected for the forthcoming year and members have the opportunity to put questions to the board & vote for decisions and for Trustees. It’s also a great opportunity to meet their staff and volunteer workforce.

This year, we welcome guest speaker, Dr Iain Stephenson (HIV consultant at the Leicester Royal Infirmary) and Yusef Azad, (Director of Policy & Campaigns at the National AIDS Trust)

Our meeting last year became fully booked quite early, so we request you use the orange link below to register your attendance so we can have an indication of the numbers expected.

Eventbrite - LASS Annual General Meeting 2013

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Early HIV drugs ‘functionally cure about one in 10’

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Rapid treatment after HIV infection may be enough to “functionally cure” about a 10th of those diagnosed early, say researchers in France.

They have been analysing 14 people who stopped therapy, but have since shown no signs of the virus resurging.  It follows reports of a baby girl being effectively cured after very early treatment in the US.  However, most people infected with HIV do not find out until the virus has fully infiltrated the body.

The group of patients, known as the Visconti cohort, all started treatment within 10 weeks of being infected. The patients were caught early as they turned up in hospital with other conditions and HIV was found in their blood.

They stuck to a course of antiretroviral drugs for three years, on average, but then stopped.  The drugs keep the virus only in check, they cannot eradicate it from its hiding places inside the immune system.  Normally, when the drugs stop, the virus bounces back.

Control

This has not happened in the Visconti patients. Some have been able to control HIV levels for a decade.

Dr Asier Saez-Cirion, from the Institute Pasteur in Paris, said: “Most individuals who follow the same treatment will not control the infection, but there are a few of them who will.”  He said 5-15% of patients may be functionally cured, meaning they no longer needed drugs, by attacking the virus soon after infection.

“They still have HIV, it is not eradication of HIV, it is a kind of remission of the infection.”

Their latest study, in the journal PLoS Pathogens, analysed what happened to the immune system of the patients.  Early treatment may limit the number of unassailable HIV hideouts that are formed. However, the researchers said it was “unclear” why only some patients were functionally cured.

Dr Andrew Freedman, a reader in infectious diseases at Cardiff University School of Medicine, said the findings were “certainly interesting”.

“The presumption is that they’ve started treatment very early and the virus hasn’t spread to so many of the long-term reservoirs and that’s why it works.  Whether they’ll control it forever, or whether it’ll be for a number of years and subsequently they will progress and the virus will reappear, we don’t know.”

However, he cautioned that many patients would be diagnosed much later than in this study.

Deborah Jack, the chief executive of the National AIDS Trust said it was “exciting times” in progress towards an HIV cure, but the key was early treatment.

“This just underlines the importance of people being testing and diagnosed early. Currently half of people living with HIV in the UK are diagnosed late – indicating that they are likely to have been infected for five years.”

Analysis

There have been two stories about HIV ‘cures’ in two weeks now – yet the latest developments offer little to the majority of people living with HIV.

In the Mississippi baby case and in the Visconti cohort the infection was caught very early, within weeks, at a vulnerable stage.

This suggests that by hitting the virus hard when it first infects the body, it might be possible to live for years without needing treatment – a functional cure.

However, these patients were the lucky few who were detected in the days and weeks after infection. Most cases are detected years later. For these patients a cure looks, at best, distant.

The hope is that by investigating how patients treated early, and a group of people who are genetically resistant to HIV, can combat the virus – it will give scientists clues for developing cures for everyone else.

Original Article by James Gallagher
Health and science reporter, BBC News

WHEN WAS YOUR LAST HIV TEST?

If all the recent news about the importance of an early HIV diagnosis is persuading you to think about having a HIV test, you should know we offer offer a completely free and confidential rapid HIV test.  This means you will get your test results within a couple of minutes, and it’s a simple simple finger prick test.  (We don’t collect blood and send it off, we do it there with you)!

We use the Insti HIV test produced by BioLytical laboratories. The test is 99.96% accurate from 90 days after  contact for detecting HIV 1 and 2 antibodies.  We also have a mobile testing van which is often out in communities providing mobile rapid HIV tests. Appointments are not necessary, call us (0116 2559995) we’re here to help.

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The Need for A HIV Strategy

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By the end of 2012 it is estimated that there will be 100,000 people living with
HIV in the UK.  HIV diagnoses remain stubbornly high.  The two communities most affected are gay and bisexual men and African men and women.

Approximately one in twenty gay and bisexual men and one in twenty African men and women in the UK are living with HIV. In 2010, 3,000 gay and bisexual men were newly diagnosed with HIV; this is the highest number of gay and bisexual men newly diagnosed with HIV ever reported in a single year.

In the same year, half of all people diagnosed were diagnosed late; people diagnosed late have a ten-fold increased risk of death within one year of HIV
diagnosis compared to those diagnosed promptly. And still nearly a quarter of people living with HIV in the UK are unaware of their status. This is of real
concern given that the majority of transmissions come from people who are themselves unaware that they have HIV.

Advances in treatment have seen enormous improvements in quality of life and life expectancy for people living with HIV. In 2010, 85% of people on treatment had an undetectable viral load within a year of starting medication, a marker of
successful treatment. However, this success in treatment has not been matched by improvements in social support for people living with HIV. Many still  experience stigma and discrimination, live in poverty and cannot access the psychological support they need.

Although HIV remains one of the most serious infectious diseases affecting the UK, public understanding and knowledge of HIV is poor and getting worse. Recent Ipsos MORI research commissioned by NAT revealed that only one in
three adults were able to correctly identify all the ways HIV is and is not transmitted from a list of options, with almost a fifth mentioning one incorrect
method such as spitting or sharing a glass. One in five were unaware that HIV is transmitted through sex without a condom between a man and woman.

The research also showed a link between poor knowledge about HIV and negative and judgemental attitudes towards people living with HIV. There is
clearly still a need to improve awareness among the public, both to prevent the spread of HIV – each new infection costs the UK over a quarter of a million
pounds in direct lifetime medical costs alone – and to prevent misconceptions which fuel stigma and discrimination.

Despite this situation, there is no strategy for HIV in England – the last national strategy for sexual health and HIV came to an end in 2010. Over 90% of people living with HIV in the UK live in England, and yet England is the only country within the UK not to have a strategy.

Would you like to know more? Read the National AIDS Trust HIV Strategy.

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