HIV/AIDS

Background

HIV infection is now considered to be a long term condition which is managed through a combination of antiretroviral drugs. However, without treatment, the virus may start to damage parts of the immune system over a period of time. A damaged immune system (immuno-compromised) results in a person being vulnerable to opportunistic infections which can be life threatening. If someone has HIV, it is best to start treatment before the immune system has been damaged, therefore, the sooner someone tests the better, as people diagnosed in the later stages of HIV may have already had their immune system compromised.

News

AIDS Support Grant has had its ring fence removed. This wil mean that the ASG will be part of the general budgets provided to Councils and will not necessarily be spent on HIV in the future. More details at http://news.pinkpaper.com/NewsStory.aspx?id=3208&xtra=email&dm_i=3XT,6JZH,S52QG,G71X,1 

HIV has been around for at least 25 years and the HIV antibody test has been available since 1985. HIV is not highly infectious but it can be contracted through:

  • Unprotected sex (vaginal, anal and occasionally oral)
  • Blood to blood transmission (sharing needles for injecting drug use; blood transfusions where the blood supply is not screened & tissue transplantation)
  • Mother to baby transmission

HIV is passed from a person with HIV to someone without HIV. A benefit of people at risk of HIV infection being tested, is that anyone newly diagnosed with HIV can, with support, make positive changes in their behaviours to reduce the further transmission HIV.

Treatment of HIV (Anti-retroviral therapy) became available through drug trials in the late 1990s and has advanced dramatically in recent years. This medication aims to reduce viral replication and a person can maintain their immune system.

People with HIV infection are advised to have a check up every 3-6 months or more often if advised by their doctor. Baseline bloods are offered, including monitoring their viral load (amount of virus in the blood) and CD4 count (a measure of immune function). This provides information on the person's response to the treatment as not all people respond to treatment in the same way. HIV is a chronic infection that can be managed with medical support and/or medication and people who are diagnosed in the early stages of infection, can expect a life expectancy similar to any other person living with a chronic condition.

National Statistics

The number of people living with HIV in the UK continues to rise, with an estimated 83,000 infected at the end of 2008, of whom over a quarter (27%) were unaware of their infection.

During 2008, there were 7,298 new diagnoses of HIV in the UK. This represents a slight decline on previous years, predominantly due to fewer diagnoses among black African women who acquired their infection abroad. New diagnoses among men who have sex with men remained high in 2008, and four out of every five probably acquired their infection in the UK. New HIV diagnoses among those who acquired their infection heterosexually within the UK have risen, from an estimated 740 in 2004 to 1,130 in 2008.

Over half of patients were diagnosed with a CD4 cell count <350 per mm3 within three months of diagnosis in 2008, the threshold at which treatment is recommended to begin. This suggests that they have been living with undiagnosed infection for some time and potentially passing HIV onto sexual partners.

Preliminary data for the first six months of 2009 indicate that one in five men who have sex with men, and one in ten heterosexuals newly diagnosed with HIV were likely to have acquired their infection within the last six months. Earlier diagnosis is seen as one key aspect to preventing HIV onward transmission.

Local Statistics

In 2008, 5459 individuals with HIV accessed treatment centres in the North West (HWPHO 2009). This is 11% increase on 2007. people with HIV who access Centres outside the North West are not captured in this dataset. SOPHID Data reports 5472 people resident in the North West accessed services in 2008 suggesting a small number accessed care outside the North West. This is a 4 fold increase from 1999.

60% of HIV in the NW is in Greater Manchester and 20% in Cheshire & Merseyside and Lancashire & Cumbria. Outside of Manchester and Liverpool, Blackpool has the highest number of people living with HIV (80% of whom are MSM compared to around 50% in Manchester and 40% in Liverpool). Cumbria and Lancashire have a higher proportion of white heterosexuals with HIV than elsewhere in the North West.  55% of heterosexuals with HIV in Lancashire are white background, and 68% in Cumbria. In Greater Manchester, more than 80% of heterosexual HIV is among BME communities.

In Lancashire, people with HIV are more likely to be on treatment (77.4%) compared to North West (72.2%).

PCT Statistics (2008)

Blackpool 315 cases; North Lancashire 132; Blackburn with Darwen 78; East lancashire 113; Central Lancashire 174; Cumbria 123 (some may be lost to North East treatment centres).

Source: Hargreaves et al (2009) HIV & AIDS in the North West of England 2008. North West HIV/AIDS Monitoring Unit, Centre for Public Health, Research Directorate Liverpool John Moores University

Local services/referrals (See the Services Section)

Genito urinary Medicine GUM

Local GUM Departments provide a confidential and non-judgemental service and people can self-refer by phone or walk in to open session clinics. People who want to have an HIV test or screening for sexually transmitted infections (STI) can expect to be offered an appointment within 48 hours of contacting a service. Where walk-in clinics are available, people with concerns can walk into GUM where no appointment is necessary.

All GUM testing, treatments and advice are confidential and free and are offered in a safe non-judgmental environment. Concerns over embarrassment should not put people off being checked out regularly for STI or HIV if they feel they have put themselves at risk of infections, for example having sex with a new partner.

GP’s (Doctors)

Anyone concerned about their sexual health including those who think they may have contracted a sexually transmitted infection (STI) including HIV can visit their own GP. Any consultation with a GP is confidential you can just make an appointment in the usual way. However not all services are available at a GP practice, but the doctor will be able to refer as appropriate.

HIV and Black Africans

In the UK Black Africans are the second largest group with HIV infection in the UK. Most heterosexual HIV transmitted infection is within this community with much of the transmission taking place in Africa and being diagnosed in the UK, often as late diagnosis. A report into BME and HIV can be found here:

downloads/HIV Africans.pdf

Instant Testing

Body Positive North West (BPNW) are running the 'Go 4 it' campaign and offering instant HIV testing in some services. The details are here. The test does not tell you if you have HIV but it does tell you if you haven't. The test is simple and the results available within minutes. If you have a reactive result then you would need follow up blood tests to check whether you have HIV or not. Some reactive results are 'false' positives. If you are reactive then you would be fast tracked to specialist services and support.

If you are diagnosed HIV positive, it is a condition which can be well controlled with drug therapy and people can live relatively long and healthy lives if HIV is diagnosed and treated. If you have contracted HIV it is better to be diagnosed early before you become ill and your immune system has been weakened. Late diagnoses account for the majority of deaths from HIV because people get diagnosed too late for treatment to be effective.

Links

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