African Film Against Stigma

posted: 11/05/2011

No Blame, No Shame is an epic new HIV health promotion film from the African Health Policy Network (AHPN). The film tackles the taboos and stigma surrounding HIV infection in UK’s African community. No Blame, No Shame features top comedian Gina Yashere, alongside HIV positive UK Africans, in a film made by Angus Malcolm.
 

No Stigma in living with HIV

No Blame, No Shame is an online video that is also available as a DVD, promoting the African Health Policy Network’s Public Faces  campaign, that there is no stigma in living with HIV and that stigmatising attitudes only help spread HIV.
 

Watch No Blame, No Shame here
 

Eunice Sinyemu, Head of Policy and Deputy Chief Executive at AHPN says “We have to challenge the stigma around HIV in the UK's African communities. It stops individuals from getting tested, which means they don’t get the treatment they need, and are more likely to infect others. With Gina’s help, we are confident we can get this message across in a colourful, punchy and accessible way.”
“Gina is much-loved in the African community, and having a big name on board is really going to help us reach our audience.”

Wide distribution

AHPN is promoting the film to reach as many people in the African community as possible, including viral marketing and distribution on DVD, use in training for a wide range of specialists and professionals, faith leaders and communities, local and national policy makers, workers in the health and social care sectors, local and national media.

Read about the comedian Gina Yashere

The film was made by Angus Malcolm, writer and producer. With a background in healthcare, including several years in the AIDS Unit at the Department of Health, Angus specialises in producing low-cost media for the statutory and not-for-profit sectors, especially education and healthcare.

No Blame, No Shame
 

People’s Guide to Police HIV Investigations

posted: 11/05/2011

NAT (National AIDS Trust) have just produced a guide for people living with HIV about how the police should investigate any complaints about HIV being passed on. The Police now have their own detailed guidance for doing these investigations.

This plain English leaflet is for people with HIV and it gives the key points and answers people’s common questions. It does not deal with Scotland where the law and legal system is different, so the guide is just for England, Wales and Northern Ireland.

Prosecutions are rare

Police investigations into reckless HIV transmission are uncommon. In 2009 around 6500 people found out they had got HIV but few people complain to the police about someone infecting them recklessly, and there was only one prosecution in 2010 and none at all in 2009.

Answers to common questions

The leaflet answers these common questions:

• What should I do if someone goes to the police (or threatens to) accusing me of giving them HIV?
• How much will the police know about HIV?
• Should the police investigate if the person complaining does not have HIV?
• When will police end the investigation?
• Will the police keep my HIV status confidential?
• Can the police see my medical records?
• Should the police comment to the media?
• What if the person accused is under 18?

Expert Guidance for Police and Prosecutors

The police now have their own national guidance to follow when investigating these unusual, complex and sensitive cases. The Crown Prosecution Service also has a guide about prosecuting these cases.

HIV organisations like NAT, George House Trust and Terrence Higgins Trust have worked hard with police and prosecutors to produce these guides to reduce as far as possible problems for people with HIV who may be accused.

The police guidance makes plain that all allegations should:

• be fairly investigated
• not be begun or continued if a successful prosecution is not considered realistic
• respect the dignity and confidentiality of people with and affected by HIV.

The Association of Chief Police Officers (ACPO) has approved ‘Investigation Guidance relating to the Criminal Transmission of HIV’ for the police.
This sets the standard for police investigations. Police will find the guidance very helpful; it is available on the national police information and training website ‘POLKA.’ The public can find a public copy on the NAT website.
 

Accused? Remember:

If you are accused of reckless or intentional HIV transmission, get immediate advice from a HIV voluntary organisation with experience in HIV prosecutions, or ring THT Direct (0845 12 21 200)

• Get legal advice when the police start to investigate
• Make sure the police know about and use the ACPO Investigation Guidance
• Get advice and support from a HIV voluntary organisation with experience in dealing with HIV prosecutions.

 NAT Guide for people living with HIV on police investigations is at the bottom of this page.

Answers in Untested Mystery

posted: 12/04/2011

HIV experts in England are puzzled why some people using STI clinics refuse HIV tests. We know for sure that some of those refusing HIV tests do have HIV (from using blood from samples given for syphilis tests and after the syphilis test is done and the blood sample is made completely anonymous, it can be tested for HIV).

The 2009 results from doing this show that 2.4% of gay and bisexual men and 0.25% of heterosexuals tested for syphilis came to the sexual health clinic with undiagnosed HIV.

But only 63% of these people agreed to a HIV test at the STI clinic - much lower than the average rate of HIV testing for people using STI clinics.

Why are so many people who have ‘undiagnosed’ HIV, refusing HIV tests?

One quarter must already know they have HIV - they are taking HIV treatment !

Some useful answers to the testing mystery have now emerged. Now we know that around a quarter of people with ‘undiagnosed’ must know they have HIV, because blood tests prove they are taking HIV treatment. These and other results, given at the British HIV Association conference in Bournemouth last week, are the first clear evidence of some answers to the ‘undiagnosed’ mystery.
 

Slightly more heterosexual women and men (32% for both men and women) than gay men (24%) are using a different clinic for STI checks than for their HIV treatment. Experts thought gay men with HIV were more likely to go elsewhere for HIV checks than heterosexuals. Experts don’t always guess right. Some people with HIV have told community organisations and patient advocates that one reason they go elsewhere for testing is to avoid unwanted, intrusive or judgemental discussion of their sexual behaviour by their own HIV clinic.
 

The results means

• 9 in 100 of the gay and bisexual men who said yes to a syphilis test but no to a HIV test have HIV. At least 2 of those 9 are on treatment but didn’t tell the STI clinic they have HIV
• 8 in 1000 of the heterosexual women and men similarly are HIV positive. At least 2 of those 8 are on treatment but did not tell the STI clinic they have HIV.
   

These findings will make little difference to national estimates of how much undiagnosed HIV there is in the country.
 

Why do gay men who don’t yet know they have HIV refuse HIV tests?
Another small study given to last weeks conference looked at why some gay men refuse HIV tests. Researchers gave an anonymous questionnaire to 19 men who didn’t want to be tested, even though they had had anal sex without condoms and have, either never been tested, or had taken anal sex risks since their last HIV test.

The men could tick more than one reason.
 

15 of the 19 men said they believed they were at low risk of HIV infection [2 of the 19 men knew their partner has HIV]

• 14 said they were emotionally unprepared for a positive result
• 4 said they don’t like giving a blood [but nonetheless gave this to have the syphilis test]
• 4 also mentioned prosecutions for HIV transmission
• 4 said they were planning to test 'next month'
• 3 mentioned worries about the confidentiality of the HIV test result.

Testing Advantages well known

Most of the men know the advantages of HIV testing

• 16 said testing could give peace of mind
• 16 said testing allows treatment to start at the best time.

Testing worries rule

But all the gay men listed the disadvantages to them of HIV testing.

• 17 said testing was stressful
• 8 were worried about having to tell a boyfriend if they were positive
• 7 were concerned about the insurance and mortgage implications.

Unready for positive result, testing stress, in denial about risks

So most of these gay men didn’t feel emotionally ready to deal with a positive result, and find HIV testing stressful.

• Most thought their HIV risk was low, despite having taken enough risks to have got HIV and needing to visit an STI clinic.

The study authors suggest investigating ways of overcoming gay men’s resistance to testing at STI clinics.
 

Source 
Reference – the free conference abstracts - read O13 & P152

Texts Doubles HIV Testing

posted: 08/04/2011

Twice as many gay men tested for HIV again, when they were sent text (SMS) reminders, than men who were not texted a reminder to come back for another HIV / STI test.
Gay men in Australia are advised to have an HIV test once a year – like gay men in the UK. And men with riskier sex lives are advised to test every 3 or 6 months.

Increasing the proportion of men who know their HIV status through testing regularly helps cut the number of new infections. The problem in Australia (and it is not much different in the UK) is that only a quarter of gay men taking more sex risks do take more than one HIV test a year.
 

So a clinic in central Sydney tried sending text (SMS) reminders to see if this helped get the men in for testing more often. 714 HIV-negative gay men who had an HIV test and sexual health screen between January and August 2009 were sent a text to remind them to come for another HIV/STI check, every four months.
 

They compared these 714 HIV negative men with two other groups. 1084 other men who had had a HIV test got no text reminders. Another comparison was made with 1753 men who tested at the Sydney clinic in 2008 before they tried sending anyone text reminders.
 

Re-testing doubled returning for testing
The answer was texting more than doubled the rate of returns for testing within the year - 64% of the men who had a text reminder came back, compared with 30% of those who didn’t and 31% of those from before texting started to be tried.
 

Really it was 4 times better 
After taking into account some differences in the study groups, the clinic found the text reminders meant there was in fact a four-fold increase in the chances of re-testing (using an odds ratio statistical analysis).
 

Texts are an easy win for clinics

They comment that text reminders are an easy win for the clinic because they “allowed large numbers of messages to be sent simultaneously and automatically, reminders were direct, immediate and cheap to send and demanded minimal labour.” If morwe clinics used text reminders this has “great potential to reduce HIV/STI infection rates” among gay and bi men.
 

Frequent testing means people who do get HIV will have better health

Another study, this one from the Netherlands, shows that frequent testing (at least once a year) means people who do get HIV have better prospects for good health and life with HIV. “Our findings illustrate the benefit of repeated testing for HIV,” write the investigators, “it shortens the time between infection and diagnosis and improves the likelihood of timely treatment, with the prevention of clinical progression to AIDS and death.”
 

The Dutch researchers also believe that “increasing testing to annually may greatly impact on transmission rates at a population level.” They quote a modelling study that suggests transmission rates in the Netherlands could fall by 40% over ten years “if the average time between infection and diagnosis was reduced to 1 year.”
 

Source for Austrailian texting with reference

Source for Dutch annual testing, better health if you do get HIV with reference

Messaging Gay Men About STIs

posted: 07/04/2011

Manchester gay and bi men using the Royal Infirmary's Hathersage Clinic (along with men using STI clinics in Sheffield, Brighton and at four London STI clinics) now have a new way to warn partners they may have been in contact with a sexually transmitted infection.

The Sexual Health Messaging Service has just begun, launched by GMFA, the gay men’s health charity, and is linked in with the popular gay profile sites Fitlads, Gaydar, Manhunt and Recon, and the cruising app Bender.

Men need to Opt-in for notifications  if they get an invitation, for it to work.

It's funded by the Elton John AIDS Foundation and aims to help cut the number of men with undiagnosed STIs, including HIV. Men who are diagnosed with an STI can tell previous sexual partners by using an online system (anonymously if prefered), so the partners can go and get tested and, if necessary, treated.
 

99% want to know about any STIs

Over a quarter of gay men with HIV do not know they have HIV. GMFA’s study shows that the vast majority of gay men (99.3%) want to be told if any sexual partner gets an STI and 97.5% want to be told if this is HIV.
 

Matthew Hodson of GMFA, commented: “Many STIs don’t show any symptoms, so lots of men may be infected and not know it. While it’s best to tell men you’ve had sex with if you find out you’ve picked up an STI, making that awkward phone call or sending an email can be difficult. As a result, some men choose not to tell, even though they know they should. We’ve made the process as easy as possible by doing most of the work for you – all you need is a contact for your partners and we’ll take care of the rest.”
 

An easy (even anonymous) way to tell

Existing ways of telling partners often require anyone who is diagnosed with an STI to contact their partners direct, sometimes using a pink slip issued by the clinic. GMFA’s research shows these systems often don’t work.

For all kinds of reasons some men can't or won't notify sexual partners. Of the men who do tell partners about having an STI or HIV, only 65% told all their partners. Here's some of the difficulties and reasons for this

• not having partners’ contact details (sometimes only a first name, or only a profile name)
• embarrassment
• not wanting the partner to know about their having an STI or HIV 
• not wanting to see the guy again.

Now men using the Hathersage in Manchester, men in Brighton, Sheffield and parts of London can use GMFA’s new Sexual Health Messaging Service. It  will then be spread across the rest of London later this year and then the rest of the country next year. 

The GMFA service means clinics give men a unique reference number so they can log in to the online system and send notifications using a number of contact methods, including

• website profile name
• cruising app profile name
• mobile 
• email.

The message is automatically written and contains links to where their partners can go for testing. While men are encouraged to say who they are, it can be kept anonymous.

The service started its six-month pilot on Monday. The clinics taking part are

• In Manchester, the Hathersage Centre (Upper Brook Street / Hathersage Road corner) 
• In Sheffield, the Royal Hallamshire Hospital
• Brighton, Claude Nicol Centre at Royal Sussex County Hospital
• 56 Dean Street, Soho, London,
• Homerton University Hospital, London
• The Lloyd Clinic at Guy’s Hospital, London
• St Bartholemew’s Hospital, London 

Men can use the service to send messages to partners met through the four participating gay dating websites (Fitlads, Gaydar, Manhunt and Recon) and the cruising app, Bender.

Opt-in to take part 

Profile site members need to opt-in to receive notifications if and when they are sent an invite.
 

Matthew of GMFA tells us: “This is a major project and marks a huge shift in the way men can notify their partners about STIs they’ve picked up. By making the process easy, we hope to make more men aware of any STIs they may have and ultimately reduce the number of STI infections in the community.”