Public Health Watch

posted: 29/10/2010

Updating of public health rules means public authorities in England and Wales have powers they can use against individuals with HIV to protect the public health from 'infection or contamination'. Magistrates can make compulsory public health orders (known as Part 2A orders) on people. Similar powers were used in Manchester against a man with HIV in 1985.

Late in 1985, just after Manchester AIDS-Line (later George House Trust) was set up with the help of a small grant from Manchester City Council, the same council used its public health powers backed by a magistrate. It compulsorily detained a man with HIV at Monsall Hospital. Major protests followed and, after a court case, he was freed to leave hospital a few days later.

This was the first and only time public health powers have been used against someone with HIV in this country. You can read more about this here.

New Health Protection Regulations

These old public health powers have now been updated in new Health Protection Regulations. Helpful guidance has been produced by the Department of Health on how to use (and not use) these powers.

This makes clear that in almost all cases using these powers to manage the risk of HIV or STI transmission would be inappropriate and should only be considered, if at all, in the most exceptional of circumstances.

HIV community and clinical organisations like BHIVA and BASHH oppose the use of these powers against people with HIV. They would cause more harm than good, damaging trust in STI and HIV clinic confidentiality, increasing HIV hate and discrimination, and would only ever be a short-term fix for someone with a life-long health condition.

More information

More information on the new public health powers and HIV can be found at the NAT website.
 

The official guidance makes clear that Part 2A orders 'are not a tool for managing long-term problems' and that the orders:

• are not meant in any way to change the current system and culture of confidentiality within sexual health services
• are not to be a routine part of managing those with HIV who present with evidence of ongoing unsafe sex (for example by presenting with repeated STI infection)
• are not generally appropriate for contact tracing
• could have harmful consequences for wider trust in sexual health services
• and that in the very exceptional circumstances where a Part 2A order might be considered, advice should be sought from the treating clinician and clinic director as to the possible consequences of such an order, and confidentiality must be respected at all times.

Even with this guidance, these powers could be misapplied to people with HIV or another sexually transmitted infection.

We, and NAT, are keen to hear about any attempts to coerce someone with HIV, through the use or threatened use of these powers. We do not expect the powers to be used, because the old powers were only used once against someone with HIV, 25 years ago, and have not been used again since. But it could happen. 

Department of Health: Health Protection legislation guidance 2010, laws and regulations

HIV Prevention for Africans in England

posted: 12/10/2010

KWP in Practice is a new website and planning toolkit for meeting the HIV prevention needs of African people in England. The site combines and updates the two key documents, The knowledge, the will and the power, and the African HIV prevention handbook, which were both produced by Sigma Research for the National African HIV Prevention Programme.
 

Whether you fund HIV prevention for African people, or you plan and deliver these, the website's modular, practical, toolkit approach has something to offer.
 

Condom use briefing

The new website has a useful new detailed Briefing on condom use among African people in England.

In the Bass Line survey undertaken with more than 2,000 African people in 2008-09,

• one third (30%) of those who had used condoms said that one had slipped or broken off in the past year.
• More than one third (32%) said they would worry about what others thought of them if they carried condoms.
• One fifth (20%) said they sometimes had problems getting hold of condoms.

Condoms and Africans in England seminars
 

You can also book a place at a seminar about condom use among Africans in England, in either Leeds or London.
 

These full-day seminars are for service providers, clinical staff and commissioners who want to learn and share experiences of meeting the needs of African people regarding to male and female condoms. Sigma staff and local experts will lead a day of practical discussion and debate.

The seminars start at 10:30am and end at 16:30pm.
 

Book the Leeds condom seminar Tuesday 26 October 2010

Book the London condom seminar Wednesday 3 November 2010