International HIV Sidelines Gay Men

posted: 07/03/2011

Every two years the world’s biggest HIV conference faces criticism for sidelining the needs of gay men, sex workers, transgender people, and injecting drug users. The International AIDS Society conference visited Vienna in 2010, around 25,000 people attended, but it still grossly under-represented four groups most at risk for HIV infection.

A detailed study by the Global Forum on MSM & HIV (MSMGF), confirms the long-held suspicions and criticism of this neglect, and calls for change.

The International AIDS Society may be part of the problem, but it can solve it.

Shame of stigma and discrimination
Stigma and discrimination against marginalised and unpopular groups affected by HIV is unprofessional and brings shame on the International AIDS Society.

The 2010 conference programme seriously neglected key needs. There is little exclusive time and exposure given to the four groups, and the four groups are often ignored even in general studies.  

• Only 6.6% of the abstracts of studies were only concerned with gay and bi men / MSM, 5.7% targeted only people who use drugs, 3.5% looked only at sex workers, and 0.6% solely considered transgender people.
• Only 3.8% of ordinary conference sessions exclusively focused on gay and bi men / MSM, 5.1% on IDU people, 2.5% on sex workers and 0% on transgender people.
• Just 3.7% of all workshops exclusively focused on gay and bi men / MSM, 6.4% on people who use drugs, and 0% on sex workers and 0% on transgender people.
• Out of over 4,500 abstracts sent in for selection and publicity, only 558 even mentioned MSM, only 442 mentioned IDU, just 338 mentioned sex workers, and a bare 134 mentioned transgender people.
• Only 2.6% of all sessions in the entire conference programme exclusively focused on MSM, 4.5% exclusively focused on IDU, 3.0% on sex workers and 1.1% on transgender people.

The percentage of all sessions at the conference exclusively focused on the four marginalised groups was 2.6% for MSM, 1.1% for transgender people, 3% for sex workers and 4.5% for people who use drugs.

Research shows these four populations are at higher risk for HIV than the general population in nearly every country where reliable data exist.

Compare tiny conference gestures with actual needs

• MSM represent more than a quarter of HIV infections in Latin America and the Caribbean
• People who inject drugs are more than half of HIV infections in Eastern Europe
• Up to half of all sex workers across Sub-Saharan Africa have HIV
• Transgender people in El Salvador, Indonesia and India have HIV rates as high as 25%, 35%, and 42% respectively.

"Abysmal representation reinforces discrimination and invisibility"

“While the International AIDS Society turns a blind eye, HIV rates among these populations continue to climb around the world,” said Dr. George Ayala, Executive Officer of the MSMGF.

“The IAC is the world’s most important opportunity for international exchange and collaboration on HIV and AIDS. Such abysmal representation of most-at-risk groups only serves to reinforce the invisibility, discrimination and disregard that drive the epidemic among these communities.”

“Ostensibly, the IAC offers chances for local healthcare providers to learn ways to improve their services, provides channels for advocates to engage in dialogue with powerful decision-makers, and creates opportunities for community members to shape global funding and research agendas,” said Dr. Mohan Sundararaj, Policy Associate at the MSMGF. “This really is a phenomenal platform, but how useful can it be when those who need it most are locked out?”

Calls for change
The report recommends steps to make the Conference programme fairer, based on the numbers of people affected . These include involving the communities affected in the conference planning.

“The International AIDS Conference has unparalleled potential to impact the global AIDS epidemic,” said Dr. Ayala. “It is incumbent upon the organizers to ensure that the IAC becomes a vehicle for change, shifting the global landscape so that funding, research and programs are directed to those who need them most. Right now it’s part of the problem.”

Source The Global Forum on MSM & HIV

Read the full report Coverage of Four Key Populations at the 2010 International AIDS Conference: Implications for Leadership and Accountability in the Global AIDS Response February 2011

The Global Forum on MSM & HIV (MSMGF) is an expanding network of AIDS organizations, MSM networks, and advocates committed to ensuring robust coverage of and equitable access to effective HIV prevention, care, treatment, and support services tailored to the needs of gay men and other MSM. Guided by a Steering Committee of 20 members from 18 countries situated mainly in the Global South, and with administrative and fiscal support from AIDS Project Los Angeles (APLA), the MSMGF works to promote MSM health and human rights worldwide through advocacy, information exchange, knowledge production, networking, and capacity building.

HIV Teenagers to Adults

posted: 21/02/2011

Older teenagers with HIV are our HIV pioneers because they are the first generation of young people growing up with HIV. Being the first at anything is often exciting, but with HIV it can be much less fun and more of a struggle.
 

Making the change better

The Children and Young People HIV Network are working to make it easier to move from being a teenager with HIV to being an adult with HIV.

Young people with HIV have two main challenges 

• growing up from a child to adult with HIV (e.g. beginnning sex and relationships with HIV)
• moving from children's HIV clinic and education, into adult HIV services and employment or claiming benefits with HIV.

The Children and Young People’s HIV Network have now finished checking all the expert articles and books about changing from child to adult with HIV in a ‘literature review’.

They looked to learn lessons about improving the change from child to adult, including learning from experience with other conditions like diabetes and epilespy.

The HIV child to adult change literature review is here 

The review 

• has statistics about young people with HIV in the UK
• finds existing policies and guidelines for the child to adult change
• looks for useful lessons from other longterm conditions, like diabetes
• considers the needs of carers and family
• considers rural areas with very low numbers of young people with HIV.

Professionals tell us

Last week we pointed out the useful article where HIV health workers describe helping teenagers to make the change from child to adult with HIV, which is in the 200th issue of HIVTreatment Update.

Teens talking life with HIV
Two young people making these changes talk about their own lives. JD Bailey (20, female) talks about growing up with HIV, and Max, (19, male) talks about telling others about HIV
 

‘Transition of care from a paediatric to adult setting is not specific to HIV … However there are important differences … with HIV which may make this process more difficult’  Lyall, 2007.

Join HIV and Benefits Survey

posted: 16/02/2011

Lots of changes (including cuts) will be happening to the welfare benefits used by many people with HIV in the coming months and years. We need evidence now about how the changing nature of HIV affects people’s ability to do a paid job.
 

Would you please help our friends at NAT (National AIDS Trust) by answering their short (10 question) online survey about HIV-related symptoms of people living with HIV.

Please Take part in the quick survey, here

NAT are part of a national benefits working party trying to improve the Work Capability Assessment (which is used to help decide claims for Employment Support Allowance - the new benefit for sickness and disability).

The Work Capability Assessment fails many people with HIV – it doesn’t cope well where symptoms can come and go, like with HIV. Your answers will help us and NAT make it work better for people with HIV.
 

Be a big help for many

Your answers will help make a major difference to many people – everyone now receiving Incapacity Benefit will have to have their own Work Capability Assessment within the next 2-3 years. Many people are having to appeal bad decisions about this and 40% of the people who appeal refusals of these claims win.

The findings of this research will help NAT speak for the needs of people living with HIV who apply for illness and disability-related benefits. In particular, it will lead to recommendations to the second annual independent review of the Work Capability Assessment.

NAT will be on the working group which will recommend changes to the Work Capability Assessment (WCA) to more accurately and fairly assess people with fluctuating conditions, such as HIV.

Anything you can add?

NAT welcome other evidence about the impact of fluctuating symptoms on the lives of people living with HIV, and particularly want to hear the experiences of people who have HIV-related symptoms who have gone through the Work Capability Assessment.

For more information about the survey or the working group, or to send case studies and other evidence, please contact Sarah Radcliffe

Please Take part in the quick survey, here

End to HIV Health Staff Ban?

posted: 10/02/2011

The much criticised ban on surgeons and dentists with HIV from working could be lifted this year. At long last, the government is acting on HIV campaigners’ calls to end the employment ban.

Department of Health rules stop HIV-positive health workers from carrying out what are called ‘exposure prone procedures’ which are thought to risk HIV and hepatitis transmission. Basically 'exposure-prone procedures' are treatments where the healthcare hand goes inside the patient body, especially when there are sharp things like bones and surgical tools around - like when a dentist is extracting teeth.

But the rules are old and there is very little solid evidence of actual HIV transmissions from health care workers to patients. Despite this, the UK rules mean no dentist with HIV can carry on working as a dentist, and many midwives, surgeons, some nurses and ambulance workers have also had to end or change their careers.

Rules review

The Department of Health has now said there will be a review of the rules. HIV charities have been invited to join the working group that will draw up new guidelines.
 

The British bans on healthcare workers with HIV and hepatitis are stricter than in many European countries and the USA and Australia, where dentists with HIV can work, so there are alternative rules ready to be adapted for Britain.

Evidence gap

With effective HIV treatments there is usually almost no virus in healthcare workers’ blood, so whatever risk there was, is even smaller now, say campaigners. It is extremely unusual for blood-borne viruses to be passed between doctors and patients. Only four patients worldwide are thought to have contracted HIV from health workers. There have been no transmissions from healthcare workers in the UK. And there are significant doubts about the evidence even for these few transmissions. 

Deborah Jack, chief executive of the National Aids Trust, said ‘advances in testing technologies and treatment’ and ‘high levels of infection control’ supported calls for change.

Catherine Murphy, of the Terrence Higgins Trust, added: ‘We’re not saying entirely lift restrictions but it is time for another look – especially for dentists.’ The British Dental Association has backed calls for change.

UK healthcare workers and exposure prone procedures policy

Source

Discrimination and Volunteers with HIV

posted: 09/02/2011

Volunteers do not have the same rights at work as paid workers, and that means disability discrimination at work against a volunteer with HIV remains legal.

The Equality Act 2010 left untouched this loophole in disability rights in the workplace.

This was made clear by the Court of Appeal recently when it threw out a HIV+ woman volunteer’s claim that a Sussex Citizens Advice Bureau had discriminated against her because of HIV, by stopping her working as a volunteer. Her case was backed by the Equality and Human Rights Commission.

 

The Appeal Court ruled that disabled volunteers do not have the disability rights protection of paid workers.

This has revived concerns about the unfair treatment some volunteers face at work.
 

Prospects for volunteer equality?

Mrs X wants to appeal to the Supreme Court, but to do this first she has to convince the court that she has a reasonable legal point that the Appeal Court got wrong. That looks unlikely to succeed. The other hope is for law change, but with the Equality Act less than one year old that is not going to be a priority for Parliament.

Volunteers are not ‘employed’ so don’t have paid workers’ rights
The court found she was not protected by disability rights law for workers because she was unpaid and did not have an employment contract. Mrs X was a volunteer with a law degree, a post-graduate qualification and she also hoped to secure a training contract with the Citizens Advice Bureau so she could qualify as a solicitor.
 

No European rights either
The court also found that volunteers were not protected by the European Union’s equal treatment directive.
 

Alex Eastwood, a legal caseworker for Disability Law Service, said discrimination against disabled volunteers was “all too common”, so it was “strange” they were not covered by the law. He said government welfare reforms were likely to lead to disabled people being forced to undertake voluntary work, but without any protection from anti-discrimination laws. He said: “Employers will therefore have no duty to make adjustments for disabled volunteers or take steps to prevent harassment of volunteers.”
 

‘Big Society’ wants volunteers but without equal rights 
The Equality and Human Rights Commission (EHRC), which “intervened” in the case, warned that if such laws do not apply to volunteers, organisations will legally be able to discriminate against disabled people and other groups. An EHRC spokeswoman said: “Given that many employees begin their working life as volunteers, which provides them with valuable experience which they can use as a step up to paid employment, it seems unfair that certain groups of people can legally be denied this experience.”
 

Andy Williams, from solicitors Charles Russell, who represents Mrs X, said the ruling could stop some people volunteering, harming the government’s “Big Society” programme. He said: “If the government’s Big Society vision involves an increased requirement for volunteers, as things stand those volunteers currently have no legal rights whatsoever.”
 

Discrimination may be legal, but it’s wrong
A CAB spokeswoman said: “The law is clear that volunteers do not have the same legal rights and responsibilities as paid employees. That is not the same as saying that organisations should be able to treat volunteers unfairly.” She insisted that CAB was “committed to equality, values diversity, and challenges discrimination” and had a “range of policies to support disabled people to volunteer”, with more than 1,500 disabled people volunteering across England and Wales last year.

What is the law?

The Volunteering England factsheet tells us:

"Discrimination and harassment           Anti-discrimination legislation applies to employment and the provision of goods and services, so doesn’t cover volunteers because they are not employed under the relevant legal definitions. Volunteering England advises organisations to reflect the spirit of such legislation in their volunteer involvement as a matter of good practice, to help ensure that volunteers are treated fairly and equally.
 

Harassment differs from discrimination, and although the Protection from Harassment Act 1997 doesn’t specifically refer to volunteers, it appears that anyone found guilty of harassment could face imprisonment and/ or a fine, as well as civil action by the person subjected to the harassment.

To summarise, if a volunteer were found guilty of harassment then they could face legal proceedings as well as civil action (although their status would be that of an individual, rather than a ‘volunteer’). Similarly, if a volunteer were subject to harassment, then they (as an individual) would be covered by this legislation.
 

Protection from Harassment Act 1997: The case of Majrowski v Guy's and St. Thomas' NHS Trust (2006) UKHL 34 suggests that it may not just be the abusive or threatening staff member who may be liable - their organisation may have vicarious liability as well. Majrowski v Guy's and St. Thomas' NHS Trust (2006) UKHL 34
 

To summarise, volunteers may have some form of redress against the worst forms of bullying or similar behaviour, but does this does not give them protection against discrimination as such."

Employment rights as a volunteer

Disability Law Service - rights factsheets

Volunteering England factsheet : When things go wrong

Source – Disability Law Service