NW Gay HIV Stigma and Risks

posted: 04/01/2010

The NW England results of the annual Gay Men’s Sex Survey are now out. ‘Vital Statistics 2008’ gives us the latest information on the prevention needs of gay and bisexual men in the UK and our region.

It also tells us some useful things about HIV stigma across the region, the numbers of men who have never taken a HIV test, and about the numbers who take significant HIV risks.
 

Blackpool – gay hotspot missing
There had to be 20 or more men in a NHS district (Manchester, Liverpool etc) fill in a survey for results from that district to appear in this report.  Unfortunately the gay hotspot of Blackpool only had 17 men fill in the survey, so we can’t say much about gay and bisexual men’s needs there.

Stigma and rejecting men with HIV
This survey asked questions about what undiagnosed men say they would do if a potential sex partner told them he had HIV. Would they change their mind and turn down sex, have sex but be extra careful, have sex just as they planned, or do something else?
 

Men who said they’d reject positive men are showing strong signs of HIV stigma and discrimination. Across NW England half the men said they would reject any HIV positive man for sex. This really discourages diagnosed men from talking and telling any sex partners about HIV.
Things look best for positive men in Manchester and Stockport, but not much better – in Manchester 39% of undiagnosed men say they would reject any positive man for sex.
 

Are George House Trust’s anti-stigma campaigns at Pride helping to cut stigma by rejection locally? It’s difficult to say – in next door Salford the rejection rate is higher – with rejection by almost half the men, like the regional average. HIV rejection is worst of all in Cumbria and Sefton (Merseyside) at 61%, and 56% of undiagnosed men would reject any positive man in Liverpool. [See 19 in the report].

Mixed HIV status relationships
The number of men who have regular partners of a different HIV status is another way of trying to measure how much HIV stigma is about. Sadly it is almost impossible to reach a clear answer from the survey report. In Manchester around 1 in 10 do have a regular partner of a different HIV status. Another 1 in 4 have a partner of the same HIV status, which could be where both men are HIV positive, or both are HIV negative – we just don’t know.

Another 1 in 10 have a regular partner and the man has no idea whether they have the same HIV status or not – a recipe for risking HIV transmission. [See 10 in the report].

Testing or not?
Last year the Health Protection Agency advised that the amount of HIV in Manchester, Salford and Blackpool meant special measures to increase HIV testing are needed and that gay and bisexual men living there should test at least once a year.
 

1 in 5 gay and bisexual men in Manchester have still not tested, ever. Almost as many didn’t test last year but have tested at least once before.

However 28% of Manchester men in the survey have tested HIV positive. That does NOT mean 28% of gay men in Manchester have HIV – just that more men with HIV took part in the survey. A previous study shows the real HIV rate on the scene in the city is about 1 in 10. [See 13 in the report]
 

Risk taking evidence
When men were asked how they rated their chances of passing on or picking up HIV in the next year, 6% think HIV transmission is very or quite likely for them within 12 months.

77% think it is very or quite unlikely, which just shows how many men really are deluding themselves. 63% had also told the survey they had at least one partner with whom they had unprotected sex that year. And 1 in 10 Manchester men reported they had 5 or more partners a year with whom they had anal sex without condoms. [See 14 and 16 in report].
 

We thank all the men who completed either a booklet or the website survey that George House Trust promoted.

NW England 2008 ‘Vital Statistics’ report

Survey questions
UK and English regions reports (including for past years)

HIV Statistics for NW England 2008

posted: 02/09/2009

The 2008 HIV statistics have recently been published. Here is a table showing the pattern of change in the number of new cases ('new cases' means new to the North West of England - it is mainly people newly diagnosed in the region, but also includes people who were diagnosed outside the region and now attended a HIV clinic in the region for the first time in 2008). The table also shows the total number of people who attended a NW HIV clinic sometime in 2008.

At first glance the number of new cases leapt by almost 100 between 2008 and 2009, and comments in the media have made much of this increase. The media also leapt on to the fact that 42% of people were infected abroad. Both points are true, but we need to read between the lines and not leap to false conclusions. 

Yes the number of new cases is up, about 100 more than in 2007, but hardly different to 2005 and 2006.

For the last 5 years new cases have been broadly around 800 – 900 a year. We need to bear in mind that the numbers testing positive in 2008 tells us nothing about when the person became HIV positive, which may have been several, or even many years ago. We shouldn't leap to conclusions about any year to year change in the numbers, because there are all kinds of explanations. Here are a few -

• More people are testing each year
• Gay men especially have recently been encouraged to test at least once a year in high prevalence areas of the NW such as Manchester, Salford and Blackpool
• A larger number of people at higher risk of HIV who attend Sexual Health clinics may now be agreeing to take HIV tests - many refuse, especially people from groups more likely to have HIV, gay men and other men who have sex with men, migrants especially from regions with high rates of HIV such as sub-Saharan Africa, people from ethnic minorities, injecting drug users
• More pregnant women may be agreeing to antenatal HIV testing
• The greater availablility of community testing services
• More people are taking more sexual risks by having unprotected sex
• Random variation - when you flip a coin 100 times you don't get 50 heads and 50 tails each time - because of random variation. Sometimes it's a few more than 50, sometimes a few less. Sometimes a lot fewer of one than the other. It's always at work in HIV statistics - it depends on thousands of people's decisions about whether and when to go get tested.  

'Infected abroad' pot stirred

The media reports picked out that 42% of the new cases in 2008 were infected abroad - particularly people from sub-Saharan Africa. This is old news - a quick look at the 2007 figures would have revealed an almost identical percentage. The explanation is simple. Britain is a global travel hub with strong ties to Commonwealth countries, many of which have high rates of HIV. Millions of people come and go here each year - as students, as workers (including doctors and nurses the NHS depends on), as visitors and tourists, and as people seeking safety here through asylum. Asylum applications are very much lower than in some previous years. Some people arriving here have HIV, but a George House Trust / Terrence Higgins Trust survey found most people have no idea of this before travelling here.

Use of NW HIV Voluntary Organisations chart

We will be carrying out a more detailed analysis of the 2008 HIV statistics for the region and will share this with you in due course.

The 2008 NW HIV Report is now published here 

You can download this report HIV&AIDS in North West England 2008 direct from us - it is a large pdf file (2.48 Mb), so please be patient.