HIV in NW Rises Above 6000

posted: 17/08/2010

The latest annual report on HIV in NW England shows us that there are 8% more people with HIV using HIV clinics in 2009 than the year before: for the first time there are now over 6,000 people using NW England's HIV clinics. in 2009 there were 6,238 people using clinics compared with 5,767 in 2008. Modern HIV treatments are working well for most people.
 

Infections in the UK - gay and bi men

Almost three quarters of all the new people who get HIV in the NW are gay or bisexual men. However gGay and bi men are only 43% of all the new HIV cases in the NW in 2009.

This is because many people in NW England got HIV abroad - forty-one percent of the new cases were people who were infected outside the UK. Four out of five of the new cases infected abroad are heterosexual women and men, and most had no idea they even had HIV when they left their home countries.

Some countries, especially in sub-Saharan Africa, have very much higher rates of HIV compared with the UK.
 

Five times more using HIV clinics than a dozen years ago

Now the total number of people using HIV clinics in the NW of England (6,238) is five times bigger than a dozen or so years ago. This is because there are around 800 to 900 new cases each year, and modern HIV treatments work so that very few people die with HIV now. The death rate from HIV is below half of one per cent now, while before modern HIV treatments really started working, the death rate was 9%, back in 1996.

Around the region

Greater Manchester has the largest number of people with HIV by a long way, ahead of Merseyside and Cheshire, and Cumbria and Lancashire. Greater Manchester has 3,754 people using HIV clinics – here HIV affects around 137 per 100,000 people. In 2009 there were 498 new cases in Greater Manchester. Most people with HIV in Greater Manchester live in Manchester and Salford.
Cumbria has the fewest people with HIV in the NW (131; HIV affects around 25 per 100,000 people), and there were 16 new cases in Cumbria last year.

Dr Penny Cook, the author of the HIV & AIDS in the North West of England 2009 report said:
“The number of people in treatment for HIV in the North West has now reached over 6,000. Many of the new infections were acquired in the UK and would have been entirely preventable. We must ensure that in this difficult economic time resources continue to be invested in prevention, since targeted health promotion campaigns save the NHS a substantial amount of money on treatment in the long run.”

Professor Mark A. Bellis, Director of the Centre for Public Health commented:
“As the NHS is transformed, prevention of sexually transmitted infections must be seen as a priority.”

Source - Press Release

2009 Report - HIV & AIDS in the North West of England 2009

All years - HIV in NW reports and data 1996 -2009

Living Positive Exhibition

posted: 24/03/2010

Living Positive is a Manchester-wide HIV awareness event lasting over the next week or so. Artist Charlotte Barnes and Body Positive North West service users created Living Positive. Photographic workshops taught basic photographic skills to people using BPNW services to help document their stories and experiences through photography.
 

The images produced by service users, as well as photographs uploaded to the website, are now being exhibited at 60 venues throughout Manchester. You can also view the images online.

The images are being shown on the large digital City GateWay screen at Piccadilly train station, as well as the website.

Free booklets, exhibitions

There are around 2,000 free booklets of the images distributed around Manchester. Find the exhibitions and venues with booklets.

Upload your images

Upload your own images for the online gallery

The exhibition runs for two weeks from the 22nd March 2010.
 

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)

NW England HIV in Mid 2009

posted: 21/12/2009

HIV figures in NW England for the middle of 2009 show a continued rise. The total number of people seeing clinics rose by 9% compared to the middle of 2008. In the first half of 2009 there were 453 new cases (mainly people newly diagnosed) and the total in touch with clinics was 5601. The experts predict that the total seeing clinics by the end of 2009 will be 6211.
 

Mother to Baby - can do better

There are a lot of details in the latest half-year report. Most HIV transmissions from mother to baby are entirely preventable, as long as women are diagnosed in time and then have the right treatment and care. The national target is for at least 90% of pregnant women to be tested for HIV. Most hospitals in NW England are now above this level and getting even better.
 

However, in Manchester, where the chances of a woman with HIV having a baby are so very much higher than anywhere else (237 out of every 100,000 women in the city have HIV, compared with the regional average of 45/100,000 women) the 90% target has still not been reached (87.8% are now tested in pregnancy).

St Mary’s Hospital for Women in Manchester (beside the Manchester Royal Infirmary) has improved but there it has only reached 80%. Warrington Hospital and Highfield Maternity Unit in Wigan both reported falls in the proportion of women having a HIV test in pregnancy since this time last year and they are below the 90% target.
 

The government set the target of 90% some years ago when things were very much worse and many babies were being born with HIV. Now hospitals should all be aiming to exceed the official target and aim for 100% testing take up by pregnant women. Otherwise some babies will be harmed by having HIV when this could have been prevented.

Source - the full report is available here from the Liverpool Centre for Public Health

The main NW England HIV statistics page will additionally have the usual web data tables by the end of January - there have been some technical problems in their publication

Prevention Needs of Africans

posted: 16/12/2009

Updated with additional information  - The HIV and sexual health prevention needs of Africans living in England are highlighted in a report out today. During late 2008 and early 2009, Sigma Research worked with over one hundred organisations, including George House Trust, to carry out the Bass Line 2008-09 survey.
More than 2500 African people living in England took part.
 

The main report is in two parts. Part one sets the scene, discusses demographics, HIV testing, sexual HIV transmission behaviour, HIV prevention needs and HIV prevention interventions. The second part aims to identify sub-groups of Africans with high levels of risk behaviours and / or high levels of unmet prevention needs.
 

More detailed findings for NW England are in a supplement based on the 157 people in the region who took part. Most live in Manchester and detailed figures for Manchester are available. The rest of the region is aggregated together, because fewer than 20 took part from each of the other Primary Care Trusts.
This BASS Line survey and particularly the NW regional figures will help identify the most pressing regional HIV prevention needs of African people, and should help planning, delivering and funding HIV prevention services for Africans.

African Men Top in HIV Prevention Needs
Men, not women, should be the top priority among Africans in the UK. This survey suggests that men are more likely than women to report sexual risk behaviours, to know less and be less likely to have been tested for HIV. Women are far more likely to be tested because testing in pregnancy is now routine.

They also recommend that work with men pays particular attention to the needs of men who have sex with both men and women, and to men who only have sex with men. In addition, there are high levels of need among people with limited schooling.

‘I’ve no need to test’
A third have never had a HIV test result and a similar proportion have never been tested for other STIs. Only a half of those who haven’t yet had a HIV test would consider having one.

Men were less likely than women to have tested for HIV, to have diagnosed HIV and to know where to get tested for HIV.

The main reason people gave for not testing was thinking there was no need: only 1 in 3 Africans knew that at least 1-in-20 of all Africans living in England have HIV. The report recommends that to increase uptake of testing, health promoters must increase individuals’ awareness of their vulnerability to HIV and the costs of not knowing their HIV status early enough for HIV treatment to be able to work properly.

Sexually active, sexual risks
Three quarters of the people taking part had sexual partner(s) in the last year. More than half had a regular sexual partner, which was more common in men than in women. One-in-four of the people with regular partners said they had other sexual relationships outside the regular relationship, again more common in men than women.

In addition, one-in-ten who said they had sex in the last year reported definitely or probably having sexual intercourse without a condom with someone of a different HIV status to themselves. Men, and those with more sexual partners were more likely to report this risk.

Moreover, compared to women, men were more likely to be unconcerned about being involved in HIV transmission, and more likely to have a problem getting hold of condoms, and were significantly less knowledge about HIV in general.

Among the men, those who had sex with both women and men were the most likely to report having multiple partners, sex outside a relationship, unprotected sex with someone of a different HIV status and condom failure. Men who only had sex with other men were the most likely to be diagnosed with a sexually transmitted infection or with HIV.

As a consequence, the researchers call for more work with homosexually active African men, including men who also have sex with women.

Some under-educated
Although the sample was generally well educated (three quarters had a university or college education), 4% had no formal education or only went to primary school. The researchers recommend that more prevention resources are targeted at this group. While they were the least likely to be tested for HIV, they were the most likely to be diagnosed with it, or with another sexually transmitted infection. There were also strong associations between low education and risky behaviour, and low education and lower levels of HIV knowledge.

Preferences for information
The survey asked respondents about the ways in which they would prefer to learn more about HIV. Overall, more respondents preferred to get further information through reading compared to talking to someone, although many people mentioned both.

“Reading in private” was the most popular reading option, and of those who specified a particular type of written format, a website was the most popular. However talking face-to-face with a health worker was preferred to using a helpline or internet chat room.

People strongly prefer being given health information by health professionals, especially doctors (49%). The authors therefore advise community organisations that workers need to have sufficient expertise in HIV if they are to engage effectively with service users. Very few people say that the person giving information should be of a certain ethnicity, gender or age, or should have HIV themselves.

England findings
Ignorance is about - 1 in 10 do not know

• that people can have HIV without knowing
• there is still no cure for HIV
• you cannot tell whether someone has HIV by just looking at them.

1 in 5 do not know

• there are HIV treatments
• condoms are free from some services - in Manchester even fewer know this - 1 in 4

2 in 5 do not know

• there have been prosecutions for HIV transmission in England
• Africans are not deported from the UK simply for having HIV
• the high prevalence of HIV among Africans in England.

Condom shame
There are problems with condom access and use. Condoms are unwelcome to 1 in 3 who fear stigma - they worry what people would think of them if they were seen carrying condoms.
Too shy to talk about HIV
1 in 3 have problems with safer sex negotiation skills and confidence who are not sure that they could easily talk about safer sex and HIV with new sexual partners.

1 in 10 feel powerless to manage transmission risks
Among those not diagnosed HIV positive, more than one-in-ten did not feel they were in control of whether or not they became infected.
Similarly, among those diagnosed with HIV, one-in-ten disagreed or was unsure that they had control over exposing sexual partners to the virus or getting infected with another type of HIV.
 

NAHIP programme
This study adds to a body of work undertaken as part of the National African HIV Prevention programme (NAHIP) that will help health promoters tailor interventions for African communities in England:
This was the largest ever study of sexual health and HIV prevention needs among African people in England.

Download the main report from George House Trust, or order a free paper copy

The NW England report is here.

Other regional reports for England.  
 

African Prevention ToolKits and other resources

Source