Compensation for Bad Blood

posted: 11/01/2011

More compensation will be paid to people (who are mainly people with haemophilia) who got hepatitis C from contaminated blood transfusions by the NHS over 20 years ago, the government announced.

Many people got HIV through the same contaminated blood scandal, while others got both HIV and hepatitis C and some just hepatitis C. The compensation arrangements for HIV and hepatitis C were different and people with hepatitis C felt cheated.

Hepatitis C campaigners are still unhappy and will continue to fight for more help. One of the campaigning groups, Tainted Blood, said the offer "hugely disappointing", and Haemophilia Society chief executive Chris James said the payments "would not bring closure to many people."
 

HIV complaint too

A man with HIV from Blackburn, Lancashire, 'John Smith' has also criticised the compensation scheme as inadequate. 

‘Serious disease' payments
The announcement by the health secretary, Andrew Lansley, follows a three-month review of the compensation paid to those who were infected with hepatitis C, which can cause liver damage and cancer. Separate settlements were made to those who got HIV through blood transfusions. Some people were infected with both HIV and hepatitis C. Many of those who received contaminated blood in the 1970s and 1980s have died.
 

Cirrhosis and liver cancer
The new deal offers better compensation to those whose hepatitis C infection has progressed to cause serious disease. The current terms allow a one-off payment of £20,000 to all those infected, with a further £25,000 if they develop more severe diseases, such as cirrhosis or liver cancer.

Under the new deal, the second group – those with severe diseases – will get an annual payment of £12,800 a year. Those with severe diseases who have already been given a lump sum will have it increased from £25,000 to £50,000.

There will also be "discretionary payments" to those most in need, and the dependents of those who died before 2003 will for the first time be able to claim. There will also be a doubling in a one-off payment to £50,000 when people become very ill.
 

"I fully recognise that the unintended and tragic consequences of these treatments have seriously impaired the lives of many people, together with those of their families," said Lansley. "For too long those people infected with hepatitis C have received different support to those infected with HIV. We now intend to make the financial support for hepatitis C patients fairer and more comparable to the arrangements for those infected with HIV."
 

Campaigners’ disappointment
But, after decades of fighting for what they consider fair settlement, including the recent independent inquiry by Lord Archer which recommended much greater generosity from the government, campaigners said they were devastated.
 

Sue Threakall, secretary of Tainted Blood, said: "While there are some minor positive points, we are devastated by this announcement. There are a limited number of people that the new financial support will be available to and the level of payment to those who will qualify is hugely disappointing. It will not bring to an end the years of suffering and will mean that the campaign for achieving proper compensation for all will continue with a new vigour."
 

Chris James, chief executive of the Haemophilia Society, said he thought the reaction from the community would be that it is "a gesture rather than a settlement. People will not feel that this is going to bring closure in terms of the money being paid. The levels of compensation are not in the region that people still feel is appropriate for the impact on their lives."
 

Those who were infected but not severely ill would get nothing more – unless they were in serious need and qualified for a discretionary payment – and the new annual payment for those with liver cancer is only likely to be paid for very few years because life expectancy for people with liver cancer is short.
 

Sources

Guardian
BBC

Hepatitis and HIV Compensation

posted: 19/04/2010

An award-winning composer who contracted HIV and hepatitis C after receiving contaminated blood on the NHS around twenty years ago has made more progress in the legal battle for compensation.
 

Andrew March, 36, applied for a Court order to overrule the government’s decision not to award compensation similar to the compensation given to people infected by blood products in the Republic of Ireland.
 

An independent inquiry last year called for an overhaul of payouts to those who got HIV and / or hepatitis in the 1970s and 1980s through transfusions with unscreened and untreated contaminated blood. Ministers refused.
 

But a High Court judge has now ruled that the Government’s approach “has been, and remains, infected by error.”
 

Inquiry recommended compensation like in Ireland
The 2009 inquiry by Lord Archer of Sandwell found that 4,670 haemophiliacs who received blood transfusions in the 1970s and 1980s were infected with hepatitis C, of whom 1,243 were also infected with HIV.
 

By May last year, almost 2,000 people had died as a result, and £142 million has been paid in compensation to victims.
 

But the inquiry recommended that British victims be compensated on the same level as in Ireland, where those who contracted hepatitis C from contaminated blood were paid on average £750,000, and people infected with HIV received up to £101,000.
 

Dodgy excuse to say no
The Government refused to pay patients a similar level of compensation as it argued that the Irish blood transfusion service was found to be at fault, which was not the case in the Britain. This interpretation is disputed both in Ireland and the UK.
 

Although the government announced increased compensation for those who got HIV, it only offered to review the hepatitis payments in another five years. It refused to assess payments in the same way as Ireland.

Judge warns against 'false optimism'

Mr Justice Holman, sitting in the High Court, said that this argument was flawed, but that it was not his role to rule on the amount that should be paid, adding that campaigners should not now have “false optimism”. “I have given no steer or indication whatsoever as to what the Government may decide upon reconsideration, and it would be a grave abuse of my role if I were to do so,” he said. “The campaign may now return to the political arena, but no one should leave this courtroom with a false optimism.”
 

The Department of Health now says it would "now consider the position".
 

Mr March said: “Having the judgement go in our favour gives us no pleasure at all. The judge’s decision proves the flawed basis on which the Government made it decision not to implement the recommended compensation scheme. The judgment now compels the Government to retake the decision lawfully and based on accurate information.”

Source

Source 2 
 

Hepatitis C - Blood Blamed

posted: 13/11/2009

Contact with blood, not semen, is how hepatitis C is being passed on among some gay men living with with HIV. This is what is now being reported at the European HIV conference underway in Cologne, Germany.

Fisting, group sex, and snorting drugs emerged early on as significant risk factors for sexual transmission of hepatitis C. But unprotected anal sex on its own, without fisting, parties and snorting drugs, doesn't seem to transmit hepatitis C. 

The investigators believe we should refocusing hepatitis C prevention campaigns for HIV-infected gay men from warning about unprotected sex to warning about transmission, probably through tiny, usually invisible, droplets of blood.

Since 2000 outbreaks of sexually transmitted hepatitis C have been reported amongst HIV-positive gay men in a number of large northern European cities including London, Amsterdam and Berlin. Unprotected anal sex and fisting were quickly identified as risk factors.

Semen or Blood?

But is hepatitis C transmitted through the semen (like HIV), or through blood in these encounters?

Because men living with HIV have a higher hepatitis C viral load in semen than men without HIV, this could explain the higher rates of hepatitis C among HIV positive gay men. But HIV-negative partners (of gay men with both HIV and hepatitis C) almost never get heptaitis C, so it looks like it isn't transmitted through semen. HIV-positive heterosexual couples where one partner also have hepatitis C don't infect each other either. This points strongly to blood, not semen, as the means of hepatits C transmission among HIV+ gay men.

Positive gay men in Bonn

Investigators in Bonn did a case-controlled study involving 34 gay men with both HIV and hepatitis C, and 67 age-matched men who only had HIV. None of the men reported injecting drug use.

The men were recruited to the study between 2006 and 2008. They provided information on their sexual and drug use behaviour, and also stated if they had experienced rectal bleeding as a consequence of sex.

Unprotected anal sex was widely reported, and approximately 50% of men reported receptive fisting.

So how does the blood get transmitted?

The first set of statistical analysis showed that several risk factors were associated with infection with hepatitis C including

• use of sex toys
• rectal bleeding
• receptive fisting without gloves
• sharing and snorting stimulant drugs like cocaine and amphetamine during group sex.

Only these three things were clearly linked to heptatits C transmission when they did a more detailed multivariate analysis:

• receptive fisting 
• rectal bleeding 
• drug use during group sex.

So the researchers propose hepatitis C is being transmitted via blood rather than semen, and that even men without hepatatis C can be involved in a transmission chain, during group sex sessions.

Some disagreement

However, not all delegates at the conference were convinced. A questioner from the floor pointed out that many HIV-positive people with acute hepatitis C infection in London do not report fisting.

Moreover, Dr Sanjay Bhagani told aidsmap that it was his sense that the epidemiology of hepatitis C amongst HIV-positive gay men in London was changing and that many infections could probably be attributed to injecting drug use rather than sex.

In addition, HCV itself is sometimes found in semen, and men who have both HIV and HCV tend to have HCV in their semen more often than men who have HCV but not HIV, according to a report from Canadian AIDS Treatment Information Exchange.

Nevertheless, the investigators conclude that prevention messages should inform HIV-positive gay men of the risks of hepatitis C that arise from long-lasting, group-sex sessions where there is rectal trauma caused by activities such as fisting. The blood may not be visible - microscopic amounts are enough - hepatitis C is vastly easier to pass on than HIV.

Source with more details and reference

Gay Blood Donor Ban Plans

posted: 03/11/2009

The longstanding ban on gay men giving blood, for fear that HIV might get into the country's blood supply, was debated last week as part of a national consultation.

The meeting, held by the Independent Advisory Committee on the Safety of Blood, Tissues and Organs, is part of the latest review of the long list of people banned from giving blood for life.

Gay men and other men who have ever had sex with another man, people who have injected drugs, prostitutes and those who have ever had syphilis, hepatitis B or hepatitis C are all banned for life. Others are banned for a shorter time, such as people who have visited some countries, or had sex with someone from some countries.

Suggestions

One suggestion for a new policy for gay men and blood donations was to allow donations from gay men who have not had sex with another man in the last five years, banning only those who have had anal sex rather than oral sex, and lifting the ban on women who have had sex with a gay or bisexual man.

The meeting began with talks from some experts. Dr Richard Tedder, a microbiologist from University College London, argued that viruses were "not politically correct" and pointed to windows of time before HIV could be detected in blood samples. He also cited issues with testing blood donations for HIV, saying that not all of the blood in one donation can be tested.

Professor Deirdre Kelly, a liver specialist from Birmingham Children's Hospital, spoke of the need for people to donate blood and said she was not satisfied that certain deferral and exclusion policies were consistent with estimated risk.

The audience also heard from a heart transplant patient who argued that lifting the lifetime ban on gay men would "de-demonise HIV and AIDS" and would create a larger pool of blood donors. The meeting was then opened up to the audience to have their say.

HIV organisations views
Yusef Azad, from the National AIDS Trust, said he believed population-based deterrents were justified but added: "If you look at five-year deferrals [for gay men] with fourth-generation HIV testing, there is no significant risk."
Nick Partridge, the chief executive of Terrence Higgins Trust, said research has found that the vast majority – 93 per cent – of gay men have complied with the current ban on donating blood. But he added: "I'm struggling to calculate how many gay men haven't had sex in five, ten years. What realistic difference would it make?" Dr Tedder said he did not think gay men who hadn't had sex for five years would make a significant difference to safety.

Professor Kelly raised the issue of heterosexual men who may have once had a gay experience and said it was problematic that they, and their wives and girlfriends, were barred from donating blood.

Deborah Jack, of NAT, asked whether men who have only had oral sex with another man posed a significant risk.

Demonstrators’ question time
A group of around 40 students, along with Peter Tatchell, had been protesting against the ban outside the conference venue in Greycoat Street. Several attended the meeting along with National Union of Students LGBT officer Daf Adley. Adley suggested that the blood service was missing out on donations from thousands of healthy men and also argued that including protected oral sex as a reason for banning some gay men sent out the wrong message, as young gay men were being informed that protected oral sex was safe. He called for gay men to be screened for blood donation according to their individual behaviour, rather than basing specifications on whole groups.
However, a number of experts present refuted this, saying the lengthy questioning procedure this would involve was simply not practical.

Matthew Beaver, a local councillor, introduced himself to the audience as a gay man and suggested that those in the closet posed a far greater risk to public safety than men who were openly and confidently gay. This was dismissed by Nick Partridge, who said he doubted this was happening.

Stonewall previously supported the lifetime ban on gay men but recently changed its position. Terrence Higgins Trust maintains the lifetime ban is necessary. Stonewall spokesman Derek Munn said: "It is difficult for us to have different views from Terrence Higgins Trust but we reached our current position from the input of our members. "To have men who have sex with men as a single undefinable category is like using a blunt instrument."

The last review, in January 2007, recommended that the policy of banning gay and bisexual men from donating blood should be continued. A study commissioned by the Health Protection Agency is currently underway to find out more about compliance with rules. It will be published next year. A Department of Health spokesman said that the findings from the current review will be announced in 2010.

Source
 

Gay Blood Ban Challenge

posted: 10/08/2009

Despite all the improvements in HIV testing and treatment, gay and bisexual men are still barred from ever donating blood. The blood of every single man who has ever had sex with another man, whether or not they used protection, is apparently too likely to contaminate UK blood banks.

This article is part of the public debate about whether the ban should be lifted. It's not George House Trust's official position. People living with HIV simply cannot donate blood. We are an organisation supporting people living with HIV, so the ban makes no difference to people using our services. 

However George House Trust does have a concern about this ban sending out out-dated messages about HIV. We also think the ban reinforces HIV stigma and homophobia, and neither of these help reduce the spread of HIV.

Is the ban still justified?

The fact that every single blood donation is screened using two different and very sensitive virus tests strongly suggests that, conscious or not, the continued existence of this ban is the result of an underlying prejudice, an example of 'institutionalised homophobia'.

The National Blood Service (NBS) justifies its position with the 'window period.' Some viruses can't be detected in blood when the infection was recent - the so-called 'window period'. So the NBS argues it should not take blood from homosexual and bisexual men.

'Window Period' is history

In the past, the HIV tests available to screen blood had problems - there was a significant gap when someone could have HIV but the tests we had could not find this. The old tests looked for antibodies to HIV and these antibodies take weeks (sometimes months) to appear. You could have HIV and the tests wouldn't find it. This was the fear of NBS - undetected HIV would get into the public blood supply. Things are now very different. Now there is almost no window period when HIV is undetectable by the NBS.

Blink and you'll miss the window period

But the NBS seems unwilling to admit these changes and update its practice from two decades ago. Given these significant improvements in blood screening, does this justify the lifetime exclusion for gay and bi men from donating blood? The answer is simply no.

Statistically, a gay man is more likely to have HIV than most heterosexuals: however, the same vetting process that decides if a heterosexual's blood can be accepted, based on their sexual activity, should be good enough for gay men too. If it isn't, then we should all be worried about the entire vetting process.

There is a huge inconsistency in the NBS's argument. We are told that the blood screening process is reliable and effective. But in some unexplained way it is not good enough to screen the blood of gay men. Hepatitis and HIV, and the biological components of blood, aren't any different in gay men. Either the screening works for everyone, or it doesn't work for anyone.

The problem with the NBS's ban is that it is no longer 'reasonably justifiable' discrimination. If the screening process and vetting processes are good enough there is no need to treat the blood offered by gay men and heterosexuals any differently. Scientific progress seems to have removed this risk to the blood supply.

Illegal sexuality discrimination?

The NBS, in sticking to its position in the face of the evidence, risks breaking the law and may face claims for illegal discrimination, because of sexuality. 

Black Africans and gay men - the rules discriminate

The same statistics that the NBS use to argue their case also show that 46% of those newly diagnosed with HIV in the UK are black African. NBS logic should mean a permanent exclusion on blood donations by black Africans. The NBS has one rule for gay men and another for black and heterosexual Africans. No one would contemplate banning donors on grounds of race. Therefore, since no legitimate scientific reason seems to exist, why do we allow the ban on gay men because of their sexuality to remain?
 

Flu blood demand pressures

The NBS's plans to increase blood stocks by nearly 38% to meet increased needs due to the swine flu epidemic means that less people are eligible to donate. Is it still sensible to exclude approximately 2 million gay male donors? The position seems even more ridiculous when we consider that only 4% of those who are allowed to give blood actually donate any.

Source edited

Terrence Higgins Trust current policy