Training - No Recourse to Public Funds

posted: 20/05/2011

No Recourse to Public Funds (NRPF) Training will be provided in Manchester on Tuesday 7th June (10am – 4.30pm) for Local Authority representatives with responsibilities for people with NRPF.

There will be NRPF training specifically for the voluntary sector in London, on 10th June. Details about Voluntary Sector NRPF Training are here

Voluntary sector people are also welcome at the Manchester training but in Manchester the training focuses on social services assessments.

This training is provided by the No Recourse to Public Funds network.

Limited places available

The cost of the training is £125 per person and will take place at Manchester City Council. Limited places are available. To book a place, please complete the booking form and return it to No Recourse to Public Funds at Islington. The training terms and conditions are here.

The Manchester training for local authority workers covers key issues, legislation and social services assessments, for adults, children and families, and includes human rights obligations.
 

• No recourse to public funds - introduction and overview
• Key legislation
• Assessing eligibility for support
• General considerations in assessments of need - adults, children and families, human rights
• Community care and community mental health assessments
• Child in need and human rights assessments
• Good practice in assessing and supporting people with NRPF
• National NRPF Network and the policy context of NRPF
• Case studies

Booking Form

Terms and Conditions

Enquiries and bookings to nrpf@islington.gov.uk

More information on the No Recourse to Public Funds training programme for Local Authorities

More information on the No Recourse to Public Funds training programme for Voluntary Sector

More information on No Recourse to Public Funds from the network

More information on No Recourse to Public Funds from UK Border Agency
 

African Film Against Stigma

posted: 11/05/2011

No Blame, No Shame is an epic new HIV health promotion film from the African Health Policy Network (AHPN). The film tackles the taboos and stigma surrounding HIV infection in UK’s African community. No Blame, No Shame features top comedian Gina Yashere, alongside HIV positive UK Africans, in a film made by Angus Malcolm.
 

No Stigma in living with HIV

No Blame, No Shame is an online video that is also available as a DVD, promoting the African Health Policy Network’s Public Faces  campaign, that there is no stigma in living with HIV and that stigmatising attitudes only help spread HIV.
 

Watch No Blame, No Shame here
 

Eunice Sinyemu, Head of Policy and Deputy Chief Executive at AHPN says “We have to challenge the stigma around HIV in the UK's African communities. It stops individuals from getting tested, which means they don’t get the treatment they need, and are more likely to infect others. With Gina’s help, we are confident we can get this message across in a colourful, punchy and accessible way.”
“Gina is much-loved in the African community, and having a big name on board is really going to help us reach our audience.”

Wide distribution

AHPN is promoting the film to reach as many people in the African community as possible, including viral marketing and distribution on DVD, use in training for a wide range of specialists and professionals, faith leaders and communities, local and national policy makers, workers in the health and social care sectors, local and national media.

Read about the comedian Gina Yashere

The film was made by Angus Malcolm, writer and producer. With a background in healthcare, including several years in the AIDS Unit at the Department of Health, Angus specialises in producing low-cost media for the statutory and not-for-profit sectors, especially education and healthcare.

No Blame, No Shame
 

Answers in Untested Mystery

posted: 12/04/2011

HIV experts in England are puzzled why some people using STI clinics refuse HIV tests. We know for sure that some of those refusing HIV tests do have HIV (from using blood from samples given for syphilis tests and after the syphilis test is done and the blood sample is made completely anonymous, it can be tested for HIV).

The 2009 results from doing this show that 2.4% of gay and bisexual men and 0.25% of heterosexuals tested for syphilis came to the sexual health clinic with undiagnosed HIV.

But only 63% of these people agreed to a HIV test at the STI clinic - much lower than the average rate of HIV testing for people using STI clinics.

Why are so many people who have ‘undiagnosed’ HIV, refusing HIV tests?

One quarter must already know they have HIV - they are taking HIV treatment !

Some useful answers to the testing mystery have now emerged. Now we know that around a quarter of people with ‘undiagnosed’ must know they have HIV, because blood tests prove they are taking HIV treatment. These and other results, given at the British HIV Association conference in Bournemouth last week, are the first clear evidence of some answers to the ‘undiagnosed’ mystery.
 

Slightly more heterosexual women and men (32% for both men and women) than gay men (24%) are using a different clinic for STI checks than for their HIV treatment. Experts thought gay men with HIV were more likely to go elsewhere for HIV checks than heterosexuals. Experts don’t always guess right. Some people with HIV have told community organisations and patient advocates that one reason they go elsewhere for testing is to avoid unwanted, intrusive or judgemental discussion of their sexual behaviour by their own HIV clinic.
 

The results means

• 9 in 100 of the gay and bisexual men who said yes to a syphilis test but no to a HIV test have HIV. At least 2 of those 9 are on treatment but didn’t tell the STI clinic they have HIV
• 8 in 1000 of the heterosexual women and men similarly are HIV positive. At least 2 of those 8 are on treatment but did not tell the STI clinic they have HIV.
   

These findings will make little difference to national estimates of how much undiagnosed HIV there is in the country.
 

Why do gay men who don’t yet know they have HIV refuse HIV tests?
Another small study given to last weeks conference looked at why some gay men refuse HIV tests. Researchers gave an anonymous questionnaire to 19 men who didn’t want to be tested, even though they had had anal sex without condoms and have, either never been tested, or had taken anal sex risks since their last HIV test.

The men could tick more than one reason.
 

15 of the 19 men said they believed they were at low risk of HIV infection [2 of the 19 men knew their partner has HIV]

• 14 said they were emotionally unprepared for a positive result
• 4 said they don’t like giving a blood [but nonetheless gave this to have the syphilis test]
• 4 also mentioned prosecutions for HIV transmission
• 4 said they were planning to test 'next month'
• 3 mentioned worries about the confidentiality of the HIV test result.

Testing Advantages well known

Most of the men know the advantages of HIV testing

• 16 said testing could give peace of mind
• 16 said testing allows treatment to start at the best time.

Testing worries rule

But all the gay men listed the disadvantages to them of HIV testing.

• 17 said testing was stressful
• 8 were worried about having to tell a boyfriend if they were positive
• 7 were concerned about the insurance and mortgage implications.

Unready for positive result, testing stress, in denial about risks

So most of these gay men didn’t feel emotionally ready to deal with a positive result, and find HIV testing stressful.

• Most thought their HIV risk was low, despite having taken enough risks to have got HIV and needing to visit an STI clinic.

The study authors suggest investigating ways of overcoming gay men’s resistance to testing at STI clinics.
 

Source 
Reference – the free conference abstracts - read O13 & P152

Late Diagnosis - More AIDS Deaths

posted: 11/04/2011

12 years of UK HIV data shows that people diagnosed late with HIV (when the CD4 count was under 350) are 6 times more likely to die of AIDS than other people with HIV.Three quarters of all the people who die with an AIDS diagnosis were diagnosed with HIV late – when their CD4 cell count was below 350.
 

The researchers who gave this news to the British HIV Association Conference in Bournemouth last week, used the UK’s national HIV surveillance system data and death certificates at the Office of National Statistics, for the years 1997 to 2008.
 

While HIV deaths have plunged since combination treatments began in the mid 1990s, over 500 people with HIV die each year, and the HIV death rate is still five times higher than for the general population.
 

Over these 12 years, almost half the deaths were due to AIDS (49%). The proportion varied during this time but is not falling steadily, as we would hope.

The researchers milked the data by using advanced statistical tools. That is how they discovered that being diagnosed when the CD4 is below 350 makes people six times more likely than others with HIV to die of AIDS. They also estimate that 74% of all AIDS deaths are explained by late diagnosis. Even among people infected in the UK, 66% of AIDS deaths are linked to late diagnosis.

• Men were more likely than women to die of AIDS.
• But men who have sex with men were less likely to die than heterosexually infected men and women, whether this was in Africa, the UK or anywhere else.
• Injecting drug users had a much higher risk of death than all others.

The most common causes of AIDS deaths were PCP (a type of pneumonia common with advanced HIV illness), other AIDS-related pneumonias, non-Hodgkin's lymphoma, TB and neuro-cerebral causes.
These findings make very clear how important it is to reduce late diagnosis – NorthWest England is the worst region in England for late diagnosis.

Source with link to reference

Talking and Telling about HIV

posted: 28/02/2011

There’s a lot of fuss made about how important it is for gay and bi men diagnosed with HIV to tell their sexual partners about HIV, before any sex takes place – which is known as ‘disclosure’.

Telling people whether or not you have an STI / HIV is your choice.

We think it is smarter if every  person in the UK were to talk about HIV and discuss their and partners’ HIV and STI status and risks before sex. But telling others about having HIV is always a choice.

One-sided talking

One major problem is that undiagnosed people, including gay and bi men, rarely ever talk about their own HIV status, but instead expect diagnosed people to always reveal their HIV status.

Some undiagnosed men then decide not to have sex, or decide on less risky sex after the partner says they have HIV.

Conference debates

George House Trust has critically examined the evidence for and against relying on being told HIV status as a way of avoiding getting HIV. Chris Morley, George House Trust's HIV policy expert, issued a challenge to gay men's HIV prevention workers when he gave a detailed presentation at the CHAPS conference last week for England's sexual health and HIV prevention organisations.

The challenge is to tell undiagnosed men that relying on being told by people with HIV is a seriously flawed way to try to avoid HIV. The HIV risk run by men expecting disclosure is simply too high. The challenge was also to help undiagnosed men be more respectful to anyone who does disclose having HIV. Some disclosing men with HIV are then shamed, abused, rejected, or worse.

Talking about HIV happens very unevenly and the expectations of disclosure put an unbalanced burden on people with HIV.

Dysfunctional Disclosure

The far bigger problem however, is that relying on being told, and being told accurately, is a highly risky way to manage anyone's HIV risks.

Only men diagnosed with HIV have HIV status information that is at all reliable.

Depending on men to tell you they have HIV puts you at a big HIV risk. Disclosure doesn't work at all well as a way of staying HIV negative. 

• 1 in 3 gay and bi men have never had a HIV tested - so untested, can't tell anyone anything useful about their own HIV status
• Men who have been tested usually only have information that is past its sell-by date
• Many men have had condomless anal sex since they had their last negative HIV test. An MOT certificate saying your car was roadworthy is no guarantee of future safety after you have had a crash. In the same way, a negative HIV test result becomes worthless once you have had unprotected sex.
• The only dependable information is from men who have been diagnosed with HIV to tell you this; but not all diagnosed men disclose in all situations; for example disclosure by diagnosed HIV+ men is less common in gay saunas and clubs.

George House Trust is also making a second presentation, about cuts in legal advice and representation for people with HIV. 

HIV Legal Advice Services
Among the hundreds of cuts, one cut would remove most legal aid for advice and representation at courts and tribunals. £450 million is to be slashed from budgets for advice, such as provided by Citizens Advice, Manchester Advice, Law Centres and other organisations, for immigration and asylum, welfare benefits, housing, employment and most discrimination cases.
 

This will affect millions of people a year, and you can tell things will become really bad, because even the Judges’ Council has gone public with its objections.

HIV Talking and Telling - George House Trust discussion for CHAPS-14 conference, Manchester  

HIV Advice Services - George House Trust discussion for CHAPS-14 Conference, Manchester

CHAPS-14 Conference, Manchester, March 9-11th

Image - Let's Talk HIV - Swedish language HIV site