Feeling Exhausted?

posted: 17/06/2010

Mental or physical exhaustion, feeling drained and weary, is one of the most common HIV symptoms. Doctors call this fatigue. It makes you much less able to get on with everyday tasks, and you feel a tiredness that won’t go away, even with a good night’s sleep.

42 different studies were checked over and these show that anything between 1 out of 3 people, and 4 out of 5 people with HIV, face fatigue.

Dutch researchers looked at 42 different HIV studies done between 1996 and 2008 to see how common fatigue was; what causes it; and what works best as treatment.

Fatigue is really common

They found fatigue was very common – in one study it was reported by 88% – 4 out of 5 people.

What causes it - not clear

It is linked to poverty and a low income, and emotional and mental health problems. Perhaps surprisingly, high viral load or low CD4 cell count don’t seem to be linked with people’s chances of having fatigue – although some of the 42 studies found some links with HIV factors. However, some symptoms, such as fever and stomach problems, were often found along with fatigue. People with other infections such as hepatitis B or hepatitis C, and having other health problems, were linked with more severe fatigue. There is some evidence that people with lower testosterone levels were more likely to report fatigue.

Stress, depression, anxiety and poor coping strategies were all consistently related with greater worse fatigue.

What helps?

A wide range of medicines were used to treat fatigue, including testosterone, antidepressants, and psycho-stimulants. But evidence to show they worked is limited. But the researchers did find that counselling, such as cognitive behavioural therapy (CBT), sometimes helps.

While pills, testosterone, or counselling may help with fatigue, we should not overlook the harm poverty causes. Poverty and low income are a burden that makes coping with life generally much harder. If you have fatigue, poverty makes it even harder to cope. So increasing people’s income, helping people budget better, reduce spending, cut back on drink, smoking, drugs, may all help too.

The study authors end by saying “treatment for HIV-related fatigue is important because of its social, psychological and behavioural consequences and it requires a multidisciplinary approach. There is a need for an appropriate evidence-based practice guide for the management of HIV-related fatigue.”

Source with reference

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Refused Asylum Seekers Fed by Charities

posted: 16/06/2010

Up to 20,000 refused asylum seekers are living destitute in the UK, relying on charities for food, reports the Red Cross today. George House Trust supports around 40 people living with HIV who are destitute.The Red Cross report criticises the government's asylum system as "shameful" and "inhumane".
 

A network of Red Cross "destitution clinics" across the country, including Manchester, give out food vouchers and food parcels to thousands of refused asylum seekers every week. The Red Cross say that this is like their work distributing emergency humanitarian aid in countries such as Sudan.
 

Sharing the burden

The Red Cross, George House Trust and other charities provide a mix of small payments, food parcels and other help to people living with HIV who are destitute. But the numbers of people requiring help and the cost of meeting everyone's needs are beyond any charity's means. Many other migrants share what little they have themselves to help those with nothing.

Destitution strategy
"This is a serious humanitarian situation for these very vulnerable people," Nicholas Young, chief executive of the Red Cross, said. "We do feel that this needs to be tackled by the government because there appears to be a deliberate strategy to make people destitute … for centuries refugees have been coming to this country and receiving kind treatment. It is a shame that is not the case now."
 

Because many refused asylum seekers no longer register with the Home Office, it is hard to get precise figures about the scale of the problem. Asylum organisations estimate that around 200,000 people have been refused asylum but remain in the country. Most are being sheltered by friends, but the Red Cross estimates that up to 20,000 are wholly dependent on charities for food, with some sleeping on the streets, in garages and in hedges.
"In many cases they experience exploitation, overcrowded living conditions, street homelessness, physical and mental illnesses and malnourishment," the report states.
 

Can’t work, no money, no food, no home
Once an asylum request is refused, the asylum seeker is no longer eligible to receive any state support and remains prohibited from working. "You can remove people back to their home country, or you can keep them here. But you have to give people food. You cannot starve people out of the country," said Joseph Nibizi, who runs the Red Cross food distribution centre for asylum seekers in Birmingham. The Red Cross report reflects its conviction that the situation is worsening.

Call for humane treatment - the right to work and healthcare

Red Cross are calling for a support system that will ensure that individuals have the right to work, and access to healthcare, throughout their application until they are either granted leave to stay or are able to leave the country.
 

HIV and destitution
People with HIV who are destitute cannot leave for various reasons, including the lack of life-saving HIV treatment, they would have no income or support in their home country, or the danger they face that caused them to flee still remains.
 

Section 4
The current system does have a safety net of hardship support, known as "section 4", which is available for those who have been refused asylum but are taking steps to return to their own country, or who are appealing against the decision. But it is a safety net with big holes and many fall through the gaps. People are left destitute until they have put together a new application which has to be accepted by the Home Office as based on new evidence. Applications are not accepted automatically, and some, including people with HIV, are unwilling to apply for section 4 because they do not want to be forced to return home.
 

One meal a day – for a year or more
A survey by Red Cross reveals that 87% of people in this situation often survive on only one meal a day, with six out of 10 remaining destitute for more than a year.
 

More than 1 in 4 appeals won
Asylum support organisations argue that refusing asylum does not automatically mean the application was unjustified. Last year 28% of people who appealed against asylum refusal were granted leave to remain, a figure that activists say reflects serious flaws in the process. About half of those whose claim is rejected come from countries such as Congo, Iraq, Zimbabwe, Sudan, Somalia and Eritrea where there is conflict and in some of these countries HIV rates are high.
 

Minister responds
Damian Green, minister for immigration, said: "The government is committed to exploring new ways of improving the current asylum system. The UK Border Agency provides support to asylum seekers who would otherwise be destitute until a decision on their application is made. However, when the independent courts have decided that an asylum seeker does not need international protection, support is discontinued and we expect them to return home voluntarily. Where a refused asylum seeker does not return voluntarily we will take removal action. Where a person faces a temporary barrier to their return which is not their fault, we will provide support until that barrier is removed if they would otherwise be destitute."
 

However the facts speak for themselves.
 

Surviving on £10 a week
If you can't work, can't claim benefits, and have nowhere to live, how do you survive with one £10 food voucher a week? Four refused asylum seekers tell their survival tales. Helpful tips come from four refused asylum seekers in Birmingham, who remain in this country, preparing to appeal the Home Office decision, sleeping meanwhile in hedges, doorways, old garages and staircases.

Read four people’s accounts of survival on £10 a week in vouchers

Red Cross news
Red Cross Destitution report – Not Gone But Forgotten 
Source

Foil for Injectors

posted: 28/09/2009

'Harm Reduction' is the name given to anything that reduces health risks. For years injecting drug users have been provided with clean needles and syringes and this has helped keep the number of people with HIV from injecting drug use in Manchester and the rest of NW England low. Just 2% of HIV infections in the region came through injecting drugs, 118 people. This is far less than in Scotland and many other countries in Europe.

Now there are moves to provide aluminium foil as an alternative - the foil is used for smoking heroin and this is safer than sharing and using needles and syringes.

Drug treatment experts say that inhaling heroin instead of injecting reduces a user's risk of contracting HIV and Hepatitis C. A drug user heats a blob of heroin on the foil and smokes the fumes - which is called "chasing the dragon".

drugs paraphernalia and police

The Advisory Council on the Misuse of Drugs (ACMD) is examining whether the law should be changed to allow Britain's 300,000 problem drug users to receive foil as a way of protecting their health. Since last year, the ACMD's 31 members, who advise the Home Office, have been considering whether section 9A of the Misuse of Drugs act, governing "paraphernalia" or equipment used in the consumption of illicit substances, should be amended to allow the UK's network of needle exchanges to supply foil. At present, it prohibits the supply of "articles to be used for the preparation or consumption of illicit drugs".

Foil ban criticised

Critics say the ban endangers users' health because most drug workers are too afraid of being prosecuted to risk giving out something that many see as a sensible harm-reduction measure. An estimated 100 of England's 1,300 needle exchanges already defy the law by providing foil. Some have even had tacit support in the form of "letters of comfort" from their local police force, such as Avon and Somerset, which emphasises that it does not see the pursuit of section 9A as a priority.

The ACMD's technical committee has held two private evidence-gathering sessions on the subject with with Jamie Bridge of the International Harm Reduction Association, which backs legalisation, and drugs treatment researchers Neil Hunt and Rachael Pizzey. It is due to hear on 29 October from veteran Dutch drugs worker John-Peter Kools, who has issued foil in the Netherlands. Both Holland and Spain issue foil through needle exchanges without any major problems.

The full ACMD is to debate the issue in November and is expected to suggest setting up a pilot study on the effects of foil provision. It hopes to advise ministers of its views soon – possibly before the end of the year – on whether the law should be changed. Bridge said: "Smoking drugs is by no means safe, but is a great deal safer than injecting drugs – which is particularly associated with overdose, blood-borne viruses, drug-related litter, greater dependency, abscesses and vein damage.

police edging closer to foil acceptance

"The law has unintentionally put us in a strange position whereby we can give someone clean needles to inject with, but we face arrest for giving them aluminium foil to smoke with. Providing foil in this way is such a common-sense approach – with huge potential benefits and little opposition or potential costs – that we hope the law will change soon." Significantly, the Association of Chief Police Officers, which represents the country's most senior officers, is neutral on whether the law should be amended. But it would support a change if the ACMD recommended such a move on public health grounds, sources told the Observer.

Harry Shapiro of Drugscope, which represents 800 drug projects, said: "It's important to do everything possible to discourage Britain's 300,000 problem drug users from injecting their drugs, and we should allow injecting heroin users to be provided with foil as part of a harm-reduction programme. As the law now stands users' health is being compromised and it would be better if section 9A was repealed."

But James Brokenshire, the Conservative shadow home affairs minister, said: "I'm cautious about these sort of moves, which progress harm reduction rather than focus on getting people drug-free. In recent years there has been insufficient focus on getting people off drugs and too much on just maintaining people on drugs through methadone and other measures.

"I would need to be swayed that there are clear and compelling public health arguments to make such a change [in the law]. I want to promote abstinence-based rehabilitation. There needs to be a greater emphasis in getting people off their drug habit rather than maintaining their addiction."

Paul Hayes, the chief executive of the NHS's National Treatment Agency, which funds drug treatment, said: "Any way of using heroin is dangerous and likely to lead to addiction. However, injecting the drug is far more dangerous than other means of ingestion, such as smoking. Currently, the provision of foil is not legal. The NTA cannot advise drug treatment services to follow a course of action which is illegal and could have adverse consequences for provider services."
 

Source

Legalise It - former Chief Constable Tom Lloyd writes about legalising all recreational drugs instead of continuing the failing 'war on drugs'

Red Ribbon Pantomine

posted: 09/09/2009

The Red Ribbon Pantomine is for grownups and is a fundraising event for HIV support charities in Lancashire. It's presented by Preston LGBT centre and stars Linda and The laundrettes, Virgins in Peril, Blackburn DAPA and more.

There are two performances only - Wednesday 25 November at the Empire Theatre in Blackburn, and on Friday 27 November at the 53 Degrees, in Preston.

Blackburn Wednesday 25 November, Empire Theatre, Aqueduct Road, Ewood, Blackburn, (map here) 7pm entrance, curtain up 7.30pm.

Box Office 01254 685 500 Tickets £10 (seated)

The Red Ribbon Cabaret was first conceived in Blackburn as 'Aid for AIDS' in 1992, in response to a friend of the original event organiser being diagnosed HIV positive. Tony Abbott was from Blackburn, and the trust fund that was initiated in his name was to support people living with HIV in the Blackburn area.Through the original 'Aid for AIDS' event and subsequent annual Red Ribbon Balls, over £11,000 was raised for the trust in Tony's name.

Preston Friday 27 November, 53 Degrees, Brook Street, Preston (map here), doors open at 9pm. 

Box Office 01772 893 000 Tickets £8 for a standing performance.

Useful Pre-Pay Visa Cards

posted: 28/07/2009

Many people with HIV find getting debit and credit cards almost impossible, including migrants with HIV, and the gap could now be filled by pre-pay cards. These allow you to buy things and pay bills by plastic, including on the web, but you don't need a good credit score, or have enough regular income. You simply pay for credit to be added to the card as you can afford this.

O2 has launched a pre-pay Visa card for adults, called Cash Manager, which may finally make these products a viable choice for millions.

The chief attraction of Cash Manager is that it's free of charges. Until now, pre-pay cards have tended to levy an "issuing fee" (usually £10), monthly fees (up to £5 at some providers) and "reload" fees. They have largely been used as an alternative to travellers' cheques when overseas.

Good option for migrants

But now Britain's unbanked – especially recent migrants, but all those refused by banks – can obtain a Visa card for free. They'll be able to load it with cash at thousands of Paypoint and ePay terminals around the country, which will then allow them to buy goods over the net or over the phone.

The catch is that you have to have an O2 mobile. The cheapest deal the network offers right now is its Sim-only Pay & Go deal, although you have keep it active by topping up £10 every three months.

If you don't want to sign up with O2, there are plenty of other pre-pay deals, although all come with some level of charging.

Try the website what-prepaid-card to compare deals.

• Virgin has a MasterCard, which does not charge a monthly fee but has a start-up fee of £9.95.
• The Post Office offers its Travel Card, which has no issuing fee or monthly fee, but charges a 1.5% fee when re-loading money. Its big attraction is that it is an Electron card – so you can avoid the £5 that Ryanair charges on each leg of a flight.