People’s Guide to Police HIV Investigations
posted: 11/05/2011
NAT (National AIDS Trust) have just produced a guide for people living with HIV about how the police should investigate any complaints about HIV being passed on. The Police now have their own detailed guidance for doing these investigations.
This plain English leaflet is for people with HIV and it gives the key points and answers people’s common questions. It does not deal with Scotland where the law and legal system is different, so the guide is just for England, Wales and Northern Ireland.
Prosecutions are rare
Police investigations into reckless HIV transmission are uncommon. In 2009 around 6500 people found out they had got HIV but few people complain to the police about someone infecting them recklessly, and there was only one prosecution in 2010 and none at all in 2009.
Answers to common questions
The leaflet answers these common questions:
- What should I do if someone goes to the police (or threatens to) accusing me of giving them HIV?
- How much will the police know about HIV?
- Should the police investigate if the person complaining does not have HIV?
- When will police end the investigation?
- Will the police keep my HIV status confidential?
- Can the police see my medical records?
- Should the police comment to the media?
- What if the person accused is under 18?
Expert Guidance for Police and Prosecutors
The police now have their own national guidance to follow when investigating these unusual, complex and sensitive cases. The Crown Prosecution Service also has a guide about prosecuting these cases.
HIV organisations like NAT, George House Trust and Terrence Higgins Trust have worked hard with police and prosecutors to produce these guides to reduce as far as possible problems for people with HIV who may be accused.
The police guidance makes plain that all allegations should:
- be fairly investigated
- not be begun or continued if a successful prosecution is not considered realistic
- respect the dignity and confidentiality of people with and affected by HIV.
The Association of Chief Police Officers (ACPO) has approved ‘Investigation Guidance relating to the Criminal Transmission of HIV’ for the police.
This sets the standard for police investigations. Police will find the guidance very helpful; it is available on the national police information and training website ‘POLKA.’ The public can find a public copy on the NAT website.
Accused? Remember:
If you are accused of reckless or intentional HIV transmission, get immediate advice from a HIV voluntary organisation with experience in HIV prosecutions, or ring THT Direct (0845 12 21 200)
- Get legal advice when the police start to investigate
- Make sure the police know about and use the ACPO Investigation Guidance
- Get advice and support from a HIV voluntary organisation with experience in dealing with HIV prosecutions.
NAT Guide for people living with HIV on police investigations is at the bottom of this page.
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HIV Sperm Washing NorthWest
posted: 08/02/2011
Sperm washing for people with HIV is now available in North West England. Sperm washing cuts the risk of HIV transmission for couples who want a baby, when the male is living with HIV but his female partner is HIV negative. Sperm washing cuts the risk of passing HIV to the female partner and of the mother then passing HIV to the baby.
More information on sperm washing and HIV here
New sperm washing service in Liverpool
A Liverpool clinic now offers sperm washing and fertility services to people with HIV and other blood borne viruses.
People wanting sperm washing before now have had to travel around 200 miles to London.
Dr Chitra Babu (from the Hathersage Clinic at Manchester Royal Infirmary), has worked with the Greater Manchester Sexual Health Network to arrange in principle for funding to pay for this sperm washing, as a way of reducing the risk of HIV transmission.
HIV positive men with HIV negative partners who want to have children should both go together and talk with their HIV clinic about sperm washing and other ways to cut HIV transmission risks. Liverpool can also provide other fertility treatments – talk with your local HIV clinic.
Leaflet for patients and guidelines for clinics
Within the next couple of weeks there will be a leaflet for couples affected by HIV and guidelines for clinics, and we will then add these here.
Information Sessions - HIV and having a family
Positively UK are holding two HIV and Pregnancy information sessions at George House Trust:
Preconception and Pregnancy:
Saturday 19 February 2011
13:00 – 15:00
Delivery and After Care:
Saturday 19 March 2011
13:00 – 15:00
Both men and women are welcome to attend.
If you need a space for a child at the crèche, please book this in advance
For further information contact Jill Cooke at GHT on 0161 274 4499 or email her, or Angelina from Positively UK on 0207 713 0444 or email her
More information on HIV and pregnancy
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HIV and Teenage Pregnancies
posted: 26/01/2011
Behind the good news that 58 London teenagers with HIV successfully gave birth to 66 babies, there’s another story.
This is a saga of sex education that isn’t working, major gaps in HIV prevention, little or no use of contraception, unplanned pregnancies, vulnerable teenagers and sexual abuse, domestic violence, undiagnosed HIV, late diagnosis, further pregnancies after the birth, and complex psycho-social problems.
We learn this from the first British study to look at pregnant teenagers with HIV, in the latest issue of the British HIV Association journal, HIV Medicine.
Over the seven years up to 2007, 12 London hospitals found 58 teenage (13 – 19) women with HIV who became pregnant. 66 babies were born live to the 58 mothers and only one baby developed HIV. The mothers (and the babies) have done well and that is what the study was looking into.
Gaps and needs
But the study uncovered evidence of significant gaps, and exposed teenagers’ needs and some of the life problems that can help explain these pregnancies, and how HIV pregnancies and HIV transmissions to vulnerable teenagers might be avoided.
The young women here faced “difficult medical and social circumstances,” used condoms infrequently, and a quarter became pregnant again within one year. Other studies have shown many young people with HIV have complex psychosocial problems, take high levels of sexual risk and have significant recreational drug and alcohol use. This study found this too.
11% of the new HIV diagnoses in the UK are young people aged 16 to 24.
Ethnicity
Four out of five pregnant teenagers have ethnic minority backgrounds:
- Black African, 59%
- Black Caribbean, 17%
- Other ethnicities 10%
- Only 14% were white females.
Almost three quarters (72%) were born abroad.
When infected?
One woman was definitely HIV-positive from birth, but as many as 43% of the women might have got HIV as babies from their mothers. These young women were diagnosed with HIV in their teens, but after they begun their sexual lives, so we don't know how they became HIV positive.
Late diagnosis too
Some of the young women were diagnosed at a late stage of HIV : 5% of the young women had already developed symptoms of HIV illness, and 9% had an AIDS-defining condition.
However, most of the women (87%) had no HIV symptoms.
Almost two-thirds of the young women (63%) were diagnosed with HIV during the normal antenatal checks, and the others were diagnosed before they became pregnant.
How infected?
How might these young women have got HIV?
- 1 (but possibly 25) infected from mother to baby
- 42 (63%) migrated from a high-HIV-prevalence country (so possibly mother to baby, possibly sexual, possibly through infected blood or tissue)
- 24 (36%) sexually through a ‘high-risk’ partner, or someone with HIV
Most (92%) were sufficiently sexually active before they became pregnant to have had a sexual health screen the year before, and 45% have had another sexually transmitted infection.
No condoms or contraception
Most of the pregnancies (82%) were unplanned, and only four were taking anti-HIV treatments when they conceived.
- Only 1 in 3 used condoms, and often condom use was inconsistent
- 2 out of 3 didn’t use any contraception.
2nd pregnancies
Despite this, the hospital notes show that less than half (43%) of the new mums were advised about contraception after they had their baby, and not surprisingly 1 in 4 of the women then had a second pregnancy within a year. Contraception advice (and having a baby as a positive teenager) is not enough to prevent conception again. 47% of the second pregnancies followed contraception advice, 88% of the second pregnancies were unplanned and 12% ended with a termination.
Life problems
“Significant and complex psychosocial problems” were very common, for example
- Almost half (45%) were sexually abused
- 58% had housing problems
- 63% had financial problems : only 8% were in paid work, the rest were unemployed (54%) or students (38%).
94% took anti-HIV treatment during pregnancy and for most (81%) this was to prevent mother-to-child transmission of HIV. By the time of the birth 62% of women had an undetectable viral load.
Good results for mums and babies
The investigators emphasise that despite their vulnerability and difficult social and medical circumstances, these HIV-positive teenagers had a “favourable” result – they did well themselves and their babies are fine.
The authors say the good results were due to the “multidisciplinary care the patients received.” This was provided by expert teams working closely together at major London hospitals - HIV physicians, obstetricians, paediatricians and specialist midwifes.
They say their study identifies “a need for more effective strategies in the management of HIV-infected teenagers with particular emphasis on sexual and reproductive health.” To meet these needs, the authors call for the establishment of “a one-stop shop including HIV care, sexual and reproductive health input and psychosocial support in an appropriate environment provided by skilled staff in a sensitive and nonjudgmental manner.”
UK Guidance Managing the sexual and reproductive health of teenagers with HIV
Acute HIV prevention needs of vulnerable teenagers
While this study says nothing about HIV prevention needs, (they were studying how well the the care for HIV positive pregnant teenagers and babies worked), it is very plain that these pregnancies, and teenagers becoming HIV positive exposes a major failure to meet HIV prevention needs.
At least a third of these teenage women were sexually infected with HIV.
Almost all of these teenagers were sexually active in the year before they became pregnant, when they may not yet have got HIV. 92% of them had a sexual health screen in the year before they became pregnant. Almost half have had an STI.
Four out of five have an ethnic minority background; three quarters were born abroad and are migrants.
Most have complex psycho-social needs and are likely to be in contact with other services.
Target vulnerable teens for intensive HIV prevention
All services providing sexual health checks and contraception services to teenage women matching this profile should particularly target HIV information and support services to meet those needs.
The teenagers' male partners are invisible in this study - some must have HIV. There is a risk that those males without HIV might get HIV from their girlfriends, because few of the males are using condoms consistently.
We know nothing about their male partners' ages, ethnicities, whether they are migrants, use of sexual health services, or whether they are also vulnerable because of complex psycho-social problems. We need more information before we can meet the male partners' HIV and contraception support needs.
Source, with reference
Related news - Unplanned pregnancies in teenagers infected from their mothers
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Pregnancy HIV Risks for Men and Women
posted: 17/01/2011
A new study shows that a man's risk of getting HIV from a woman partner doubles when she is pregnant. Other studies have told us that women are more likely to get HIV from men when the woman is pregnant. This is the first study showing that a woman being pregnant raises men’s risk of getting HIV from her.
The results come from the Partners in Prevention HSV/HIV Transmission Study, of 3,210 couples, where one partner has HIV and the other partner does not, in seven African countries.
Pregnancy and HIV infections
61 women got HIV during the two year study period and 28% of these women were pregnant; 57 men got HIV during the two years of the study while 21% of these men's partners were pregnant.
Analysing these results showed that pregnancy roughly doubles the HIV risk for both sexes, but other factors, such as sexual behaviour, makes a difference for some women and men.
Among men, uncircumcised men, and men who did not use condoms, are much more likely to get HIV when their partner is pregnant.
Pregnancy changes biology
One of the study investigators, Dr Nelly Mugo, of the Kenyatta National Hospital and University of Nairobi, and of the University of Washington in Seattle, suggests that biological changes during pregnancy might explain higher female-to-male HIV transmission during pregnancy.
Men should take HIV tests at antenatal clinics along with their partner
The increased risk of HIV infection for men when their partner is pregnant emphasises the need for men to join their women partners and get tested for HIV at antenatal visits.
These study results were presented at the International Micobicides Conference, Pittsburg, USA.
Source
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HIV and Law Book
posted: 28/10/2010
HIV & the criminal law is now for sale. The book was launched as a free web resource during the International AIDS Conference in Vienna, and now you can buy it in print from the NAM shop.
HIV & the criminal law explores the issues relating to the criminalisation of HIV exposure and transmission around the world, with information on current laws and practice internationally.
Produced in a handy A5 size, HIV & the criminal law is normally £34.95, but you can buy it with £5 off, at their special introductory price of £29.95.
Contact NAM for more details, or to place an order, on 020 7840 0050 or by emailing.
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