End HIV Dentists Ban

posted: 26/10/2010

A call has gone out to end the Department of Health ban on people with HIV from treating dental patients. The ban continues despite the evidence that there is no risk of transmission.

A spokesperson for Dental Protection, who are indemnity providers, says: ‘It is 20 years since the draconian rules were introduced preventing dentists (and other healthcare professionals) from providing treatment to patients.

‘Initially introduced as a precautionary measure soon after the mysterious case of Dr Acer, a dentist in the USA who was thought to have infected six patients, there has never been any other recorded transmission of the disease in a dental setting.'

Out of date ban forces out of work

Meanwhile many UK dentists – along with dental hygienists and therapists – have lost their livelihood because they have been forced to stop working in their chosen profession.

Dental Protection continues: ‘On being given their own diagnosis they were told to “clear their desk” with immediate effect.'

Europe, Australia, USA – Dentists with HIV: no problem
HIV treatments now effectively control HIV, so that the levels of HIV in the blood are too low even to measure. This, with the high standard of infection control that is demanded of dentists, means that this outdated ban on dentistry for people with HIV has disappeared in much of Europe, Australia and the USA.

International declaration from Beijing
The Beijing Declaration from the 6th World Workshop on Oral Health and Disease in AIDS in April 2009 highlighted the outdated stance currently adopted by the Department of Health.

Department of Health discrimination?
The Department of Health in England’s failure to update its ban and guidance despite the consensus of evidence-based opinion means the Department risks complaints of discrimination.

Standing up for dentists with HIV
In calling for greater fairness and a more consistent application of the evidence, Kevin Lewis, director of Dental Protection, says: ‘Dental Protection has championed the cause of HIV-infected dental health professionals for more than a decade in several parts of the world and will continue to take action against this kind of unfair and discriminatory treatment of its members.

‘The international evidence base is overwhelming and the Beijing Declaration unequivocal in confirming that HIV infected dentists can continue to practise safely with no risk to patients, subject only to some very clear and manageable criteria being met.

‘In every other area of professional activity, dental health professionals are directed to follow the evidence base, but HIV has for too long remained a singular exception – during which time careers have been destroyed, lives have been devastated and patients have been deprived access to safe dentists.'

He continues: ‘The time has come to acknowledge the evidence and stop running scared of ill-informed public perception and media scaremongering. It seems to be forgotten that infected dental health professionals are also patients themselves and they should they be treated no less fairly than other patients. The sound of foot-dragging has been deafening and some immediate action needs to be taken to bring the UK guidance out of the previous century.'
 

Source

HIV Prevention for Africans in England

posted: 12/10/2010

KWP in Practice is a new website and planning toolkit for meeting the HIV prevention needs of African people in England. The site combines and updates the two key documents, The knowledge, the will and the power, and the African HIV prevention handbook, which were both produced by Sigma Research for the National African HIV Prevention Programme.
 

Whether you fund HIV prevention for African people, or you plan and deliver these, the website's modular, practical, toolkit approach has something to offer.
 

Condom use briefing

The new website has a useful new detailed Briefing on condom use among African people in England.

In the Bass Line survey undertaken with more than 2,000 African people in 2008-09,

• one third (30%) of those who had used condoms said that one had slipped or broken off in the past year.
• More than one third (32%) said they would worry about what others thought of them if they carried condoms.
• One fifth (20%) said they sometimes had problems getting hold of condoms.

Condoms and Africans in England seminars
 

You can also book a place at a seminar about condom use among Africans in England, in either Leeds or London.
 

These full-day seminars are for service providers, clinical staff and commissioners who want to learn and share experiences of meeting the needs of African people regarding to male and female condoms. Sigma staff and local experts will lead a day of practical discussion and debate.

The seminars start at 10:30am and end at 16:30pm.
 

Book the Leeds condom seminar Tuesday 26 October 2010

Book the London condom seminar Wednesday 3 November 2010 

More HIV Testing Urged

posted: 08/10/2010

The NHS health advice body NICE has produced its first HIV guidance, about HIV testing. The draft HIV testing guidance recommends that mainstream health services offer much more HIV testing to the two communities most affected by HIV in England, black African people and to men who have sex with men. The guidelines also call for more testing to be offered in places such as bars and saunas, using rapid point-of-care tests.
 

NICE HIV testing: open for comments
The National Institute for Health and Clinical Excellence (NICE) tells the NHS which are the best and most cost-effective treatments and public health interventions. NHS bodies are legally required to fund the medicines and treatments recommended by NICE.
 

Making HIV testing guidelines work
Other organisations have produced HIV testing guidelines before, notably the British HIV Association (BHIVA) and the British Association for Sexual Health and HIV (BASHH). But these were not backed by the UK National Screening Committee, nor by NICE, and many parts of the NHS simply ignored them.

The most recent BHIVA and BASHH testing guidelines recommended that HIV testing should be offered in a wide range of healthcare settings, including GP surgeries and most hospital departments. Little was done about this.
 

NICE will force more testing action
To increase testing, the Department of Health asked NICE to produce public health guidance to increase HIV testing both among men who have sex with men and among black African communities. The new NICE guidance supports most of the BHIVA and BASHH testing recommendations, and goes further with some recommendations.
 

There are two guidelines - one to increase testing in men who ave sex with men, and a the other for increasing testing among black African people.
 

Local strategies needed

For both men who have sex with men and for black Africans in England, NICE recommends preparing local strategies to increase HIV testing, developed in consultation with community organisations and the people affected. These strategies should focus on sections of the community who are less likely to use services. Community engagement and involvement is particularly important for black African communities.
 

Africans - involve people as champions and leaders
NICE recommends that black Africans in England should be recruited and trained to act as ‘health champions’ and ‘role models’. HIV testing work must deal with people’s misunderstandings and ignorance about HIV, testing and treatment, and must promote the benefits of early diagnosis and tackle HIV-related stigma.
 

The guidance for black African communities includes providing HIV testing outside sexual health clinics. This is because the evidence from the literature is that HIV testing in sexual health clinics is seen by some black Africans as stigmatising, complicated and time-consuming, while HIV testing in other healthcare settings was welcomed.
 

NICE recommends that general practitioners should routinely offer an HIV test to black Africans who have not tested before or who have had a new sexual partner since the last negative test. In hospitals and other healthcare settings, an opt-out test should be routinely provided to black Africans who are having blood taken for other reasons.
 

Testing in sex venues to reach gay men
Health promotion interventions promoting testing to men who have sex with men should include venues, such as saunas, clubs and cruising areas, or websites, which facilitate sex between men.
NICE appears more enthusiastic than BHIVA about community testing in sex on the premises venues. In gay venues, NICE says rapid tests (using mouth swabs or finger-prick blood samples) should be provided by trained staff, in a secluded or private area.
 

NICE’s guidance for men who have sex with men encourages testing in primary care (GPs), but not in secondary care (hospitals). The BHIVA guidelines are different, and recommend that all healthcare settings should offer an HIV test to any man who says he has sex with other men.
 

NICE recommends that GP surgeries should recommend all males to have HIV tests where the surgery is in an area with a large gay community or theer is a high rate of HIV.
 

Carl Burnell, of the gay men’s health charity GMFA, questions whether this will is work, because of the many other demands on GP surgery capacity. “The strategy assumes that other services are running like clockwork and have capacity to offer HIV testing,” he said.
 

Clear path from testing to services
All testing services need clear pathways for people to obtain any necessary confirmation of the HIV test result, HIV treatment services and HIV support groups. People who test negative may need help through counselling and safer sex interventions.
 

The draft guidance comes before results are published on several Department of Health funded pilot projects evaluating new testing strategies.
 

NICE’s guidance is open for feedback and comments until late November. The final NICE HIV testing guidance will appear in March 2011.

HIV testing guidelines for MSM 

HIV testing guidleines for black Africans in England
 

Source

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

Africans HIV Prevention in England

posted: 23/06/2010

HIV prevention among black Africans in England describes the major prevention challenges and highlights the actions that are needed and details the sexual health needs of Africans in England. It’s a useful briefing paper with helpful information on where to find more information and guidance. It is one of a series of briefings from the Race Equality Foundation.

Its key messages are that

• Black Africans in England have the highest rates of heterosexually acquired HIV. Black Africans are about 1% of the population, but have nearly half of new HIV diagnoses. Many of these infections occurred abroad, but a rising proportion happen here.
• The majority of black Africans in England are tested for HIV very late; this makes onward HIV transmission much more likely. Most, particularly men, are diagnosed at such a late stage that treatment does not work as well as it should. This cuts the quality and length of life.
• There are many more same-sex relationships than reported among black Africans in England. Often men have relationships with both women and men.
• The sexual health of black African communities is worsened by many socio-economic factors.
• There are many unmet sexual health and social needs among black Africans living in England, making people far more vulnerable to HIV.

It concludes with a shopping list of the main unmet needs that require action. These include

• Late HIV testing and undiagnosed HIV are serious issues. All myths and misconceptions about testing and treatment need challenging to encourage testing. More information about the available services, and more support to encourage their use are needed, particularly to reach men and new migrants. There need to be good referral systems within and between organisations.
• Prevention interventions and information should target people with lower education, and young black Africans. People, including late teenagers, lack basic information concerning condom access and use and negotiating safer sex, for example. Interventions should target heterosexual men and men who may have sex with men.
• Educating men especially about consistent condom use is critical because many women are vulnerable to HIV infection due to socio-economic factors, lacking the power or authority to safely insist on condom use. Positive women often face the same problem with negotiating in safety for condom use to avoid onward transmission. Condom distribution, including of female condoms (femidoms), needs to be intensified to improve condom accessibility.
• People diagnosed with HIV should be involved in the development and implementation of interventions (sometimes called ‘positive prevention’), because people with HIV have a key part to play in halting onward transmission and reducing HIV-related stigma and discrimination. However, ‘positive prevention’ needs to respect human rights and dignity, incorporate shared responsibility and avoid reinforcing HIV stigma and discrimination.
• Service providers working with Africans should be aware of HIV trends in the countries of origin of their service users, and the local prevalence data in England, in order to plan and target their interventions appropriately. NW England annual district level detailed HIV statistics
• The majority of black Africans are involved in various religious faiths, making religious leaders key contacts for reaching wider audiences. Interventions should be sensitive to faith issues. Many religious leaders would benefit from training in HIV issues.
• Service providers should recognise that there are many more same-sex relationships among black Africans than reported, and tailor their services appropriately. Providers should not assume having same gender sexual relationships has much or any connection with the gay and bisexual sexual identities familiar in England. However services should also seek out Africans who do have gay or bisexual identities. Whatever the sexual identity a person has, it is same sex behaviour that gives rise to significantly higher HIV transmission risk and unmet sexual health needs than with exclusively heterosexual black Africans.
• There is a need for continuous information, education and communication on HIV and sexual health, targeting not just black Africans but also the general population, in order to reduce stigma and discrimination, which undermine the impact of current interventions. Tightly targeted interventions risk increasing HIV stigma among and directed towards black Africans.
• GPs (family doctors) can play a leading role in HIV diagnosis among black African communities. This needs handling with sensitivity. 

HIV prevention among black Africans in England