Category: end
Disadvantage Affects HIV Futures
posted: 25/01/2011
Low incomes and social disadvantage strikingly affects the life and health prospects of people newly diagnosed with HIV, according to a multi-national study.
An international team wanted to find out if sex and ethnicity affect the outcomes people can expect from their HIV treatment and care. The study looked at people in Australia, Brazil, Canada and the US, and found that sex and ethnicity make often striking differences in health prospects for women and men, and for ethnic minority people compared with white people.
Lesson - deal with disadvantages
The lesson the study teaches us “is that socioeconomic factors are a critical influence in determining the likelihood of engaging patients in care. As a result, these factors cannot be overlooked when developing programs that aim to increase the percentage of HIV-infected patients on therapy with undetectable viremia [Viral Load].”
The editorial in the Journal of Infectious Diseases says that social and economic disadvantages “represent complex challenges that are beyond the traditional influence of public health,” but the failure to deal with these, undermines attempts to deal effectively with HIV.
UK – we have the tool but refuse to use it
In the UK, the tool in the policy toolbox that could make a real difference, the new legal socio-economic equality duty on public bodies, has been locked away by the new government. The conservative led government has decided not to implement this part of the new Equality Act.
The government has also introduced a programme of major cuts in welfare benefits, and in funding for the NHS, Councils and community sector, which will all deepen the HIV disadvantages among people in the UK that we already see.
Do sex and ethnicity make a difference with HIV?
The new study looked at eight years in the life of people who were diagnosed very soon after getting HIV. They found that women do worse than men, and people of ethnic minority backgrounds living in the South of the USA have the most HIV-related illnesses.
Even when people take HIV tests and become diagnosed, poverty and social disadvantage remain real barriers to many people attending clinics, taking treatments properly and having a reasonably healthy lifestyle.
This was an observational study of over 2250 people who were diagnosed with early-stage HIV between 1997 and 2007, in Australia, Brazil, Canada and the US. The people were followed for up to eight years.
Women and men
Only 5% of the people in the study are women and most of the women (55%) were of ethnic minority backgrounds. Women had a significantly lower Viral Load (VL) count to start with than the men, but significantly higher CD4 counts (not surprising, since women tend to have higher CD4 counts than men). Three quarters of the men were white.
It seems there were few women in the study because the women were half as likely as men to have symptoms typical of early HIV infection, and so women were much less likely to be diagnosed than men at this early stage of HIV.
Treating women and men
Similar proportions of both women and men began HIV treatment, and their CD4 cell counts matched when treatment began.
But women and men of ethnic minority backgrounds were less likely to start HIV treatment than white men and women. And anyone living in the southern states of the USA was significantly less likely to start HIV treatment.
Six months after treatment started, men and women were as likely to have their viral load fall below 400 and have similar increases in CD4 counts.
Untreated women and men
However, the investigators then analysed changes in the viral load and CD4 cell count of the people who did not start HIV treatment for up to three years. “Despite the fact women had higher CD4 cell counts and lower viral loads at study entry, they subsequently experienced significantly more combined HIV-related and AIDS-defining events,” emphasise the investigators.
Nothing to do with biology: it’s poverty and social disadvantage
After they did their detailed analysis there found no grounds for believing biology is causing women to develop HIV-related illnesses. Instead these illnesses “are the result of socioeconomic conditions.” These include “access to health care, health behaviors, lifestyle and environmental exposures.”
Stark ethnic treatment divide
Stark significant ethnic differences are plainly seen in the numbers of people getting HIV illnesses or an AIDS diagnosis. Eight years after diagnosis
- almost 8 out of 10 (78%) of ethnic minority people in the Southern states of the USA got either an HIV-related illness or AIDS,
- compared to less than 4 out of 10 (37%) of white people living in the same states, and
- compared with a quarter (24%) of white people living elsewhere, and
- about two out of ten (17%) ethnic minority people living outside the South.
USA HIV strategy has three goals: cutting the number of people who are undiagnosed; getting more people to clinics and on effective treatment; and cutting HIV-related health inequalities.
But the editorial points out “the findings from this study threaten the success of each of these pillars.” They therefore call for “a collaborative policy and research effort across all levels of community, government and science.”
Source Aidsmap has references and links to two free journal articles
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April Residential Weekend PLUS
posted: 21/01/2011
The success of the last Residential Weekend PLUS held in September 2010, has led to demand for another, on the weekend of April 1st to 3rd. We are holding it in the Peaks, at Whaley Bridge.
Gay or bisexual man who are interested in taking part need to have attended one of our previous weekends for gay and bi men living with HIV.
Weekend PLUS is to help you take the next 'step up' from your first residential weekend.
We’ve designed Weekend PLUS to provide the maximum time for discussion, reflection and the sharing of your experiences. A key part of the experience for everyone will be an individual reflection session with a qualified worker.
When
Residential Weekend PLUS runs from lunchtime on Friday April 1st to the afternoon of Sunday April 3rd.
Your transport from George House Trust, meals and accommodation at Whaley Bridge are all provided free.
Interested?
There are a limited number of places on this weekend. If you would like to join the weekend please email Colin Armstead, Service and Development Manager to say you are interested.
What some men said about the last Weekend PLUS :
The weekend really helped me to identify where I am now - and to look clearly at what I need for the future
I learned so much from the other men and really now feel focussed on making positive changes
It helped me connect, and gave me support and direction
Residential Weekend PLUS is financially supported by
Image : Whaley Bridge canal basin © Copyright Bill Booth and licensed for reuse under this Creative Commons Licence.
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HIV Money for Councils
posted: 21/12/2010
The Government have now said how much each council will receive for HIV social care in the next two years. This used to be paid as 'AIDS Support Grant'.
Increased Grant
Remarkably the funding identified for ‘AIDS Support’ is increased from £25.5 million this year (2010/11) and will rise to £36.2 million by 2014/15.
HIV community organisations worked hard to keep the amount for HIV listed within the overall grant to councils. This will mean people can ask what this HIV funding is really being spent on.
psending Ring-Fence Gone
The bad news is that this HIV money is no longer 'ring-fenced'. This means the council could spend the HIV money on anything. We need local people to help be our eyes and ears and put pressure on councils to spend the cash on HIV and nothing else.
MPs welcome increase
“This is a huge achievement.” said Simon Kirby MP, Vice Chair of the All Party Parliamentary Group for HIV and AIDS, who pushed for this increase. “With many councils having to make savings of up to 10% this year, there is no doubt that there will be pressure on all services including HIV services. But if councils receive a specific named ‘AIDS Support Grant’ people living with HIV have a good case to argue that the money should be spent on them.”
The All Party Parliamentary Group policy adviser, Veronica Oakeshott, says that HIV campaigners will still have a fight on their hands to ensure the grant “does what it says on the tin.”
Cuts presssure
Because of the cuts to council spending the government announced last week (the maximum 8.9% cut hits Manchester and other councils) there are great financial pressures on local authorities. Councils will be tempted to spend this HIV money on other, more popular services.
We encourage people to tell their local authority to spend all its 'HIV/AIDS Support' allocation on social care for people with HIV.
Tell your councillors what they should be spending on HIV
You can find details of your local councillors using your email address and then send an email at WriteToThem
NW England table showing HIV funding (April 2009 to April 2013) from central government to councils that provide social care services
HIV money for each council for the year April 2011 - April 2012
HIV money for each council for the year April 2012 - April 2013
More information on HIV social care on NAT's website
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HIV An Agenda for Action
posted: 09/11/2010
Would you please sign the HIV Agenda for Action and encourage others to join in? The Agenda for Action is six aims that will make a major difference to HIV in the UK. The Agenda for Action is for everyone – Government, business, trade unions, healthcare workers, MPs, the voluntary sector, individuals. NAT (National AIDS Trust) are encouraging all to sign up and pledge to help achieve the aims and practical steps.
The weight of your support is invaluable in campaigning work.
The Agenda for Action Aims are:
- To ensure that there is a national strategic approach across the UK to tackling HIV
- To reduce rates of HIV transmission through effective prevention
- To significantly reduce the number of people with HIV who are diagnosed late
- To address the current failings in treatment, care and support for people living with HIV
- To make rights, equality and respect a reality for people with HIV in the UK
- To deliver effective commissioning of HIV that addresses local need.
More information about the Agenda and the practical steps to achieve it (and pictures from its launch).
Add your support
Please show your support by emailing NAT
NAT want all organisations and individuals to sign up to the Agenda for Action and its aims.
download Agenda for Action
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Rise for HIV in Spending Review
posted: 09/11/2010
The Government has commited itself in the recent Spending Review to include specific amounts for HIV social care needs within the local authority grant for the next five years. Remarkably the funding identified for ‘AIDS Support’ is increased from £25.5 million this year to £36.2 million by 2014/15.
George House Trust and other HIV organisations have been in a campaign over the last few months lead by NAT (National AIDS Trust), to persuade the government to at least specify an amount for HIV within local authority budgets.
Following the Spending Review all the grants for special needs – including the AIDS Support Grant – are absorbed into the block grant given to councils, known as the Formula Grant.
However, the government says it will tell councils how much of their Formula Grant is for HIV. These are the figures.
Deborah Jack, Chief Executive of NAT, says:
‘NAT is extremely pleased to see a commitment from the Government to increase funding for HIV social care following our recent campaign. This commitment shows an acknowledgment of the importance of funding these services, and recognition that the rising numbers and ageing population of people living with HIV will result in both continuing and increasing social care needs within this group.
‘However, we do remain concerned that with the removal of the ring-fence around this funding and the increased emphasis on local flexibility, there is a risk that HIV social care funds could be spent elsewhere. NAT encourages all local authorities to ensure the needs of people living with HIV in every area are met, and this means using the funding committed to HIV social care to provide the services necessary.’
Further information (including the figures above) are in a
letter on Local Government and the Spending Review from the Secretary of State for Communities and Local Government
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