Category: over
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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Rise in Extreme HIV Poverty
posted: 19/10/2010
A new UK report shows one in six people with HIV are living in poverty. The new report on Poverty and HIV by NAT (National AIDS Trust) and Terrence Higgins Trust (THT) reveals at least one in six people diagnosed with HIV in the UK experienced severe poverty between 2006 and 2009. Furthermore, the level of poverty experienced by people living with HIV has dramatically increased over recent years. In the current climate – and without determined Government action – the poverty crisis for many people living with HIV will get even worse.
The HIV welfare charity Crusaid ran a welfare fund until it merged with THT earlier this year. This report looks back at the recent evidence of HIV poverty from all the applications for help made to Crusaid in the last three years.
Income falls two thirds in 10 years to £42 a week
People paid grants from the Crusaid Hardship Fund, now run by THT, had an average weekly income of just £42 per week – two thirds less income than the average person who claimed 10 years ago (£93). In addition, many have no income at all. Most applicants are now living in extreme poverty, living on only 20 per cent of the average income for a single person.
Nick Partridge, Chief Executive of THT commented:
“The level of poverty people with HIV are experiencing across the UK has dramatically increased over recent years. Where the Hardship Fund used to buy people a fridge, or pay for respite care, now it mainly goes on basic survival – food, clothes, a bed.”
Causes of HIV poverty
The report analyses the underlying reasons why people with HIV face poverty. Over a quarter (29 per cent) of applications to the Hardship Fund gave the immigration system as the main reason for poverty. In October 2009, the Government support for single asylum seekers was reduced from £64.30 to £35.13 a week - just £5 a day. A further 17 per cent of people said that problems relating to the benefits system were the main cause of hardship. These problems included awaiting a benefit decision, changes to the benefit system, or delays in receiving benefits they were entitled to.
Deborah Jack, Chief Executive of NAT (National AIDS Trust), commented:
“Charities are picking up the pieces of a poverty crisis in the UK, but there is only so much the sector’s limited funds can do. The Government needs to address the underlying causes of this hardship, some of which it has been responsible for creating. Granting asylum seekers the right to work after six months and ensuring people are not left in poverty while waiting for their benefits to be processed are two crucial steps that would release many people with HIV out of the poverty trap.
20 ideas for change
The report makes twenty recommendations that would address the root causes of poverty amongst people living with HIV.
Benefit delays make homeless
James, 35 years old and HIV positive, is homeless and sometimes sleeps on floors at friend’s houses and occasionally in shop doorways. He came to the UK as an asylum seeker and was granted leave to remain here. He was then no longer eligible for housing with his asylum support, so he applied for housing benefit but he did not receive any payments. An investigation revealed that backlogs in dealing with benefits claims meant that by the time James’ claim was processed he was homeless and therefore did not qualify for the benefit. James was one of 7,900 people with HIV in the UK who relied on a grant from the Crusaid Hardship Fund in the last three years to pay for basic needs.
George House Trust
In 2009-10 George House Trust assisted 712 people with 3160 grants through both Crusaid and our own HIV welfare fund. George House Trust paid out £112,000 in grants to people with HIV in NW England in that year.
Poverty and HIV - download here
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Disadvantages for HIV+ Over 50s
posted: 22/07/2010
Older people with HIV face many disadvantages, study finds
Most people with HIV aged 50 and over can expect to live a near normal lifespan thanks to modern HIV treatments, but are substantially more disadvantaged than their people of a similar age who don’t have HIV.
According to 50 Plus, the first national study of ageing and HIV, launched in Vienna at AIDS 2010, the 18th International AIDS Conference, older people living with HIV have worse health, are poorer, and fear for the future.
Other health problems common
Findings show that older people living with HIV are twice as likely to experience other long-term health problems alongside HIV, such as high blood pressure, kidney and liver problems and arthritis, with two thirds having treatment for these other conditions.
Worse off and money worries
Older people with HIV are financially worse off than other people of the same age without HIV. Older positive people are less likely to be working, less likely to have savings or pensions for their retirement and more likely to be on state benefits. Many have serious financial worries about the future. Older people with HIV are less likely to be homeowners and more likely to live in social or private rented housing. One said: “Since I was diagnosed in 1985 I regarded this as a death warrant and ceased to make any pension provisions.”
Good health information is top priority
Older people with HIV say having good quality health and treatment information is their highest priority, but three quarters fear needing health and social care in the future. As another person said: “I also fear that, in case I need to be cared for, the carer would be as ill-informed and prejudiced about HIV as the rest of the general public.”
Involving older people
The 50 Plus survey was designed with older people living with HIV, and it investigated the needs and concerns of 410 people, to help raise awareness of the issues that this group face and to collect evidence of the specific social care needs.
The 410 people surveyed are one in 25 of all the people aged 50 and over who are using HIV clinics in the UK – there are now well over 10,000 over 50s with HIV, with almost 1000 in the NW of England. Within the next ten years the number of over 50s with HIV will almost double.
While most over 50s living with HIV are gay men and white, there are numbers of heterosexual men and women including Africans, among other ethnic minority people.
Terrence Higgins Trust’s Head of Policy, Lisa Power, said: “As a result of effective treatment options, and our ageing population, the over 50s are now the fastest growing group of people with HIV in the UK, and there’s a long way to go regarding support for this group. Older people with HIV are living with high levels of uncertainty about their future health and social care and need substantially more support than their peers.
“The information we’ve gathered through ‘50 Plus’ is vital in giving us a better understanding of the unique problems that older people with HIV face on a daily basis in the UK. With this insight we can develop support services that are fully tailored to this group’s needs to ensure they have the same quality of life as their peers.”
Other key lessons
Other findings from the report show that:
- Older people with HIV are a rapidly growing and diverse group. The majority of this group are gay and bisexual men but there are also high numbers of African migrants and white heterosexuals. Some are long-term survivors, whilst others have been recently infected - one in five (21%) were diagnosed in the 1980s but the greatest number (41%) were diagnosed since 2000.
- Whilst older people with HIV think very well of their HIV clinicians, many report poor experiences in primary care, including discrimination, ignorance and a low standard of clinical treatment, and use their GPs and generalist healthcare services less than older people in general. Many also fear that social care services, care homes and sheltered housing might be HIV prejudiced and/or homophobic.
- Many report feeling isolated and would like more social contact and support. Most prefer to find this through HIV organisations.
- Most were open about their HIV status in key relationships and usually get positive reactions; however, telling others about having HIV is still seen as risky.
In response to these research findings, Terrence Higgins Trust, Age UK and The Joseph Rowntree Foundation made five calls for action:
- Improvements in healthcare to ensure access to good quality treatment in all settings and availability of better information to older people with HIV.
- Better employment support, money management courses and benefits advice.
- Action to deal with homophobia, HIV discrimination and ageism in all services, but especially in social housing, sheltered housing, care homes and health services (particularly primary care).
- Improved emotional support and opportunities for social contact, to prevent isolation.
- Greater cooperation and information sharing between organisations and services for older people, and those for people with HIV, to improve policy and practice.
Michelle Mitchell, Charity Director at Age UK, said: “This report clearly shows that the problems many of us face in later life, such as financial pressures, deteriorating health and isolation are all exacerbated by the impact of HIV on people’s lives. Now people are living far longer with HIV than ever before, we need to shift the focus on support services to improving quality of life. To achieve this, it is vital that we increase awareness and understanding of the needs of this group across a range of health, social care, housing and advice services.”
Terrence Higgins Trust, Age UK and other HIV organisations like George House Trust, will be using the findings to help development services.
50 Plus 4 page summary available now
The full 50 Plus report will be available from October 2010 at The Joseph Rowntree Foundation
Further data, including all statistical charts and the full literature review, will appear in the autumn in a special section of the THT website.
About the study
50 Plus research was conducted through an online and paper questionnaire and 40 in-depth interviews from a sample of adults aged 50 or over with HIV across the UK in 2009. The 50 Plus report is was based on the survey findings. The questionnaire was devised with the support of a Community Advisory Panel and interviews conducted by trained community researchers living with HIV. A literature review and visits to existing ageing and HIV work in the US were also undertaken. Age UK is the name for the merger of Age Concern and Help the Aged. The Joseph Rowntree Foundation (JRF) is one of largest social policy research and development charities in the UK. It aims to influence policy and practice by searching for evidence and demonstrating solutions to help overcome the causes of poverty, disadvantage and social evil.
Source
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HIV Hardship Fund ‘Soon’
posted: 05/07/2010
Following Crusaid’s merger last month with Terrence Higgins Trust (THT), THT have vowed to re-open the Crusaid HIV hardship fund "as soon as possible." The hardship fund provides vital financial assistance to people living with HIV.
After addressing thousands of people at Pride London's Trafalgar Square stage, Lisa Power - Corporate Head of Policy at THT - told PinkPaper "The most important thing I have to say today is that we are going to re-open the hardship fund as soon as we can, within the next few months. After that, we're going to make sure it has a long-term future. And that it helps people to help themselves.”
"We've just done a big research project with the Joseph Rowntree Foundation which shows that older gay men with HIV are in far more poverty than their peers, so we know that there's a real issue out there. As people survive longer with HIV, it's not just about the pills keeping you well, but also the quality of your life".
When asked about the criticisms surrounding THT's recent merger with Crusaid, Lisa Power rebutted complaints that they are monopolising the HIV and STI community health sector. "We merge with people who approach us, which is what Crusaid did. The issue is about making sure services survive. We represent economies of scale. We represent a whole load of stuff that is available, which smaller organisations can't do alone."
Source
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HIV Treatment Charging Harms
posted: 28/06/2010
The UK rules that mean some migrants have to pay for HIV treatment are harming the health of migrants and the UK public, says a new study in the journal AIDS Care.
The study of African migrants with HIV in London found some migrants delay taking HIV tests, some only go for HIV treatment when they are so sick they need an ambulance to take them to hospital, some use herbal treatments that don't work, and others send abroad for HIV drugs but don't take enough of these.
Findings and the government review
This Wednesday the government ends its public consultation on changing the rules and guidance about who has a right to free NHS treatment. Anyone who has a sexually transmitted infection (STI) or an Infections Disease always has a right to free treatment, but not if they have HIV. The proposed new rules and guidelines still bar some migrants from automatic free HIV treatment. While asylum seekers and those with leave to remain are entitled to free care in NHS hospitals, refused asylum seekers and undocumented migrants, including pregnant women with HIV, among others, are sometimes handed very large bills for HIV and other medical treatment.
The researchers interviewed HIV-positive migrants from Zimbabwe, Zambia and South Africa who live in London. 70 people took part in eleven focus group discussions.
Problems getting a GP
Even though there is no law stopping migrants from having a GP or free primary care, people said they had problems even registering with a GP. They are often asked to show documents that they do not have (for example, their passport – these are often held by the Home Office / UK Borders Agency because they are making an asylum claim or other application).
Waiting until you need an ambulance
The law says all treatment in a hospital Accident & Emergency department is free-of-charge for everyone. Many people in the survey knew this, and said they did not try to get treatment until their condition was so serious that an ambulance was needed. One man said:
“You would rather wait for a situation where you get taken to hospital by ambulance because even if you walk in they want to know who is your GP. And if you don’t have one they become very suspicious.”
Accident & Emergency (A&E) treatment is extremely expensive to provide. Moreover, in most cases, the person then needed immediate HIV treatment and a lengthy stay in hospital.
The rules say if you are admitted to a hospital ward after A&E, or are referred to another department (eg the HIV clinic) then you will be charged; but HIV treatment should always be provided because it is 'immediately necessary.' If you can't pay the bills, the hospital will have to cancel the debt anyway.
Some people had received bills for several thousand pounds for hospital admissions, surgery and treatment. The researchers found that these experiences often affected people’s feelings toward health providers.
In hospital but fearing bills and immigration
People who were entitled to free NHS care feared intrusive visits from immigration and hospital officials. For example one woman who had been recently diagnosed with HIV received a bill for hospital treatment:
“I was worried how am I going to pay this £4000? So what kills you first is the stress and worry . . . I found myself thinking if I did not have indefinite leave to remain in this country then what would I do?... You’d just try to go away, you’d remove the drip and run away from there before immigration got there.”
Do it Yourself treatment
Some people said they treated themselves. Some sent for drugs in their home countries, but said they took too few pills for them to work properly, for example. Some had depended on herbal remedies and other alternative treatments, and sometimes delayed taking a HIV test until it was clear herbal and alternative treatments were not working. One woman said:
"There are some people who do not have papers in this country, who can’t have access to a GP or a hospital and they have to rely a lot on the traditional medicines."
Although HIV testing is free for all (on public health grounds), HIV treatment is not. People said this discouraged others from HIV tests:
“If I cannot access services, then there is no reason for me to test. If I test and I know I’m HIV-positive, I know it will be very difficult to access [treatment].”
The researchers end by saying that current policies for charging some migrants may appease a part of the UK electorate but act as a barrier to the uptake of HIV testing and treatment. Moreover, these policies are pushing some people to resort to other forms of treatment that may be costly, harmful or ineffective. As well as having implications for the health of individuals, the policies are likely to have an impact on the onward transmission of HIV.
Campaigning for free HIV treatment for all
This Wednesday the Department of Health closes its public consultation on planned changes to the rules and guidance for free NHS treatment. This does not include adding HIV to the list of sexually transmitted infections and infectious diseases that would mean free treatment for everyone. George House Trust and the HIV sector are campaigning for free HIV treatment for all.
Source and reference
Thomas F et al. ‘‘If I cannot access services, then there is no reason for me to test’’: the impacts of health service charges on HIV testing and treatment amongst migrants in England. AIDS Care 22: 526-531, 2010.
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