Manchester Art Gallery World AIDS Day Events

posted: 19/11/2010

George House Trust and Manchester Art Gallery are working together on two events to raise awareness about HIV and challenge HIV related stigma.

The first event is a Family Art Day on Saturday 4th December from 1pm-3pm. This event is open to all families with children aged 6-11 years old and is free. The event is themed around World AIDS Day and using the UK AIDS Memorial Quilt to raise awareness about HIV. The event is completely free. Please arrive at 12:30pm to sign up for activities at Manchester Art Gallery, Mosley Street, Manchester M2 3JL.

The second event is an Imagine Weekend on Saturday 11th and Sunday 12th December, 12noon-4pm open to adults and to families with children of any age. The event will focus on making a work of art from Red Ribbons. This event is completely free. No need to book - just drop in.

Please note that both these events are open to the general public and all activities will be delivered by Manchester Art Gallery staff, not staff from George House Trust. We therefore cannot guarantee confidentiality, if you choose to share personal information at these events.

You can find further information at: http://www.manchestergalleries.org/

Comforted Creatures with HIV

posted: 04/11/2010

We produced this animation (with apologies to Ardman Animation’s Creature Comforts) as a serious but amusing presentation on some of our work, for the Elton John AIDS Foundation.

We interviewed people with HIV who have benefited from our positive prevention work and residential weekends, funded by the Elton John AIDS Foundation.
 

Excellent Presentation

After presenting all our work to the Foundation's panel, they told us:

George House Trust were the first to present and I have to say set a standard that was not replicated. If there was ever a lesson on how to do an interesting presentation, that was it.

Lynda and Colin spoke with passion about the work, the achievements so far and the publication of initial outcomes (they had the BHIVA/NHIVNA poster displayed).

An individual talked very openly and honestly about how he had benefited from the programme and to top it all we were treated to an animated film with people’s real experiences of the support and help they had received.

A perfect presentation with something for everyone - excellent! 

Watch and listen at George House Trust on Facebook

Public Health Watch

posted: 29/10/2010

Updating of public health rules means public authorities in England and Wales have powers they can use against individuals with HIV to protect the public health from 'infection or contamination'. Magistrates can make compulsory public health orders (known as Part 2A orders) on people. Similar powers were used in Manchester against a man with HIV in 1985.

Late in 1985, just after Manchester AIDS-Line (later George House Trust) was set up with the help of a small grant from Manchester City Council, the same council used its public health powers backed by a magistrate. It compulsorily detained a man with HIV at Monsall Hospital. Major protests followed and, after a court case, he was freed to leave hospital a few days later.

This was the first and only time public health powers have been used against someone with HIV in this country. You can read more about this here.

New Health Protection Regulations

These old public health powers have now been updated in new Health Protection Regulations. Helpful guidance has been produced by the Department of Health on how to use (and not use) these powers.

This makes clear that in almost all cases using these powers to manage the risk of HIV or STI transmission would be inappropriate and should only be considered, if at all, in the most exceptional of circumstances.

HIV community and clinical organisations like BHIVA and BASHH oppose the use of these powers against people with HIV. They would cause more harm than good, damaging trust in STI and HIV clinic confidentiality, increasing HIV hate and discrimination, and would only ever be a short-term fix for someone with a life-long health condition.

More information

More information on the new public health powers and HIV can be found at the NAT website.
 

The official guidance makes clear that Part 2A orders 'are not a tool for managing long-term problems' and that the orders:

• are not meant in any way to change the current system and culture of confidentiality within sexual health services
• are not to be a routine part of managing those with HIV who present with evidence of ongoing unsafe sex (for example by presenting with repeated STI infection)
• are not generally appropriate for contact tracing
• could have harmful consequences for wider trust in sexual health services
• and that in the very exceptional circumstances where a Part 2A order might be considered, advice should be sought from the treating clinician and clinic director as to the possible consequences of such an order, and confidentiality must be respected at all times.

Even with this guidance, these powers could be misapplied to people with HIV or another sexually transmitted infection.

We, and NAT, are keen to hear about any attempts to coerce someone with HIV, through the use or threatened use of these powers. We do not expect the powers to be used, because the old powers were only used once against someone with HIV, 25 years ago, and have not been used again since. But it could happen. 

Department of Health: Health Protection legislation guidance 2010, laws and regulations

Your HIV Aware Ideas?

posted: 20/10/2010

What would people around us do differently if they were HIV aware? For this year’s World AIDS day (Wednesday 1 December) people living with HIV are asked to suggest ways people can show they are ‘HIV aware’.
 

This year's UK World AIDS day theme is Act Aware and it is all about taking action to tackle HIV prejudice and to protect yourself and others from HIV transmission.

Making the world HIV friendly
NAT (hosting the UK World AIDS Day website) plan to encourage people to visit the World AIDS Day website and make a personal pledge about how they will Act Aware.

Wanted: your suggestions
That’s how people with HIV can help – NAT want your suggestions of the sort of things you would like to see people do in a HIV-friendly world.

All NAT want is a short sentence for World AIDS Day. It’s really easy – write your words on this page

The suggestions and pledges will inspire people to do something to Act Aware and make our world more HIV friendly. You can give a name and location, or be anonymous.

What people living with HIV have already suggested on the website ...
 

I would like to see society's attitudes change, so that I don't feel that I have to hide the fact that I have HIV     Alan, London
 

I would like people who are living with HIV whom are confident to do so, to share their own stories about how they have overcome the barriers and challenges of living their everyday lives      Danny
 

I would like everyone to think seriously about HIV and what it means to live with HIV - and therefore be realistic, aware and practical when it comes to safer sex      Maurice, London
 

I would like there to be a focus on education and stigma within younger groups of people, with attention paid to cultural differences and needs      Richard
 

I would like to see more positive role models of people living with HIV      Danny

Please either add yours to this webpage OR e-mail it to NAT 

World AIDS Day 2010 – Act Aware

Social Care - Feast To Famine

posted: 08/10/2010

Feast to Famine? HIV Social Care and the AIDS Support Grant is a report on social care for HIV in England, by Andrew Pearmain, HIV Consultant Practitioner, Essex County Council. As part of this investigation he spent time at George House Trust.

What is the future for HIV social care with the end of the ring-fence protecting the AIDS Support Grant? This report looks at the current provision of local authority HIV social care, recent changes, how people find and receive HIV social care services,  how HIV social care is organised, and the community sector’s contribution. Here's the executive summary; you can download the full report by clicking here or on the image of the report cover.

1. Introduction
• Around 86 HIV-specialist social workers are supporting around 9000 people with HIV/AIDS in England; most HIV social workers have an ‘open’ caseload of around 30, including between 5 and 10 ‘active’ at any one time, and around 70 more who have recently had or will soon need support.
• The ‘de-ring-fencing’ of the AIDS Support Grant poses a major threat to HIV statutory and voluntary social care.
• HIV social work has been steadily declining, partly because of the reassertion of the ‘medical model’, but also because social services have rarely embraced it. As “good old-fashioned social work”, protected by the ASG from service plans, eligibility criteria and funding constraints, it has remained separate and untypical. For most people with HIV/AIDS receiving statutory social care, HIV social work is the service.
• This report is based on visits to sixteen local authorities in England, chosen to represent different regions, social and demographic characteristics, models of service delivery and levels of HIV infection. Research included interviews with HIV social workers, their managers and commissioners, and HIV voluntary workers, observations of visits to service-users, and related background reading.
• The most notable feature of HIV-specialist social care across England, twenty one years after the inception of the AIDS Support Grant, is its extraordinary diversity.

2. HIV Social Care: A Brief History
• HIV social care developed, towards its mid-1990s heyday, in the absence of effective medical treatments for HIV infection. The voluntary sector led the way, with a heavy emphasis on self-help and mutual support, and this shaped the statutory response.
• Gay men were disproportionately affected by HIV/AIDS, and service responses were heavily influenced by gay politics, cultures and values. The state only acted when HIV infection threatened to ‘cross over’ into the ‘general population’, but it was surprisingly ‘liberal’ in its confidential, non-judgmental support and universal alarm.
• The 1987 AIDS Control Act set the legislative framework; the AIDS Support Grant was established in 1989 to promote HIV ‘community care’ and ‘joint working’ with the NHS and the voluntary sector.
• HIV social work grew and spread steadily, with a strong sense of ‘trailblazing’ radical mission; this included pioneering and highly effective programmes of ‘AIDS Awareness Raising’ across social and other public services.
• The introduction of ‘care management’ in the 1990s created sharpening and debilitating tensions between generic and specialist social services. At around the same time, the experience of living with HIV/AIDS was being transformed for many people by effective anti-retroviral drugs, which revived ‘the medical model’.
• Changes in the HIV population since, specifically the growth in black Africans, have revived HIV stigma in new forms, challenged all HIV social care services and further complicated HIV social work.
• New Labour substantially increased the AIDS Support Grant, but just as steadily downgraded the importance of HIV by subsuming it within health strategies for ‘blood-borne viruses’ and ‘broader sexual health’.
• The historical basis for HIV-specialist social care, specifically the prejudice and discrimination and consequent stigma and shame experienced by people with HIV/AIDS, remains as much of a factor in many of their lives.

3. HIV Social Care Now
• HIV/AIDS ‘awareness’ and services are still clustered in places with substantial and influential gay populations, even with the emergence of ‘new client groups’. The AIDS Support Grant has failed to ‘nationalise’ provision.
• The service response to the needs of black Africans with HIV has generally been limited, temporary and grudging.
• There is a “massive divide” between statutory and voluntary HIV social care, with frequent mistrust and misunderstanding on both sides; but where efforts are made to define roles and boundaries, and to maintain good communication, services for people with HIV/AIDS markedly improve.
• For all the constraints and pressures, there are still examples of high-quality, effective and appreciated HIV social work; it constitutes a viable, necessary and highly professional specialism within HIV social care.

4. How People Get HIV Social Work
• There is some tension between the ‘medical’ and ‘social’ models in HIV care, and considerable variation in relationships between ‘frontline’ HIV services.
• ‘Single Access Points’ into statutory social care are not generally receptive to people with HIV/AIDS; the HIV-specialist ‘back door’ is wherever possible being retained.
• HIV social care assessments are generally rigorous and comprehensive, especially when compared to generic assessments.
• Less than 10 per cent of HIV social care cases meet the ‘critical or substantial’ FACS eligibility criteria for services. In some places, the availability of HIV-specialist services has been used to justify withholding necessary and ‘eligible’ generic social care.
• The level and quality of ‘cross-referrals’ between statutory social care and the HIV voluntary sector vary widely across the country, depending on the level of ongoing practical collaboration between them.
• ‘Self-Directed Support’ offers a chance to restore ‘good old-fashioned social work’, with the service-user in control and a healthily preventative approach, but it may prove difficult to sustain under spending cuts and ‘institutional inertia’.

5. Organisational Issues for HIV Social Work
• There is an obvious and serious tension between HIV specialist and generic social work, which can be eased by good management. Where HIV and generic social work are combined in single posts or teams, the HIV element tends to get squeezed out.
• Good HIV social work supports people throughout their HIV infection, prevents crises and keeps them well, promotes life planning and HIV treatment adherence, enables challenge to other professionals’ decisions and access to suitable generic services, and as such is demonstrably ‘cost-effective’.
• Hospital settings for HIV social work can be isolating and dominated by ‘the medical model’; for similar reasons, HIV social work does not easily fit into Drug and Alcohol teams. The most congenial setting is Physical/Sensory Impairment; the least of all is generic Adult Social Care dominated by services for older people.
• Close working relationships with NHS-based HIV services are crucial, but HIV social workers must retain some independence.
• Under ‘personalization’ or ‘transformation’ agendas, ‘outsourcing’ to other settings is being considered for HIV social work; the biggest but not insurmountable problem is preserving links back into the local authority.
• HIV infection is either recorded in code on local authority databases or on separate ‘protected’ records, or not recorded at all. This can conflict with local authority obligations to monitor and account for their social work, and with leave-cover arrangements.
• In fact there have been very few serious breaches of confidentiality in Adult Social Care – they tend to occur in other agencies - and in general people trust the security of local authority databases.

6. The HIV Voluntary Sector
• The HIV voluntary sector is diverse, complex and occasionally fractious. There are particular tensions between national, regional and local organisations.
• There needs to be a revival of HIV voluntarism and self-help, and clearer recognition of new client groups.
• The expectations of funders and commissioners can be either too vague or misguided, with limited monitoring and contracting.
• The NHS and ‘the medical model’ still dominate HIV care. Working relations between (and within) the NHS, the voluntary and statutory sectors are complex and ‘political’.
• There are opportunities as well as threats in a future without the ASG, especially in ‘Self-Directed Support’ and NHS reconfiguration, including comprehensive and coherent, integrated HIV statutory and voluntary social care, which might even be purchased by non-HIV service-users’ ‘individual budgets’.

Copies of this executive summary, and of the full ‘Feast to Famine?’ report, and presentation, consultancy and training based upon it, are available from Andrew Pearmain by e-mail or phone 07505 083 864