More African people acquiring HIV in the UK

A large study has suggested that more African people are acquiring HIV in the UK than previously estimated. It has generally been thought that the vast majority of African people living with HIV in the UK acquired their infection in an African country, before arrival in the UK.

The usual method used by the Health Protection Agency (HPA) to identify where someone was infected relies on information given by the individual to clinic staff at the time of diagnosis. But individuals may not always be completely frank about their sexual behaviour and their sexual history may be complex.

According to this method, just under 10% of black African heterosexual adults acquired their infection in the UK.

A new technique developed by the HPA compares a person’s CD4 cell count at the time of diagnosis and the year they arrived in the UK to calculate when they were likely to have been infected. Based on this method, 31% of black African heterosexual adults acquired their infection here.

And the proportion of UK infections in African people has risen in more recent years, from 24% in 2004 to 43% in 2010.

These data have implications for the resourcing of HIV prevention work with different communities in England.

Regular testing becoming the norm for Scottish gay men

The number of gay men testing for HIV in Scotland has increased significantly in a decade. Comparing 2000 and 2010, the number of men who said they had been tested in the previous year rose from 27% to 57%.

And the proportion of men who had never been tested for HIV fell from 50% to 20% over the same time period.

The figures come from annual surveys conducted in gay venues. The researchers wanted to see if efforts to promote testing were having an impact on testing rates and attitudes to testing.

There were increases in the proportion of men who thought testing was beneficial and a community norm.

On the other hand, barriers to testing did not change over time. Some men continued to fear a positive result, fear sexual rejection if HIV positive and have concerns about how easy testing services were to access.

Free HIV treatment for all in England

The removal of charges for undocumented migrants and non-UK citizens accessing HIV treatment and care in England came into effect on October 1st. From now on, HIV treatment will be provided free of charge to all who need it, regardless of citizenship or immigration status.

When the move was first announced in February, health ministers justified the change on the grounds of public health, pointing to the impact that HIV treatment has on onward transmission. Moreover, it is hoped that the new rules remove a significant barrier to the uptake of HIV testing in African communities.

While treatment in HIV clinics will be free of charge, migrants living with HIV who need hospital treatment for another health condition, such as diabetes or heart disease, or who require antenatal care, may still be subject to charging regulations.

Different rules apply in Wales, Scotland and Northern Ireland.

National HIV testing week: 23 to 30 November

The HIV Prevention England partnership is designating the last week in November as National HIV Testing Week and hopes that a wide range of organisations, inside and outside the partnership, will take this opportunity to promote HIV testing.

The week aims to increase testing rates amongst England’s most at-risk populations – gay men and African people. It is hoped that the week will increase awareness and acceptability of testing in these groups, as well as access to testing, so as to improve early diagnosis.

Terrence Higgins Trust will co-ordinate national campaigns and media work, while local delivery partners will be funded to deliver increased testing and awareness work.

All organisations involved in HIV and sexual health are invited to get involved in whatever way is appropriate. Some possibilities include organising outreach events, encouraging local personalities to visit testing centres, and running educational events with primary care clinicians on the role they can play.

If details of events are sent to ben.mccelland@tht.org.uk, they will be listed on the Terrence Higgins Trust website.

National HIV Testing Week runs from Friday 23 November to Friday 30 November. The week is planned to become an annual event.

Condom use needs to be correct and consistent

Rates of sexually transmitted infections (STIs) are much lower when people use condoms consistently and correctly, compared to people who use condoms some of the time, according to a new study. The authors comment that prevention programmes should not limit themselves to promoting condom use, but also educate on correct use.

American researchers asked 929 heterosexuals who were at high risk of having an STI to keep a daily diary with details of sex and any condom use, including whether the condom slipped, broke or was not used throughout the penetrative sex. The participants were tested for chlamydia, gonorrhoea and trichomonas.

Among people who used condoms less than consistently, or who reported problems with their use, 8.75% had an STI during the three months' follow up.

But among those who used condoms consistently and correctly, only 3.35% had an STI.

BHA’s role in HIV Prevention England

BHA is one of six partners making up HIV Prevention England, the new national HIV prevention programme that is targeted towards African communities and gay men.

BHA (formerly the Black Health Agency) was established in 1990 in Manchester in response to the lack of services and voice for black communities in relation to HIV. The charity exists to challenge health inequalities and now addresses a wide range of health issues in marginalised and disadvantaged communities.

Within HIV Prevention England, BHA will provide strategic advice to the partnership on African community issues.

Moreover, it will ensure that local African communities engage with national HIV prevention campaigns. BHA will do this through a co-ordinated network of organisations across England (known as local delivery partners), which will deliver activities in support of the campaigns. This will include working with NHS clinics, commissioners and businesses, as well as delivering interventions within communities. 

The programme is also committed to working more closely with faith communities, given the key role that faith plays in the lives of many African people. BHA will take a lead on this work through engaging with churches and mosques, and creating a toolkit to help faith communities to play a positive role in HIV prevention.

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