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SEXUAL HEALTH


Tackling the widespread rate of HIV in the UK needs a fresh start and government support. Jason Warriner, Clinical Director of the Terrence Higgins Trust, tells us more.


F


acing a lack of involvement from the Government and fi nancial constraints


in a climate of cuts, the Terrence Higgins Trust (THT) – the national charity for HIV and sexual health, providing testing services and long-term condition manage- ment for people living with HIV as well as counselling, advice and support – needed a re-launch.


This has been kicked off with the publi- cation of a report entitled ‘Tackling the spread of HIV in the UK’, which aims to bring HIV back into public focus.


Jason Warriner, the clinical director of THT, talked to NHE about the restored drive behind the charity.


He explained: “In relation to our health improvements we do campaigns and work about preventing people getting infected with HIV and STIs, through to educating people with HIV and reducing the risk of them passing the virus on to other people. Our clinical services include Chlamydia screening programmes, contraception and STI screening services.


“This document is trying to highlight that we need a new vision for HIV prevention to reduce the risk and number of infections and the impact it has on public health in terms of outcomes. It is also to save money – about £1bn per year. We need to get pre- vention campaigns out there, and educate people to push it back up the agenda.”


Getting people diagnosed early is a key aim for the launch as well as ensuring that any- one who is infected with HIV has access to effective treatment.


Warriner said: “The key measures we’re looking at in relation to that is reducing the number of undiagnosed people who have HIV. At the moment about 25% of people living with HIV don’t know they’ve got it.


“We get people diagnosed late when they’re 88 | national health executive Sep/Oct 11


unwell and then they get taken to hospital, to A&E, or to a GP, and then it costs more if somebody has to have intensive care, it takes longer to get better and may affect the overall prognosis. So it’s about getting people diagnosed early, and getting them early into HIV treatment or services.


“If we get the virus down to undetectable in the bloodstream where the drugs slow it down from reproducing, it means that it re- duces the risk of passing it on to other peo- ple, and can reduce onward transmission.”


Risky business


“For people who take risks, like not using condoms, possibly exposing themselves to HIV or other STIs, it’s actually supporting them to change their behaviour. It may be a counselling service, group work or even online. Sometimes people know they’re taking risks but it’s looking at why they’re taking those risks,” he said.


“More awareness around HIV is key for prevention to succeed. It has to have con- sistent messages; how you can get HIV, how you can’t and more importantly how you can avoid it. We tend to focus on groups most at risk of HIV but there’s a message there for the general population as well.”


Time for change


After almost 30 years of working with peo- ple with HIV, why is now the right time for a re-launch?


Warriner explained: “At the moment the number of people living with HIV and get- ting newly diagnosed is increasing. We’re expecting it to be 100,000 people living with HIV by the end of this year and about 7,000 people a year get infected with HIV.


“It’s renewing the public health campaign. There was a lot of campaigning and work on HIV going on in the 80s and 90s and


that’s slowly fallen off the government’s agenda. Now it’s actually in a position where increasing numbers of people living with HIV and increasing numbers of peo- ple who don’t know they’ve got the virus.”


It’s also about saving the health service and the government money, as Warriner high- lights: “Linking it in with public health, we’re looking at the increasing costs around it; its better to keep people fi t and well, free from HIV than on treatment for the rest of their lives. If you look at the 7,000 people diagnosed with HIV in the UK every year, over the lifetime costs of treatment, it can easily add up to £1bn per year.”


Health services


The THT also works with the NHS to inte- grate its expertise into local services, and provide people with the access and oppor- tunity for testing and treatment.


Warriner said: “At the moment we’re lob- bying governments across Scotland, Wales, Northern Ireland and England to recognise the need for HIV and sexual health strate- gies. We also support national campaigns, and will make sure that HIV is on the agen- da within local providers.


“If you’ve got a hospital or a clinical com- missioning group or at local authorities, they need to have effective campaigns, and access to testing services.”


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