Opinion

Less blame, less shame, less stigma and less HIV

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Between 2011 and 2015, the World Health Organization (WHO) is promoting the theme: ‘Getting to Zero: Zero new HIV infections: Zero discrimination and Zero AIDS-related deaths.’ By supporting this campaign, all healthcare workers can help challenge the discrimination and stigma faced by people living with HIV, raise awareness of HIV among members of the public, and encourage people to test.

Public Health England has recently produced the annual report on the UK’s HIV epidemic. There are now nearly 110,000 people living with HIV in the UK, around a quarter of whom (26,100) are unaware of their infection. They do not know they are living with HIV and are at risk of passing the virus on to others through unprotected sex. Encouragingly, the number of people diagnosed with late stage HIV infection fell from 57 per cent in 2004 to 42 per cent in 2013.

Modelling by the WHO suggests if countries can meet a target of 90-90-90 by 2020 this can dramatically reduce the spread of infections. This means 90 per cent of people living with HIV diagnosed, 90 per cent of those diagnosed on treatment, and 90 per cent of those on treatment having an undetectable viral load and are therefore non-infectious. Public Health England has confirmed that the UK is closer to this target than any other country.

To achieve the 2020 targets we need to increase testing and continue to encourage people to test, ensure that all people living with HIV are accessing treatment and care, and continue to raise awareness and understanding to reduce the stigma around HIV.  If condoms are used correctly and consistently they remain the most effective way to prevent HIV and sexually transmitted infections. Education for young people on sex and relationship is vital to empower them to make choices about relationships and their sex lives, know how to use condoms, and access sexual health services.

In the run up to World AIDS Day on December 1 each year, National HIV Testing Week aims to raise awareness of testing and encourage people who would not usually test to take a test. Increasing the number and frequency of HIV tests will contribute to reducing the number of people undiagnosed.

Marie Stopes International supports HIV Testing Week to ensure that as many people as possible do test and know their status.  With the development of rapid HIV testing over the last ten years, testing for HIV is more accessible and can be delivered in a range of hospital and community settings. Rapid HIV tests are accurate, and depending on the type of tests used, patients can receive a result in 20 minutes or less. The quickest HIV test will provide a result in one minute.

Following the advances in HIV medicines and treatment over the past 20 years, HIV is now seen as a long term condition. When people are diagnosed and access care and treatment, they are looking at a near normal life expectancy. In 2013, 81,512 people accessed care and treatment – 55,200 men and 26,312 women. This is almost double the number of people who accessed care a decade ago.

In the past few years there has been an increase in older people living with HIV. This group of people will continue to grow in number every year due to the effectiveness of treatment. For the NHS and voluntary organisations, this provides an opportunity to consider how services can be provided in community settings, develop ways of working with organisations that provide services for older people and, most importantly, engage older people living with HIV in the development of these services.

At RCN congress in June 2014, a resolution on HIV was successfully passed mandating RCN council to raise awareness of HIV. The RCN public health forum is currently leading a piece of work to raise awareness of HIV among all health and social care workers. If all nurses, healthcare assistants and students have awareness and understanding of HIV, this would dramatically change the lives of people living with the condition.

A range of online learning resources are available on the RCN and National HIV Nurses Association websites. By completing these online courses, nurses and healthcare support workers will develop an understanding of HIV that will improve their clinical skills, increase their knowledge and improve patient care.

For more than 30 years, nurses have cared for and supported people living with HIV. Members of the nursing profession have been challenging stigma since the 1980s, promoting the rights of people living with HIV, and providing high quality care.

Remember, we need less blame, less shame, less stigma and less HIV.

About the author

Jason Warriner is UK director of quality and clinical services at Marie Stopes International, and chair of the RCN public health forum