Opinion

Men who have sex with men are still the main HIV risk group

Outcomes for people with HIV have improved since the 1980s, but some things have not changed, writes Jason Warriner

When HIV is mentioned, many people think back to the 1980s, remembering the national advertising campaign with its icebergs and tombstones and John Hurt warning the nation not to die of ignorance. But in the last 30 years, HIV care and treatment has advanced almost unrecognisably.

From those early days when the focus was on acute and palliative care, the introduction of effective drug treatments has transformed HIV into a long term condition. This means so long as people are diagnosed in good time and access the antiretrovirals they need, they can expect a near-normal life expectancy.

The battle is far from over though. Currently in the UK, there are 100,000 people living with HIV, of whom one in five (22%) remains undiagnosed. These people have either never tested or have contracted HIV since their last test. In the UK, the two main groups at risk of HIV continue to be men who have sex with men, and the African communities.

A large amount of work is underway to raise awareness of HIV in these communities, including an England-wide HIV prevention campaign, funded by the Department of Health and coordinated by the Terrence Higgins Trust.

The campaign, It Starts With Me, has a simple message: through a combination of condom use, regular HIV testing, and treatment for anyone diagnosed, communities at increased risk have the power to halt the spread of HIV. These may seem like simple messages but if followed they will have a potentially massive impact in reducing the spread of transmission. To find out more: click here.

Many healthcare professionals trained a number of years ago when living with HIV was very different. Others who trained recently may have received no HIV training at all. Knowledge of HIV in the health and social care sector is based mainly around risk management in the workplace, rather than understanding the current realities of the condition.

Treatment and care for people living with HIV is still changing, and is increasingly provided outside non-specialist settings. As the number of people living with HIV increases and many more reach older age, they will have more touch-points with non-specialist health and social care services.

Nurses working in any setting have a role in reducing the stigma around HIV, whether it is bringing education and up to date knowledge to colleagues who may not know as much about HIV, or providing high quality care when nursing patients. We need to ensure that health and social care professionals have an up-to-date understanding of HIV so they are able to provide high quality care, reduce the number of people who remain undiagnosed and do everything we can to prevent the onward spread of the virus.

Ensuring that all health and social care workers in the UK have a basic awareness and understanding of HIV would help improve practice and patient care, increase diagnosis rates by reducing stigma and encourage more people to test.

Even in the past two years, there have already been developments in these areas, such as the change in legislation enabling people to undertake a HIV test at home, and the changes in the regulations that will allow healthcare workers living with HIV to undertake exposure prone procedures, so long as they’re accessing the appropriate treatment.

But it’s not just about legislation. The next step is to improve the knowledge and understanding of HIV within health and social care sectors to reduce stigma and ensure that services are accessible and free from prejudice for people living with HIV.

About the author

Jason Warriner is clinical director of the Terrence Higgins Trust

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