London HIV infections up 58%?

[Cliff]

On the tube today, I saw someone holding up a paper with a daily headline of "HIV up 58% in London."  Did anyone else see it?  Any details?  I didn't get a chance to read it and saw nothing on Google News.

[Ldn+]

Yeah I saw that too.  Caught my attention.  Was in "The London Paper".   It's a very short article so I'll post it here...  (they also have a website: www.thelondonpaper.com)

The London Paper
08 March 2007

LONDON HIV CASES UP 58% IN FIVE YEARS
More than 40,000 Infected
by John Dunne & Katharine Hibbert

The number of HIV cases in London has rocketed by 58 per cent in just five years, government figures reveal today. More than 40,000 people have the virus and experts claim one of the major reasons for the crisis is the growing number of young people practising unsafe sex.

The worst-hit borough is Lambeth, with 3,984 cases in 2005, followed by neighbouring Southwark, with 3,154 HIV infected residents. The number of cases in Southwark is nearly double its 2001 figure.

Rena Greifinger, of HIV charity Body & Soul, said: “We are very aware of the rising number of cases in London because our referral rates are growing week by week. We are seeing more young people contracting the virus sexually.”

Liberal Democrat Hornsey and Wood Green MP Lynne Featherstone said the Health Department figures highlighted a dangerous trend. She added: “The government can’t run or hide – urgent action is needed. The problem is spreading and ministers need to realise that.”

The Worst-Hit Boroughs  (number of cases in 2005)
1. Lambeth 3,984
2. Southwark 3,154
3. Newham 2,104
4. Camden 2,074
5. Westminster 2,020
6. Islington 1,900
7. Haringey 1,810
8. Lewisham 1,774
9. Hammersmith & Fulham 1,741
10. Kensington & Chelsea 1,732

[alberche]

Hiya all!

Here in Spain, no clear direct indicators show an increase on HIV infections, but many indirect ones do: STD are increasing again since 2002 -a pannel of experts recently talked about we are entering in a sort of "pre-AIDS" era situation as per regards of trends in STDs- , charities and NGOs report an increase in the number of people attending looking for help or counselling due to beign newly diagnosed: young people, women and migrants being the most affected, and AIDS cases rates have stabilised after many years of yearly decrease.

I also read something about the number of AIDS cases has grown again by 12% in average in some cities in the US.

So, yes, something is going wrong with prevention strategies.

Regards,

:-)

[Andy Velez]

WOW! This is really shocking. I didn't realize those countries are also tragically failing in their responsibility to educate young people about how to protect their health. 

Here in the U.S. because of school administrations and others being afraid of right wing backlash and the Bush's abstinence is the way program, there is virtually no realistic safer sex information being made available to teenagers.

50% or more of new infections in the U.S. are among those under 25 and over half of  them are among women.

When are we going to be able to turn this around?   

[Jeffreyj]

This is shocking and disturbing. More education is needed apparently, just like here in the US.

This is really sad news.

[dtwpuck]

Yikes.... this is sad news indeed. 

I have been dismayed at the effect of hiv education for a while.  I used to think someone had to be living in a cave if they didn't know how it was transmitted.    But ultimately, after moving to the midwest I discovered an appalling lack of knowledge because of the religious discomfort with discussing sex in schools. 

But also, there are two other overwhelming factors which, in my opinion, have essentially doomed the behavior modification which is the goal of hiv education.  In my mind, this is why it will continue to fail.

One is the rise of party drugs.  While drugs are not new, the last decade has seen a huge surge in the use of sex drugs like meth and ecstasy.  We have addressed this issue ad nauseum, and everyone who works in the hiv field has drawn a really common correlation between the letters pnp and hiv.

The other is the widespread perception that hiv is a manageable disease.  We see it in the media all the time.  We talk about it here all the time.  However, the fact that people are living longer and we are not attending a funeral a week really doesn't do much to instill a sense in gay men that they have all that much to lose by engaging in unprotected sex.  Not that I am advocating any kind of return to that, but AIDS is no longer visible like it once was.  And, sadly, I don't see a way around this trend until a cure is found.

[Cliff]

Thanks for that Ldn+.  I wonder if there is a break-down in the stats.  How many of the cases were due to infections in the country and how many were diagnosis of infections originally transmitted in other countries (migration of people)?

[mjmel]

What could have happened? The English are a smart and savvy people. This spike is so disturbing.

[Esquare]

The forums here will crash if this keeps up.

Seriously though, I was surpised to see this out of London.

[tigger2376]

They missed out the fact that is reckoned that estimated SEVEN THOUSAND are infected each year in London and home counties and don't know, (source body and soul).
The English attitude is odd. Maybe because HIV is so closely associated with sex, its only sporadically highlighted. There are sweeping cuts in services at present, the system is close to collapse,and yet more and more of the supposed 'ringfenced' funding is being cleverly diverted.
Whilst clinics try and educate,and theres been some good fundraising/awareness efforts recently, we need to do more, complain more, push more.
Unfortunately its a fact of life,that if you put your head above the parapet,it may well get shot off
I don't have the answers. In my own small way I'm trying, but until its an 'acceptable' disease those with HIV are in the main ignored. We're not 'trendy' any more..we're living longer, and most of the bleeding heart liberals have found another cause.
I wrote to Prince Charles recently, (hey,go to the top)....I await a reply
The UK has a serious problem, its so called 'developed' nations that need reminding its NOT GOING AWAY!
sorry to rant but it breaks my heart
x

[jack]

freaking limeys, too drunk to put on a rubber.  Have the new hiv drugs made many complacent? I dont think its an education thing. Is the attitude,wtf, my insurance or the govt will pick up the tab for the drugs?  Aside from dying from HIV, and I dont believe I will, the most frightening thing to me about HIV is the fucking cost. I paid out of my own pocket the first two or three years and it was very expensive and very scary. In other words if the drugs keep you alive and side effects are small, and  you dont have to pay for them, people are gonna have unsafe sex.  Why shouldnt they? Whats the downside? Is it possible better drugs and free drugs actually increase HIV?

[tigger2376]

I'm sorry, that may have been meant lightheartedly but its offensive. NO ONE would think that way, and we're not all drunks
The cost is not just financial,its a lifetimes worth of pain
Paid 40% income tax and 10% national INSURANCE for most of my working life so have contributed
Far from smug, count myself F@@@ING lucky to live here

[libvet]

Is the attitude,wtf, my insurance or the govt will pick up the tab for the drugs?

Is it possible better drugs and free drugs actually increase HIV?

I rather doubt they are even thinking about it all that much in the terms you put it.  The notion is kinda laughable that better treatment is responsible for a rise in HIV infections because people think having HIV is no big deal or that somehow "free drugs"are responsible (which is not really true either considering people pay for their health care in the UK too, just not the same way Americans do).  It's probably about as true as the notion that giving women the HPV vaccine is going to create a generation of promiscuous women.

In some respects you are CORRECT that the better treatments are probably  related, because unlike many of us who lived through the 80's and 90's, the current crop of youngsters didn't have to experience the era of the HIV=AIDS=DEATH and watching their friends drop like flies from this virus.  It's a double edged sword in that respect that better treatment and lower mortality has led to complacency and the sense of danger that unsafe sex had when an HIV diagnosis was practically a death sentence.

What that means is that HIV doesn't seem as "real" or close to home to people in the industrialized world.  It's not about "I don't care if I get HIV because the meds will be paid for", it's more about lack of real awareness of what living with HIV disease is really like and to some extent, the kinds of actions taken to raise public awareness of HIV in the past couple of decades has fallen by the wayside. 

So it's really an issue of "out of site, out of mind".

[Ldn+]

Living in England, and London specifically, I can say that I DO NOT think it is the attitude that "Oh well, the NHS will pay for it.  I can't speak for everyone, but my guess is that it's the same issue you get everywhere... a lack of education.  I've lived in both the UK and US, and it seems to be the same attitude - "It can't happen to me."  (I know I thought that way.  You ask a guy if he's neg, he quickly says yes, and you bury your head in the sand.) 

In many pubs and clubs in London you can get free condoms, but it's VERY sporadic... they may have a supply which disappears rapidly and then doesn't get refilled.  Or they're behind the bar and you have to ASK for them (how fucked is that?).  And having lived in the US, I know for a fact that condoms are not as freely available there as they are here.  I know it costs a lot of money, but the government MUST work hard to educate, as well as supply condoms.  You can preach about "personal responsibility", but I think this goes way beyond that.

ALSO - and this is where WE can do something besides educate...  I think there needs to be a concerted effort by the gay community to work against the culture of barebacking.  I think it's gotten worse in the past few years.  There is a lot of pressure to do it, and even more now that I've been diagnosed.  SO many poz guys want to do it.  I hope I don't have to go into WHY that's wrong here.  But if anyone wants to argue this with me I'm more than happy to.  I sincerely hope that all of you frown upon it when it crops up in bars and cyber chatrooms.  (Look at me, all preachy.  Hehe - Sorry!)

[Central79]

I read this. Sadly, it was just a front page thing to grab your attention. There was no follow-up article inside the paper. I thought this was a missed opportunity to educate people about the transmission of HIV, and the effects it has on your health.

Britain is pretty backward in looking after sexual health. We have a large and growing problem, which the government seems unwilling to acknowledge or unable to deal with. As pointed out previously, a lot of the funding allocated has been syphoned off by PCT (primary care trusts) to pay off debts from other activities. This is a massive false economy, given the cost of a lifetime of HIV drugs. I went to a NAM meeting on Monday evening and the doctor there was saying that large numbers of the HIV/STD clinics in London may have to close to rationalise services. Whilst I think London may have too many HIV/STD clinics, I don't think the money saved will go back into HIV/STD care - we will see less accessibility, and further erosion of funding for drugs and prevention.

I'm 27 yo. I knew about safe sex before I got infected. But I had an attitude of invincibility. It needs a sustained campaign to get people to stop and think for a second about what they might be doing to put themselves at risk. I'm pretty convinced I contracted HIV through oral sex, secondary to having problems with my gums. I knew I had gingivitis, but didn't have the money to go and see a dentist, and failed to make the connection with an increased risk of getting HIV. I failed to modify my behaviour and here I am.

I have never seen a cinema or TV advert talking about HIV in the UK. Some gay charities try to educate by flier, but it's stuff you can skim over. What people need to sit through are ads in the cinema, and on TV, like at the beginning of AIDS. And we need to flood this country with condoms - they should be everywhere. In addition, PEP provision is extremely patchy in the UK. It should be provided as a standard of care in every A+E department.

Matt.

[carousel]

If I just count my immediate circle of friends, there are six of us who have been diagnosed in the last couple of years.  If I counted people I know, the figure goes up considerably.

I don’t think it is just one factor that has led to the rise, but a whole series.  I do think drugs and alcohol play their part and it seems to me that this is not being addressed properly.  I’m not talking about the ones that get the headlines, meth and ghb, but the drugs that are very much part of many people’s life, partying at the weekend, making decisions that are clouded.

Invincibility, lack of education, resources, self esteem and many other issues play their part.

The media should also accept some responsibility, with their seemingly lack of interest in raising this, when it is affecting so many of those in London.

I also wonder what part the HIV/ AIDS Charities play in sending out information about the danger of HIV and promoting safe sex. 

 

[keyite]

I went to a NAM meeting on Monday evening and the doctor there was saying that large numbers of the HIV/STD clinics in London may have to close to rationalise services. Whilst I think London may have too many HIV/STD clinics, I don't think the money saved will go back into HIV/STD care - we will see less accessibility, and further erosion of funding for drugs and prevention.

Hi Matt, I was there too on Monday - very interesting meeting! I don't think Gazzard meant general STI clinics will have to rationalise and close, rather that HIV clinics (which currently go hand-in-hand with, and tend to share premises with, STI clinics) would be better off by rationalising. So probably the same amount of STI clinics but rather than every STI clinic also having an HIV clinic more STI clinics would in future refer newly diagnosed patients to more specialised HIV clinics, often outside their own trust, rather than always caring for them 'in-house'. In London, I actually think this would be a good thing; anecdotal evidence suggests quality of HIV care between clinics is far too varying and expertise is too thinly spread in geographical terms. I think a handful of HIV "superclinics" in London would be better for patients and for the NHS, even though some people will need to travel slightly further for their visits.

If anything London needs more and better resourced STI clinics to be able to cope with the rising tide. After years of total neglect I finally see some evidence that this is happening - a new community STI clinic opened in my local area in South London about a year ago; they only offer the basic tests, chlamydia and gonorrhoea, no blood tests at all, but then refer people onto full-service STI clinics.

If the vision indeed is a more tiered system of care, i.e. basic community STI clinics, full-service STI clinics and specialised HIV clinics, then I think it's the right way to go.

[indyguy]

I know it doesn't equal death any longer but I wish I had been smarter about it.

[jack]

You just can't ignore the idea that lack of fear of death because of great drugs, lack of drugs sides, and no exposure to the monthly cost of drugs and treatment, other than the insurance bill or tax bill you would be paying whether you have HIV or not could cause a rise in HIV infection rates.
You have to have great discipline forged by fear and education to overcome the human lust,need, and desire to have sex often and without protection. Education by itself is fucking useless. Would people quit smoking without the fear of death or bad health? If we came up with some type of miracle drug or treatment to reverse the effects of smoking tobacco,do you think more or less people would smoke?
My children learned about HIV in school before they ever knew what sex was,it has been pounded into their heads just like the horrible consequences from smoking tobacco. They are educated that hiv can kill you.  If we are at a place in time, and I dont know if we are, where HIV will no longer kill you if you take the drugs, and the drugs no longer have the devastating sides they had ten or twenty years ago, and you aren't faced with a monthly bill of over a thousand dollars for meds and drs fees, what other forces of nature or economics will change our human behavior?
We still dont know if these are real numbers.

[keyite]

I wish more availability of condoms would help but I seriously doubt it - let's face it, the problem isn't that condoms are unobtainable, the problem is that people don't want to use them. Improving the abysmal sex education in schools and organising new media campaigns might well make a bit of a difference. Many young people just don't know even the basics on how to protect themselves.

Being gay, that is the community I know the best, and I definitely think the social acceptability and 'trendiness' of barebacking accounts for a big part of the rocketing infection rates. I don't think it works at a very conscious level, so I don't think the better meds or that the state will be paying for it figures highly in the risk-taking.

It's more the insidious effect of 'peer influence', if you will. The collective state of denial and 'head in the sand' mentality. Moreover, that works so well in tandem with the endemic issues gay men have with sense of self-worth, self-esteem, isolation and depression, often arising out of the homophobia they've been subjected to. Cue abuse of alcohol, party drugs, etc. A better vehicle for transmission is hard to imagine and unpicking it is going to take much more than condoms or leaflets.

Choosing to swim against that tide is very difficult indeed and pretty lonely, I should know. Sad to say I don't see much cause for hope; the state can only do so much and ultimately change has got to come from within the community - I simply don't see from where or from who that would be led, at least at this point in time.

[Miss Philicia]

Is it possible for one certain poster here to ever comment on a subject without interjecting extremist radical political thinking?

[jack]

If you are referring to me, I have to ask, what is radical about using common sense?
If true that infection rates in London are up almost 60%, and if it isnt just a blip or bounce from very low levels of infection, it is very alarming.
If HIV drugs keep you healthy, and the drugs have no sides, and it doesn't cost you anymore financially than you are paying today in taxes or ins.premiums, how do you get people to have safe sex and what would be the reason not to have unsafe sex?
To keep saying the reason for high infection rate is not enough money being thrown at education or we need to have more rubbers everywhere is foolish in my opinion.

[jack]

Sorry, I guess using common sense is radical.

[sweetasmeli]

I would hazard a guess that the rise of hiv infections in the UK is in part down to lack in adequate sex education in schools and British attitude to sex in general. Sex (let alone sexual diseases!) is not something that is thought or talked about comfortably amongst the British, as a society. There is still an, umm ‘ickiness’ about sex and anything to do with it.

And despite all the sex splashed about on most TV channels, newspapers and magazines, actual education is somewhat lacking. That is, unless you’re wanting to learn how to shag your boyfriend’s father without getting caught or how to give a 45 minute blowjob without asphyxiating et al! Granted I only venture back to the UK for 2 weeks at a time, every few months now, but nothing much seems to have changed since 2 years ago. Anyone, please free to correct me and point me in the right direction, if I am in fact mistaken…

Oh and not to mention the fact that most people still don’t really think they are at risk – especially those folk engaging in unprotected sex in long-term relationships. Can’t speak for other countries other than Britain and Greece, but from what I understand hiv is still viewed by many British individuals as a disease which predominantly effects homosexual men, intravenous drug-users and people who shag around. Not by all of course, but frightening, still by too many. And of course not by people participating in these forums...well not any more anyhow!

The irony in all this is that, not only are many British folk actually at it like bunnies, but since I was a teenager (20 years ago now, sigh!) many British folk have been not just sexually aware but also sexually active since their early teens or younger. And from what I’ve witnessed over the last couple of decades, the only thing that has changed on that score is that it has got worse; kids seem to be getting more sexually aware and more sexually active from an even earlier age nowadays. Unfortunately, education about STD prevention  doesn't seem to be keeping up with the horny little buggers!

---BIG SIGH---

Melia

[Central79]

To keep saying the reason for high infection rate is not enough money being thrown at education or we need to have more rubbers everywhere is foolish in my opinion.

I think this is wrong. Although maybe I'm a poster boy for your arguement, as I'm a medical student who always used condoms and still caught it!

I just think that you only have to look at the "Am I Infected" forum to realise the degree of ignorance out there. It really is quite frightening. Here's a link that shows that not only are people in London ignorant about HIV, but they have gotten MORE ignorant since 2000:

http://www.nat.org.uk/page/791

I think there are two issues in educating people about HIV: the first is to say "This exists. It's getting more common. It's a problem and YOU could be affected", which is a problem with HIV as there is stigma attached to it and although I knew people who are HIV positive before I was diagnosed, they didn't tell me until after I told them. These were close friends. The second issue is to say "here's how you catch it, here's how you avoid it, these are the consequences of getting it".

At the end of the day it's all about knowledge and mindfulness. Having the power to make an informed choice. Not being allowed to forget. I'm sorry, but "common sense" just doesn't cut it, and it's a government's duty to at least TRY and educate people, like we do for smoking, or driving drunk, or any other risk-taking activity in our societies and to provide resources (like free rubbers, like PEP) to help people make good choices. The government in the UK is failing in this regard.

[jack]

by "common sense" I meant using common sense when determining the reasons or factors behind the most recent rise in GB infection rate(if true). Again, what are you educating people about if  there are drugs that keep virus in check, the drugs have little or no sides, and the drugs and treatment present you with little or no out of pocket cost other than what you are already paying in insurance and taxes? I am not saying to stop educating people about HIV,what I am saying is laying the blame for the recent rate increase solely on lack of education doesnt make any sense to me.
My point is why should people fear HIV if there are drugs that keep you alive and healthy,no sides,and no cost?
An informed mind has nothing to do with staying HIV free,many informed minds get HIV.  There has to be a reason why you dont want to get it, some fear of death or the cost, otherwise whats the big deal?

[newt]

While tis true that the total number of HIV cases in London is 60%+ over the timeframe there is little evidence of an increase in transmission compared to say 1985 or 1995.  About 2,000-2,500 gay men have been diagnosed each year since 1985. The big rise since 1999 is nearly all Africans, mainly women.  While it is not quite true, the domestic epidemic is largely confined to gay men and the acquired overseas epidemic is largely confined to Africans.  A few other lonely souls get caught up in the damn business, or confound the general trend.  But I see no evidence that the incidence of new infections in London is increasing dramatically.  There is a cogent analysis that explains 90% of theincrease in terms of a more testing rather than transmission.  It will be interesting to see if this holds true now that testing in London seems to have reached a plateau, though with a 20% refusal rate there's some way to go

Motivationally/behaviourally, I agree with Jack. Plus risky sex in the UK (HIV, otherwise) seems something of a national characteristic, like warm ale and cricket.

HPA report with summary and PowerPoint slide set (for nerds)

- matt.

[tigger2376]

I think risky sex is pretty much a global pastime..however informed you are, if theres alcohol,drugs or just plain old lust involved,mistakes happen.
I agree, the UK is pretty poor in regard to sex education. Because of our generally acknowledged slightly odd attitudes to sex,wer'e told about STDs,HIV and teenage pregnancy, but no one stands there and actually says...THIS COULD BE YOU.
I apologise to jack for overreacting a little earlier in this thread,my sense of humour had gone AWOL.
It was Veuve Cliquot and lust that did me 'up like a kipper',real ale drinkers and cricketers wear weird jumpers 

I will say though...yet another example of UK press,screaming headlines. As someone said...wheres the follow up?

[Central79]

My point is why should people fear HIV if there are drugs that keep you alive and healthy,no sides,and no cost.

Well, given the degree of ignorance shown by the link I gave earlier, I'd be interested to know what proportion of people know that HIV is still incurable. Or what proportion of people know that the treatment of HIV usually involves taking pills same time every day for the rest of your life. Or that the meds are toxic. And that they DO have side effects. And that you're life expectancy is still reduced even if you take the meds. If there's a public perception of HIV as a picnic then it needs to be combatted.

About 2,000-2,500 gay men have been diagnosed each year since 1985.

This figure is not correct. Since the advent of HAART in 1996 new infections amongst gay men have been increasing, after a period of modest decline in the 1990s. Since 1999 the figures have risen year on year from under 1400 per year to 2400 per year in 2006. Maybe some of this is driven by the increased prevalence of HIV in the gay population, but this in itself is something people should be told about. Here's the reference:

http://www.avert.org/uksummary.htm

Maybe some of this is down to increased testing. But an estimated 1/3rd of people infected in the UK are unaware of their status.

You're right about straight sex though - it is mostly driven by African immigrants or acquired outside of the UK. But the number of straight people in 1998 getting HIV in the UK was 181. In 2005 is was 556. Small numbers, but a worrying trend.

Matt.

[newt]

I believe my reading of the figs is correct. 

The overall, (perhaps even dramatic) rise between 1999 and 2004 is almost entirely down to Africans getting tested, the begininning of the rise coincides with introduction of testing for HIV in antenatal clinics in London (1997-1999 depending on clinic).

Gay men, a little over 2005 were diagnosed in 1985, the first year testing was widely available in London, then there's a sharp decline, and a rise back towards 2,000 in 1989 where the nos. stayed more or less until 1999. And now a little over 2,500. There is a trend for more new cases being diagnosed in gay men, so the numbers is creeping up, but whether this represents increased transmission is a moot point, prob not in a major way (see eg AIDSMAP report).

Clearly, a rise in total numbers itself is cause for concern, but maybe, just maybe, with us queers, we've got a good as we can prevention wise (just to be a pessimist for a moment).  We have a very small epidemic in the UK.  Our response, esp. in bars etc, was swift and perhaps looking back very effective, perhaps still is.

- matt

[Cliff]

I'm still a bit confused at all the numbers, but maybe I'm not reading the info close enough.  Some of the numbers don't seem to add up or are different between the two reports (avert vs aidsmap).  For example, one says the increase is primarily due to infections obtained overseas, but then goes on to say that such infections constitute a minority of total heterosexual infections.  While another says that the rate of infections from overseas has actually decreased (3,200 to 2,700) over the past 3 years.  (How do they know when/where someone acquired HIV?)

If the numbers are increasing due to better & more frequent testing, then I would assume this should translate to a reduction in late-term diagnosis/deaths.  Anyone have those stats?

Does this also give support for those who prefer that the UK prevent immigration from people living with HIV?

[Central79]

I believe my reading of the figs is correct. 

Well I guess we're just going to have to disagree on this point. I think the AVERT figures, separating out the various communities affected by HIV are indicative of something going wrong in the gay community certainly. But, like the report quoted in AIDSMAP says, it's a complex picture.

Purely anecdotally, for a while after diagnosis I had my status in my gaydar profile. It didn't really affect my sex life much, but people were constantly messaging me and asking me to basically educate them about HIV transmission and life with HIV. So from my own personal experience there's some way to go in education, even of gay men.

Matt.

[tigger2376]

I think the straight community are less targeted by education, and we need to do it better
Being one of those 'lonely islands' can be a bitch, but thats where I'm told infection is rising alarmingly quickly, (NOT that any part of the community is any less/more alarming than another)
Please correct me if I'm wrong but isn't there a sharp increase in straight,white hetero diagnosis happening? Again, maybe due partly to more testing, but there seems to be in every part of society, as someone has already said, an attitude that 'it won't happen to me'
We're the living proof thats wrong
and some of us may end up being the dying proof
(God forbid)
xxx