HIV and Hepatitis C poll results

Monthly polls on different issues around HIV and hepatitis C (HCV) garnered well over 1,000 votes during 2014, from respondents representing the community, private, charity, voluntary and third sector in the UK and beyond. Opinions were sought on topics ranging from preventative treatment to international studies to smoking. Poll host David Rowlands reviews the results.

82 per cent supported the premise that HIV screening should be offered routinely in any A&E department.

More than 450 people have undergone the 30-second HIV test at the Chelsea and Westminster Hospital in London since the programme started in March 2014. The scheme has been deemed necessary in an attempt to 'diagnose the undiagnosed' because these people cause an estimated 75 per cent of new cases. This pilot came about after research found people who were diagnosed late accounted for nearly a third of all AIDS deaths in 2013.

82 per cent agreed that prisoners should be offered an HCV test as part of their induction into prison.

Between a third and half of new arrivals in prison are estimated to be problem drug users, which is equivalent to between 45,000 and 65,000 prisoners in England and Wales. 69 per cent of those who enter prison have taken drugs within the previous 12 months. Of these, 40 per cent report injecting drug use within the 28 days preceding imprisonment.

Prisons are a key area where HCV services need to be improved. Most prisons have high numbers of HCV patients, many of whom are undiagnosed, and there is insufficient work going on to address this growing problem.

Awareness of HCV needs to be sustained and enhanced among professionals and people at risk of HCV infection to ensure that more people are tested, and levels of undiagnosed infection are reduced.

Testing needs to be sustained among those attending specialist services for people who use drugs. The use of newer technologies, like dried blood spot testing that make testing easier in non-clinical settings should be further expanded through the UK.

86 per cent supported a recommendation by the World Health Organization (WHO) that all gay men should take antiretroviral therapy (ART) to halt the HIV epidemic.

A report published by WHO made 'strong recommendations' that all men who have sex with men should seriously consider taking antiretroviral medicine 'as an additional method of preventing the HIV infection from spreading', even if they haven't got the virus themselves.

The report said that, in addition to other forms of protection like condoms and regular testing, increased use of antiretroviral drugs in the gay community could have a significant impact in stopping the spread of HIV and could prevent a million new infections in the next 10 years.

78 per cent agreed that people living with HIV should stop smoking to reduce potential health issues.

A recent study showed that people living with HIV who smoke shorten their lives more from smoking than from HIV itself. Smoking weakens the immune system. It can make it harder to fight off HIV-related infections.

Smoking doubles the risk of death. Data from the study showed that each year, eight in every 1,000 smokers died. Among non-smokers, four in every 1,000 died. This increase in deaths was mostly due to cardiovascular disease, stroke, lung cancer and liver disease.

The life expectancy of a 35-year-old HIV-positive man who smoked was, on average, eight years shorter than that of an HIV-positive non-smoker. As people got older, smoking had even more impact. What was interesting was the fact that the risk of death for ex-smokers was no higher than for people who had never smoked.

97 per cent agreed with the use of pre-exposure prophylaxis (PrEP) within the men who have sex with men (MSM) community.

Recent announcements from the PROUD study and the IPERGAY study both found that PrEP substantially reduced HIV infections among gay men recruited to the studies.

NHS England has begun developing a policy on PrEP but this will not be implemented until early 2017. Organisations working on HIV prevention have called for the NHS to speed up its processes and make PrEP available to those at the highest risk of acquiring HIV. The continued high rate of new infections shows there is an urgent need to improve HIV prevention within the UK.

86 per cent agreed gay men who indulge in risky, drug-fuelled sex should be given kits to protect themselves from HIV and/or hepatitis.

The Burrell Street Sexual Health Clinic in Southwark is the first in Britain to provide packs of clean syringes, spoons and thermometers in response to the rise of 'Chemsex'.

So-called 'slamming' parties can last for days and involve men often sharing partners and having unprotected sex while under the influence of illegal drugs such as Crystal Meth and GBL. A report commissioned by three south London boroughs warned that men indulging in Chemsex were placing themselves at significant risk.

MSM are increasingly using recreational drugs such as GBL, GHB, meth and mephedrone during sexual activities, which enhance the experience and are associated with high risk of sexually transmitted infections (STIs).

When these men present in clinics, often healthcare providers struggle to understand how to communicate appropriately with this group, thereby limiting the identification of exposure to risks or an existing infection. With 92 per cent of the 218 newly diagnosed HCV infections in the UK in 2011 occurred among MSM who were HIV-positive, the time is now to address this public health situation.

Poll data

Read the full 2014 poll findings. A total of 1,086 responses were given between 5th January and 21st December 2014, with data collected via: online hosting at www.Design-Redefined.co.uk (850 visitors per calendar month) and social networking: Twitter (1,900) Facebook (500+) LinkedIn (500+) e-Subscriptions – quarterly (1,300).

The monthly polls will continue throughout 2015, with January's examining HIV coverage in the UK media. Vote here. David Rowlands will continue his series on HIV/HCV topics on pharmaphorum during the year.

About the author:

David Rowlands is the director of www.Design-Redefined.co.uk, delivering effective healthcare communications to professionals and patients. His key objective is to design, develop and deliver community projects to enable people living with, or affected by, HIV and/or HCV to become better engaged with their treatment and care. Working over a number of media platforms across the public, private and third sector, he is able to establish a link to these sometimes hard-to-reach communities. Contact David on Email: david@design-redefined.co.uk Twitter @DR_tweetUK Website www.design-redefined.co.uk

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