here - United Kingdom Parliament

307WH
HIV
1 DECEMBER 2010
HIV
308WH
[Mike Weatherley]
I wish to make two clear points. First, HIV does not
always conform to stereotypes. HIV does not affect
only young men on the gay scene, or people in or from
Africa. As we heard earlier, it also affects white, middle-aged
and older straight men and women. Until politicians,
policy makers, doctors and the general public take that
fact on board, dealing with HIV will continue to be
hard work. Secondly, 26% of all who live with HIV in
the United Kingdom are undiagnosed. Tackling this
must be a priority.
In Brighton and Hove City primary care trust, about
450 people are HIV positive without knowing it. The
Government and local services must do everything that
they can to bring the number down, and I am determined
to do what I can to support the NHS at the local level in
this task.
My two earlier points are linked, because it is precisely
those who are not in what are known as high-risk
groups who get diagnosed the latest. Heterosexual men
have the worst rates of late diagnosis, at 65%. That is
possibly because they are less likely to consider themselves
at risk, as we heard earlier, and unlike women they will
never be tested in ante-natal settings. It could also be
because clinicians may not consider them to be at risk.
Heterosexual men over 50 years old have the worst rates
of diagnosis; 73% of those not diagnosed until over the
age of 50 are diagnosed late.
HIV comes in many shapes and sizes. At 54%, more
than half of new diagnoses in 2009 were among
heterosexuals, something that surprised me when
researching for the debate. At 51%, more than half of
HIV-diagnosed individuals accessing HIV care in 2009
were infected through heterosexual sex. The proportion
of heterosexual diagnoses in which people are believed
to have been infected in the UK has risen year on year
throughout the epidemic. From 2003 to 2007 it doubled
from 12% to 24%, and it continues to rise. It is now
about 32%. The over-50s represent one in five of all
adults seen for HIV care in 2009. That is due to an
ageing cohort of people diagnosed previously, as well as
an increase in new diagnoses among older people.
I dwell for a moment on the growing cohort of people
of more than 50 years of age that live with HIV. This
cohort will be bringing new needs to the NHS, and it
should be ready for them. As people get older, they see
more of their GPs. Many older people living with HIV
suffer side effects from treatment; overall, they report
twice as many other long-term non-HIV conditions as
their non-HIV positive peers. As a consequence, they
need to spend more time in health care, including
primary health-care settings, than their peers. That makes
their relationship with non-HIV specialist doctors almost
as important as their relationship with HIV doctors.
The Terrence Higgins Trust surveyed about 400 people
aged over 50. It found that
“respondents repeatedly told stories of discrimination, ignorance
and poor clinical treatment in generalist healthcare, particularly
in primary settings.”
The survey concluded that there was important work to
be done to address HIV discrimination in primary care
settings, as doctors there may not be so familiar with
people that have the virus.
In Hove and in Brighton, we have some of the most
HIV-aware clinicians in the country, and our specialists
are among the best in the world. However, we must not
be complacent, as parts of the NHS in our area will be
less HIV-aware, as we heard earlier. I urge the Minister
to work with her colleagues, the all-party group on HIV
and AIDS and charities such as the Terrence Higgins
Trust to tackle the problem. Training for GPs and
surgery staff could be one way to do so.
Medical care is not the only service needed by older
people. In the same Terrence Higgins survey, fewer than
one in 12 older people with HIV said that they would
approach a mainstream organisation for older people
for support. Age UK and the Terrence Higgins Trust
are working to change attitudes and to improve
understanding of HIV in mainstream social care and
social networks for older people. Again, I hope that the
Minister will listen to the views of people living with
HIV as her Department moves to create a social care
system fit for the 21st century.
I turn next to late and undiagnosed HIV. Of all adults
diagnosed with HIV in 2009, 52% were diagnosed late,
when their CD4 count dropped below 350. People with
the worst rates of late diagnosis are over the 50s. Recent
research suggests that the majority of those people will
have had previous contact with their doctors. Late
diagnosis, whatever the age, is a problem; if treatment is
not started promptly, it can do serious damage to the
body and severely cut life expectancy.
HIV treatment is excellent, and if diagnosed promptly,
one can live to an old age. It is not right that some of my
constituents will not have this opportunity by being
diagnosed too late to benefit from it. It even makes
financial sense to treat people early; it is much cheaper
to have people someone stable on HIV treatment than it
is to treat them for the endlessly recurring serious
conditions that can result from undiagnosed HIV. HIV
treatment also reduces viral load; as a result, those who
are diagnosed and on treatment are less likely to pass on
the virus.
Now is the time, while we are focusing on public
health and while we are worrying about public finances,
to take action to tackle late diagnosis and undiagnosed
HIV. I am proud to say that people in Brighton and
Hove are not sitting back waiting for someone to come
up with a solution but are already working hard to
tackle the problem. There have been two pilot studies in
our area looking into ways of reducing undiagnosed
HIV, using clinicians in the area. Of 596 people tested,
only two positives were found. However, even more
people were identified through an anonymous survey
done by the university of Brighton. I urge as many
people as possible to be tested, because of the 3,872
anonymous tests 54 were positive.
My constituency is proof that HIV can affect anybody,
whatever their background, age or sexuality. As more
people with HIV grow to old age, we must ensure that
they receive services of which we can be proud. Such
services should include prompt diagnosis.
3.6 pm
Ian Austin (Dudley North) (Lab): I am delighted to
take part in this debate. First, it gives me the opportunity
to congratulate my hon. Friend the Member for Inverclyde
(David Cairns) not only on securing the debate but on
the important work that he does in chairing the all-party
group on HIV and AIDS. Secondly, it gives me the