HIV treatment and care
HIV treatment has always been available free of charge for those eligible for free NHS hospital treatment.
However, some non-UK citizens and undocumented migrants were still charged for HIV treatment and care. Anxiety about high treatment costs and inability to pay was identified as a possible reason why people would not get tested for HIV.
In February this year, it was announced that free HIV treatment would be made available to everyone, regardless of their immigration status or nationality. Legislation was enacted on 1 October giving this the force of law.
The policy was changed in part because of the impact of HIV treatment on infectiousness. Advocates argued the public-health benefit of diagnosing and treating people with HIV, regardless of their immigration status.
The change in charging policy does not apply to Scotland, Wales and Northern Ireland. Charges have not been enforced in either Scotland or Wales in recent years, but some people have been asked to pay for treatment in Northern Ireland.
People who are not eligible for free NHS hospital treatment may still be asked to pay the costs of treating illnesses such as diabetes, heart disease and cancer, as well as of antenatal care.
For more information on access to health care in the UK, visit our website.
Sexual health
Promoting condom use is a mainstay of HIV prevention and sexual health campaigns.
It is well known that their use can prevent pregnancy and the transmission of HIV and other STIs such as gonorrhoea and herpes.
However, their impact on the risk of acquiring an STI is less certain, as research often doesn't look at whether condoms are used correctly.
US doctors undertook a study involving over 900 people, recruited from sexual health clinics. The participants had a sexual health check-up when they entered the study and again after three and six months.
The researchers wanted to see if condom use reduced the risk of acquiring three common bacterial STIs: gonorrhoea, chlamydia and trichomonas.
The study participants recorded electronically all instances of penile-vaginal sex.
They reported over 14,000 instances of sex. Condoms were used 64% of the time. But a quarter of the time, sex with a condom involved a problem, such as slippage or breakage.
Approximately 8.5% of people who didn’t use condoms all the time were diagnosed with an STI. This compared to a rate of 7% in those who reported consistent condom use. This difference wasn’t statistically significant.
However, the rate of STIs among people reporting both consistent and correct condom use was only 3.35%.
The researchers therefore calculated that correct use of condoms all the time reduced the risk of STIs by almost 60%.
For more information on condom use, sexually transmitted infections and other aspects of sexual health, you may find our booklet HIV & sex helpful.
Mother-to-child transmission of HIV
With the right treatment and care, the risk of mother-to-baby transmission of HIV is under 1%.
The risk of transmission can be reduced by the use of HIV treatment during pregnancy, delivery and after the birth; having an appropriately managed birth; and – when practicable – not breastfeeding. In the UK, where formula milk is available, it is recommended that women with HIV do not breastfeed at all, to minimise the risk of HIV being passed on.
Use of formula milk is not an option in many resource-poor countries. Therefore, doctors have been looking at the use of antiretroviral treatment during breastfeeding as a way of further reducing the risk of mother-to-child transmission.
The latest research showed that only a third of women who started HIV treatment less than two weeks before they gave birth had an undetectable viral load at the time of delivery. This compared to 81% of women who started treatment more than six weeks before delivery.
This finding was significant because the research also showed that viral load level at the time of delivery and up to six months afterwards was associated with the level of risk of mother-to-child transmission.
The study underlines the importance of early diagnosis and appropriate HIV treatment during pregnancy.
Editors' picks from other sources
The mirror has two faces – a personal account of using facial filler for lipoatrophy
from Positively Aware
In the end, for me the few small lumps, the cost of treatment, and the pain were all a small price to pay for what it has ultimately done for my self-esteem. I feel better about myself overall, because I look healthier.
San Francisco: Volunteers Sought for HIV Prevention Study
from San Francisco Chronicle
“How many of you think you will be breaking down the doors?” Oliver Bacon asked the crowd at a San Francisco AIDS Foundation meeting at the Department of Public Health one recent evening. He was asking about their interest in a new AIDS prevention pill – the first to block HIV before it strikes. “Raise your hands.”
Hilary Clinton Applauds Namibia
from AllAfrica
The United States Secretary of State, Hillary Rodham Clinton has applauded the Namibian Government for taking ownership and providing half of the financing in the fight against HIV/AIDS in Namibia.