BHIVA supports free registrations for over 50 community representatives to attend their conferences and it is through this process I attended the autumn BHIVA conference that covered a wide range of important topics relevant to HIV, with accommodation and travel supported by EATG. This report is a snapshot of the event, outlines some of the key messages and topics discussed and does not cover all speakers and sessions.
Wednesday 13 October commenced with:
ViiV healthcare symposium on HIV in Women : Science, stigma and society.
Chaired by Dr Annemiek de Ruiter, Senior Global Medical Director, ViiV healthcare,
Dr Paul Benn, European Medical Team ViiV, highlighted
- 17.4m women in the world live with HIV, 2014
- 1 in 3 patients were female attending clinics in 2014;
- Women have poorer treatment outcomes.
- Low numbers of women in clinical trials - Only two studies raised:
Dr Annemiek de Ruiter, ViiV discussed cultural aspects for women:
- Global studies highlight 80% of women with HIV experience violence
- Outlined studies across the world and impact of violence on women:
- Nigeria - 50% WLHIV should be ashamed
- Mumbai - 73% denied to marry
- Vietnam -70% not safe for children with HIV to play
- Malawi -5 0% isolated; Fear of disclosure
Dr Sara Paparini, Research Fellow, London School of Hygiene & Tropical Medicine
- Presented impact of stigma and discrimination
- Outlined stigma as an attribute, a product of relationship and a process – stigmatisation.
- Two key approaches Individual and Society based.
- Stigma can impact on a spectrum – depends on where the person is at a specific time.
Paula Evenden Co-Director Dragonfly Collective;
- is a social venture tackling inequality and injustice, supporting socially conscious organisations to enhance their social impact and encourage citizens to engage in change.
- Links into local domestic abuse & HIV organisations.
Commissioning in England for the future.
Professor Simon Barton Chelsea & Westminster Hospital discussed:
- Five new models of NHS care:
- Integrated primary and acute care systems
- Multi-specialty care providers
- Enhanced health in care homes
- Urgent and emergency care
- Acute care collaboration.
Sustainability and Transformation Plans (STPs) key local bodies, collective discussion forums which aim to bring together health and care leaders to support the delivery of improved health and care based on the needs of local populations. They are not statutory. Essential for local organisations to engage and influence the STPs.
BHIVA/Primary Care Project
Recommendation for Commissioning
- Person-centered and not facility based or disease specific commissioning
- Commission care coordinators
- Support development of shared EPR
- Financial incentives and support for HIV testing
- Resources and financial support for the primary care of PLHIV
Same Day Treatment
Dr Nneka Nwokolo Chelsea & Westminster Hospitals discussed the impact of starting treatment following a diagnosis of HIV, and the findings from 56, Dean Street Clinic, London. Although no data about starting treatment within a day of diagnosis she explained that some of the patients saw it as increased hope, which assisted psychological care for some. Coupling this with peer support many patients benefitted from earlier treatment.
Professor Saye Khoo, University of Liverpool outlined long acting treatment with anti-retrovirals. He talked through the LATTE study and the complexity of intramuscular injection of ARVs. ‘Results of the LATTE-2 study show that long acting injectable drug formulations may offer an important option for HIV maintenance therapy and we remain committed to developing such combinations as we enter phase 3 studies’ stated Wim Parys, M.D., Vice President and Head of Research and Development Global Public Health, Janssen.
PrEP: the politics and practicalities of implementation
Dr Laura Walters, University College London and (earlier in the day) Dr Michael Brady, King’s College London outlined what is happening with PrEP in the UK following the High Court hearing held on Wednesday 13 July 2016. The judge has now handed down his judgement, and has concluded that both local authorities and NHS England have the power to commission PrEP. NHS England is appealing the judgement. Key challenges : lack of evidence & gaps on dosing and risk, heterosexual issues, no prep studies on transmen and transwomen; ethics of buying PrEP outside of the NHS.
Key presentations :
Thursday 14th October commenced with:
Gilead Sciences Satellite Symposium Achieving a balance : planning ahead for the real world challenges we face in HIV.
Dr Christoph Spinner, Technical University of Munich
HIV remission : viral suppression in the absence of ART.
Dr Sarah Fidler Imperial College Healthcare NHS Trust, London introduced the SPARTAC study which examined whether treating people recently infected with HIV with anti-HIV drugs for a short period of time could slow down the damage caused by HIV to the immune system and consequently delay the need to start long-term treatment.
BHIVA Community Symposium
Paul Clift Chaired the community symposium “What are the effects of ‘austerity’ on the HIV population.
Ms Marie Pousseau, Kings College Hospital, London, presented two cases of PLWHIV who have been affected by the ‘austerity’ cuts within the social housing services and loss of community support leaving the individuals in homeless situations.
Andrew Dalton, University of Sunderland presented a National Perspective: the current health of the UK-based HIV/AIDS organisations and the effects of ‘austerity’. He outlined the impact of cuts in health and social care funding on national charities following a research study he undertook. Many smaller organisations have already closed or merged with larger organisations due to the cuts in funding. He outlined the need for all charities in the field of HIV to work more in partnership to ensure the person living with HIV continues to benefit long term.
Mr Bryan Teixeira, EATG, presented Internal Commitments: ‘austerity’ and ending AIDS by 2030.