BHIVA Conference 2019

At BHIVA's Autumn Conference, there were many notable discussions around the availability of information, testing and medication related to HIV, including:

  • Chair of BHIVA conference Professor Chloe Orkin kicking off the autumn conference with a clear message regarding the ZERO risk of HIV transmission from someone with an undetectable viral load
  • Mr. Lloyd Russell-Moyle MP sharing some of the personal and political reasons for talking openly about living with HIV and how doing so helps lift a personal burden and puts others at ease. He also addressed the public moralisation of PrEP and the government funding cuts.
  • Latest data presented by Dr Mark Nelson, which included insights into the future of HIV: dual therapy seems as effective as triple therapy, ARVs and PrEP implants work, microneedle patches can be effective and new medications that don’t need to be taken as often work.
  • BHIVA calling for the universal availability of PrEP in their new statement

There was also a much-needed and crucial discussion around the accessibility of the above for minority groups or rural communities, including:

  • Dr Aedan Wolton, Dean Street, on transgender advocacy in healthcare, including the need for disaggregation of data regarding trans people, the need for medical workplaces where there is a trans representation, the importance of meaningful involvement of trans people, and the impact of trans people being named a key population by WHO.
  • Dr Annabel Sowemimo, Community Sexual and Reproductive Health Doctor, on Decolonising Contraception, asking why when training as medical doctors and clinicians, students are so rarely engaged in discussions about race and colonisation. She also mentioned how important it is for women and other BME people to have access to spaces in which they can challenge and address the issues around contraception. She mapped out what colonisation looks like in health/sexual health today:
    • White westerners doing medical electives and trainings abroad and doing things out of their scope.
    • Global policies (e.g. global gag rule) in which the white west control the reproductive health of brown people in the global south.
    • Forced sterilisation of those living with HIV (e.g. Namibia).
    • Disparities driven by intersectionalities
  • Dr Annette Haberl and Chloe Orkin agreeing that women are not a ‘special population’ and Haberl on female community involvement as crucial to empowering women in regards to their HIV treatment at all stages, including pregnancy and menopause.
  • There was also discussion around how smaller urban/rural communities can achieve zero HIV-related stigma, infections and deaths, in the era of Fast Track Cities:
    • By reviewing successes and challenges for smaller community organisations in rural areas, such as: higher stigma and self-stigma, need for more discreet outreach activities and need for more innovative prevention activities.
    • Considering the unpredictability of rural areas, such as issues related to the weather (floods) or poor internet connectivity.
    • Panel comment: ‘We must prevent patients testing reactive and then ‘getting lost’ in postal HIV testing.’
  • A workshop on drug use and HIV, lessons from Glasgow:
    • There is an increase of diagnoses among drug users Why?
    • Drug users have other priorities, such as finding accommodation, money, drugs and alcohol, avoiding others, or seeking out drug replacement therapy.
    • There is a lot of stigma amongst this group, so there is disengagement with services, no way of contacting them, and the geographical location of clinics is a problem given they typically have a lack of financial resources for transport.
    • Transmission is happening both sexually and non-sexually. It’s mostly over 45’s and highly affects women. Why?
    • They’re injecting cocaine, not heroine, so they inject more often. They don’t know if they are sharing needles or not, and they are injecting on the streets, when they weren’t before.
    • What has been done? (Simon Community Glasgow). Assertive and persistent outreach, as well as understanding that this isn’t their priority, so engaging with other community organisations and building relationships with them, e.g. clinic on the move.
    • They have managed to put more people on ARV, and there is increased word of mouth communication and trust within drug users.
    • A very similar phenomenon is happening in Birmingham and some of this outreach work is being replicated, including more innovative models on mopeds.