Below is a brief overview of some of the major projects we are currently working on. If you would like to provide information about any of these areas or if there are other issues that you think we should be working on please let us know.
Young gay, bisexual and other men who have sex with men (MSM) - A survey of understanding about sex
We have designed a survey for young gay and bisexual men (aged 14 - 19) looking at where and how they learn about sexuality, sex and relationships, safer sex, and HIV; including where they source information, advice or support; whether they think these sources are helpful and what types of additional information they would like more of. The survey also aims to assess what young gay and bisexual men know about safer sex, HIV and their rights.
NAT decided to undertake this project in order to help better understand support and information-related need among young gay and bisexual men which forms an important part of the UK's HIV prevention response.
Research shows that sex and relationships education (SRE) in schools is often inaccessible and not relevant to the needs of lesbian, gay, bisexual and transgender (LGBT) young people, which threatens to undermine this group's right to education. At the same time, HIV diagnoses among young gay and bisexual men have more than doubled in 10 years and rates of HIV transmission among gay and bisexual men in general remain high.
We will use the survey results to develop recommendations for relevant professionals who provide information, advice or support around sexuality, sex and relationships, safer sex, and HIV, as well as more broadly - resources and campaigns which aim to provide information and support for this group.
Policy Lead - Tom Perry
Campaigning to retain universal access to primary care
The Government has proposed significant changes to migrant NHS access, some of which are contained in the Immigration Bill, currently before Parliament. One of the proposed changes is to extend NHS charges to primary care, meaning that some migrants would have to pay for the healthcare provided by a GP. We have had an early success in that the Government has announced that the GP consultation itself will remain free - however, all other primary care could be chargeable for some migrants. We are very concerned about the impact this will have on public health, in particular efforts to reduce rates of undiagnosed and late diagnosed HIV in at-risk communities. We believe that retaining free universal primary care access for all is the only way to ensure that HIV testing, prevention and other public health effots reach everyone in our community. We are engaging with MPs and peers around the Immigration Bill to ensure that they understand the impact that primary care charges would have.
Policy lead: Sarah Radcliffe
Residential and Domiciliary Care - producing a best practice framework for HIV
We are undertaking a project to look at residential and domiciliary care for people living with HIV. The project will result in a best practice guide on HIV for UK providers of residential and domiciliary care.
People living with HIV and on treatment are now likely to have a normal life span and are living into later life - with one in four people living with HIV now over 50. However, this positive news for people living with HIV has implications for the services they receive and will need in the future. It means that providers of residential and domiciliary care need to be prepared and have the policies in place to provide high quality appropriate care.
The guide will seek to ensure that everyone living with HIV receives integrated and person-focused care, which respects their dignity and independence, whether they are receiving care at home or in a residential setting. It will cover a range of issues including confidentiality, access to HIV treatment, access to psychological support, infection control policies, impact of co-morbidities, dignity and human rights as well as ensuring care staff have a basic understanding of HIV and the needs of people living with HIV and feel confident in delivering care to them.
We are interested to hear about from people living with HIV or supporting those living with HIV about their experience of this increasingly important sector.
Policy Lead - Philip Glanville
Defending HIV support services
At a time of great change in how public services are commissioned, and with the pressures of austerity and cuts to English local authority funding, NAT is working to ensure the continuation of high quality support services for people with HIV, often provided outside the clinic by voluntary sector organisations and commissioned or funded by local authorities.
There is growing evidence such services may be under threat in many areas. Work includes campaigning for the continuation of the HIV/AIDS Support funding line in the local authority grant; developing the evidence-base for the importance and effectiveness of such services; and calling for greater clarity as to which commissioners are accountable to ensure relevant needs are met. We continue to lobby both central and local government on these issues and support local organisations to make the best possible case for local provision.
Policy leads - Yusef Azad and Philip Glanville
NAT has learnt that some funeral directors have refused to fully handle funeral arrangements for HIV positive people who have died. NAT will be working to address this discrimination and secure changes in policy and practice as soon as possible. We are now waiting to participate in the forthcoming review of Health and Safety Executive (HSE) guidance pertaining to funeral directors, which we have reason to believe is at the root of such practices.
Policy lead - Sally Thomas
Other things we are currently working on include:
- Personal Independence Payment and HIV- Engaging with the development of the new benefit assessment for Personal Independence Payment (PIP), which will replace DLA, and ensuring that the needs of people of HIV are considered in this process. In February 2014 we produced an updated Factsheet on PIP. Policy Lead - Sarah Radcliffe
- Improving HIV care in immigration detention- Working with NHS England and Public Health England to ensure Immigration Removal Centres consistently provide high quality HIV testing, treatment and care to people in detention. Policy Lead - Sarah Radcliffe
- Treatment as prevention- Treatment as prevention- NAT is campaigning for NHS England to commission and fund HIV clinics to provide 'treatment as prevention'. This would mean people with HIV who wish to start treatment before their CD4 count reaches 350 would be able to do so to protect sexual partners from the risk of HIV transmission. Policy Lead - Yusef Azad
- Keeping track of investment in HIV prevention - Historically it's always been difficult to monitor how much is being spent on HIV prevention and on what, largely due to inconsistency in how HIV prevention is defined. NAT is gathering information from local authorities and others with prevention responsibilities to assess what HIV prevention activity is happening in high prevalence areas across England. We want to find out what prevention activities are being commissioned, where, and who they are intended to reach. We hope to provide definitive overview of investment in prevention and to monitor how it is changing. Policy Lead- Kat Smithson
- Criminal prosecutions for reckless transmission - NAT would like to improve the quality of resources and guidance available to legal practitioners brought in to defend against allegations of reckless HIV transmission. Current guidance is targeted at prosecutors and does not fully address considerations for the defence or potential needs of the defendant. We are working on a resource which we hope will support defence lawyers to increase their understanding of HIV, the evidence presented, and which we hope will in turn support better practice in these cases. Policy Lead - Kat Smithson
Please click here for NAT’s complete 2014/15 policy workplan