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
The HIV-related policy agenda for African communities in the UK
NAT is undertaking a project to identify what aspects of the HIV-related needs of African communities in the UK can be addressed by changes and developments in policy, in other words by decision-makers doing things differently. The project will involve desk-based research and discussion/interviews with key stakeholders. The output will be a report mapping the HIV-related policy agenda for African communities in the UK. The aim will be to use this output to refocus activity in the HIV sector and beyond, securing real advances in how we respond to the HIV epidemic amongst Africans in the UK.
Policy Lead - Yusef Azad
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
Confidentiality of HIV status within the NHS
This last year NAT have been undertaking a project examining current law, policy and practice within the NHS relating to the handling and sharing of personal medical information of people living with HIV. The project also looked at recent developments in data sharing and secondary uses of healthcare information and the implications for how HIV patients’ information is used, handled and shared. It was also considered whether the NHS number should be routinely used by HIV clinics for their patient records. The output for this project was a policy report summarising our findings and outlining key recommendations, which can be read here.
We are now currently developing a resource for people living with HIV which explains how their medical information is handled and shared and what their rights are around confidentiality in the NHS. We will also continue to monitor changes to data sharing to ensure that the concerns of people living with HIV are considered and their rights around confidentiality are upheld.
Policy Lead - Yusef Azad
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
- Housing and HIV - housing continues to be an issue for many people living with HIV, especially given recent reforms to housing and benefit policies. NAT is always interested to hear from people living with HIV about the impact of these changes, and from organisations that support them. NAT is looking revise our briefings on housing in the Spring, but in the meantime please take a look at our page on housing where you can find out more about these issues and our previous work on HIV and Housing. Policy lead – Philip Glanville
- 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
- Improving HIV training for GPs - NAT are working to improve the HIV training and information provided to GPs in the UK. We will explore ways of engaging GPs more effectively on HIV testing in particular, including influencing key quality standards around HIV testing and diagnosis in primary care. Policy lead- Sally Thomas
- Understanding the impact of changes to public services on people living with HIV. In recent months there have been a significant number of changes to the way that public services including health, social care and benefits, are delivered. NAT wants to know how these changes are affecting people living with HIV and if they are receiving the support that they need and are working with local organisations to better understand the impact. Policy lead: Sarah Radcliffe