As part of my work at Positively Women this year I have been running some HIV awareness trainings for dentists and GPs in the London Boroughs of Hammersmith and Fulham.
The trainings had been designed following a small research we did among people living with HIV in those boroughs. We distributed questionnaires, ran focus groups, and the findings were quite shocking
Even if 96% of people living with HIV are registered with a GP, 60% would not tell their GP of their HIV status, and 33% perceive their HIV status prevents them accessing effective care from a GP.
Looking at PLHIV accessing dental care, the picture is even gloomier. Only 65% of people living with HIV, who participated in our research, are registered with a dentist
Moreover 55% would not tell their dentist about their HIV status. Overall 53% of our respondent told us that they felt that their HIV status was preventing them accessing dental care.
The positive people involved in responding to the questionnaire and the focus groups suggested that to improve the situation GPs and Dentists should receive more trainings around HIV and stigma.
So I designed a module that could be delivered in about an hour which would go through the basics of HIV awareness and address stigma. GPs and Dentists have very busy schedules and I needed to have something that could be delivered during their lunch breaks.
We offered the free training to most GPs surgeries and Dentists in Hammersmith and Fulham. Only 4 surgeries replied they were interested in attending even if we were offering it for free and to be delivered at their premises.
I went on to deliver those few trainings, and it was one of the most difficult experiences in all those years that I have been an HIV and Sexual Health trainer.
For the first time I found myself addressing a definitely unsympathetic crowd. In spite of my quizzes, DVD with people talking about living with HIV, case studies, I constantly had the feeling that they were thinking that I couldn’t possibly know more of them, who were medically trained.
Some dentists felt it was totally justifiable to always book HIV positive patients last, because a special cleaning was needed, and they also suggested that it would be better to have a ‘special room’ to reserve to treat HIV positive people. They seemed unmoved by my questions: What about the fact that a third of those who live with HIV still haven’ t been tested? What about other blood born viruses such as Hepatitis C which are much more endemic and contagious? Shouldn’t everybody be treated as if they were potentially contagious? What are Universal Precautions recommended by the World Health Organization for?
Another shock came with a group of GP’s. I had a question in my quiz which asked what the probabilities were for HIV positive women who have access to ARVs and all the interventions to reduce transmission to have a healthy baby. Most of them ticked the box 50%, while it is 99%!
Afterwards they didn’t even let me play the DVD where people talked about stigma, and when I asked them if they understood the role that stigma played in stopping people accessing health services they corrected me saying: ‘Imagined stigma…’. I felt like shouting: “Well I have lived with HIV for 13 years and I can be pretty certain that there is nothing imaginary about the stigma and discrimination many of us experience.”
I left the GP training fuming. I kept thinking, if these are the attitudes of well educated health professionals, how much worst can it be among the general population? How much more do we need to speak up, be visible and educate our communities for ignorance and prejudice to be over come?