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It is the last few days of consultation on the new BHIVA guidelines for treatment of people living with HIV.

I am really pleased to say that there  has been extensive consultation with the community of people with HIV.  BHIVA had  a community representative on the writing committee and also held two large consultative meetings with the community: one before Christmas and one last Tuesday. On Tuesday the room at Friend’s House in Euston was filled to the brim with a good diversity of people.

There are two extremely  innovative sections in the guidelines: one dedicated  to Patient Involvement in Decision Making and one on Treatment as Prevention. The latter is especially ground-braking because it acknowledges in practice the prevention revolution brought about by the HTN052 study. This was a research  among couples where one partner was positive and one was negative, who were not always using condoms, which proved scientifically that people on HIV medications are 96% less likely to transmit HIV.

It’s a fact: there are HIV  positive people who are not able to use condoms, maybe because they want to conceive, or because they feel it interferes too much  with the pleasure and spontaneity of sex, or maybe because, as a consequence of power dynamics, it can be difficult for women or young people to always negotiate condoms. Starting treatment in order to avoid passing HIV to a negative partner is acknowledged as an ethical option by the guidelines. Obviously the guidelines also include a lot about in-depth discussion with the doctor of all the ‘caveat’ and especially  the crucial importance of stressing the use of condoms ( and  I suggest to include female condoms! )  to further reduce the very low risk.

I feel it this is  an amazing acknowledgement of the sexual and reproductive rights of people with HIV, as well as that  it could contribute to reduce stigma,  and finally  that it  also provides a strong argument to make treatment available  to all.

It is not surprising and maybe not a coincidence, that this week there has also been a change in the UK policy that prevented foreigners, such as failed asylum seekers and people on a student VISA, to access HIV medication  (an issue on which we had been campaigning since 2004). The rationale beyond this change was not just that it was absurd and incoherent that ‘ foreigners’ could access treatment for all infectious diseases apart from HIV ( the evil disease that needs to be singled out!). The argument for providing treatment to everybody on UK territory was very much made on the notion that this is important for public health and prevention, because people on treatment are so much more less likely to transmit HIV.

I really hope that what is happening in the UK will have even further ramification in promoting Universal Access to treatment to the millions of people who still need it, especially in the current climate of uncertainity created by the the Global Fund Crisis.

Good coverage on the change in policy on access of HIV treatment was on the Telegraph.

If you  are interested in commenting on the BHIVA treatment guidelines (and can digest the 111 pages written in medical jargon….gulp!)  the consultation is open until Monday 5th March.

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2 thoughts on “BHIVA HIV Treatment Guidelines

  1. Great Post.

    It seems to me that the Swiss Statement should be celebrated and much of that celebrating should be done in a highly visible and public way by HIV charities. We have here a ground breaking piece of research that categorically shows a link between HAART and the decreasing rate of infectiousness, to the point of none infectiousness when certain conditions are met. And yet, what I see are HIV charities making a decision at board level not to push this information into the hands of the press/media and also refusing to endorse this scientific information via their helplines to HIV+ community. Quite frankly, this is shocking behaviour. All journalists should be equipped with this information.

    Why is the Swiss Statement not publicly celebrated when some of us are already being told by our medical teams that we are not infectious? I have been told by my HIV team for the last 2 years that I am not infectious because I meet the conditions of the Swiss Statement.

    The Swiss Statement needs to be in the public domain and it seems to me that if HIV charities cannot do that, then they are missing a fantastic opportunity to tackle discrimination, hate crime and the criminalisation of HIV by the legal system. Further, are HIV charities passing information about the Swiss Statement to Police Forces and to the CPS to tackle their ignorance?

    The Swiss Statement is a huge opportunity to break the link between HIV as a chronic medical condition and the horrific discrimination/hate crime and criminalisation of people with HIV in the UK.

    There should be a UK coalition supporting and endorsing the Swiss Statement.

  2. Dear Beth Thanks for your comments. I cannot speak for all HIV charities but I know that Positively UK has always spoken very clearly about the powerful effects of the HPN052 study which is the clinical trial that has provided the scientific evidence to the Swiss Statement. We have held many workshops with people living with HIV to understand the implications etc. I think it is also important to understand and stress that the evidence behind the HPN 052 Study only applies to heterosexual couples, within certain parameter. But I agree that it is an pivotal tool in fighting HIV related stigma.

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