The new Homerton Hospital waiting room. Credit: NHS
Hackney is fighting its high HIV rate with major efforts to raise levels of sexual awareness and tackle the disease.
The number of people attending Homerton Hospital for HIV-related issues has risen markedly in the last five years alongside a huge rise in the overall attendance at sexual health clinics in Hackney, according to figures obtained by a Freedom of Information request.
These findings come after it was revealed last year by Public Health England that Hackney’s rate of HIV is five times higher than the UK average and the tenth highest in the UK.
The number of people with HIV receiving care at Homerton Hospital rose markedly by over 100 every year, from a total of 1182 in 2008 to 1660 at the end of 2012. Meanwhile, clinic attendance at both Hackney’s sexual health centres, the Clifden Centre at Homerton Hospital and the Ivy Centre in Hoxton rose in their thousands annually within the same time period.
Yet according to Professor Jane Anderson, director of the Centre for Study of Sexual Health and HIV in Hackney, these increases result from “the major change in approach within the borough, with services becoming much more accessible to meet the demands of what should be a completely preventable infection.”
The changes have been facilitated by a merger between the NHS acute trust at Homerton and the community trust. This arrangement has integrated all services on offer, bringing everything from contraception advice to HIV testing under one roof, providing easier access and refocused efforts and budgets on a local level.
In addition, the Clifden Centre at Homerton Hospital underwent a major refurbishment, reopening in October 2013. The Ivy Centre raised its profile, providing some explanation as to why attendance rose from 9,766 in 2010/11 to 15,241 in 2012/2013.
“We have seen a very interesting population shift in the borough,” says Prof Anderson. “Now it is a very young population, so the number of people needing services such as contraception and treatment for sexually transmitted infections are high on our agenda. Our services must meet the demands of our population and that has shown in attendances.”
The nature of HIV makes it very tough to tackle, as symptoms can go almost completely undetected over a long period of time. There has been a national drive to try and diagnose people and get them into care early.
This is a challenge in Hackney because the prevalence of the disease is so high. The two main groups of people at risk for HIV in Hackney are homosexual men and the mainly African migrants in the borough.
As part of the changes two years ago, a concerted effort was made to diagnose HIV both in and outside the hospital and to educate staff to recognise the tell-tale signs of the infection, otherwise known as indicator conditions, such as, pneumonia, tuberculosis and shingles.
All 44 GP practices in the borough pledged to tackle HIV testing, referring more and more people to Homerton and the Ivy Centre.
Alongside these measures, patients in Homerton are recommended to take an HIV test if being treated for these indicator conditions unless they choose to opt out.
Eighteen months ago, Out There in Hackney, a dedicated clinic for homosexual men based at the Ivy Centre was set up after feedback indicated that gay men were not using the existing services, preferring to travel outside the borough or not be checked out at all.
With migration, Prof Anderson is convinced that HIV is being contracted in London every day due sexual networks within migrant communities, rather than being brought back into the country from elsewhere.
“I have seen a major transformation in my own professional career,” she explains. “When I started working in this field in 1984, everybody died. Now, if diagnosed in time, you can expect an almost normal life expectancy with HIV. In 2014, it is a preventable infection but still we see people walking in through the door with new HIV. That is our biggest challenge and it forces us to work smarter to combat the issue in Hackney.”
The efforts of Prof Anderson and her team have been heralded by the National Aids Trust. Suzy Price, the spokesperson for the Trust says: “While the increase in HIV patient numbers is related to the demographics of the area, it also reflects the efforts of sexual health clinics and GP practices in Hackney to reduce rates of undiagnosed HIV in the borough.”
Meanwhile Mark Santos, director of East London HIV charity Positive East, contends that while more work needs to be done to eliminate the onward transmission of HIV, Hackney leads the way in HIV testing enabling reach to those with undiagnosed infection.
He says: “Hackney’s continued commitment to specialist HIV support services which underpin the effectiveness of HIV clinical outcomes is key to ensuring the health and wellbeing of people living with HIV is much welcomed.”
