Terrence Higgins Trust

Direct and indirect consequences of climate change pose significant challenges to people with cancer and the healthcare systems that support them. Healthcare providers are increasingly observing the ramifications of climate change across the cancer care continuum. Climate-related health challenges faced by people with cancer are expected to intensify without substantial intervention. This study aimed to assess the awareness, concerns, motivations, and behaviors of oncology nurses regarding climate change and its impact on health. This cross-sectional, exploratory study used convenience sampling and an open-access, anonymous online survey. Data were captured through the Climate and Health Tool. Among the 135 participants, most were aware that climate change is caused by human activity, but fewer were aware of the healthcare sector's contribution. Most were concerned about the effects of climate change on health and were motivated to respond but need additional knowledge and skills to act.

Background:There have been impressive advancements made in preventing and treating HIV. However, the impacts have not been experienced equally across demographics in England. African born persons, in particular women of Black African ethnicity, continue to be disproportionately affected by HIV. HIV prevention campaigns have often overlooked social, cultural, and structural factors that shape access to HIV prevention.Objectives:This paper explores how women of African and Caribbean heritage understand HIV within their social networks, and how they perceive HIV and sexual health services. This insight is needed to develop more inclusive and effective approaches to HIV prevention.Design:This study adopted a participatory action research framework, acknowledging lived experience as a basis of knowledge.Methods:Focus groups and one-to-one interviews were used to collect qualitative data from a local community women’s group between June 2021 and November 2021. In total, 23 women of African and Caribbean heritage participated in this study. Four women opted to take part in a one-to-one interview, and 19 women participated in one of five focus groups. Data were analysed using an applied thematic analysis.Results:Three key themes emerged from the data. Enduring fear of HIV rooted in past lived experiences: Fear of HIV derives from traumatic lived experiences, which have shaped trust in health care services in England and limited the acceptance of information about HIV treatment, such as U=U (Undetectable = Untransmittable). Responsibility for HIV transmission and prevention: There was a low perception of HIV acquisition risk, shaped by personal circumstances and stigmatising beliefs. For those acknowledging they may be at risk of HIV acquisition attributed this to the behaviour of their male partners. Motivation to change attitudes and reduce stigma: Participating in this study provided a safe space for women to share their experiences of HIV, ask questions, and learn new information, revealing focus groups as an effective method of raising awareness and reducing stigma.Conclusions:Multiple factors shape the understanding of HIV and uptake of HIV prevention among women of African and Caribbean heritage. Local, community-specific, and participatory HIV prevention interventions are needed to understand and respond to these factors.

This is the first British Association of Sexual Health and HIV (BASHH) national guideline for the management of sexually transmitted enteric infections (STEI). This guideline is primarily aimed for level 3 sexual health clinics; however, it may also be applicable to other settings such as primary care or other hospital departments where individuals with STEI may present. This guideline makes recommendations on testing, management, partner notification and public health control of STEI.

The use of digital vending machines (VMs) to delivery HIV self-testing (HIVST) could expand HIV testing in priority populations. We surveyed primarily Black African (BA) participants and other minority ethnicities, to identify acceptability, preferences, and concerns of using VMs for HIVST dispensing. A structured survey was developed with Black African and Caribbean, Latin American and other Minorities (BLAM) communities, and distributed between September 2018 and January 2019. Participants were recruited using mobile tablet surveys distributed by outreach volunteers, and online through BLAM communities’ websites, workshops, and language-specific messages on social media. Descriptive analyses were undertaken stratified by ethnic groups. One hundred and twenty-eight (67.0%) participants identified as BAs, 31 (16.2%) Black Caribbeans (BCs), 22 (11.5%) Latin Americans (LAs), and 10 (5.2%) other non-white ethnicities (ONWEs). Rates of willingness to use the HIVST were high in all groups except BCs (BAs 77.9%, BCs 53.6%, LAs 81.8%, ONWEs 80.0%). Most participants favoured healthcare-associated venues for VM placement, but there were differences in community venues favoured by different ethnic groups and concerns reported. HIVST is acceptable in many BLAM communities and increases understanding of the concerns and how to address them in the design of VMs for HIVST, to expand HIV testing in these priority communities.

IntroductionNational HIV Testing Week (NHTW) is an annual event co-ordinated by HIV Prevention England (HPE) which aims to increase HIV testing in England, as well as to increase awareness and acceptability of HIV testing among key populations. It takes place each November in the lead-up to World Aids Day.MethodsDigital and print promotion of: the event and postal testing services, as well as digital interactive information tools which seek to reduce barriers to testing. Provision of printed resources, including customizable and community-language posters to promote local testing events. A post-event evaluation to assess the effect of the campaign was also completed by the organisations involved.ResultsFor NHTW 2016, 100 organisation representatives responded to the post-event evaluation. 65% agreed that NHTW increased their capacity to impact their community/clients. The biggest impact was through increasing awareness of the importance of HIV testing in the local community (86%), followed by delivering more HIV tests (57%). Of those organisations who provide HIV testing, 33% provided at least twice as many tests in testing week compared with a regular week.Nearly 320 organisations ordered 400,931 NHTW resources. 211 testing events were registered on the website and 5,740 HIV home-sampling kits were ordered by the public, driven by social media and mobile app advertising.DiscussionNHTW is a high-impact event which promotes HIV testing, uniting community, clinical, government and statutory stakeholders. The campaign in the future will hope to engage more partners and keep amplifying local HIV testing and raising awareness.

The objective of this study was to investigate if patients diagnosed in community clinics have higher baseline CD4 cell counts than those diagnosed in Genitourinary medicine (GUM)/HIV clinics. We undertook a retrospective review of baseline CD4 cell counts for patients receiving a reactive HIV test in community-testing clinics. Eleven local HIV clinics were contacted to determine the baseline CD4 cell counts of these patients. Baseline CD4 cell counts of those diagnosed in the community were compared with mean local GUM/HIV clinic and median national baseline CD4 cell count for their year of diagnosis. Clients diagnosed in community settings had a mean baseline CD4 cell count of 481 cells/mm3 (SD 236 cells/mm3) and median baseline of 483 cells/mm3 (interquartile range 311-657 cells/mm3). This was significantly higher than those diagnosed in the GUM/HIV clinic local to the community-testing site (mean baseline CD4 397 cells/mm3, p = 0.014) and the national median for that year (336 cells/mm3, p < 0.001). HIV testing in community settings identifies patients at an earlier stage of infection than testing in clinical settings.

After many delays, the public consultation on HIV prevention tool PrEP (pre-exposure prophylaxis) is finally here. Now is the time to mobilise - help end the HIV epidemic by responding to this NHS England consultation before 23 September.

ObjectivesTo describe an outbreak of infectious syphilis in rural North Wales and the control measures implemented.MethodsFollowing reports of an increase of syphilis in North Wales, a multidisciplinary Outbreak Control Team (OCT) was established. A multilevel prevention and control response was initiated, including: active case surveillance, partner notification and treatment, sexual network analysis, awareness raising with professionals and affected communities, point-of-care syphilis testing at a sauna and a health promotion campaign targeting users of men who have sex with men (MSM) social network mobile phone applications (apps).ResultsFour cases of infectious syphilis were diagnosed in clinics in North Wales per 100 000 population in 2013 compared with a mean of one case per 100 000 in the preceding decade. Diagnosed cases peaked in January 2014, declining in the first half of 2014. Initial cases were clustered in the westerly rural counties of North Wales and were predominantly white men, self-reporting as MSM (median age: 34 years, range: 17–61). Point-of-care testing at a sauna did not identity further new infections, suggesting that the cluster was relatively focused and had probably been detected early. The use of apps to find sexual partners was a feature of the network affected. A health promotion campaign, initiated by the OCT, targeting men using MSM apps reached 92% of the 755 men messaged.ConclusionsThe outbreak was successfully controlled. However, it is difficult to determine which of the interventions implemented were most effective. Future outbreaks should be used as an opportunity to evaluate interventions using apps.