What is good HIV
prevention?
Ross Boseley
Health promotion Coordinator
Terrence Higgins Trust Brighton
HIV, MSM, Brighton & Hove
• Approx
1,550
accessed
HIV care
in B&H in
2012:
• 84% MSM.
• 50% of the
new
infections
in 2011 were
between MSM.
• 4% increase
over 2010
low rates
of late
diagnosis
For MSM
(Top 5th
PCT: 39%
CD350,
18%
CD200).
•More than 4 out of 10
MSM locally are
exposing themselves to
risk of HIV by having
unprotected
penetrative sex with
partners whose HIV
status is either
unknown, or one
partner is HIV
positive and the
other is negative.
*GMSS 2007, reported in B&H NHS
Sexual Health Needs Assessment
2010.
Highest
rate of HIV
outside of
London
So what's good about Brighton's HIV
prevention program?
• Well attended community clinics which identify infection
(THT Brighton Centre Positivity rate of 2.81% sauna positivity rate of 4.5 %)
•
Engagement with local stake holders, service users and community
•
Use of web and phone based social / dating sites, for promotion and interventions
•
Integration of health promotion in to outreach, local GUM, substance misuse, social care and
counselling services
•
Local research and collaboration with Universities
•
Targeted information and services based on need and insight
Partnership and
collaboration
Consultation and Development
What do people want ?
’
As long as it's safe, discrete
and confidential, I'd be more
likely to accept a test in a
sauna than schlepping all
the way up to a busy clinic
with long waiting times
‘On BBRT, it's specific bareback
site. If you say anything, “You
should use a condom” you’re
blocked. They're not there for
condoms. Otherwise why are they
on BBRT? … You want bareback
fuck, you go to BBRT. If you tell
me I must be using a condom. I’m
a bad boy. Fuck off. … What I'm
saying is don't contradict the site
you’re in. You gotta work with
within the site.’
Both younger
and older
participants felt
that messaging
needed to be
more ‘current’
and ‘localised
Community Engagement & Outreach
DudesNude
Fitlads
Bareback RT
Squirt
Gaydar
Outeverywhere
Recon
Grindr
Scruff
Craig’s List
Integrating services
Poster, referrals,
Grindr message,
Gaydar
intervention,
Outreach team
HIV & STI tests
&
Identification of
further need
Four week structured
programme & counselling
Integrated Services
45 Minutes
Community HIV / STI testing
HIV:
• Scheduled Community clinics (office based & Sauna
based evenings)
• 5 Day Walk in PoCT
• Weekend sauna based clinics
STI:
• Offered to all MSM in sauna
• Self taken STI swabs
• Offered with HIV PoCT
Face2Face
• Four new programmes have been developed
where a presenting issue would require
more than one initial Face2Face
consultation.
Fresh Start Programme (Addictions)
Choices (Sexual addiction/compulsion)
Sex and Relationships Programme
Newly Diagnosed Programme
• The programmes all use MI techniques and
aim for the client to explore their
feelings and presenting issues with the
view that they then can identify and
benefit from the programmes.
Counselling
• The more complex clients then work
with a counsellor for up to twelve
sessions and here themes may include:
• Learning how to be with their
uncomfortable emotions without always
choosing avoidance techniques
• Further help with where their risky
sexual behaviour links with alcohol
and drug use.
Looking forward
• Expanded community testing
• Increase substance misuse and sexual health
interventions
• Bringing up to date clinical and cultural
knowledge together to develop targeted
local approaches.
(e.g. VL, PrEP, Harm reduction in the ‘chem
sex party’)
• Expansion of digital approaches and online
outreach
Thank you