A Look at HIV in the UK

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Here's the intro to an interesting article on the state of HIV infection in the UK. It's not as pretty a picture as has been painted.

 

We agree to meet outside Pret A Manger on Southampton Row, central London. Waiting in the distance, through the grimy sunlight and the clatter of lawyers, City workers and literary types – all macchiatos and adrenaline – stands a frail-looking figure, bent over and clutching a walking stick. As I approach he smiles. His name is Hugh, he is HIV positive and he is 35 years old.

 

What follows is a story we never hear. It is a tale of seizures and brain cancers, of mental illness short-circuiting anti-HIV medication. It is a story, far from unique, that has been sunk, weights tied to the ankles. Meanwhile, on the surface ripples just one notion: that today in the UK – perhaps the best place in the world to be living with human immunodeficiency virus – HIV is nothing more than a chronic, entirely manageable condition.

 

“It’s all fine now – you just take a pill!” says Chris Sandford, mocking the chorus of voices desperate to convey only the positive about being positive. “I’ve had an MP, a Lord and a GP say this to me in the last month,” adds Chris, who is a patient representative at a London HIV clinic.

 

In April 2014 the HIV-is-fine-now rhetoric reached its mainstream zenith when Dr Max Pemberton, a psychiatrist and columnist, wrote an article in the Spectator entitled ‘As a doctor, I’d rather have HIV than diabetes’ – his rationale being that “for those with HIV, providing they take their medication, there are very few problems”. The story was quoted in Parliament the following month and picked up by media outlets internationally. It topped off several years of headlines in which ‘cures’ were mooted – even predicted to arrive “within months” – and in which “normal life expectancy” was the resounding message.

 

Over the last three decades, HIV ‘messaging’, as charities are wont to call it, has swung from black to whitewash: from John Hurt’s booming voice of doom, terrorising the British not to “die of ignorance” in the 1987 television public awareness campaign – complete with the notorious falling tombstone – to today’s trickle of bouncy news stories, each painting HIV as just another condition that medicine has under control.

 

Yet there are more than double the number of new infections in the UK today than there were 20 years ago – and, for the first time, more than 100,000 people living with HIV. Among the statistics are stories far more complex than suggested. These lives, unnoticed, find the virus seeping into wide and unexpected territories: the psychological, social, financial and, as if in direct contradiction of the headlines, the medical.

 

Since 1996, combination therapy – or highly active antiretroviral therapy (HAART) – has indeed transformed the health and lives of HIV-positive people. Deaths have plummeted, and many with HIV lead entirely fulfilling lives, enjoying success at work and in relationships, and having uninfected children. The medication has, for most, lowered their viral load – the amount of virus in the blood – to such a level as to render them effectively uninfectious.

 

If a person is treated early, their life today is such that it would be unrecognisable to someone infected with HIV 20 years ago. Many do just take a pill. But what goes unmentioned are the side-effects, stigma and related conditions either triggered by the virus or ushered in by it.

 

Seismic changes in HIV demographics, in the UK especially, have also gone largely unnoticed. Once an overwhelmingly white, gay and male phenomenon, HIV is now transmitted through heterosexual sex in 48 per cent of cases (compared to 43 per cent through sex between men). Women make up a third of patients receiving specialist HIV care, and black and minority ethnic people nearly half.

 

To capture these complexities, I sought four people whose experiences would reveal the untold story of HIV in the UK today. Their stories uncover a variety of issues, which, while not often seen together in one person, are separately found in many. What emerges is a picture of a uniquely individual condition, one that defies the everything-is-fine-now gloss with which it is now so routinely painted.

The entire article can be found here:

 

One virus, four lives: the reality of being HIV positive (Mosaic)