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Jim McManus, OCDS, CPsychol, CSci, AFBPsS ,FFPH, FRSPH

Director of Public Health, Hertfordshire County Council

Thanks to Rob Bacon for work on this presentation

HIV in Hertfordshire 1 December 2014

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The Hertfordshire Sexual Health Strategy (2014 – 2019)

• A sub-strategy of the Hertfordshire Public Health Strategy

• Our ambition is healthier, longer lives for everyone

• The Sexual Health strategy aims to improve sexual health for the whole population of Hertfordshire by considering sexual health across the life course; and includes the needs of those populations that are more at risk of poor sexual health outcomes.

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Caveat

• We emphasise that the data reported here is only collected from ages 15-59 years, so numbers are likely to be higher than quoted

• We are seeing rising STI and HIV infections in over 50, so even more likely to be an underestimate

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HIV in the UK

• According to Public Health England data there are 21,900 people in the UK living with HIV, who don’t know they have it.

• Rates of HIV are disproportionately higher in sub-Saharan African groups and men who have sex with men (MSM).

HIV in the UK at the end of 2012

HIV Prevention England 2014

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• In 2012, 948 Hertfordshire residents aged 15-59 were accessing HIV related care in 2012, a rate of 1.4 per 1,000 population (Sexual and Reproductive

Health Profiles, Public Health England, 2014).

• This is slightly higher than the rate for the East of England (1.3), but lower than England (2.1).

• Within Hertfordshire, Watford had a rate three times higher than East Hertfordshire (2.8 compared to 0.8).

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But

• Some people accessing care in Herts, some elsewhere

• Between 240 and 400 undiagnosed depending on how we break down the 21,900 undiagnosed

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• The outcome for HIV reported in the Public Health Outcomes Indicator Framework is ‘late diagnoses of HIV.

• 107 adults with HIV in Hertfordshire (55%) presented at a late stage of infection from 2010 to 2012, a slightly higher proportion than England (48%).

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• The earlier HIV is diagnosed, the sooner a person can get access to treatment and improve their individual prognosis while making any changes necessary to prevent onward transmission.

• National Late diagnoses rates suggest heterosexuals with HIV are particularly prevalent in late diagnoses. We’re awaiting local data on this

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Percentage of Adult (over 15 years) Late HIV diagnoses

2008/2010 2009/2011 2010/2012 2011/2013Source: Survey Of Prevalent HIV Infections Diagnosed (SOPHID), HIV and AIDS New Diagnoses

Database (HANDD), and CD4 Surveillance - analysed by the Health Protection Agency

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Number of adults (over 15 years) with a late HIV diagnosis by district

2008/2010 2009/2011 2010/2012 2011/2013Source: Survey Of Prevalent HIV Infections Diagnosed (SOPHID), HIV and AIDS New Diagnoses

Database (HANDD), and CD4 Surveillance - analysed by the Health Protection Agency

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Testing Services

Across Hertfordshire, free and confidential HIV testing is available from:

• Any county sexual health service

• Any hospital

• Selected GP practices

• HertsAid (commissioned to promote and provide HIV testing)

finger prick rapid HIV tests are now available, giving results in less than 10 minutes! Many do not know this

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Next Steps

• Our goal is to help people with and affected by HIV to thrive for as long as possible

• Increase testing in specific settings, among high risk groups and areas of high prevalence

• Increase the uptake of HIV testing in MSM through outreach and access to home self-sampling HIV kits

• Assess local need for targeted promotion of HIV testing among black Africans groups

• Ensure equality and diversity information is collected by testing services and used to inform service development and identify barriers to access

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The Future

• As more people live longer with HIV, they age

• We are seeing emerging care needs in the next 10-20 years due to an ageing population of PLWH

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And finally……….

• From April 2015, Central London Community Healthcare NHS Trust will run the new integrated sexual health service in Hertfordshire, working in partnership with Chelsea and Westminster Hospital NHS Foundation Trust.

• Herts Aid will continue to provide HIV support services commissioned by HCC

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• For more information and to find services in your area visit:

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finger prick rapid HIV tests are now available, giving results in less than 10 minutes!

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