Case study: Delivering an HIV prevention workshop with DeafLGBTIQA

As part of Sexual Health Week 2019, which takes place from Monday 16 to Sunday 22 September, we look back at how partners in the HIV sector delivered an HIV prevention workshop in April 2019 with deaf LGBTIQA people.

HPE, along with the Bloomsbury Network, IWantPrEPNow and Prepster, supported deaf-led LGBTIQA group DeafLGBTIQA to host a successful workshop that provided HIV prevention training to more than 30 deaf people in London.

The event focused on HIV testing and pre-exposure prophylaxis (PrEP), as well as information on condoms and treatment as prevention.

This was the first event of its kind to be organised by DeafLGBTIQA. The group worked with the Bloomsbury Network at Mortimer Market Centre to host and provide expert speakers for the evening, as well as inviting a deaf person living with HIV to share their journey with the virus.

The aim of the collaboration was fourfold:

To raise awareness of the availability and types of HIV test to a population at risk of HIV.
To raise awareness of the availability of PrEP, including where to access it and how to take it.
To distribute condoms and HIV/safer-sex information resources to deaf LGBTIQA people.
And importantly, to raise awareness to health professionals who work in HIV prevention and health promotion of the barriers faced by deaf BSL users.

Deaf British Sign Language (BSL) users often face issues accessing health information and initiatives due to ineffective communication from healthcare professionals, or even a complete lack of accessible means to receive the information.

Captioning and other text-based services can assist with relaying information, but face-to-face delivery from sexual health experts, via interpreters and in partnership with deaf role models, provides an engaging way to provide important information.

There are a number of barriers that hinder the provision of accessible information to deaf people, which can lead them to assume a service will be inaccessible by default. Health services are often developed in ways that adversely impact on the way deaf people can access them:

Telephony services can be a physical barrier to booking appointments or making contact with services.
There is a lack of awareness that not all BSL users have adequate literacy levels to understand clinical or technical language, or to be able to book appointments online.
Healthcare professionals often do not know how to book BSL interpreters, and some deaf people report services failing or refusing to book one.

Resources and support for the workshop, including funding for interpreters, were provided by HPE, IWantPrEPNow and Prepster.

DeafLGBTIQA was successfully able to create an accessible event for a community which are traditionally left behind or who’s needs are not fully considered. Some of the successes included:

Providing a safe and inclusive space for participants to discuss HIV and PrEP, which for many was the first time communicating with others on the subject.
Connecting 35 deaf LGBTIQA people with approximately 10 health and community professionals working in HIV and sexual health, who were able to learn about the different needs of deaf people.
Providing free condoms, lube and HIV/sexual health resources to attendees.

The event successfully raised awareness and knowledge in a number of key areas, given that some people attending the event had never heard about interventions like PrEP before. On a scale of 1-10, all the key areas covered by the workshop showed an increase in knowledge among attendees:

HIV: an increase from 6.9 before the event to 8.8 after.
HIV testing: an increase from 7.1 to 8.9.
PrEP: an increase from 5.0 to 8.4.

To find out how you can make your services and projects more deaf friendly, please contact Deaf LGBTIQA:

Email: [email protected]
Twitter: @DeafLGBTIQA
Instagram: @DeafLGBTIQA

Further decline in new HIV diagnoses in the UK

New HIV diagnoses have fallen for a third consecutive year, the latest data from Public Health England (PHE) shows. In 2018 a total of 4,484 people were diagnosed with HIV in the UK, a 6% reduction from the 4,761 diagnosed in 2017.

PHE has advised the intensification of combination prevention has been critical to the decline in HIV incidence in gay and bisexual men since 2012. Further information will be released in PHE’s annual report, which will be published in November.

The increase in HIV testing, access and availability to immediate antiretroviral therapy for people diagnosed with HIV, and the scale-up of access to pre-exposure prophylaxis (PrEP) have all played a role in the continued decline of new diagnoses.

The decline in gay and bisexual men

Since 2015 there has been a staggering 39% decline in new HIV diagnoses among gay and bisexual men. Within this group, the steepest declines have been recorded within men who are:

White (46% decline since 2015)
Born in the UK (46%)
Aged 15-24 (47%)
Resident in London (50%)

The biggest declines outside of London in gay and bisexual men were seen in:

West Midlands (47%)
Scotland (43%)
East Midlands (40%)

In 2018, two out of every five gay and bisexual men newly diagnosed with HIV lived in London.

The decline via heterosexual contact

During the same time period (2015-2018) the fall in new diagnoses from heterosexual contact was 24%. Within this group the biggest declines have been recorded in people who are:

Adults in London (40% decline since 2015)
Aged 25-34 (34%)
Born in Africa (24%)

Late diagnoses

There are still challenges for the sector despite the continued decline in new HIV diagnoses. In 2018, 43% of all diagnoses were late. PHE has once again repeated its warning that people diagnosed late face a ten-fold increased risk of short-term mortality.

Population groups with particularly high late diagnoses rates include:

Heterosexual men (60%)
Black African adults (52%)
Those aged 50 and older (59%)

People diagnosed late are more likely to experience an AIDS-defining illness at the time of their diagnosis: this was true of 225 people in 2018, a similar number to 2017.

People receiving HIV care in 2018

In 2018 there were 96,142 people receiving HIV care in the UK, of which:

97% were receiving antiretroviral treatment
97% of people on treatment were virally suppressed

The percentage of those receiving treatment was slightly less in 15-24 year olds and in people who inject drugs. Viral suppression was consistent across all population groups.

Trans people

For the second consecutive year PHE has supplied data on HIV diagnoses in trans people. In 2018, 11 trans people were diagnosed with HIV, which is a fall from 16 in the previous year.

The data from PHE now shows that 152 trans people were seen in HIV care in 2018. Of these, 33% were 50 or older and 39% were black, Asian or minority ethnic (BAME). All trans people seen in care were on treatment.

What this means for HIV prevention in England

The hard work to sustain the decline in new HIV diagnoses must continue. The combination prevention approach is working in the UK and efforts to increase awareness and knowledge of correct condom use, HIV testing, PrEP and HIV treatment are necessary to maintain this momentum.

Late diagnoses remain an area that the entire health system needs to take responsibility for, ensuring that all population groups have access to HIV testing. The HIV sector must work with primary and secondary care providers to increase opportunities for people to test outside of traditional sexual health services.

Particular attention needs to be paid to regions outside of London and to those subgroups which are not seeing as large declines in new diagnoses as witnessed in white gay and bisexual men.

National HIV Testing Week presents the next opportunity for the sector to continue to increase HIV testing and reduce late diagnoses in all groups affected by HIV across England. The campaign starts Saturday 16 November 2019. Stay informed with our plans for the campaign by signing up to our newsletter using the form on this page and following us on Twitter.

New local PHE indicators

PHE has announced a number of new HIV indicators on its Fingertips online sexual and reproductive health profiles. In addition to existing measures including HIV testing coverage and new HIV diagnoses rates you can now access local and regional information on:

Late diagnoses rates for MSM, heterosexual men, heterosexual women and people who inject drugs
Repeat HIV testing in MSM within the past year
Prompt ART treatment initiation in people newly diagnosed with HIV

PHE Fingertips webinar

If you would like to know more about PHE’s online health profiles, join us at 1pm on Tuesday 24 September for our webinar looking at getting the most out of PHE’s fingertips tool.

Find out more and register for this event

Official Statistics from PHE

Read HIV annual data tables

Introducing the HIV Prevention England Faith Engagement Strategy

Despite the excellent headway the UK has made to reduce new HIV transmissions, stigma is prevalent and may curtail our ambitions for ending new HIV transmissions by 2030.

Stigma is a barrier to people testing and accessing biomedical interventions such as pre-exposure prophylaxis (PrEP).
Stigma affects the wellbeing, health and overall quality of life of people living with HIV.

We have produced a national faith engagement strategy which aims to increase the involvement of faith leaders and communities in challenging HIV-related stigma, supporting the uptake of HIV testing and prevention, and promoting the good health and wellbeing of people living with HIV.

Faith leaders are well-respected role models in their communities; they have the ability to reach people who do not necessarily access health services, and they have a role in supporting efforts to end discrimination against marginalised people.

HIV Prevention England (HPE) will provide opportunities to support faith leaders and communities, including through National HIV Testing Week, providing free resources, information briefings, and sector training events.

Download the strategy document

HIV Prevention England Faith Engagement Strategy [PDF]

Get involved

HPE provides resources and training. If you are a faith leader or work with faith communities:

Take advantage of our free resources.
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