BBC Monday, 16 July, 2001, 23:38 GMT 00:38 UK HIV linked to social exclusion

The socially excluded are at the highest risk from HIV in the UK, a report has suggested.

Groups such as asylum seekers, black Africans and gay men face many more problems than members of "mainstream society" which are likely to put them at risk from the disease, said the Terrence Higgins Trust (THT).

There is a vicious circle whereby social exclusion can lead to HIV infection, and having HIV can itself lead to further exclusion.

Nick Partridge, THT chief executive officer, said: "Any chronic health problems can contribute to social exclusion, but HIV can cause particular difficulties due to the prejudice and, frequently, ignorance with which those of us who have the virus are too often treated."

The THT is calling for concerted government-wide action to combat the problems these groups face.

It said such an approach has proved vital in tackling such issues as rough sleeping and teenage pregnancy.

For instance, the Department of Education and Skills should tackle homophobic bullying in schools, and include the needs of gay pupils in sex education.

Discrimination in schools can lead to low self-esteem among gay pupils, which in turn can lead to risky behaviour, the THT report said.

It also calls on the Home Office to make more information about treatment available to asylum seekers, who are often ill-informed.

Deported

For example, many widely assume they will be deported if they are found to have the disease and therefore do not seek treatment, it said.

The policy of "dispersal" across the UK makes life very difficult for asylum-seekers, says the report.

They may find themselves in areas which have no HIV clinic, or no experience in treating people from different cultures.

They may not understand how the health system works, may be unable to speak English, and may be isolated from the support of their own community.

The report also criticised the voucher system as making it difficult for people to adhere to HIV drug regimes - as it was hard to purchase the particular foods required for the regimes to work.

The prison service should acknowledge that prisoners are at risk of HIV infection from sexual relations and injecting equipment, says the report.

And it should provide condoms, and cleaning materials for injecting equipment.

Social stigma

The report called for the health service to target its campaigns at communities where HIV carries stronger social stigma.

African women, for example, may be worried about being abandoned by their husband - while African men may be worried about losing their position as family breadwinner.

This means they may get tested much later than other people - often only when they are already ill.

The report called for a "robust" public information campaign to break the stigma of HIV.

And it said health and social service professionals should be retrained to make sure they understand the realities of living with HIV.

The trust also called on the Department of Employment and the Department of Work and Pensions to do their bit.

It said employment and benefit regimes are currently too rigid to cope with the needs of those with long-term chronic medical conditions.

This places people in a vicious circle, where their HIV damages their ability to work, their unemployment contributes to their social exclusion, and this - through poverty, depression and isolation - impacts further on their health.

-- Anonymous, July 17, 2001