Vital HIV prevention and support services are facing closure after being earmarked for cuts by local authorities across the country, leaving potentially thousands of people with the virus cut adrift at the very time the transmission rate is increasing.
Users typically turn to these units for help with their medical treatments, counselling and mental health assistance, peer support and legal advice – while many support centres also provide HIV prevention services for those most at risk of transmission, such as gay men.
But some services are now set to shut down. So far, six councils – Oxfordshire, Bexley, Portsmouth, Slough, Bromley and Bracknell Forest – have proposed a decommissioning of HIV support services, effective from 1 April.
In Oxfordshire, the county council will cut the entire annual funding for its Community HIV Prevention and Support service after 16 years in operation.
According to the Terrence Higgins Trust (THT), the charity that runs the centre for the council, 500 people living with HIV or at risk of the virus accessed the service in 2015.
“The council hasn’t organised any contingency plans for support,” says Debbie Laycock, head of policy and parliamentary affairs at THT. “This will mean that more than 200 people living with HIV in the county will be without support from 1 April. The THT service is a lifeline for a lot of people. A 15-minute patient slot with a GP is just not adequate for people who need these support services.”
Case study: ‘This was my lifeline’
Anna* first accessed THT’s Oxfordshire centre after her diagnosis 10 years ago. They provided comprehensive specialist advice and support during what she describes as a “traumatic time.”
They were unbelievable; they were just a lifeline,” says Anna. “If there was a crisis like ‘how do I tell my family?’… who do I need to tell?… if I was going on holiday would I be able to get travel insurance?… they were there. Without their help and support initially I don’t think I would be still here really.”
When Anna fell pregnant, the service centre advised her on the additional medication she would require and supported her throughout her pregnancy. “The cuts are so short-sighted because that was such specialist care,” she says. “Without that support we might have had another person that had HIV.”
*not her real name
A spokesperson from Oxfordshire county council said: “It is felt that nationally and internationally the nature of HIV has moved into a more chronic, long-term condition due to the advances in medical management. More people are living longer, healthier lives with HIV and there is less stigma attached to the condition.
“As a result, the funding of £150,000 was considered no longer appropriate, as service users could avail themselves of other support services provided locally by the county council and their health needs are met by the NHS.”
Other councils have also claimed that the NHS meets the needs of those living with HIV, but health workers say a large proportion rely on the support provided by the services at risk.
“Public Health England have surveyed a representative sample across HIV clinics of people living with HIV, and in a 12-month period over a third of them had to access support services,” says Yusef Azad, the director of strategy at the National AIDS Trust.
“Politicians have talked about the importance of these services, but it isn’t clear who has responsibility to commission them. And, as a result of that accountability gap people with HIV are suffering.”
More than 103,000 people in the UK are living with HIV and the latest figures show that in 2014 there were 6,151 new diagnoses, a rise from the 6,032 in 2013.
Metro HIV Support currently operates in seven local councils, including Bexley, where it has been told it potentially stands to lose all £33,847 of its funding despite being the only service of its kind in the area.
Cllr Peter Craske, a cabinet member for community safety, environment and leisure at Bexley, said: “We have been consulting on changes resulting from reductions in the public health budget but no final decisions have been made at all, and indeed we have only just completed reading the responses.”
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But one of its users, a 50-year-old care worker who did not want to be named, said the changes should not be considered. “Metro is like a home for us,” she said.
“They advocate for us in various issues like housing benefits and other social services. I don’t think we will have anywhere else to go where they will accept you.
“When you are in this situation, sometimes you need someone… You want someone to talk to who listens to you. But these other services don’t have time. The NHS doctors are just there to give you the medication and the treatment or whatever; they don’t have time to talk to you.”
The charity Positive Action, which helps people across South-east England, has also been told it faces funding cuts and, in one area, a complete decommissioning of its services. It currently holds five contracts across the region, but from 31 March all funding for its Portsmouth operation will be withdrawn.
“There will be no future funding available to us, so theoretically the service we are providing in the city will be completely removed,” says Donna Bone, the chief executive of Positive Action.
“This wasn’t done by any means of a consultation; there was no equality assessment impact undertaken at all.”
Positive Action is now looking to secure independent funding from other sources, and has been assuring service users in Portsmouth that there will be some form of ongoing support from the organisation, particularly with regards to peer-to-peer support.
Portsmouth City Council is yet to respond to The Independent.Reuse content