Alarming health stats..

[lettie]

Firstly, let me apologise in advance if this topic offends anybody but in my humble opinion this is way too important to ignore.

In the course of researching a project for University, I have come across some rather alarming figures, well, I think they are pretty frightening and would love to know your opinions.

In February this year the Health Protection Agency published the latest figures for HIV statistics in the UK. The 2003 figures show that there have so far been 5047 new diagnoses of HIV in the UK. The figure is thought to be nearer to 7000, as they haven't yet received all the reports from various parts of the country. Last year, we had 4204 new diagnoses, so therefore we have 20% more new cases this year.

Only 1414 new diagnoses were made within the homosexual community, compared to 2785 within the heterosexual community, both men and women being affected. The report does not comment about where the rest of the numbers come from, I can only assume injecting drug use (IDU), vertical transmission (mother to baby) and infected blood products, transfusions in countries such as China being particularly dangerous.

Of these new diagnoses, 254 were acquired within the UK, the rest were acquired abroad.

Between 1995 and 1999 Sexually shared infections rose by 76% for Chlamydia, 58% for Gonorrhoea, 54% for Syphilis and 20% for genital warts (PHLS 2001) The majority of cases, especially Chlamydia/Gonorrhoea occur in age groups 16-21 in females, 20-25 in males. I don't know about anyone else on this site, but I find these figures alarming. Who is educating our teenagers about sexual health? Whose responsibility is it? What can we do as parents and responsible citizens to ensure that future generations are protected. I know that people may find this a distasteful subject, but the implications are huge in terms of cost to the health service, as complications from these infections can lead to both male and female infertility, pelvic inflammatory disease, ectopic pregnancy, reactive arthritis and in the case of HIV, ultimately death.

I know because we're British, we don't talk about sex (although everybody does it) Maybe it's time to talk..

[Tealeaf]

I assume the figure of 254 new cases above is 254 of the total of 5047. In other words, 95% of all new HIV diagnoses pertain to HIV acquired outside the UK. Surely the answer is simple - keep the so-called asylum seekers and the rest of the riff-raff out of this country.

The medication bill alone for someone who is HIV positive is over £10,000 per annum; under current asylum law, anyone who is HIV pos has indefinate leave to remain in the UK.

Anyway, I could speak about this all day, but I'm going back to my Bacon Butty.

[lettie]

That's right!! The HPA reckon that the figure will be nearer to 400 contracted in this country by the time the figures are all in. It costs roughly £188,000 to look after somebody with HIV during their lifetime after diagnosis. This includes the Antiretroviral drugs, cost of blood tests, nursing and medical care/ hospitalisation when terminally ill etc.
One concern at the moment, is that when the Eastern Europeans start to come over, their HIV statistics are huge, due to intravenous drug use, so will we end up with the increasing burden of having to provide care and treatment for them?
Anyone who wants to find out more about HIV, and STI's the following websites may be helpful..
www.hpa.org.uk
www.avert.org/treatmentnews.htm
www.doh.gov.uk
www.tht.org.uk


Enjoy your bacon butty..

[Tealeaf]

In other words, the cost of looking after that lot from abroad - from just last year - who are here getting HIV treatment over their life expectancy will be just over £900m (Nine Hundred Million Pounds). Which is the equivalent, based on the Hyndburn Council budget agreed last week, of total council tax income for the next 75 years.

There is only one simple solution to this nonsense. If you are HIV positive & you are not British, then get out of the country.

[lettie]

It is not an inconceivable notion that many of the cases brought in from abroad, would be found in white british people who travel, either to work or for pleasure. The Far East in particular are only just starting to tackle the problem of rising HIV cases. Thailand, which is a favourite destination with European visitors has a major problem, and I believe that the commercial sex workers over there are now using condoms more often than they used to (although not all the time). China only admitted to having a problem in about 2002, prior to that, the Chinese government tried to bury it under the carpet, even though their first reported cases were in the mid 80's. Major mode of transmission in China being infected blood/plasma transfusion, drugs are now becoming more prevalent, and although being openly gay is frowned upon, everybody there knows it happens. The only reason that the Chinese have now admitted to the problem is because they now have somewhere between 1 - 1.5 million affected people that they are aware of, and if the numbers continue to grow, they will eventually need help.

[Roy]

Hmmmm... are you guys trying to say something to me, all the places I've visted in the last 12 months - China, Thailand, Eastern Europe.... Anyway, the reason why these countries are having big problems with HIV is because they don't have 180000 per person to spend on the treatment, never mind the money to have a decent AIDS awareness campaign. However I would struggle to believe that any significant amount of these figures are composed of business or pleasure travellers returning from these places. The use of Condoms really is being promoted in these parts, although not for the STD reason, purely as birth control, of which the primary method in all of these places is an abortion!

[Tealeaf]

I accept that a (relatively) small number of new HIV cases are those of British people who have travelled abroad for business or holiday & have contacted the disease. The vast majority are not that...they are quite simply asylum seekers or from Sub-Saharan Africa who enter the UK in the full knowledge that the NHS will provide free treatment for them, guaranteed under UK law, and with no fear of repatriation to their home country. Naturally, they are free to carry on here having unprotected sex with whoever they please with the knowledge that even if they are caught & jailed, they will still have recourse to free medication.

And Eastern Europe is full of 'em. Is'nt it nice to know that we are one of only 2 countries giving free entry when the new eastern states join. Oh, the other country don't have an NHS.....I wonder whats going to happen????????

[Jo in Bolzano]

I see two separate topics here:
1) why should the british tax payer pay for HIV positive immigrants
2) how can we stop HIV coming into the country, and more importantly spreading within the country among British citizens.

Spontaneously, I would suggets HIV tests for all immigrants and people who travel to risky countries. The problem is, if they test positive, what do you do?
Regarding immigrants, you could refuse them entry to the country, as with rabid dogs, but regarding British citizens, you have to let them back in.

Of the two groups I find the latter the most offensive. The number of Europeans that go to Asia and the Far East, not to mention Easten Europe for "cheap sex" holidays is increasing and it is precisely those people that are more likely to return to Britain and spread the disease. As a naive Brit, I would be more likely to contract the disease from some white, British male that has been abroad on such antics, than from an African immigrant, who I consider risky.

The question is, why not introduce complusory HIV tests? It would be cheaper in the long run and would allow the government to control entry of infected foreigners and monitor affected Brits. Every citizen should have a HIV-free stamp on those famous ID cards that are going to be brought in..................
Sorry if it sounds like I'm jesting, I'm not - I just feel that everyone has the right to know about the HIV status of new partners, I don't feel it's enough to just educate - and statistics are beginning to show that.

ps I wanted to ask Lettie if pregnant women are automatically tested for HIV in the UK? I had to have the test when I was 8 weeks pregnant and then again at 20 weeks. I think I have to have it re-done again at 30 weeks.

[lettie]

Sorry Roy, not getting at you!! I too have travelled to the far east, and one of the reasons for dodgy blood products is a lack of funds to make them safe. I do concede that the majority of HIV being brought into the country is by immigrants, but a small number of brits have definately caught the infection abroad. Although the numbers may not be significant in a statistical sense, when you look at the long term implications ie, spread to others, long term medical costs etc then I think it is very significant.


Jo, in December 2000 the UK launched ante natal screening for HIV for all pregnant women. This is an opt out test, so if the woman does not wish to be tested she has to say so. Counselling is given by the Midwife prior to testing and we are aiming for an 80% uptake of the test, which I think we have roughly achieved in our area. Worryingly we have had positive results in young women through heterosexual sex. Women are tested only once during each pregnancy. This is usually done at about 14-16 weeks. I personally think that there should be at least 2 HIV tests in pregnancy, bearing in mind that even in long established relationships, both parties are not always faithful and it takes about 12 weeks from HIV contact for the blood to seroconvert.

I did ask at Uni about the screening of immigrants, and the tutor ( a GUM clinic health advisor) mentioned that it was once an idea that was bandied around Parliament, but was chucked out on ethical grounds. I have not seen anything in writing which backs this up, but am still looking for material. I have until May to get my work in, and when you search the net for info regarding STI's there's millions of pages containing info (not to mention the odd porn site that comes up when you search for anything in this topic area) I also have stacks of papers on hard copy from various journals, so this project is turning into a mammoth task.

The only way the government have been able to roughly establish the numbers, has been by unlinked anonymous testing. This has been happening since the 80's and what basically happens is - when you go for a blood test, after the local lab has checked your blood for whatever they need to. All the labelling is taken off the blood tube, and the blood sent to a central lab and tested for HIV. There is absolutely no identification on the blood bottle, not even the health authority in which the test originated apparently. So if the lab get a positive result, it is just a number, there is no way to contact the person and let them know that they're positive. I know that they have done this on routine antenatal blood in the past and on baby heel prick scriver test spots. This kind of testing enables the DoH to write lots of bumf about how the NHS can cope with the numbers in the future. The figure for UK is 45.000 affected people so far and they reckon a third of those are unaware due to the unlinked screening.

[Roy]

The question is, why not introduce complusory HIV tests? It would be cheaper in the long run and would allow the government to control entry of infected foreigners and monitor affected Brits. Every citizen should have a HIV-free stamp on those famous ID cards that are going to be brought in..................

Funny you should mention that. To get a 12 month visa to Russia you do have to have an aids test and be clear, or they wont let you in, and they don't stop at that, just to renew your visa you have to have the aids test again. Yet we can waltz back into the UK like we've just been down the pub for a pint, as can any other foreigner. It is a bit strange that our rules seem so lax. We can't even blame Europe for this one as they have a totally different visa scheme to us in the UK....

[Tealeaf]

I agree with Roy...we're the soft touch here. Every other Western Country has external restrictions on entry & internal identity controls...the US, Australia, the rest of the EU...if you want to enter those countries you apply for a visa in your own country & if you're going for a work visa you pass your medical. You also vouch not to be a burden on the state. If you suddenly need medical treatment, you show your ID or Health Insurance documentation.. What system do we have here? Butlins - they pay you.

[lettie]

I totally agree with pre immigration testing, and also think that all non-british entrants to the country should have health insurance to cover the cost of their care for however long they are here for. We all have to pay for our care abroad, so why not the other way round.
I think the pre immigration testing is to do with ethics, bearing in mind that some people would not want to know if they were positive or not. Also, groups and societies formed to educate and reduce stigma regarding HIV and AIDS have probably had a hand in any decision our soft touch government have made regarding the issue. If the numbers of HIV positive people continue to rise (which they will do) then I think eventually the gov. will have no choice but to impose compulsory testing on immigrants, probably due to public demand, but how many people would agree to compulsory testing for everyone? because all the do gooders out there would be up in arms (distibuting pamphlets) How many people on this site would volunteer to take a test? If you have a positive result, who do you tell? Would you be eligable for a mortgage? life insurance? How would you feel if your son/daughter told you they were positive? Could you and your family cope with the stigma?
A lot of food for though in this issue isn't there? I am glad to hear your opinions, as it will help me in my studies. Any volunteers to write this assignment for me would be gratefully welcome..

[Tealeaf]

Whats the title?

[lettie]

The title is. - Critically analyse the increasing burden of sexually transmitted disease in the United Kingdom. Or. - Critically evaluate the current NHS service provision for the screening of sexually transmitted infections. Haven't quite decided which one to go for yet, but am veering toward the increasing burden one.

[Tealeaf]

No....go for the second one...the first question has been worded by an idiot.