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The Debate: Are we doing enough to tackle Aids threat; Kate Mansey on the disease that still kills millions.

Byline: Kate Mansey

FOLLOWING the extensive awareness campaigns concerning the dangers of HIV and Aids in the 1980s and early 1990s, the public consciousness seems to have turned away from the issue.

At one time it seemed as if almost everyone you met wore a red ribbon while news stories, coupled with government health warnings, constantly told us of the dangers.

Now, though, the message seems to have been watered down. Gone are the newspaper adverts and billboard posters while the issue itself is more often that not portrayed as a problem for the African continent rather than something we need to concern ourselves with in Britain.

This lack of awareness was reflected in new data published last week by Liverpool John Moores University which showed that Merseyside has the highest percentage growth in the number of new HIV cases in the whole of the North West. The figures reveal an increase of 122% from 2001-2004.

It is feared that the message is not getting through to our younger generations, a section of society more likely to engage in casual and, it would seem, unprotected sex.

According to HIV awareness and support groups such as Sahir House in Liverpool, the report shows a bigger percentage increase in the number of new cases among heterosexuals than homosexuals for the third year running, destroying the myth that HIV is a gay disease.

Despite the fact that levels of HIV are escalating at a rate never seen before in the region, there are still no campaigns on our television screens or in our newspapers to raise awareness

YES: It is important campaigns are based on real risks

Alastair Miller, consultant physician at the Tropical and Infectious Disease Unit, Royal Liverpool University Hospital

WITHIN the health service we are not complacent about the threat of HIV.

The number of HIV infected patients that are being seen is increasing dramatically.

Undoubtedly it is putting a strain on resources but there are increasing resources being put into clinics and there has been more joint working especially between Infectious Disease clinics and the Genito-Urinary Medicine clinics (GUM - formerly known as STD clinics) across the country.

Here in Liverpool for example there is excellent collaboration between the GUM clinic and the Infectious Disease unit at the Royal to the extent it is virtually run as a single service for HIV patients.

Since 1996/97 we've had very good, new effective

drugs for HIV and that may have led to some complacency. It has essentially become a treatable condition, not in terms of being able to eradicate the virus but in being able to control it.

At first in 1997 patients had to take possibly up to 20 or 30 tablets a day in three or four doses, with all sorts of difficulties and constraints such as exact timings, food restrictions etc.

There were also very unpleasant side effects. With the newer drugs available recently some patients just need to take two tablets a day.

But the message is that while we can to some extent control HIV - with the majority of people living relatively normal lives (although it is too soon to say whether the effects of the pills will last indefinitely as we have only had them available for 10 years or so) - the drugs don't work for all and some patients will continue to develop Aids and some will die.

Those who go on the tablets also have to adhere strictly to them because if people miss doses then the virus can become resistant and the treatment fail. The drugs still have some side effects and are expensive so as in all health care - prevention is better than cure!

Talking to people at a young age is vital in educating them about the risks so clearly it has to happen in school.

In most areas of the country there are local health educators working in schools and youth clubs to get the message across In the early days of Aids when I saw my first patient in 1984 it was regarded as a gay man's disease.

In 1987 the government ran its infamous 'tombstone campaign' with the message that HIV would sweep through the heterosexual population.

This did not happen as in the apocalyptic predictions but now we are seeing increasing heterosexual spread.

It is important that future publicity campaigns are based on real risks.

The chances of catching HIV from a one night heterosexual encounter in Liverpool from someone who is not in a 'high risk' group are not huge but they are definitely there and the message has got to be - limit your number of partners and use condoms

NO: The disease continues climbing to new records

Felicity Greenham, chief executive officer, Body Positive North West

THE shocking news from the Centre for Public Health: 'HIV continues to climb to new records in the North West'.

In the North West last year, 814 new people were diagnosed with HIV - and Merseyside has seen the largest increase in new cases since 2001 - 122%.

So there are many more in the North West living with the knowledge that they are HIV positive.

Regrettably, with the withdrawal of public funding from some support centres, many people will have to cope with this devastating news on their own.

The only way to stop the rises in HIV infection is to change people's behaviour. And to change their behaviour, people have to have information.

With all STDs on the increase, it is obvious that there is not enough

information about sex, about the dangers of unsafe sex or about the simple steps you can take to prevent infection.

With little money now being spent on sexual health education the days of everyone knowing the dangers of HIV are passed.

Part of the problem are the myths surrounding HIV. The myth that it only affects gay men, that it only affects those in sub Saharan Africa ... that it is not to do with you.

Well, the myths are wrong. HIV affects anyone and everyone. The most common route for infection in the UK is heterosexual sex.

At Body Positive North West, the HIV positive clients range from teenagers, just out of school, to a grandmother in her 60s.

The idea of 'high risk' groups does not apply any more. Everyone who engages in heterosexual or homosexual sex is at risk. And this is part of the challenge. The debate must move beyond its traditional boundaries. It must be inclusive - because HIV is inclusive.

Organisations working with people affected and infected by HIV must get out and reach all communities, with clear messages on prevention. We need more money to spread the message. To take the message into every community.

We need to challenge the fact that HIV is perhaps the only potentially fatal disease that doesn't elicit sympathy. Many at Body Positive North West have faced discrimination and violence due to their being HIV positive.

From death threats to bricks through windows, this disease still is not treated as a disease. Unless we challenge this stigma we cannot spread the final vital message. HIV is now, for many people, a chronic condition that they live with. New medications had changed the disease from a terminal to a chronic condition for many people.

But it does not work for everyone - so prevention is still key in defeating this disease.

More and more people are living with HIV - leading full and active lives. More people live with HIV in the community - now 3,574 in the North West - and so more needs to be done to support them in living healthy lives, and to prevent further infections.

We need to get back to the campaign of the 80s. But they need to target society as a whole. If we all take responsibility for our sex lives, attitudes and reaction to this disease, we will defeat it

CAPTION(S):

The then Health Secretary, Norman Fowler, launching an Aids awareness campaign; Research chemists pictured working on finding a cure for Aids
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Title Annotation:Features
Publication:Daily Post (Liverpool, England)
Date:Jul 19, 2005
Words:1337
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