4 minute read
Innovation and collaboration in HIV
Innovation and collaboration in HIV
Brighton & Hove became an HIV Fast Track City in August 2017 with the aim of reaching zero HIV transmission by the year 2030. We intend to achieve this by scaling up HIV prevention initiatives, increased HIV testing, keeping people living with HIV engaged with care, and tackling negative attitudes and behaviours towards HIV.
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We are making excellent progress thanks to integrated working across the city and effective commissioning for the last 20 years. At present 94% of people living with HIV in Brighton & Hove know their status; 99% of those are on treatment with 98.5% of those have undetectable viral load.
The Martin Fisher Foundation was founded in 2015 to take forward the work of Professor Martin Fisher, an inspirational leader and an outstanding physician.
The charity has led on digital innovations in HIV testing with the development of a worldfirst touch-screen vending machine distributing free HIV self-tests. A further four machines were rolled out to venues around Kemptown. User feedback was positive but suggested STI testing kits would be a useful addition. During the Covid-19 pandemic, when venues were closed and sexual health services limited, the machines were upgraded to include STI kits.
These machines are now installed across the city in Jubilee Library; Portland Road, Hove (between Wish Park Surgery and Kamson Pharmacy); the Wellsbourne Centre in Whitehawk; the Brighton Sauna; and the Black & Minority Ethnic Community Partnership Centre in Fleet Street. An HIV self-test machine dispensing free HIV tests remains in Prowler, Kemptown. It is hoped the presence of the vending machines in prominent locations will normalise HIV testing and reduce stigma.
We asked users of the first machine to give us feedback: “I think this is genius and am so impressed. My friend has HIV and his family disowned him for it. Thank goodness times are changing and people understand that there is nothing wrong with being in very close contact with someone with HIV.
It’s charities like yours that are changing things for the better. Hopefully in the future no one else will have the same problems with family as he has had. I want to say a huge thank you to you for all you do and also for my test too.”
These machines have now been installed in Zambia (in collaboration with the Centre of Infectious Diseases in Zambia), in New Zealand and Japan.
HIV prevention continues to be developed and expanded. While condoms, post-exposure prophylaxis (PEP) and behavioural changes remain important, more recent strategies linked to effective HIV treatment have led to rapidly falling rates of new infections over the last six years.
‘Treatment as prevention’ (where people living with HIV are promptly started on effective treatment and are unable to pass the virus on) and pre-exposure prophylaxis (PrEP) have been central. PrEP has been available through the NHS since October 2020, one of our aims was to reliably deliver the medication to people who need it, while enabling them to maximise their adherence and overall sexual health.
PrEP EmERGE is a digital mobile health app (mHealth) launched in May 2021, designed to support people using PrEP and co-designed by community and clinicians in Brighton, including Terrence Higgins Trust, the Martin Fisher Foundation, University of Brighton and University Hospitals Sussex NHS Trust.
The app aims to support people using PrEP by providing them access to their results, medication reminders to support adherence, vaccination history, details of appointments and a messaging system which allows direct communication from the clinic directly to the end-user.
The app supports a reduction in necessary clinic appointments by providing a virtual pathway. People say: “I like being able to see my latest test results and vaccination status. Not having to go to the clinic to do a check-up”, “Seeing my test results and appointments in detail. Access to FAQs which answer pretty much every question I could have about PrEP”, “Lets me take responsibility of my own PrEP journey”.
We have been working alongside clinical, voluntary, academic and community partners to deliver innovations and interventions to reduce HIV stigma in healthcare settings and across the city as a whole. This includes education programmes for healthcare professional groups and public awareness campaigns.
The Martin Fisher Foundation Bus travels through Brighton and beyond every day with words ‘HIV isn’t scary anymore’ and ‘Towards Zero HIV’. The bus has 15 information panels inside which travellers can read and digest during their journeys. One of only a handful of HIV-themed public information buses in the world, the bus was co-designed with people living with HIV, encouraging people to have an HIV test and get treatment if they need it, while tackling some of the myths and stigma that still surround HIV.
A number of ongoing studies by researchers and clinicians in Brighton are aiming to better understand ways of tackling HIV stigma, and as a community we are ready to implement evidence-based recommendations. Community and stakeholder engagement has been central to shaping our action plans for increasing public awareness of HIV.
