The London Assembly is failing gay men scandalously and is paving the way for even more HIV infections, argues researcher Ford Hickson
This is an abridged version of a letter of protest sent to the London Assembly earlier this year. I am outraged at the London Assembly report Living with the Virus: A Scrutiny of HIV services in London, which parrots half-truths and untruths to present a warped ‘heterosexist’ overview of the current HIV epidemic. The report pits affected groups against each other and relegates them to second place behind a group at far less risk but with greater political sympathy: young white heterosexuals. This is a strategic error likely to cost Londoners more new HIV infections in future. A section on ‘HIV prevalence and trends in London’ fails to acknowledge that half the people living with HIV in London are gay or bisexual men or that 70 per cent of Londoners becoming infected with HIV are gay and bisexual men. You say nothing about this group being a priority for equality policies or health promotion. Instead, you use increases in STIs to push your concern for young white heterosexuals. Why?
You seem to think that there are a finite number of infections to go around when you state: “In the UK the demographics of those living with the virus is changing from gay men to African communities.” In no sense is the HIV epidemic moving from gay men. Today, more gay men are living with HIV in London than ten years ago, more gay men with HIV are moving to London than ten years ago, and more gay men living in London without HIV became infected last year than did ten years ago. Yes, we have an increasing sexually transmitted HIV epidemic among African communities in London. This is in addition to the large on-going and growing epidemic among gay men in the city. How dare you play one group off against the other.
The data also clearly show while HIV affects both children and adults, it disproportionately affects adults and that while HIV affects both women and men, it disproportionately affects men. The only conceivable explanation for your blindness is that you think gay men do not count and that further HIV infections in gay men do not matter. This is a disgrace and a scandal. You express concern about something that has not yet happened (young white heterosexuals acquiring HIV in large numbers) while tuning a blind eye to what is actually happening: large numbers of gay and bisexual men becoming infected.
The increase in diagnoses has not been in the heterosexual population of Londoners, but in heterosexuals with HIV moving to London from abroad. More people now move to Britain with HIV than people living in Britain acquire it, an uncomfortable fact which you choose to ignore in order to suggest that there has been an explosion in heterosexually acquired HIV among Londoners.
You recognise the value of HIV prevention interventions but then wholly fail to direct them toward people most likely to become infected. You call for co-ordinated health promotion, including HIV awareness campaigns across London, for both the ‘general population’ and high-risk groups such as ‘sexually active young people’. The general population (everybody) is absolutely not an ‘at risk’ group from HIV. The suggestion that HIV incidence can be reduced by targeting the HIV prevention needs of the general population is ludicrous. Although “sexually active young people” are clearly at greater risk from HIV than “the general population”, compared to the groups you do not mention, their collective risk is also small.
This is an example of the ‘heterosexism’ that is preventing London from reducing new HIV infections. The majority of potentially sexually active people living with HIV in London are gay or African or both. The majority of people who will have sex with them will be gay or African or both. As groups, gay men and African men and women are so much more likely to both have HIV or to have sex with someone with HIV. That you mention neither gay nor African people beggars belief.
I expect more from the London Assembly.
You claim in the report that there is now a “deep-rooted apathy and indeed ignorance amongst the population over the gravity of this disease and its impact.” I am afraid that Living with the Virus confirms that ignorance and apathy about HIV is as deeply rooted in the London Assembly. You are denying gay men our history, ignoring our present and robbing us of our future. What hope for tackling HIV in London?
Ford Hickson is senior research fellow in sexual heatlh, at Sigma Research www.sigmaresearch.org.uk
Living with the Virus: scrutiny of HIV services in London www.london.gov.uk/assembly/reports
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