Time for vigilance
With the NHS facing debts of up to £800 million and some 7,000 jobs
cuts already planned, few realistically expect HIV and haemophilia services
to come through the crisis unscathed. Public health minister Caroline Flint
this month tells PN how she expects the new NHS system of ‘payment by
results’ to make sexual health and HIV clinics more efficient. But for
London the main problem is trying to treat 11 per cent more patients in 2006/7
with no budget increase on last year.
London HIV doctors, health managers and commissioners are holding emergency
meetings to work out how to get a pint out of a half pint pot. Doctors say
they won’t let lack of money get in the way of good clinical practice
but you have to wonder how long they can resist. A recent successful bid by
a breast cancer patient to be treated on the NHS with the drug Herceptin offers
some hope to people denied specific HIV drugs on the grounds of cost. But
the appeal court ruling still allows primary care trusts to ration treatments
to balance the books. So people with HIV should remain vigilant for any attempt
to switch them off expensive drugs for no obvious clinical reason. And those
starting HIV therapy should ask hard questions about the drugs they are offered
to ensure they are the most suitable for them.
Rubber allies?
While activists celebrate the VAT cut on condoms, few will have considered
the demise of the female condom which has slipped (so to speak) from public
consciousness. Femidom has not always had a good press in the UK thanks to
comparisons to wind socks and plastic bags. But elsewhere attitudes are different.
In Sri Lanka, sex workers market Femidom as a sex toy to clients, charging
higher rates for using it. While in Zimbabwe there is huge demand for Femidom
among women without social power to negotiate condom use with their men. I
am also reliably informed some gay men use Femidoms because they are safe
with oil-based lube, and can feel more ‘natural’ than ordinary,
more restrictive, male condoms. Alice Welbourn, chair of the International
Community of Women Living with HIV/Aids, found Boots had ceased to sell the
product that has helped her have a fulfilling sex life with her HIV negative
husband for 13 years. Superdrug was no help - they have never stocked it.
Luckily, a few persuasive emails and calls from Alice plus a well timed press
inquiry from PN finally forced Boots to see sense and agree to restock Femidom.
Next stop: Superdrug.
Victory on PEP
Another victory on the prevention front as the Chief Medical Officer orders
local health services to make PEP (post exposure prophylaxis) available for
non-occupational exposure to HIV. This follows a vigorous campaign by two
HIV positive men shocked at Government failure to adequately promote the HIV
treatment over the last decade. So now, in theory, if you inadvertently expose
your HIV negative lover to HIV during sex and there is a risk of transmission,
you can take them to the GUM clinic or A&E department within 72 hours
and demand they get a course of preventative HIV drugs. But when you consider
the state of the NHS right now, doubts remain whether it is capable of delivering
on this latest potentially life saving promise.
Amanda Elliot, managing editor
