Scientific evidence in HIV
cases ‘flawed’
There are serious flaws in the way scientific evidence is used in court to
prosecute people for transmitting HIV, a new report has revealed.
In cases where the sexual transmission of HIV results in grievous bodily harm
and a criminal prosecution, scientific evidence is inevitably crucial. But
a paper by the National Aids Trust and NAM points out that cases so far brought
to court have shown how difficult it is to establish who infected whom and
when.
The science, known as phylogenetic analysis, is easily misunderstood and police
and prosecutors’ assumptions about who is the guilty party are not enough
to prove criminal liability.
This analysis examines small differences in HIV's genes to identify the difference
between strains of the virus.
To date it has been a key element in proving both innocence and guilt in recent
cases.
But HIV experts say it is impossible to scientifically prove that person A
got a particular strain of the virus from person B.
Use of phylogenetic analysis in the courts has caused widespread concern and
one case of acquittal came after Dr Anna Maria Geretti, virologist at the
Royal Free Hospital and co-author of the paper, highlighted serious flaws
in the prosecution's use of the data.
“The courts and legal profession have come to recognise that establishing
the route and timing of transmission is not something that can simply be assumed,
but something which the prosecution should be able to prove to the criminal
standard,” said Matthew Weait, a law lecturer at Keele University.
“This briefing paper... will ensure judges, prosecutors, lawyers and
medical professionals involved in cases concerning transmission are better
informed, and so better able to protect the due process rights of defendants.”
• www.nat.org.uk
• www.aidsmap.com
Law lecturer Matthew Weait (left) said the new advice on genetic evidence
will keep doctors and lawyers better informed of defendents’ rights.
“Phylogenetic analysis (PA) is critical in cases where HIV transmission
is alleged. Until now, lawyers, judges and defendants appear to have taken
PA at face value. PA evidence, while important, should be subjected to the
most rigorous evaluation and cross-examination. Unless this happens, there
is a very real danger that there will be miscarriages of justice."
Gay men’s sex risk study announced
The
government is planning a study into why gay men in Britain are taking such
big risks with their sexual health.
Public Health minister Caroline Flint announced the study at the ninth annual
CHAPS (Community HIV and Aids Prevention Strategy) conference in London last
month.
The study will be a retrospective analysis of data collected over the last
10 years from the annual Gay Men’s Sex Survey and will examine trends
and changes in behaviours over time.
It will look for clues as to why gay men are taking greater sex risks and
find out why rates of HIV and sexually transmitted infections are increasing
each year.
The new study means an extra £40,000 in funding for the University of
Portsmouth-based research company Sigma Research.
“There is a persistently high number of HIV transmissions among gay
men in the UK – at least 2,400 in 2005,” Caroline Flint MP said.
“We need to look at what is stopping some individuals from sustaining
safer sex behaviour.”
THT’s head of health promotion, Will Nutland, welcomed the study: “The
new research funding will allow for detailed analysis of sexual behaviour
and the findings will help shape and inform future health promotion programmes.”
The minister said she was committing an extra £1 million towards HIV
health promotion work for gay men and African communities.
Gay men pay for cervical cancer vaccine
Gay men in Britain are joining the queue for expensive private health vaccinations
to prevent anal cancer.
The vaccine protects against infection by certain strains of the human papilloma
virus (HPV) that can lead to cervical cancer. It is widely believed it may
also offer protection from anal cancer associated with HPV in men.
Merck’s vaccine Gardasil is as yet the only vaccine licensed in the
UK, though GSK’s version Cervarix is currently seeking European approval.
Gardasil is currently being offered through private clinics at £450
for a course of three shots.
A large number of gay men are afflicted with genital and anal warts, caused
by the HPV virus, which can be spread very easily by touch. And many go on
to develop dangerous pre-cancerous lesions.
The rate of anal cancer among gay men is 35 per 100,000 but this rises to
70-100 per 100,000 in HIV positive men.
Dr Paul Fox, anal cancer specialist at the Chelsea and Westminster and Ealing
hospitals, suggested the vaccination may be worthwhile as infection with multiple
types of HPV is strongly associated with cancer and even limited protection
might still lower the likelihood of cancer.
Meanwhile in Africa, between 50 and 90 per cent of HIV positive people are
also infected with the genital herpes virus. Interaction between the two leads
to a much faster progression to Aids and death.
Studies in Bakina Faso found treating women for genital herpes significantly
reduced the amount of HIV virus and prolonged the period during which they
showed no symptoms.
Demands for ‘opt-out’ testing to defuse undiagnosed HIV time-bomb
As
many as 20,000 people in the UK are walking the streets of Britain with HIV
but don’t know it, according to new data.
An estimated 65-70,000 people are now living with HIV but most new cases in
this country are now acquired heterosexually and in Africa.
Dr Valerie Delpech, of the Health Protection Agency, highlighted the startling
figures at a recent All Party Parliamentary Group on Aids meeting.
Forty-seven thousand people are receiving HIV care in the UK, Dr Delpech explained,
but now more heterosexuals than men who have sex with men (MSM) were getting
help for the first time.
“4,500 new cases of HIV were diagnosed in black Africans in the UK in
2005,” Dr Delpech said.
HIV-related deaths have dropped to about 550 a year, but most of these would
be avoidable if people came forward for testing and treatments earlier.
But Delpech urged gay men and sexual health workers not to be complacent with
the highest number ever of MSM diagnosed with HIV in 2005 (over 2,200) and
9,000 MSM with HIV still undiagnosed.
Around 50 per cent of gay men with HIV were leaving GUM clinics without even
knowing their positive status, she added. Dr Delpech called for ‘opt
out’ rather than ‘opt in’ HIV testing as with pregnant mothers
in Britain.
Lisa Power, policy director at Terrence Higgins Trust, told the group to expect
more than 100,000 people with HIV in the UK by 2010 with inevitable rationing
of treatments.
“People are ringing us saying they’ve been told by their clinics
that they’re going to start treatment after April when the new financial
year’s money arrives,” Power said.
Ignorance, stigma and prejudice about HIV in the UK appeared to be growing
as more people are infected. “People in Britain now know less about
HIV than they did 10 years ago,” she added.
The linking of migration with the criminalisation of HIV in the media, with
the tabloid press blaming African migrants, means that the stigma is getting
worse not better.
And there is a serious need to involve people with HIV in prevention, Power
said, but, “this is something we’re very bad at doing in this
country.”
And as PN went to press, figures emerged showing rates of HIV in London rose
58 per cent in the last five years, with biggest rises and largest numbers
of people living with the virus seen in the London boroughs of Lambeth and
Southwark.
• www.hpa.org.uk
news on the side
£25 million for carers
The government has unveiled a £25 million New Deal for Carers to help
the estimated army of two million people in Britain caring for disabled and
elderly relatives, partners and friends, including many thousands living with
advanced HIV. The money will go to local authorities to fund emergency respite
care for people who neeed a break from caring responsibilities.
Blood probe launched
More than 1,750 people with haemophilia have died in Britain since receiving
blood products in the 1980s contaminated with hepatitis C and HIV.
After years of campaigning the government has finally agreed to an independent
inquiry.
Medical academic Lord Winston dubbed the ‘bad blood’ scandal “the
worst treatment disaster in the history of the NHS”.
Pre-election push on HIV
HIV Scotland has launched its manifesto in time for the upcoming Scottish
parliament and local elections in May. Covering ten points, the manifesto
includes a demand for strengthened human rights, improved sexual health services
and access to free treatment for HIV throughout Scotland.
www.hivscotland.com
NHS to end year in surplus
After claims of record billion pound deficits, the NHS is set to end the financial
year with a £13 million surplus, according to the Health Service Journal.
The priority of clearing the estimated £1.3billion deficit was largely
achieved through cuts in primary care trust and strategic health authority
budgets, the journal reports. However this resulted in several hospital trusts
going into the red, leading to a severe cut backs to jobs and services.
Crusaid suspends fund
Crusaid's Hardship Fund is to be closed until 16 April, according to Steven
Inman, head of grants and projects. The closure is to allow for the recruitment
and staff training. www.crusaid.org.uk
Disabled law fails HIV+
Due to a legal loophole, legislation for disability-related hate crime fails
to protect the majority of people living with HIV in the UK, according to
the National Aids Trust (NAT). Because they may not suffer 'physical or mental
impairment' thanks to effective treatment, they are not considered disabled
and fall outside the protection of legislation. NAT is now asking the government
to close this legal loophole and give full protection to all the 60,000 plus
people living with the virus in the UK.
NHS pays too much for drugs
The Office of Fair Trading (OFT) says the NHS is getting poor value for the
£7bn it spends on drugs each year. Although the pharmaceutical industry
insists the NHS gets a good deal, the OFT recommends an overhaul of the Pharmaceutical
Price Regulation Scheme. Some NHS HIV clinics now buy their antiretrovirals
from other European countries where they are as much as 50 per cent cheaper
than in Britain.
PN online readership expands
A million pages of PN were read online last year according to the latest website
statistics. More than 3,000 pages of the magazine are accessed each day, spread
equally across days of the week and around the 24 hour clock. The most popular
edition was number 115 from September 2005, which highlighted the plight of
HIV positive people behind bars. PN’s online readership is growing rapidly
and is now three times our hard copy readership.
www.positivenation.co.uk
HIV murder charge touted
Ugandan president Yoweri Museveni has called for a new law to punish those
who intentionally spread HIV. He said people who knowingly spread HIV were
“murderers” and suggested the death penalty for those convicted,
according to www.allafrica.com.
African Aids dementia fears
Researchers fear Africa is suffering from “alarmingly high rate”
of Aids-related dementia.
A study of HIV positive Ugandans found 31 per cent were affected.
“If the rate we saw in our study translates across sub-Saharan Africa,
we are looking at more than eight million people in this region with HIV dementia,”
said Dr Ned Sacktor, neurologist at Johns Hopkins University.
HIV can cause dementia by destroying brain cells but antiretroviral drug combinations
greatly reduce this risk.
Aids priest shot in SA
An Irish priest famous for helping people dying of Aids was shot and seriously
wounded in a robbery at his home in Pretoria.
Father Kieran Creagh, featured in PN 106, was the first person to volunteer
to take part in a South African Aids vaccine trial. Twelve per cent of South
Africans are living with HIV in a country where there are 50 murders every
day.
Global Fund saves 1.5M
Funding from the Global Fund to Fight Aids, TB and Malaria has already saved
more than 1.5 million lives, it was announced at the Fund’s meeting
in Oslo in early March. The Global Fund calculates lives are being saved at
a rate of 3,000 per day as it scales up operations and programmes around the
world. Progress includes 1.5 million HIV and TB infections prevented, over
700,000 more people on antiretroviral therapy and 33 million malaria episodes
have been prevented. www.theglobalfund.org
