APPENDIX 10
Memorandum by Positively Women (HA 12)
In response to the enquiry into the consequences
of the new and proposed charges for overseas patients with regard
to access to HIV/AIDS services I wish to submit the following
evidence. Positively Women would also be prepared to submit oral
evidence.
INTRODUCTION
Positively Women (PW)
Positively Women is the only national charity
working to improve the quality of life of women and families affected
by HIV:
— Providing specialist support by women
living with HIV.
— Enabling women to make informed choices.
— Challenging stigma and discrimination.
Central to Positively Women's work is the ethos
of "peer support", that is support for women living
with HIV by women living with HIV. Services to women and families
include:
— One-to-one and group support.
— Volunteering and work opportunities.
— Specialist work with parents and
young people.
— Outreach in clinics, hospitals and
women's prison.
Nationally, PW provides expertise to other organisations
in developing services to meet the needs of women and families.
The quarterly newsletter, written and edited by women living HIV,
is a vital resource for those who are isolated. To ensure the
voices of women living with HIV are heard, the Taking Part project
trains women with HIV to lobby and inform policy at all levels.
PW works collaboratively with a range of organisations
including Asylum Aid, THT and The UK Coalition of People Living
with HIV and AIDS, and is a founding and leading member of the
Positive Futures Partnership.
Positively Women (PW) recognises the issue of
applying limited NHS resources accurately to improve health and
treat disease and illness. This response results from direct contact
with people living with HIV who use PW services.
Positively Women believes the results of
the charges to overseas visitors is to create a situation that
endangers the health of individuals and will lead to the increase
in onward transmission of HIV.
The failure to include HIV in the exemptions
for free treatment has serious consequences in causing individual
hardship and constitutes a public health danger. As such this
regulation is likely to have high cost implications.
The widespread perception at grassroots level
that treatment will be refused is preventing people with HIV from
accessing health and support services.
Anti-retrovirals act to suppress HIV, which
breaks down an individual's immune system. Without this treatment
HIV will resume the destruction of the immune system, opportunistic
infections will then be able to take a hold, resulting in increased
use of emergency services and long use of hospital beds. Failure
to treat the cause of illness is not good clinical practice.
The cost in health terms to women, who are still
in the main the carers of the family's health, is particularly
high.
The ethos of the National Strategy for Sexual
Health and HIV/AIDS is to promote testing in at risk communities,
to identify early those with HIV, in order to treat, promote health
and prevent transmission.
There is evidence that many migrants have been
diagnosed as HIV positive after entering the country for purposes
other than health benefits. To refuse treatment for people in
this situation is at odds with the commitment of the National
Sexual and HIV/AIDS strategy to reduce transmission of HIV by
25%.
Refusing treatment will further fuel the stigma
of HIV, which the strategy is committed to reducing. It is also
likely to lead to lower levels of diagnosis of other sexually
transmitted infections and TB both of which have public health
implications. A number of migrants with HIV have also proved to
be co-infected with TB.
In PW's experience, which is borne out by research
by Sigma Research, most migrants with HIV do not have the means
to pay for treatment, and HIV takes a back seat to housing and
food needs.
Since September 2004, PW's full-time team of
HIV positive women peer mentors report the following:
— eight women reported that their doctors
have asked them for proof of immigration status so they can be
able to access ARV treatment;
— three women on treatment reported
have been threatened with withdrawal of treatment if they do not
confirm their immigration status; and
— one woman has been denied treatment.
On a day-to-day basis this team is now seeing
women who are facing withdrawal of life saving medication.
CONCLUSIONS
PW recommends that treatment for HIV should
be exempt from charges.
— The amendment to remove treatment
rights for migrants who have been resident in the UK for more
than 12 months will lead to increased onward transmission of HIV,
including that from mother to child.
— The charges will ultimately be costly
in personal health and emergency treatment terms.
— The amendment is contrary to the
commitment of the National Sexual Health and HIV strategy
— HIV should be included with other
STI's and TB for eligibility for NHS treatment on public health
grounds.
20 December 2004
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