Page last updated at 06:36 GMT, Monday, 4 August 2008 07:36 UK

Towns across UK face HIV challenge

By Paul Steinberg
BBC News

As experts gather at an international conference in Mexico to discuss HIV, British delegates will be sharing their experiences of the changing face of the condition back at home.

Men holding hands
Gay men are still one of the main groups requiring HIV services' support

It's a rapidly developing picture, with the impact of new drug therapies, improved life expectancy and recent immigration creating new challenges for HIV service providers.

In the UK, gay men and black African immigrants continue to make up the majority of patients with HIV.

Although the illness is no longer regarded as terminal, it is still a chronic condition.

High costs of treatment and care are involved and, every year, thousands of people are diagnosed with HIV for the first time.

In recent years, the Yorkshire and Humber region has seen increasing numbers of people accessing HIV-related care.

As more people with HIV move away from major urban centres like London and Manchester, services in smaller towns are having to adapt to new ways of working.

Changing demographics

Gugulethu, Rob and Adele all use Begin, a newly refurbished HIV support centre in Wakefield.

Marrying the needs of increasingly diverse groups of clients is part of the challenge for this service.

Gay men's health leaflets sit alongside information on breast feeding, and the service has introduced a creche to cater for the growing number of African women with children.

Tom Doyle, director of Yorkshire Mesmac, a Leeds-based HIV service which recently merged with Begin, said: "Traditionally, social services for people living with HIV were set up by and for gay men.

"Up until fairly recently, the vast majority of Begin's service users were gay men.

"But in the past five years, that's changed dramatically and now the majority are African women, who are often asylum seekers or refugees."

Begin is located on an anonymous industrial estate near a desolate railway station.

But the discreet location is essential for preserving the confidentiality of the people who attend its weekly drop-in and peer support sessions.

Zimbabwe to West Yorkshire

One woman who uses the service is Gugulethu, 45, who is from Zimbabwe.

She did not want to give the BBC her real name, instead using that of her late daughter which translates as "precious" - all the more poignant given that her daughter died of Aids at the age of 27, leaving behind a little boy who is also HIV positive and increasingly ill.

Gugulethu came to the UK in 2003 as a political asylum seeker.

She was dispersed to West Yorkshire and has lived in Wakefield ever since.

Young and Positive poster
One teenager's sense of isolation has prompted her to set up a support group

Gugulethu was diagnosed with HIV about 10 years ago, and thinks she contracted the virus through sexual intercourse.

Her experience as a black woman living alone in this former mining city has not been easy.

"I hide my HIV status from my neighbours, but unfortunately some people around where I live found HIV magazines in my dustbin and stuck them on my door.

"l had to hide in my flat for quite some time until Begin helped me out.

"I still feel very lonely, and keep my windows closed. There are people who call me names, but you get used to it."

For Gugulethu, the services at Begin provide her with both a lifeline to alleviate her sense of isolation and food to maintain her health.

'Cooking around the pot'

The emotional support offered by Begin is equally as important for one of the gay men who attends the lunch service.

Rob Sheldon-Chappell, 46, is in a civil partnership with his partner of five years.

Both men are HIV positive, although Rob is not yet taking medication and hopes to remain healthy enough to avoid drugs for some time.

"I use this service for financial and moral support.

"With HIV-related problems, you can't always discuss them with your doctor or your family. Here you can have non-judgemental conversations with staff and other service users."

He said that the group's diverse make-up has "opened his eyes" to the situation facing people in other countries, especially African women.

'On the same wavelength'

Sitting at the lunch table in Wakefield, a lone white woman represents another important part of the HIV story in the UK - the worsening sexual health of young people.

Adele, who doesn't want to give her surname, was diagnosed with the virus during a routine smear test four years ago, just before her 21st birthday party.

Although she has a supportive family, and her work colleagues are aware of her status, Adele's sense of isolation has led her to set up a new peer support group for young people with HIV.

African men are over represented amongst homosexually acquired HIV infection
Tom Doyle, Yorkshire Mesmac

Young and Positive is targeted at 16-25 year olds living in the area. She hopes it will bring some of the most isolated people in the region together to help one another.

"There'll be young women and young men out there who are straight and who have HIV.

"This will be a chance to get together and be on the same wavelength."

Tom Doyle admitted there had been tensions between different groups with HIV, although he cautioned against simplistic notions of gay men as racist, or black women as homophobic.

Rather, he said that tensions have arisen as a result of competition for finite resources, but being open and transparent about the reasons for the allocation of funding has helped.

"There is still an epidemic amongst gay men, and there is an imported epidemic amongst African people in the UK. But those groups aren't always distinct.

"We know, for example, that African men are over represented amongst homosexually acquired HIV infection. So there are often crossovers in infection, but that's not often talked about.

"Prevention has to be the key. Unfortunately, prevention is often the thing that's cut first."


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