HIV in Focus

• The Dual Perspective

  In The Dual Perspective, Dr. Naomi Sutton is joined by Aoife Commins, a registered nurse and HIV advocate based in Galway, Ireland, to speak about Aoife's unique experience of being both a healthcare professional and living proudly with HIV. Aoife shares her diagnosis story and the challenges she encountered along the way, including stigma and misinformation - even among healthcare professionals. Aoife and Naomi discuss the state of HIV education, while sharing some key tips and resources for listeners to combat stigma and improve the understanding of HIV outside of the specialty." I did everything right. I took every step. I got tested. We were using condoms. We decided to stop using condoms and I still caught it. You know, it can happen to literally anyone. You can do everything right and still catch it. So, we have to stop with this kind of whole moral hierarchy of HIV" " In society, we should not have to defend ourselves and advocate for ourselves in healthcare. It just shouldn't be the way it is. And it's very frustrating for people living with HIV."" And if somebody sat in front of you saying, please, could you test for HIV? Just do the test. "Aoife Commins is a Registered Nurse in Acute Medicine at University Hospital Galway, an HIV advocate and speaker dedicated to raising awareness about HIV, sexual health, and combating stigma based in Ireland. Follow Aoife on Instagram @aoifecommins. Hosted on Acast. See acast.com/privacy for more information.

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• Managing Complexities

  In Managing Complexities, Dr. Naomi Sutton is joined by Dr. Lauren Walker to discuss a topic that is becoming more pertinent as people living with HIV live longer: multiple co-morbidities in an aging cohort. The goal has shifted from keeping people living with HIV alive to improving their quality of life as they age. Lauren walks listeners through the relationship between HIV and co-morbidities, the cumulative burden of small harms and the impact of polypharmacy on quality of life. Lauren and Naomi discuss where the responsibility of de-prescribing lies, and when clinicians should undertake medicines optimisation; as well as working towards a more ideal approach to managing co-morbidities in the presence of HIV. " The important point for GPs that are listening is around challenging diagnoses and making sure that actually, that diagnosis is still present, that the person is still dizzy or itchy, so therefore they still need it – because they may not. " " Decisions about medicine shouldn't only be made by the clinician in front of you. It should be a shared decision where we talk about risk and we talk about benefit and the potential harms of medicines and we decide together what's your priority and what do you want to do. " " And that's really important then that if there is medicine that you feel that this patient needs to manage their multiple long-term conditions, then by all means speak to the HIV team to say, is this safe?" Resources: Liverpool Combined Comorbidities Calculator, University of LiverpoolDr. Lauren Walker is Senior Clinical Lecturer in Clinical Pharmacology & Therapeutics and an Honorary Consultant in General Internal Medicine at the University of Liverpool. She is the Academic Director of the university’s NIHR Clinical Research Facility, and a co-Director of the Liverpool Early Phase Hub. Lauren’s research and clinical interests include improving the safe and effective real-world use of medicines in adults with complex multimorbidity & polypharmacy. Lauren also co-chairs a National Polypharmacy Services Consortium (PPSC).UK-UNB-5076Jan 2024 Hosted on Acast. See acast.com/privacy for more information.

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• Fast-Track Cities

  Dr. Naomi Sutton is joined by Professor Jane Anderson to talk about Fast-Track Cities and their role in Getting to Zero, particularly in maximising the collaboration between funding bodies such as local government, existing health and care services, patient advocacy groups and charities to design and deliver interventions tailored to local populations. Jane takes Naomi and listeners through the history and accomplishments of Fast-Track Cities, and how to implement the principles of Fast-Track Cities and partnership working even if you don’t live in a city." Cities are places that have got huge populations. HIV is often an urban problem. And importantly, cities have got power over their health economies, over the lives of their citizens that can be used to really good effect, to ensure that cities fast-track their HIV responses "" People living with HIV are experiencing stigma and discrimination in their lives, and in particular, in some healthcare settings. And we know that internalised stigma is a real problem. So, without addressing that, we're not going to get to zero "" We are in a health and care system that's quite split and quite divided. So we need to make sure that we are together, and we also need to make sure that people living with HIV are front and centre of every initiative " Resources: Fast-Track Cities London, Evolving HIV Care Professor Jane Anderson is a Consultant Physician and Clinical Researcher in HIV Medicine at Homerton University Hospital and Barts Health in East London. Her interests include delivering joined-up, equitable, person-centred services for people living with HIV and their families. Jane is a past-chair of the British HIV Association, the current chair of the National AIDS Trust board, and co-chair of London’s Fast-Track Cities Leadership Group. Follow her work on Twitter/X @ProfJAnderson and @londonftciUK-UNB-5077Jan 2024 Hosted on Acast. See acast.com/privacy for more information.

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• Out of Care

  Dr. Naomi Sutton is joined by Dr. Grace Bottoni and Dr. Kate Childs for this episode to talk about a growing challenge in HIV: re-engaging people living with HIV who are out of care. Kate and Grace both play key roles in delivering the world’s first Social Impact Bond that focuses on bringing people living with HIV back into care. Kate explains the meaning of “not in care”, why it’s important and the size of the problem in the UK. Grace takes listeners through her personal experiences of re-engaging people back into care as a GP and highlights some barriers that some patients need to overcome. Kate, Grace and Naomi discuss why people may be out of care, while sharing compelling cases and strategies for re-engagement that have worked for their patients. " If we want to end HIV by 2030, the people out of care are a really important group to address. And Primary Care teams are in one of the best positions to support these people. " " People who are out of care often don't really want to be out of care. They found themselves in that situation. It's the same way I haven't been to the dentist for ages. It's something they know they should be doing, but they haven't quite got around to and they feel well. And they often feel quite guilty and ashamed about that as well. " " There are three main questions that you can ask, and these are not to be asked in a judgmental way. And it's just you being inquisitive because as I said, HIV is a chronic condition and you would ask these questions of any person with a chronic condition like diabetes or COPD" Resources: Elton John AIDS Foundation, Achievements of the Zero HIV Social Impact BondUniversity of Liverpool HIV Drug Interactions websiteHowarth et al. REACH studyHIV Prevention England, Practical guidance for Primary Care to optimise HIV testing and re-engagement of people living with HIV Dr. Grace Bottoni is an HIV GP Champion, as well as a Hepatitis C Champion, working out of the borough of Lewisham in South East London. Her clinical interests include increasing testing in primary care and re-engaging patients living with HIV who are out of care, while reducing stigma in healthcare settings. Dr. Bottoni is also the local clinical lead for the Clinical Effectiveness Group in South East London. Reach out to Grace on LinkedIn with your questions. Dr Kate Childs is an HIV consultant at Kings College Hospital, London and her clinical interests include re-engaging people living with HIV who are out of care, improving access to care, and HIV-associated liver disease. Dr. Childs is on the British HIV Association (BHIVA) co-infection guidelines writing group and was elected to the BHIVA Executive Committee as a trustee in 2023.UK-UNB-4889Jan 2024 Hosted on Acast. See acast.com/privacy for more information.

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• Positive Parenting

  For Positive Parenting, Dr. Shema Tariq returns to the podcast joined by Bakita Kasadha to debunk the myths and misinformation surrounding a joyous but potentially challenging period of life: becoming a parent. People with HIV routinely give birth to HIV-negative babies. However, they do not always have access to accurate advice or much needed post-natal support. Shema gives listeners a rundown of the latest infant feeding guidelines from the British HIV Association (BHIVA) and how clinicians can support parents living with HIV to feed their babies. Bakita talks through the Nourish-UK study findings, which looks at the experiences of birthing parents living with HIV and how they make decisions around feeding their babies. Post-natal support, particularly from peers, is crucial for birthing parents with HIV – a good place to start is reaching out to the 4M Mentor Mothers network for more information. " If a woman is on treatment, or if a birthing parent is on treatment, the risk of passing HIV onto a baby, something that we call vertical transmission, is between 1 in 500 and 1 in a 1000. […] That's the same as getting nine heads in a row if you toss a coin – so it's really, really unlikely." " It's important to work together rather than seeing it as a clinician is advocating for the safest option for the child. The parent probably wants what's best for their child, too. So it's important to approach the conversation in that way. " Resources:BHIVA Pregnancy GuidelinesPreventing Vertical Transmission, Terrence Higgins TrustNOURISH-UK Patient Information Leaflet4M Mentor Mothers Bakita Kasadha is an award-winning health researcher, health writer and poet who sits at the intersection of social science and HIV advocacy. Bakita is currently pursuing a DPhil at the University of Oxford interrogating the experiences of peer lived-experience researchers in academic health studies, and is a Co-Investigator on the Partnership for Black People’s Health study. She also chairs the board of Glitch and is a board member of the Fast-Track Cities Leadership Group. Follow Bakita on Twitter/X @BakitaKK or at her website: www.bakitakk.com Dr Shema Tariq is a Consultant HIV and Sexual Health Physician at Mortimer Market Centre, and Clinical Academic at University College London's Institute for Global Health. Her main clinical and research interest is the health and wellbeing of women living with HIV. She leads the PRIME Study - one of the largest studies internationally on HIV and menopause. Shema is also part of the GROWS team, developing information and peer support for older women living with HIV, and is a Trustee of Positively UK and Tommy's. She is also Chair of the Steering Group of 4M Network, a UK-wide Mentor Mother programme. Follow her work on Twitter/X @savoy__truffle and @prime_uclUK-UNB-4747Jan 2024 Hosted on Acast. See acast.com/privacy for more information.

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