Western Europe
Contact Information
Regional Focal Point
Nathalie Carter, United Kingdom - (Profile)
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Background
Approximately 740 000 [580 000–970 000] people were living with HIV in Western and Central Europe in 2006. In Western Europe, just over one third (35%) of HIV infections diagnosed in 2005 occurred during sex between men, while more than half (56%) were acquired during heterosexual intercourse. About three quarters of heterosexually acquired HIV infections were among immigrants and migrants (EuroHIV, 2006a).
The rate of new HIV diagnoses nearly doubled during the period 1998–2005 in Western Europe—from 42 cases per million population in 1998 to 74 per million in 2006. The largest increases have been reported in the United Kingdom. Annual, new HIV diagnoses in the United Kingdom have doubled since 2000, reaching 7700 in 2005 (Health Protection Agency United Kingdom, 2005) with it remaining high among men who have sex with men.
Compared to 2001, the number of HIV diagnoses in this population group was three quarters higher in the Netherlands (75%), more than two thirds higher in Portugal (68%) and Switzerland (71%), and 40% higher in Belgium in 2005 (EuroHIV, 2006a). In Germany, new HIV diagnoses in men who have sex with men more than doubled in 2001–2005 (EuroHIV, 2006a). Overall, an estimated 49 000 [29 000–81 000] people were living with HIV in Germany in 2005 (UNAIDS, 2006). The epidemics in the Scandinavian countries remain small and stable overall, although there has been an increase in HIV diagnoses among men who have sex with men in Sweden since 2002 (from 68 to 97 in 2005) (EuroHIV, 2006a). .
Source UNAIDS, 2006 AIDS Epidemic Update, December 2006
Regional News
Chronic Disease and African Communities: Research, Policy and Practice
Nathalie Carter, Western Europe RFP, recently presented an abstract at the second annual workshop of the UK-Africa partnership on chronic diseases, which took place at the London School of Economics and Political Science 23rd-24th June 2008. The workshop was well attended by postgraduate MSC students; doctoral researchers, medical doctors, nurses, psychologists, psychiatrists, nutritionists and other professionals in the field, and speakers from a range of countries including the UK, Denmark, The Netherlands, Ghana, South Africa and Kenya. Although the number of presenters under twenty five were a minority, effort was made to include several oral and poster presentations from MSC students.
Nathalie’s abstract on African children and families living with HIV and AIDS was based on her observations from two years work within support organizations in South London, primarily Positive Parenting and Children and The London Ecumenical AIDS Trust. The majority of the families face multiple disadvantages, especially poverty and ill health, which contribute to other social and educational difficulties.
Language barriers and lack of skills and training recognized in the UK result in unemployment and economic disadvantage. The issue of culture is a large challenge especially since most of the parents she works with are born in Africa and their children either arrived here young or were born and raised here Typical healthcare challenges this poses are some reluctance about the effectiveness of medication such as anti retroviral drugs, as compared to their UK born children.
Another cultural issue she finds is that a small proportion of clients are reluctant to take the advice of staff if they come from the same African country as them. On the contrary there are also clients who prefer to work with staff from their own country and are less likely to take the advice of British medical staff, which of course can potentially be detrimental to their health.
One of the greatest issues affecting all families is fear. Among these is fear of disclosure. The majority of families living with HIV live in fear of neighbors and others finding out their status through occurrences such as regular visits from social workers so often families reject outreach home based service which is detrimental to their own and their children’s wellbeing. Parents’ ill health and young caregivers’ duties often results in the isolation of children and young people who miss school and social opportunities. Even within families disclosure is a long and difficult process due to fear of rejection. By the time young people and partners find out the status of a family member living with HIV there is additional pain around secrecy and lying.
Finally, as heterosexual Africans and homosexual white men are considered the high prevalence groups in the UK a lot of partnerships and events tend be organized between these groups. A lot of the African families have cultural issues with homosexuality and feel their specific needs are not met, as heterosexual Africans who are single and looking for companionship and relationships. The organizations Nathalie work with aim to provide a culturally sensitive service and have based on service users reviews, they have been successful in doing so.
The main chronic diseases discussed were diabetes, sickle cell and HIV. There was also a lot of emphasis on contextual determinants of wellbeing such as poverty, environment and support network. Moving away from the traditional medical view of psychology there was great discussion from a community and social psychological perspective on the psycho-social effects of chronic illness. Much discussion focused on the difficulty of treating non-communicable diseases in Africa such as cancer, diabetes, cardiovascular and chronic lung diseases. Claims were also made that these receive less attention and support than infectious communicable diseases such as HIV, TB and Malaria even though the non-communicable diseases result in more deaths in many countries.
Other presentations on HIV included the psychosocial cost on young caregivers in Western Kenya; psychosocial needs of PLWA and carers in a changing HIV/AIDS epidemic: the role of ARV’s in Uganda; an exploration of the impact of the potential wider developmental implications through addressing mental health needs of people living with HIV/AIDS in South Africa and a case study of African children and families living with HIV and AIDS in London. Next years conference will be held in Ghana with the intention of alternating each year between the UK and Africa.
For further information please contact Ms. Nathalie Carter, GYCA Regional Focal Point- Western Europe on nathalie@youthaidscoaliton.org. For specific information on the UK-Africa partnership visit www.ncdafrica.org contact Dr. Ama De-Graft Aikens on ada21@cam.ac.uk
Alive, Kicking and Connected!
A group of young people living HIV and AIDS in London have developed a interactive website, http://crib.ppclondon.org.uk, launched on April 30th. The support group, self titled CRIB (Chasing Rainbows Is Our Business) was set up in 2004 through the charity Positive Parenting and Children www.ppclondon.org.uk to respond to the gap in peer support for adolescents living with HIV. The group meets twice per month in South London and current members range from the ages of eleven to nineteen.
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