Stakeholder Engagement Report - London Councils

4. Findings
There were a number of themes that emerged from the stakeholder engagement process.
The focus for the themes can be split into two areas:
• The what: the types of and approach to HIV prevention required
• The how: the commissioning, co-ordination and organisation required
There was consensus of opinion in many areas. However, there were also some key
differences of opinion and these have been highlighted in this report. Many submissions
from the Call for Evidence were provided by stakeholders and be found summarised in
Appendix B
4.1 the what
4.1.1 the Approach
“Are we waving or are we drowning?”
There are a number of key issues and suggested approaches to HIV prevention interventions:
Key issues
Stakeholders felt that many of the primary HIV prevention activities and initiatives
currently funded require a more robust evidence base in order for commissioners
to continue funding in the future. Communicating the evidence of effectiveness of
HIV prevention was reported as a challenge. The solution would be to impose more
appropriate and consistent monitoring.
Most stakeholders acknowledged that HIV testing is an effective primary clinical
prevention initiative and that HIV treatment is an effective secondary clinical HIV
prevention initiative; however, they cannot be delivered in isolation.
It was suggested that a combination approach to HIV prevention, rather than one
universal approach, would not only show recognition that a range of factors can influence
an individual’s relationships and safer sex behaviour, but could also offer a menu of
interventions with clear patient pathways and strong referral processes needed to meet
the different need of individuals.
“One size definitely does not fit all! This is becoming a really big problem and we
ignore it at our peril! We need to keep up with what’s really going on out there. It will
cost more than money if we don’t - the human costs are too high to contemplate!”
Service user feedback was considered a useful element of measuring the effectiveness of
interventions; however, it was felt that some commissioners place little value upon it.
“The time for TLC is over - we need to say it straight. Those people who are putting
themselves or others at risk need to get help and we need to be offering it to them.”
Stakeholders believed there was evidence to support the fact that interpersonal (face to
face) interventions including counselling, use of Health Trainers and group interventions,
help people make healthier life choices, including reducing risk taking behaviours.
Interpersonal interventions were seen to acknowledge the complexities of individual lives
which clinical/medical models and population based approaches do not.
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