Stakeholder Engagement Report - London Councils

Opportunities for boroughs to integrate HIV prevention into policy and services
In addition to actively commissioning HIV prevention, boroughs are responsible for many
aspects of the environment that influence the HIV epidemic. These include:
• Environmental Health and Trading Standards Departments in relation to
licensing and HIV prevention with businesses serving /targeting communities.
• Drug Action Teams in relation to drug use of local MSM populations.
• Education in relation to improving knowledge and
understanding of risks in relation to sex and drug use.
• Housing and Social Care services in relation to reducing vulnerability
to HIV among homeless people and young people in care and in
receipt of social services. Moreover, improved social care for people
with HIV will have an impact on secondary prevention.
There are therefore substantial opportunities for boroughs to address some of the main
‘upstream drivers’ of the epidemic.
Rises in Incidence
Finally, there were strong concerns across some submissions regarding recent rises in
HIV infections in London, specifically amongst MSM. Two interpretations regarding what
factors may be driving these rises were offered.
The first referred to reported changes in recreational drug use amongst MSM. Evidence
to support these reports come from observed changes in the profile of attenders to
community sector treatment setting and reports of GUM and HIV clinical providers at
certain clinics in central London. These refer to reported rises in use of specific recreational
drugs (Crystal methamphetamine, Gamma butyrolactone and Gamma hydroxybutyrate)
which may be ingested, snorted or injected in the context of sex and social activities that
leads to larger numbers of sexual partners, greater sexual mixing, less protected sexual
activities and the disinhibiting of personal and/or communal safer sex norms.
Responses include making clearer and more appropriate drug treatment and support
pathways for MSM. However, others also pointed out the need for greater engagement
with businesses and services targeting at risk groups operating within the private sector.
The main instances given are businesses that facilitate increased sexual exchange either
in physical or virtual space, and businesses that advertise or promote these services. Such
services and businesses may contribute to HIV by providing access to or normalisation of
risk behaviours and the advertising of the same. These services could be better regulated
and their contribution to HIV prevention increased.
The second interpretation pointed to studies showing correlations between the spend on
HIV prevention and changes in HIV incidence pointing out declines in the spend on HV
prevention with at risk communities in London over the last 10 years and concluding that
this may also be a contributing factor in the rise in incidence.
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