Stakeholder Engagement Report - London Councils

SUMMARY
1. Overarching submissions
Nineteen submissions focused on strategic priorities or overarching considerations with
regard to commissioning HIV preventative services in London.
• The strongest theme to emerge from these submissions is that the commissioning
of London’s HIV prevention services should be integrated and strategic.
• Different HIV prevention approaches should not be seen as competing or mutually
exclusive, but should be interdependent and mutually reinforcing. Moreover, no
one approach is likely to be sufficient in isolation to reduce HIV transmission.
• The aim of community approaches should not be solely to
increase access to clinical services but also, to address the
factors contributing to HIV exposure and transmission.
• The range of approaches available to reduce HIV transmission might therefore
be articulated under a strategic plan that states overarching aims roles etc.
• HIV prevention should be carried out with the consent
and ownership of the communities involved.
• Both London-wide and borough level commissioning are appropriate and
could be considered to have complementary roles. Some suggestions were
made regarding the different roles of each level of commissioning.
• Several submissions warned against boroughs acting entirely in
isolation around HIV prevention stressing that there should be a clear
rationale for carrying out prevention on a local level and that local work
should reflect overarching London-wide approaches and goals.
• London’s role as a global city attracting visitors and migrants will have a
major impact on epidemiology and HIV burden of HIV. These considerations
would need to be incorporated into any HIV prevention plan.
• There is a need for HIV prevention at several different levels: general
population, HIV risk groups and sub-populations within risk groups.
• There are opportunities for boroughs to integrate HIV prevention into
pre-existing policy and services. Examples cited included Environmental
Health and Trading Standards Departments, Drug Action Teams,
Education, Housing and Social Care. Interventions in these areas
would address some of the ‘upstream drivers’ of the epidemic.
There were strong concerns from some submissions regarding recent rises in HIV
infections in London amongst MSM. Two interpretations regarding what factors may
be driving these rises were offered. The first concerns the rise of recreational drug use
within the context of sex. The second relates to the decreasing spend on HIV prevention
over the last number of years.
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