Stakeholder Engagement Report - London Councils

Executive summary
The following activities were undertaken to elicit views from the widest range of
stakeholders feasible within the timeframe allocated:
• A series of one-to-one and small group stakeholder interviews
• A series of telephone stakeholder interviews
• An online questionnaire which was distributed across all London commissioners
• A Call for Evidence
• Stakeholder events, including the London sexual health commissioners
and a large scale multi-organisational stakeholder event
• Seminar organised by the South West London Network lead
• Use of the London Councils website and newsletter email list
twhich encouraged wider participation and feedback
The delivery team acknowledge that some stakeholders may not have been able to
participate due to short time frames. The stakeholder engagement provides a narrative as
well as acting as a source of expert opinion.
There was general agreement that the HIV prevention services currently provided in
London are based on historical models. As part of this engagement process, there was
enthusiasm for a more holistic approach to the public health interventions, which should
now encompass a broader range of health determinants, including substance misuse,
smoking cessation and alcohol use.
In terms of the future model, many stakeholders cited the Marmot review, (Fair Society,
Healthy Lives 2010) into health inequalities stating that it gave a broader and more
relevant context to risk. The majority of stakeholders were clear that there were missed
opportunities by having such a narrow definition of HIV prevention for people’s health
seeking behaviour.
What HIV prevention needs to be provided
A combination approach, rather than one universal approach, to HIV prevention recognises
the range of factors that influence an individual’s relationships and safer sex behaviour.
It also offers a menu of interventions with clear patient pathways and strong referral
processes needed to enable providers to meet the different needs of individuals. HIV
testing is an effective primary clinical prevention initiative, and HIV treatment is an effective
secondary clinical HIV prevention initiative; however, they cannot be delivered in isolation.
The division between primary and secondary prevention work is deemed unhelpful.
HIV testing as the means to an end is seen as a limited approach without the back up of
behavioural change interventions to add value and support the individual. HIV negative
diagnoses are often missed opportunities as more attention needs to be given to health
promotion interventions for individuals to remain negative. There is an opportunity to
introduce HIV testing in a broader range of community and primary care settings and a
need to incorporate much broader risk factors into the intervention portfolio (including
alcohol and drug use).
The availability of consistent quality information and resources is regarded as central to
HIV prevention. There is an overwhelming sense that HIV prevention is failing to evolve
at the same speed as societal changes and that embracing new technology is far too slow
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