Since its launch two years ago, the Foundation has been working hard with partners to develop the Towards Zero HIV Strategy for Brighton & Hove and has led, with Brighton & Hove City Council, the successful application for the city to become the first United Nations (UNAIDS) Fast Track City in the UK. This has been on the back of exciting news around the reduction in the number of new cases of HIV and further improvements in the number of people living with HIV who are on effective treatment. In partnership with Brighton & Hove City Council and community stakeholders, the Foundation is now moving to implement the strategy and seeks the support of both individuals and organisations across the city to take this exciting work forward!
The Martin Fisher Foundation has been set up to take forward the important work of Professor Martin Fisher, Consultant in HIV Medicine & Sexual Health in Brighton. The Foundation continues Martin’s ethos of treating people living with HIV with dignity, compassion and respect, and focuses on the development of new initiatives around effective HIV prevention, treatment and care.
Towards Zero HIV Strategy
The Strategy sets out the Foundation and its partners’ vision and aims to accelerate towards zero HIV stigma, zero new HIV infections and zero deaths from HIV in Brighton & Hove by 2025.
It focuses on five key activities, each of which has the following strategic goals:
• Reducing HIV-related stigma;
• Increasing HIV testing;
• Improving access to PrEP;
• Championing research and evaluation;
• Ensuring patient involvement and peer support.
Underpinning the key activity areas is a commitment to support the ongoing delivery of treatment and care services for people living with HIV across the city in order that high quality standards of care can be maintained.
Progress on delivering Towards Zero HIV
First Fast Track City in UK
The Martin Fisher Foundation has led work with Brighton & Hove City Council culminating in the city being the first in the UK to sign up to the Paris Declaration on Fast Track Cities Ending AIDS – signed at a ceremony on August 3, 2017. This initiative aims to hasten the elimination of HIV/AIDS by 2030 in over 65 cities around the world, gives access to additional support from UNAIDS and encourages sharing of expertise between the cities. The interim target for Fast Track cities is to reach the 90-90-90 targets by 2020.
These targets are:
• 90% of people living with HIV knowing their HIV status;
• 90% of people who know their HIV- positive status on treatment;
• 90% of people on treatment with suppressed viral loads.
Currently, in Brighton & Hove, the first target is not being achieved as only an estimated 86% are aware of their status. This highlights the importance of initiatives to promote regular testing. The city is already exceeding the second two targets with proportion of people living with HIV who are taking antiretroviral therapy having increased from 87% in 2013 to 97% in 2017, and 96% of these individuals having an undetectable virus in their blood stream.
The Foundation has championed a combination approach to prevention, which recognises that different prevention choices will be appropriate for different individuals and that this may vary as people’s circumstances change. This includes using condoms, PrEP, regular testing and making sure those living with HIV have undetectable levels of the virus and are then uninfectious. This approach was launched at the Foundation’s Brighton & Hove Pride events in 2016 and will be the basis of future work and a public campaign – watch this space!
Reduction in Number of New Cases of HIV
The Foundation is very excited to share news from partners at Brighton and Sussex University Hospital NHS Trust. Recent analysis has shown over the last four years that the Brighton HIV clinic has noted a decrease in new HIV diagnoses. The number of new cases has decreased from an average of six per month in 2013 to three per month in 2017. The general downturn is thought to have been achieved through combination HIV prevention – increased HIV testing, earlier treatment and possibly use of PrEP (although the impact of PrEP requires further substantive evidence).
Following a successful application to the Public Health England Innovation Programme, the Foundation has been running a pilot to provide free HIV self-sampling kits from a vending machine at Brighton Sauna. Since June over 100 tests have been supplied, far exceeding the number carried out by traditional ‘out-reach’ services at the venue.
Dr Gill Dean, HIV and Sexual Health Consultant and Trustee of the Foundation, explains: “The aim is to encourage people who haven’t tested so far to test. If we can get to that 14% of people at risk who haven’t recently tested and, for those who then test positive encourage them to start treatment, then they will essentially become uninfectious and this will further help to reduce new cases of HIV.”
Funding for five more state of the art machines at a range of venues across the city has now been secured. This will help improve access to testing and a broader range of testing services in-line with the Towards Zero Strategy!
Tackling stigma is crucial if we are to reach Towards Zero and the Foundation is proud to announce a formation of strong implementation and research partnership across city partnership with Brighton and Sussex Medical School, University of Brighton, Latest TV and Ditch the Label. We will use digital platforms and a range of innovative methods to reach new audiences to provide important messages aimed at helping to reduce HIV stigma and discrimination.
Successful implantation of the Towards Zero Strategy depends on full backing, support and engagement of community organisations in the city as well as individuals getting involved. The Foundation is delighted that over 20 key partners have given their support, and following close joint working with Brighton & Hove City Council, a ‘Towards Zero HIV Taskforce’ has been formed and ‘implementation groups’ are now being put together.
Dr Adrian Brown, Chair of the Foundation, commented, “Working together is key – Brighton & Hove has a strong track record of partnership which Towards Zero is building on. We have now agreed with the city council structures and mechanisms to deliver the strategy. Achieving Towards Zero will only be possible with the support of organisations and people in the community We would love people to share their comments and ideas and for as many people to get involved as possible. Please do get in touch with us!”