By Breda Gahan and Jennifer Schoonover, Key Correspondents for the Irish Forum for Global Health
Why is it, that in 2017, in Ireland 10 people are newly diagnosed with HIV every week?
More than 500 people were diagnosed with HIV in Ireland during 2016 (HPSC stats). I asked Jennifer, my EUSA Intern from Pittsburgh University to do a random vox pop on the UCD campus where she is staying and here in the Concern Dublin office –
Here are some of the responses:
An absence of discussion on the matter, whether from parents or in schools; a deficiency of education; stigma; young adults are under the illusion that they cannot contract HIV; a misconception that the virus is only contracted within the gay community, in poorest countries, or among drug users; with advances in treatment for HIV, it is no longer a threatening or a serious virus; young people are now more “sexually liberal” at a younger age and with more sexual partners; they aren’t using protection; the predominant Catholic school education in Ireland contributes to the rising numbers; people here take it for granted, that HIV is now under control.
“When I was at college, a lot of young people thought that if they were on the pill or using an IUD, that they were protected.”
“People still think that HIV is exclusively in the homosexual community, or only in Africa, and we don’t think it happens to us here in Ireland”.
There is a unanimous agreement that low HIV awareness and a lack of sexual education are part of the underlying problem. So what to do? Some of the important suggestions proposed to Jennifer:
“Education, that’s really the key, isn’t it, making sure people are informed and taking the right precautions.”
“Education, Education, Education, and from a young age.”
“We need something clever, and something that isn’t wasting money; like an ad on a billboard, that’s not going to help anyone. It has to be within families, and schools and communities”.
Additionally, more open parenting styles; sex education;
“Condoms should be more freely available meaning that you don’t have to ask someone to hand them to you”
“There is still an underbelly of shame here in Ireland, even with girls asking doctors for the pill or for protection”
Make PrEP available in Ireland; reduce stigma; more spokespersons on the issue of HIV:
“I think that stigma has lessened with the likes of Panti (Bliss, HIV advocate) speaking out”
More than a decade ago, Professor Peter Piot, then Executive Director of UNAIDS said, ‘know your epidemic’. Plan on, where the next 1000 infections will occur?
Led by UNAIDS, ‘Know your epidemic, know your response’ became a rallying cry for an intensified focus on HIV prevention, by identifying the behaviours and social conditions that are most associated with HIV transmission, risk and vulnerability.
This can provide the basis for countries to ‘know your response’ and to “tailor your prevention plans” to meet the needs of the populations with highest rates and highest risks of HIV (UNAIDS 2007).
HIV is technically 100% preventable and HIV and AIDS related illnesses are increasingly treatable. Access to anti-retroviral treatment (ARVs) in Ireland is thankfully guaranteed.
Access of the poorest to ARVs is still sadly low among poorest populations in Africa where Concern is working. Ireland can lead by example, acting optimally on HIV prevention and treatment here and supporting through the Irish Aid programme globally. Ireland remains a major contributor to the Global Fund to Fight AIDS, TB and Malaria.
The main drivers of HIV transmission locally and globally continue to be a lack of education, poverty, inequality – especially economic and gender, injustice in terms of access to prevention and treatment services, violence and stigma and discrimination.
Key affected populations and the extreme poor are being left behind in Africa and Asia.
Looking at the HPSC data for 2016 here in Ireland, we can ask:
Among whom, how, where did the last 100 HIV infections occur in Ireland?
Among whom, how, where will the next 100 HIV infections occur in Ireland?
How can we best prevent at risk people from becoming infected with HIV? Based on the available data, we need to better engage with young adults, gay men / men who have sex with men (MSM), heterosexual people, intra-venous drug users (IDU and with people who contracted HIV here in Ireland and with those who contacted HIV abroad. We need to support everyone to test for HIV at a younger age, and routinely.
Over 2 million people were newly diagnosed with HIV in 2015. This is almost 40,000 new HIV infections transmitted globally per week. Poorest people will die due to lack of ARVs. Irish Aid, Concern, the Global Fund and all Dochas members all have a responsibility to do more within our overseas aid programmes with local partners to end AIDS. It is an impediment to our development and emergency response efforts and optimal outcomes.
As suggested from the vox pop above, we need to take advice and plan HIV prevention responses with people living with HIV (PLHIV) diagnosed here in Ireland, and with most affected population groups. They are probably best placed to speak out, educate and ‘break the silence’ aiming to stop the spread of HIV in this country and internationally.
HIV remains incurable, a burden for a person living with HIV, like any chronic illness and it come with a personal, social and economic and health costs. 10 newly diagnosed HIV infections in Ireland a week is not acceptable when we know how to prevent it.
As we mark Irish AIDS Day on June 15th, let’s all do more to support education for HIV prevention within our families, our school and our communities.
-Breda Gahan and Jennifer Schoonover, Dublin, June 2017
*If you require additional information or assistance, or just to talk:
HSE Drugs/HIV Helpline Freephone is 1800 459 459
Jennifer Schoonover arrived in Ireland recently and has just commenced an Internship with Concern Worldwide through the EUSA internships programme https://www.eusainternships.org/. She attends The University of Pittsburgh in Pittsburgh, Pennsylvania, and she is currently studying political science, going into her third year. Jennifer has been volunteering with the Ronald McDonald House charity since January 2016. Upon graduation, she hopes to continue working in the global development field.
Breda Gahan has worked with Concern Worldwide for the past 29 years in a variety of roles, and is currently the Senior Technical Advisor for Health and HIV and AIDS. A registered general nurse (RGN) and registered midwife (RM) she also holds a Masters Degree in Public Health from Liverpool School of Tropical Medicine. Breda’s overseas experience includes 2 years in a hospital in Baghdad, 2 years in Sudan, 3 years in Cambodia and 3 years in Mozambique. Following this, Breda was Concern’s first Child Survival Program (CSP) Backstop from 1998-2002, based half-time in the US and supporting new CSP programmes in Bangladesh and Rwanda. From 2002-2012 Breda was Concern’s Global HIV and AIDS Programme Adviser, providing technical assistance to developing Concern’s first HIV and AIDS policy and strategy and to its HIV programming. In June 2006 Breda participated with the Irish Government delegation at UNGASS to amplify advocacy objectives agreed with the Dochas HIV and AIDS Working Group with whom she held the position of Chairperson for four years (Feb. 2006 – Jan. 2010). Breda has joined many of the International AIDS Conferences, most recently in Durban in 2016.