Health experts in the UK have called for a national campaign similar to the AIDS tombstone advert to end the hepatitis C epidemic and stigma about the virus.
Politicians in Westminster were told yesterday that the lethal combination of stigma, low public awareness and cuts to sexual health services have created a national epidemic with the LGBTI community in the UK particularly at risk.
The All-Party Parliamentary Group (APPG) on Liver Health, which is holding an inquiry into hepatitis C, was told that less than 40% of people who are carrying the killer virus know that have it.
Public Health England estimate around 160,000 people carry the virus.
People become infected through blood-to blood contact, poorly sterilized medical or tattoo equipment, intravenous drug use, blood transfusions and sexual contact. It can be cured by anti-viral drugs but if left untreated it can cause cirrhosis of the liver and liver cancer.
The rise of chemsex, particularly among gay men, is among the factors for the rise in cases.
David Stuart, Substance Misuse Lead at the 56 Dean Street sexual health center in London is one of the UK’s experts on chemsex.
He told the meeting that gay men using mephedrone was an issue: ‘There has been an increase in injecting drug use among gay men. We’ve not seen a large increase but there has been an increase. There are issues around chemsex which we need to address.’
Testing for the virus was critical but Stuart warned cuts to services were having a direct impact.
‘The reason we can’t beat the epidemic is we’re not getting people who are infected or carriers. It’s because we’ve been capped with numbers. Six sexual health clinics have closed in London over the last few months. We’ve had a rush of people who used to test elsewhere,’ he said.
‘It’s like closing A&E units. Trusts are closing more of the testing centers and encouraging people to test at home. It’s a terribly frightening test – the stigma of the disease – to do at home.’
Among the sexual health clinics to close in London in the last six months are the clinic at the Royal Free in Hampstead, and two in South London run by Guy’s and St Thomas’ NHS Trust.
‘Around 40% of the infected population are aware’
Dr Ian Brew, viral hepatitis lead at Leeds Teaching Hospital Trust, also called for an end to clinic closures and for the government to scale-up work to prevent the disease.
Dr Brew, who is also responsible for HM Leeds Prison, said: ‘Sexual health clinics are very important. If we up-scaled what we are doing, that would be 7,000 extra people being treated just in prisons. If you multiply that out to other settings that would make a big difference.’
He added people who are in middle age and unaware of their condition pose the biggest risk: ‘Things are a lot better than they were. But it’s estimated around 40% of the infected population are aware and unfortunately a lot more needs to be done.’
Dr Brew warned: ‘The problem is if we don’t treat those patients now, they will become cirrhotic. There is a big saving: we know the cost of two years’ hospital care will be £65,000. So we know it’s effective.’
‘The parallels with HIV are amazing’
Professor David Goldberg, consultant at Health Protection Scotland said HIV had only been tackled after the government committed to funding prevention work for 10 years.
He said: ‘The parallels with HIV are amazing. That dedicated funding lasted for 10 years. That made a difference.’
Stuart warned stigma in the LGBTI community about hepatitis C also had to be tackled. ‘We’ve got to address the stigma. It’s not “I hate you,” it’s “I feel sorry for him but I won’t have sex with him.” In a sexualized community, it’s quite a devastating diagnosis. The stigma is much worse than HIV. There’s not a lot of support within the community.’
The panel, which included Baroness Masham and Labour MP Virendra Sharma, was told a national campaign similar to the tombstone TV advert made by the government in 1987 to raise awareness of AIDS and HIV was now needed.
Dr Brew said: ‘We all remember the tombstone adverts for HIV. Something along those sort of lines would be a very good thing to raise awareness.’
Dr Brendan Healy, chair of the Welsh Viral Hepatitis Sub Group, gave his support to the call for a campaign: ‘It’s a good way to encourage people to come forward. We’ve got to find people from a range of groups. I don’t think advertising would cost a significant amount of money. We could do something like the tombstone advert.’
Stuart said: ‘We can never talk about it enough. That’s a good thing.’
‘We are now as a result seeing a concerning spike in hepatitis C cases’
All of the experts said given current funding and priorities, the government would fail to meet its target to eliminate the hepatitis C in England by 2030.
Stuart told the group: ‘We could beat this epidemic quite easily. I know it’s a money thing but it will pay off.’
Dr Healy said: ‘This cannot be achieved through a rationed approach. Money is obviously an issue.’
Havering is one of the London boroughs that is currently consulting on closure of its sexual health services and moving to a home-testing scheme.
Cllr Alex Donald, Founder of Havering LGBT+ Forum told Gay Star News: ‘Having warned locally that closing STI centers would impact on public health, we are now as a result seeing a concerning spike in Hepatitis C cases.
‘With the majority of people not even knowing they have the virus, the Government must now rethink closing sexual health centers and invest in long-term solutions.’
In a report published in March, Public Health England said that the number of people with hepatitis C in England had remained stable over the last decade, but that, ‘we need to do more to reduce the persistently high proportion who remain undiagnosed if levels of avoidable premature mortality are to be reduced.’
GSN has approached the Department of Health for comment.