Thursday, 20 June 2013
Topical Issue Debate
I thank the Ceann Comhairle for selecting this issue. HIV and AIDS are back in the news for all the wrong reasons. Recently, the HIV in Ireland 2012 Report was published by the HSE's Health Protection Surveillance Centre, HPSC. It indicates a worrying trend in the incidence of HIV that needs to be tackled as a matter of urgency in a concentrated, joined-up way by all of the relevant agencies and non-governmental organisations, NGOs.
In 2012, 341 people were newly diagnosed with HIV, an increase of 7% on 2011, with a crude notification rate of 7.4 per 100,000 of population, 30% higher than the EU-EEA rate of 5.7 per 100,000 population. These trends and statistics are worrying in themselves, but when one analyses them more closely, they highlight an urgent need for action.
Undoubtedly, gay and bisexual men are most likely to acquire HIV. The diagnosis rate in this group increased by 160% between 2005 and 2012, representing 48% of all new HIV cases. This is a key point. The remaining cohort of 52% are not in this category.
Along with an increase in the overall number of diagnoses, the median age for newly diagnosed cases in the group in question has fallen to 32 years, one year younger than the median age for all those newly diagnosed with HIV. This indicates a reluctance among some young men to engage in safe sex practices and, more importantly, to consider greater health challenges. Another significant worry is that gay and bisexual men represent an increasing proportion of diagnosed cases. We must communicate the message to young men in particular that HIV and AIDS remain a risk and can have a catastrophic effect on life. Many people are under the illusion that HIV will no longer kill them and, as a result, do not think sensibly and engage in practices that are less than beneficial to their overall health and welfare.
It is not just gay and bisexual men who are affected by these increasing rates. In 2012, there was a 12% increase in the number of heterosexual cases, from 116 to 130. The lack of awareness and testing leads to late diagnoses. In 10% of cases of people diagnosed with an AIDS defining illness, HIV was diagnosed at the same time. Of these 34 cases, 56% were heterosexual. This is a significant number.
The HPSC's report indicates that the current policy does not reduce the incidence of HIV cases and that there is a need to increase awareness of HIV and sexual health. It is important that we praise and acknowledge the work of the Gay and Lesbian Equality Network, GLEN, particularly its director of gay HIV strategies, Mr. Tiernan Brady.
While there is no cure for HIV, advanced medical treatments, including combination therapies, can improve a person's quality of life vastly and slow down the progression of the virus, preventing it from continuing to damage the immune system. Although we have moved away from the devastating consequences of the 1980s, serious repercussions for the health of all men remain. As a society, we cannot afford to let an increase in incidence rates continue without the Government taking measures to counteract it.
To address these issues, we must increase awareness, enact a Government strategy involving the Department of Health and NGOs, communicate a message on how infection can be avoided and, more importantly, make young men aware of the risks associated with their actions so that they can be informed when making decisions about protecting themselves.
I thank Deputy Buttimer for raising this Topical Issue. The HPSC collects data on new HIV and AIDS diagnoses. Data for 2012 showed that the total number of HIV infections reported in all years up to 2012 had risen to 6,629. While the annual numbers of newly diagnosed HIV infections had been decreasing since 2008, there was a slight increase in the overall numbers of new HIV diagnoses in 2012, amounting to 7%, as the Deputy stated.
Of the new diagnoses, there were 166 among gay men, the highest number ever recorded in that risk group. This is the predominant mode of transmission of HIV in Ireland.
While some aspects of the prevention agenda have proven successful in the past and have reached large proportions of the population, the statistics continue to show that increasingly people are either not hearing or are choosing to disregard the messages, and are engaging in risky behaviours. We need to deliver targeted prevention programmes in order to address this situation through partnership between non-governmental organisations, NGOs, and the statutory services.
The ongoing high incidence among the MSM group, specifically among the younger MSMs, is a particular cause for concern especially since the MSM group had responded well to awareness and prevention campaigns in the past. Clearly, not only must the messages reach the target audience, but they must make an impact when they do. We must do this in a cost-effective manner that delivers the biggest impact for investment.
The Gay Health Network, GHN, and the HSE ran an awareness campaign specifically focused for men who have sex with men, or MSM. This campaign, Man2Man.ie, was promoted over a 12-month period, from December 2011 to December 2012, and comprised four phases, with key messages developed by a peer youth group facilitated by BeLonG To Youth Services. It is therefore very timely and relevant that tomorrow the HSE and the Gay Health Network will launch the results of the joint national HIV prevention and sexual health awareness programme for men who have sex with men. Subject to resources, it is hoped to extend this awareness campaign. The 11th annual Gay Health Forum programme targets younger MSMs and aims to raise awareness, build self-esteem and equip men to be able to make safer sex choices.
In the area of responsible sexual behaviour, the ongoing stigma attached to HIV and other sexually transmitted infections, STIs, is undoubtedly one of the underlying reasons for the ongoing high incidence level of new cases of HIV and other STIs. On the wider issue of sexual health, the Department of Health has established a high level steering group to oversee the drafting of a national sexual health strategy. It will focus on improving sexual health and well-being and will address the surveillance, testing, treatment and prevention of HIV and STIs, crisis pregnancy, and sexual health education and promotion. Moreover, the strategy will be in line with the framework for health and well-being, which provides a policy framework that addresses the wider determinants of health and health inequalities.
It is important that we not only develop a high level steering group, but that we have a national sexual health strategy which targets young men in the age group I mentioned. I should put on record that the Gay Men's Health clinic and Gay Health Network, along with GLEN do powerful work in communicating and working with young men.
What cannot be lost in the bureaucratic maze of the Department of Health and the HSE is the fact that there must be outreach between the NGOs, and a joined up kind of thinking. The largest ever level of increase of HIV cases has just happened. There are many reasons for that but one is the complacency that may exist for some young men who feel they are immune from transmission of disease. We must eradicate that mindset and reach out to people
I welcome the Minister of State's reply. It is about communicating and creating a strategy that has a joined up approach. It is about education and not just about having that high level steering group to report back. We must see the implementation of that strategy which will pay dividends in the long run. It is important that the wider population be aware there is no cure for AIDS or HIV. Some of the drugs and combination therapies will prolong life and ultimately we hope the level of investment will bring about a cure. It is important that we do not become complacent and that we take note of these figures. The figures are people, not just a statistic and a report, but people whose lives are affected as a consequence of the transmission of this disease. It is important that we acknowledge this is an illness that has repercussions on the quality of life for people.
To reiterate, I agree wholeheartedly with the points made by Deputy Buttimer, specifically his point that 52% of those concerned are from the heterosexual community. We must bear that in mind in determining strategies.
I am not aware of the membership of the high level group affected but I hope it is reflective of all communities. To reinforce the point made by Deputy Buttimer, there is a very strong role for NGOs to play in the health promotion agenda and in making progress on this issue. I acknowledge the points made.
There is a role for this House, too, to be proactive in this area through the health committee and by whatever means possible. This is something that affects all of us.