2014 HIV statistics released by the HSE

Ten of Swords

In the last few days the HSE have released the 2014 HIV statistics for Ireland, it paints a worrying picture.

MSM (Men who have sex with men)..183 (49%)
Heterosexual Contact.....................125 (33%)
PWID (People who inject drugs)........27 (7%)
MCT (Mother to child transmission)....2 (1%)
Unknown Transmission Vector...........40 (11%)

There were 377 new cases of HIV infection during 2014. This makes the national average 8.2 cases per 100,000 however the Eastern region (Dublin, Kildare and Wicklow) has double the national average at 16.1 cases per 100,000.

The category MSM (Men who have sex with men) represents the largest group so gay and bisexual men are still the highest risk group.


I found these 2014 statistics to be the most alarming;

183 cases of MSM represents the highest number ever recorded in this category
48% of the MSM category were born in Ireland (The next highest ethnic group is Latin America at 21%)
MSM is, and has been, the highest category every year since 2009
The rate of MSM infection has gone from 60 cases in 2005 to 183 cases in 2014, the fastest increase across all groups
The average age of MSM being diagnosed has dropped from 37 in previous years to 31 in 2014
The decrease in MSM average age is due to more young people being diagnosed (Age 15-24 is 14% of MSM, Age 25-29 is 28% of MSM)
Across all 5 categories there were 9 deaths from HIV/Aids reported to the CSO during 2014


In spite of all of the awareness there is still a huge amount of carelessness out there when hooking up, and there are plenty of threads in this forum where people have considered the risks they were exposed to only after the fact. It's usually a pretty big reality check too when that happens, and a 6-8 week wait for a test.

Lads, be safe - always.


"The problem is, God gave man a brain and a penis and only enough blood to run one at a time" - Robin Williams

HSE 2014 Report

jimdublin15

Very true the 2014 data is interesting.
Just to add to your post

Today is Irish AIDS Day (15th June 2015)
Some interviews in the Irish media today with Irish PLHIV.

TV3: Interview with Sandy (living with HIV for 16 years) speaks about his experience living with HIV and how far things have come in the past 16 years. http://www.tv3.ie/3player/show/184/94949/0/

TodayFM radio interview with two PLHIV.
Andy an Irish gay man living with HIV for the past 9 years & Yvonne a migrant mother talks about HIV and HIV Stigma.
http://www.todayfm.com/player/shows/The_Anton_Savage_Show/35388/living_with_hivsandy_and_yvonne

HIV Ireland's press release:
http://www.dublinaidsalliance.ie/index.php?mact=News,cntnt01,detail,0&cntnt01articleid=344&cntnt01origid=380&cntnt01pagelimit=5&cntnt01returnid=170

Below I've tried to attach a jpg showing past years trends as FYI.
(not sure if the Jpg will work so typed up the numbers as well, not very good at posting with images)

---

MSM%--PWID%----Hetero % Total number of new HIV case
2003 19.0 ---12.5

---

55.4

---

---401
2004 17.6----20.7

---

50.0

---

---358
2005 18.4----20.6

---

52.5

---

---326
2006 25.2----16.7

---

51.3

---

---353
2007 23.3----14.1

---

42.2

---

---391
2008 26.0----9.9

---

47.0

---

---404
2009 34.9----7.6

---

41.0

---

---395
2010 40.6----7.0

---

38.5

---

---303
2011 44.5----5.2

---

38.3

---

---326
2012 49.4----3.8

---

39.1

---

---340
2013 46.2----5.2

---

38.1

---

---344
http://www.hpsc.ie/A-Z/HIVSTIs/HIVandAIDS/SlideSets/


http://www.irishaidsday.com/#!/

Jim.

Aard

If 48% of new cases of hiv among msm were Irish, then 52% were foreign. 21% from South America were presumably largely Brazilian. While safe sex is important no matter who the partner is, I think the message here is that it's important to be extra precautious when having sex with a foreigner. Equally, it's important to get the word out to foreigners about the importance of safe sex. Many of them would have had little or no sex education in their home countries.

jimdublin15

Aard wrote: »

If 48% of new cases of hiv among msm were Irish, then 52% were foreign. 21% from South America were presumably largely Brazilian. While safe sex is important no matter who the partner is, I think the message here is that it's important to be extra precautious when having sex with a foreigner. Equally, it's important to get the word out to foreigners about the importance of safe sex. Many of them would have had little or no sex education in their home countries.

Sure a % are from regions with high HIV prevalence, but I think the message should not focus on that too much. People should not be rationalizing the risk ever!
It's not just HIV other STI are on the rise at a far higher rate like Hepatitis C.

The message should be clear:
Use condoms consistently and correctly no matter who your partner. When used correctly and consistently, condoms are highly effective in preventing HIV infection, as well as other STI's.(sexually transmitted infections).

J_E

Aard wrote: »

If 48% of new cases of hiv among msm were Irish, then 52% were foreign. 21% from South America were presumably largely Brazilian. While safe sex is important no matter who the partner is, I think the message here is that it's important to be extra precautious when having sex with a foreigner. Equally, it's important to get the word out to foreigners about the importance of safe sex. Many of them would have had little or no sex education in their home countries.

No, this is not the message at all. You stay safe regardless of who it is. You don't take extra caution because someone might be in a certain group of people: you take the same precautions with every person you hookup with. Doing any less means you are always taking a gamble. You don't worry whether the other person is educated or not about sex ed, because if they're not playing by your rules, then there is nothing happening.

Aard

I think I must have poorly phrased. Of course there is no "risk rationalisation" and all partners must be treated with same precaution.

My final points were about making sure foreigners get the message about safe sex, seeing as how they make up more than half the number of new msm cases.

jobbridge4life

It is a disgrace and indictment of our community that we are sacrificing our young people to a disease that is utterly preventable. Its so insanely infuriating. We marched for marriage, we rallied, we fought an amazing fight so whey can't we do the same for something that could save lives.

jimdublin15

jobbridge4life wrote: »

It is a disgrace and indictment of our community that we are sacrificing our young people to a disease that is utterly preventable. Its so insanely infuriating. We marched for marriage, we rallied, we fought an amazing fight so whey can't we do the same for something that could save lives.

Do I understand correctly you want to do more action like (Marching/rally) for safe sex ?

jobbridge4life

jimdublin15 wrote: »

Do I understand correctly you want to do more action like (Marching/rally) for safe sex ?

My point is that we are capable of amazing unity and feats when we want to be for instance as was demonstrated recently with the marriage equality campaign. We should be able to come together and do something to deal with this.

jimdublin15

Oh right :-)

Sorry about that, yeah I do agree with you.

However Sex, sex education and STI's are a hush hush/taboo topic's, in particular HIV awareness in my experience.

jobbridge4life

jimdublin15 wrote: »

Oh right :-)

Sorry about that, yeah I do agree with you.

However Sex, sex education and STI's are a hush hush/taboo topic's, in particular HIV awareness in my experience.

Yeah and in my experience it is actually worse in the gay community.

jimdublin15

jobbridge4life wrote: »

Yeah and in my experience it is actually worse in the gay community.

Would agree with you on that. I mean overall the attitude & attention is pretty bad (closed) in society towards the topic of sex / sex education and STI's but yeah additional focus is needed I think for the gay community. This in conjunction with also better highlighting HIV and education on the topic.

The question really remains why don't we already and how to action this going forward.

I mean current media coverage does not help to open discussion on the topic. Take this week the statistics were released and we had Irish AIDS day and the papers run the stories mostly with pictures covering needles and drug usage ... Yeah part of the issue is drug use but running the stories in the media with shock and/or fear based one sided representation of the issues closes the conversation and makes the issue in turn worse.

(sorry had to vent slightly)

SILVAMAN

jobbridge4life wrote: »

It is a disgrace and indictment of our community that we are sacrificing our young people to a disease that is utterly preventable. Its so insanely infuriating. We marched for marriage, we rallied, we fought an amazing fight so whey can't we do the same for something that could save lives.

"It is amazing how many slang words mean both 'penis' and 'fool': purz, dork, prick, dick, weenie. Perhaps it's because a horny man thinks with his penis rather than his brain."-Charels Panati

Also, for those of us who came of age in the midst of the epidemic, the sight of emaciated bodied covered with KS, reports of CMV, an infection of cats ravaging HIV sufferers brains, uncontrollable diarrhoea, made quite an impression. That's something most youngsters have never seen.

jimdublin15

SILVAMAN wrote: »

"
Also, for those of us who came of age in the midst of the epidemic, the sight of emaciated bodied covered with KS, reports of CMV, an infection of cats ravaging HIV sufferers brains, uncontrollable diarrhoea, made quite an impression. That's something most youngsters have never seen.

That's a good thing that they don't have to either.
Thankfully it's 2015 and no longer 1985 and if the shock of the dead bodies and the living dead before they died failed to stop the epidemic back then from continuing I don't think we should revisit tactics from that area either. We all recall the John Hurst ad's about AIDS, and it did not halt infections.

Education on the subject should focus on the issues we have, one of them is making sure the issue of sex and STI's is not shamed back into the closest but spoken about. If you ask me, i think subjects and topic's that are tainted with shame by society & media just fuel myths and misunderstanding that in turn also leads to the next round of infections.

Annasopra

jobbridge4life wrote: »

Yeah and in my experience it is actually worse in the gay community.

It's funny 5-10 years ago I think it was the complete opposite. Gay men were made much more aware of safer sex practices etc.

SILVAMAN

It hasn't gone away completely. A friend has a CD4 count of 500, been on HAART fro 6 years, and has developed KS lesions specifically on his thighs. It's an increasing problem for people on HAART. Lymphoma is another increasingly common cancer amongst HIV+patients.
How many young gay me can can visualise how someone dies of AIDS? I used to work with an attorney friend in NY who did pro bono work in the evenings drawing up wills for dying men and women. What I witnessed these people suffering from will never leave me-it was a living hell for them, and despite the agony they would have given anything to live just another hour.
I agree that stigma has to be removed, but if you have no idea of the potential consequenses of this disease, it's easier to take a risk.

jimdublin15

SILVAMAN wrote: »

It hasn't gone away completely. A friend hasa CD4 count of 500, has been on HAART fro 6 years, and had developed KS lesions specifically on his thighs. It's an increasing problem for people on HAART. Lymphoma is another increasingly common cancer amongst HIV+patients.
How many young gay me can can visualise how someone dies of AIDS? I used to work with an attorney frined in NY who did pro bono work in the evenings drawing up wills for dying men and women. What I witnessed these people suffering from will never leave me-it was a living hell for them, and despite the agony they would have given anything to live just another hour.
I agree thatstigma has to be removed, but if you have no idea of the potential consequenses of this disease, it's easier to take a risk.

Problems include too little testing for HIV and even if you test positive instead of treating in Ireland they wait for your CD4 to drop and allow the damage to be caused first. Other western location treat at diagnosis to prevent damage or at least before CD4's even reach below 500 and recent studies support this. http://www.webmd.com/hiv-aids/news/20150527/global-trial-finds-hiv-drugs-should-be-taken-right-after-diagnosis Ireland waits till actually damage is done and/or below 350 CD4 See HSE link under section Combination therapy: http://www.hse.ie/eng/health/az/H/HIV-and-AIDS/What-are-the-treatment-options-.html

True even on HAART they have increased risks of illness particularly groups from the past like your friend. People with HIV that also waited too long to start treatment or were diagnosed late are at more risk. The CD4 count may increase after VL goes down but actual lasting damage is already done to many and they remain prone to illness. However that's all even more reason to talk, test and get the topic out of the social taboo so people practice more safer sex and get tested early without the barrier of shame and stigma so they can fully benefit from recent changed in treatments and live near normal life expectancy. Nowadays (2015) anyone newly diagnosed is expected to life near normal life expectancy as they will start off with better and more effective drugs before the damage is done. http://www.nhs.uk/news/2011/10October/Pages/life-expectancy-uk-people-with-hiv-improves.aspx

As for the past and your experience it is terrible that so many fell ill and died I fully agree with you and they should not be forgotten or dismissed and many are still ill who had damage done in days that meds were not as effective or had side affects allowing permanent damage to be done but in the word of HIV has changed a lot in recent years and saying that we still need to reduce the number of infected and re-educate. Clearly the shock and scare tactics from the past have not worked and so it's time to address this if we want to reduce infection rates.

SILVAMAN wrote: »

I agree thatstigma has to be removed, but if you have no idea of the potential consequenses of this disease, it's easier to take a risk.

Agree with you but the picture is not as hash in western countries as you experienced in the past anymore. What has happened is part of our experience and thankfully the new generation are not exposed to it directly. So we do need to clearly adjust our education and help them understand but not by fear or talking of what used to happen if you know what i mean.

I thought this publication was pretty good on the subject.
http://www.dublinaidsalliance.ie/index.php?mact=News,cntnt01,detail,0&cntnt01articleid=344&cntnt01origid=300&cntnt01pagelimit=5&cntnt01returnid=170
The above publication highlights the silence on the topic and I like this part as it is indeed the case let's not forget the past or the impact but it is time to talk and educate about the subject in a new 2015 light.
The impact AIDS has had on Irish society must never be forgotten. However, it is now time to focus on HIV, to have a conversation about HIV and the impact it continues to have on the lives of so many people in Ireland today.

SILVAMAN wrote: »

I agree thatstigma has to be removed, but if you have no idea of the potential consequenses of this disease, it's easier to take a risk.

I do agree in theory. He says as he takes his daily HAART medication. (Truvada/Tivicay) HIV antiviral combo.

Aard

Joeytheparrot wrote: »

It's funny 5-10 years ago I think it was the complete opposite. Gay men were made much more aware of safer sex practices etc.

Grindr

jimdublin15

Aard wrote: »

Grindr

True and Social media and platforms do seem to be getting linked to rises in STi's

When Craigslist comes to town, HIV infections go up, study says
http://www.washingtonpost.com/news/morning-mix/wp/2015/02/02/when-craigslist-comes-to-town-hiv-infections-go-up-study-says/

That said despite the apps making ordering sex easier than buying pizza (So i've heard lol :P) neither Grindr or similar apps/sites make people have unsafe sex, it's a behavior they I suspect would do anyway. In the digital age even more reason to have more up-to-date media attention towards the topic and education.

Annasopra

Aard wrote: »

Grindr

No but I dont think there is as much educational initiatives now. For example Johnny the group of volunteers used to hand out condoms in Dublin pubs from about 2000 to 2010 and they used to safer sex workshops. GMHS used to have an outreach worker but I dont think they do anymore.

L1011

Joeytheparrot wrote: »

No but I dont think there is as much educational initiatives now. For example Johnny the group of volunteers used to hand out condoms in Dublin pubs from about 2000 to 2010 and they used to safer sex workshops. GMHS used to have an outreach worker but I dont think they do anymore.

Funding cuts did for both of those as far as I know. False economies really.

Annasopra

L1011 wrote: »

Funding cuts did for both of those as far as I know. False economies really.

No. Johnny was voluntary so not really cuts.

L1011

Joeytheparrot wrote: »

No. Johnny was voluntary so not really cuts.

Did they not have their supply of condoms, printing etc from the HSE?

Annasopra

L1011 wrote: »

Did they not have their supply of condoms, printing etc from the HSE?

The condom supply is largely still there - printing not really.

jobbridge4life

jimdublin15 wrote: »

As for the past and your experience it is terrible that so many fell ill and died I fully agree with you and they should not be forgotten or dismissed and many are still ill who had damage done in days that meds were not as effective or had side affects allowing permanent damage to be done but in the word of HIV has changed a lot in recent years and saying that we still need to reduce the number of infected and re-educate. Clearly the shock and scare tactics from the past have not worked and so it's time to address this if we want to reduce infection rates.

With respect didn't the scare tactics result in a massive increase in condom use and a significant reduction in infection rates? Of course any campaign should be tailored to the realities of the disease at present but I honestly don't know very many gay people my age that are even vaguely aware of the horrors mentioned by Silvaman or the true scale of the devastation that HIV/Aids wrought on our community. At the same time it is crucial that a campaign not whip up stigma. Its a balancing act.

I honestly think that there is two main reasons for our current problem from an awareness perspective. In popular conscience HIV/Aids was originally the gay disease. Then straight people started to get infected so I think there is a hesitation amongst campaigners to focus too much on the gay side lest it create the impression that this won't affect straight people. Secondly I think there is fear of being seen as homophobic by overly associating HIV with gay people.

Within the community I know so many young gay men who just don't want to acknowledge that HIV is a gay issue. And it is. Its almost as though to admit that it disproportionately affects us is somehow a slight. I can understand that but we don't think its an insult to fair skin people to acknowledge that we need to be extra cautious in the sun. We have to be mature about this. I've seen impressive results in african-american communities (also disproportionately affected by HIV aids) almost as it were taking ownership of the issue and nullifying the stigma but confronting the disease aggressively.

jimdublin15

jobbridge4life wrote: »

With respect didn't the scare tactics result in a massive increase in condom use and a significant reduction in infection rates? Of course any campaign should be tailored to the realities of the disease at present but I honestly don't know very many gay people my age that are even vaguely aware of the horrors mentioned by Silvaman or the true scale of the devastation that HIV/Aids wrought on our community. At the same time it is crucial that a campaign not whip up stigma. Its a balancing act.

I honestly think that there is two main reasons for our current problem from an awareness perspective. In popular conscience HIV/Aids was originally the gay disease. Then straight people started to get infected so I think there is a hesitation among campaigners to focus too much on the gay side lest it create the impression that this won't affect straight people. Secondly I think there is fear of being seen as homophobic by overly associating HIV with gay people.

Within the community I know so many young gay men who just don't want to acknowledge that HIV is a gay issue. And it is. Its almost as though to admit that it disproportionately affects us is somehow a slight. I can understand that but we don't think its an insult to fair skin people to acknowledge that we need to be extra cautious in the sun. We have to be mature about this. I've seen impressive results in african-american communities (also disproportionately affected by HIV aids) almost as it were taking ownership of the issue and nullifying the stigma but confronting the disease aggressively.

Well nobody is suggesting that the gay community should be the one driving the effort in HIV reduction, at least I hope not. The high rate currently is affecting MSM contact not the Gay community as such. I mean that as a lot of the MSM might not even consider themselves gay and hence might not be reached or respond to a push on the subject from within the gay community. We need a more wide net approach I think.

It's simply if we look at the HIV report published 2014 by the OP the HSE says 49 % are presenting late to very late meaning the have been infected for a number of years. So that also means they have good chance been unknowingly spreading the illness and that tactics from a few years ago have failed for the cases in question. I am under no delusion 0 infections is not going to be achieved. Today's issue of late presenting when diagnosed is linked to low testing rates and late diagnosis, This has a different root cause than the 90's. I mean the 80's I not even going to mention testing was not around for the first part and by the time you thought you were getting sick you were dying, at least for many.

The issues back in the 90's time frame that Silvaman highlighted with the video (91 I think) is the past and some of us lived in that time and witnessed the horrors. Still we have the illness today and instead of looking back (we should not forget what happened) we should look at the current trend and why this is happening. Pushed by a fear and shock tactic this level of testing would just be pressured, people would rater not know or even if they suspect hide it.
Hence we need a more positive drive and open discussion about the issue on all front.

Below is a report about London (I wish we had this level of insight for Dublin) with shocking high numbers, compared to other major cities the issue highlighted is very low testing rates meaning high spread before diagnosis. (The longer you don't know and continue unprotected contact the higher chance of spread it's just logical) http://www.aidsmap.com/HIV-is-increasing-in-gay-men-in-London-because-of-lack-of-testing-comparative-study-finds/page/2894490/ A fear and shock tactic will just drive the subject back into the closest where it can do more harm than good. We need to change the way we approach testing.

HIV ireland also highlight the issue of testing rates combined with the silence regarding the subject.
http://www.dublinaidsalliance.ie/index.php?mact=News,cntnt01,detail,0&cntnt01articleid=344&cntnt01origid=380&cntnt01pagelimit=5&cntnt01returnid=170

BTW, regarding on the low level of testing I think the HSE and GP's have a big part to play in this.

My own experience I speak to many who think they have been tested, I am often told: "I got my bloods done when I was last in hospital, and nothing was mentioned" Sadly what people do not realize is HIV is not included in the standard test panel, yet people think that because a hospital took bloods and said nothing they are HIV Negative .... This is a real danger... It's simply not the case that they have been tested for HIV and to be honest I for one think by default the answer should be that it should be included in testing for all patients. A full blood test might be too much strain on the HSE but at least a rapid blood or oral test should weed out most of them. Also the promotion of more rapid testing in clinics and GP's is a good thing and should be done more often to combat the issue.

jobbridge4life

jimdublin15 wrote: »

Well nobody is suggesting that the gay community should be the one driving the effort in HIV reduction, at least I hope not. The high rate currently is affecting MSM contact not the Gay community as such. I mean that as a lot of the MSM might not even consider themselves gay and hence might not be reached or respond to a push on the subject from within the gay community. We need a more wide net approach I think.

I certainly am and its exactly what I am suggesting. HIV is disproportionately affecting the gay community because the gay community is made of MSM. That not all MSM identify as gay is no reason not to engage in our own campaign.

jimdublin15 wrote: »

It's simply if we look at the HIV report published 2014 by the OP the HSE says 49 % are presenting late to very late meaning the have been infected for a number of years. So that also means they have good chance been unknowingly spreading the illness and that tactics from a few years ago have failed for the cases in question. I am under no delusion 0 infections is not going to be achieved. Today's issue of late presenting when diagnosed is linked to low testing rates and late diagnosis, This has a different root cause than the 90's. I mean the 80's I not even going to mention testing was not around for the first part and by the time you thought you were getting sick you were dying, at least for many.

The issues back in the 90's time frame that Silvaman highlighted with the video (91 I think) is the past and some of us lived in that time and witnessed the horrors. Still we have the illness today and instead of looking back (we should not forget what happened) we should look at the current trend and why this is happening. Pushed by a fear and shock tactic this level of testing would just be pressured, people would rater not know or even if they suspect hide it.
Hence we need a more positive drive and open discussion about the issue on all front.

Is there evidence that the scare tactics resulted in a reduction in testing? In anycase I have already said that any campaign would need to be tailored to the present day realities and have no desire to terrify people for the sake of it. Fear however is an important and powerful motivator. It motivates to make changes to the way we live all the time, smoking kills, exercise or you'll get heart disease etc. etc. A carefully administered and reasonable campaign highlighting the reality that HIV still exists and is danger that MSM need to be aware of is what I want and I don't accept that it would lead to negative consequences.

jimdublin15 wrote: »

Below is a report about London (I wish we had this level of insight for Dublin) with shocking high numbers, compared to other major cities the issue highlighted is very low testing rates meaning high spread before diagnosis. (The longer you don't know and continue unprotected contact the higher chance of spread it's just logical) http://www.aidsmap.com/HIV-is-increasing-in-gay-men-in-London-because-of-lack-of-testing-comparative-study-finds/page/2894490/ A fear and shock tactic will just drive the subject back into the closest where it can do more harm than good. We need to change the way we approach testing.

I am glad you highlighted London because if we don't make changes now that is the sad vista we can expect for the Dublin gay community. The statistics emerging from London are genuinely horrifying. Another generation are finding themselves blighted by this entirely preventable disease.

jimdublin15 wrote: »

HIV ireland also highlight the issue of testing rates combined with the silence regarding the subject.
http://www.dublinaidsalliance.ie/index.php?mact=News,cntnt01,detail,0&cntnt01articleid=344&cntnt01origid=380&cntnt01pagelimit=5&cntnt01returnid=170

BTW, regarding on the low level of testing I think the HSE and GP's have a big part to play in this.

My own experience I speak to many who think they have been tested, I am often told: "I got my bloods done when I was last in hospital, and nothing was mentioned" Sadly what people do not realize is HIV is not included in the standard test panel, yet people think that because a hospital took bloods and said nothing they are HIV Negative .... This is a real danger... It's simply not the case that they have been tested for HIV and to be honest I for one think by default the answer should be that it should be included in testing for all patients. A full blood test might be too much strain on the HSE but at least a rapid blood or oral test should weed out most of them. Also the promotion of more rapid testing in clinics and GP's is a good thing and should be done more often to combat the issue.

Everything must be done. More testing, including it among routine blood tests for those who identify as MSM might be a start. GP's warning MSM patients that they face extra risk and explaining the disease especially to the young men. A BelongTo-esque organisation dedicated to raising awareness among young gay men whatever it takes.

jimdublin15

jobbridge4life wrote: »

I certainly am and its exactly what I am suggesting. HIV is disproportionately affecting the gay community because the gay community is made of MSM. That not all MSM identify as gay is no reason not to engage in our own campaign.

I'm not suggesting for a moment the gay community should not engage the issue, just no need to lead it either and having a wide net approach coordinated with other target groups would reach the wider audience this affects.

jobbridge4life wrote: »

Is there evidence that the scare tactics resulted in a reduction in testing? In anycase I have already said that any campaign would need to be tailored to the present day realities and have no desire to terrify people for the sake of it. Fear however is an important and powerful motivator. It motivates to make changes to the way we live all the time, smoking kills, exercise or you'll get heart disease etc. etc. A carefully administered and reasonable campaign highlighting the reality that HIV still exists and is danger that MSM need to be aware of is what I want and I don't accept that it would lead to negative consequences.

There is no evidence for it and the scare tactics from the past are out of date is my main point . Scare tactics drive things and subjects into the closet and this is one topic we want to keep on the table so it's addressed. I agree that a good campaign is needed that is tailored to the issues faced today. Your saying the words careful and reasonable and I agree with that but the scare tactics from the past were reasonable at the time the same tactics would not suit today is my point.

The soft and silent, handout condoms tactics from 2000 - 2010 ish have also not worked as well as they could, I mean 2014 reports from the HSE as posted and linked by the OP says 49 % are presenting late to very late meaning the have been infected for a number of years.

jobbridge4life wrote: »

I am glad you highlighted London because if we don't make changes now that is the sad vista we can expect for the Dublin gay community. The statistics emerging from London are genuinely horrifying. Another generation are finding themselves blighted by this entirely preventable disease.

Yeah, glad you agree and it's horrific indeed.
I think we best learn from other communities before we end up learning the lesson firsthand ourselves in the next 5-10 years. It's better to act now because by the time we notice an issue it's the tip of the iceberg so to speak.

jobbridge4life wrote: »

Everything must be done. More testing, including it among routine blood tests for those who identify as MSM might be a start. GP's warning MSM patients that they face extra risk and explaining the disease especially to the young men. A BelongTo-esque organisation dedicated to raising awareness among young gay men whatever it takes.

I do agree, and it's a start but I think and ill look for the HSE report on the topic but let's be honest we all know a lot of the MSM continuity even if asked by the GP's do not self identify as MSM. So we would miss them in such testing efforts and also not to ignore the other groups with HIV infections I think a drive from within the HSE and GP's is needed to do more universal "test all" approach is needed to stamp out this issue.

Testing is for one part a money related problem I think/feel though

I mean mind you if we start increasing testing tomorrow brace ourselves we would see a higher rates being confirmed in the next few years before we see the benefit being the drop in cases over the long run. in theory at least, so we should also not be shocked to see the number of new cases confirmed go up first.

jimdublin15

Must say to the OP Ten of Swords a thank you. My thoughts behind it is that just by having the topic and talking about it bring's attention to the ongoing issue and if even a view viewers who don't post are thinking about getting tested or thinking about using condoms because of it, it means some good has come from the thread.

Annasopra

I don't see how testing is a money issue given that free testing is available?

jobbridge4life

Joeytheparrot wrote: »

I don't see how testing is a money issue given that free testing is available?

I presume he means for the health service.

jimdublin15

jobbridge4life wrote: »

I presume he means for the health service.

Yeah, sorry indeed I mean the increased testing cost to the HSE to clarify.

jimdublin15

jobbridge4life wrote: »

Is there evidence that the scare tactics resulted in a reduction in testing?

Okay I answered but you made me think about this point.
So I think the scare and shock/fear campaigns cause denial and reduce testing, that what i think and I thought about it some more and starting reading up on the topic. I do still believe the same, it was useful back in the day but the scare and fear campaigns are no longer effective.

Still I do thank you for making me think about it, and I mean that.

Seems very little evidence either way for modern day effect of shock/fear campaigns except for some items that mention it in passing so I did want to highlight the below, call it food for thought.

http://www.aidsmap.com/More-on-programmes-using-threat/page/1768332/
There has been little research on whether threats work in HIV-prevention messages.
What studies have been done show that people are aroused emotionally by fearful images and remember the advertisements more, but the evidence on efficacy is contradictory. In some cases there is evidence that an awareness campaign using a frightening image was followed by an increase in risk behaviour. One such was an Australian campaign featuring AIDS as the Grim Reaper.

http://caps.ucsf.edu/archives/factsheets/stigma
HIV testing. Fear of negative social consequences of a positive HIV test result can deter some persons from getting tested. A study of men and women in seven cities in the US found that stigma was associated with a decreased likelihood of being tested for HIV. People who are HIV+ but haven’t tested and don’t know they are HIV+ are less likely to try to prevent transmitting HIV to others.
Safer behaviors. Some HIV+ persons may fear that disclosing their HIV status or using condoms may bring partner rejection, limit sexual opportunities or increase risk for physical and sexual violence. A study of rural men who have sex with men (MSM), found that men who thought health care providers in their community were intolerant of HIV+ persons, also reported more high-risk sexual behaviors.


http://www.aidsmap.com/BHIVA-Fear-of-stigma-and-discrimination-prevent-Africans-from-testing-for-HIV-in-the-UK/page/1423468/
BHIVA: Fear of stigma and discrimination prevent Africans from testing for HIV in the UK
Fear of stigma and discrimination are preventing Africans in the United Kingdom from testing for HIV, according to a qualitative study presented to the Twelfth Annual
Conference of the British HIV Association in Brighton on March 30st. Although investigators found that a high proportion of individuals participating in the
study were willing to undergo anonymous oral HIV testing, they also established that almost half of all individuals had never had an HIV test, and that a significant number of
individuals participating in the study had undiagnosed HIV infection.

http://www.cdc.gov/nchhstp/newsroom/docs/HIVFactSheets/Challenges-508.pdf
Some are concerned that other people will find out that they have tested positive (or that they sought testing at
all), although testing is completely confidential.
Some may avoid testing simply because they are afraid their test will be positive.

http://www.sigmaresearch.org.uk/files/MiC-briefing-1-Fear.pdf
“Inducing fear is not an effective way to promote previous HIV relevant learning or condom use either immediately following the intervention or later on.
However, HIV counselling and testing can provide an outlet for previous HIV-related anxiety and,subsequently, gains in both knowledge and behaviour
change immediately and longitudinally.” (Earl & Albarracin 2007

http://www.sigmaresearch.org.uk/files/MiC-briefing-1-Fear.pdf
Key 5 points: THE ROLE OF FEAR IN HIV PREVENTION:
Fear arousing imagery can be good at attracting
attention and is often memorable.
• Fear-based campaigns are more persuasive for
individuals who are already engaging in the desired,
health-protective, behaviour.
• Arousing fear in individuals can have many unintended
consequences, such as denial or othering.
• Most homosexually active men are already fearful
of HIV.
• Arousing fear is not an effective means of facilitating
sexual behaviour change.

http://www.aidsmap.com/Facilitators-and-barriers-to-testing/page/2821913/
The stigma associated with HIV infection is identified as a barrier to testing in all populations, but especially so in black African communities. People fear exclusion and social isolation as consequences of being diagnosed with HIV. Many people associate HIV with promiscuity or unfaithfulness, and see themselves as being at very low risk of infection
While many people test in order to eliminate the uncertainty of not knowing their HIV status, others may respond to uncertainty with denial – for example, through assessing their own behaviours in a way that minimises the possibility of an HIV-positive status. Individuals may fear that discovery of an HIV-positive status would mean facing difficult decisions and responsibilities, especially in relation to sexual partners.

Aard

While testing is very important, general education about HIV is too. Most people have no idea what behaviours do and (just as important) don't transmit HIV.

jimdublin15

Aard wrote: »

While testing is very important, general education about HIV is too. Most people have no idea what behaviours do and (just as important) don't transmit HIV.

Absolutely fully agree with that, this really needs to be addressed to be effective, testing only to identify those living unknowingly with HIV is not a solution in itself. Educating them and the rest of the population on the prevention of HIV spread and what are the risk behaviors combined is.

Aard

I think transition year in schools is a good time to educate people. Most people start becoming sexually active around that time. Also they won't have developed any "bad habits" (to put it mildly) by then – having unsafe sex, risky behaviour etc.

jimdublin15

Aard wrote: »

I think transition year in schools is a good time to educate people. Most people start becoming sexually active around that time. Also they won't have developed any "bad habits" (to put it mildly) by then – having unsafe sex, risky behaviour etc.

Yeah, would catch them early so to speak. I agree and think It's a good idea, i'm just wondering if it was done via the schools how open the schools/collages would be to including better or more detailed material on risk behaviors.

Just thinking back to some different STI campaigns that stood out for me.

https://en.wikipedia.org/wiki/Catch_the_Sperm
Was a game in 2001 and I think 18 millions players used it. Something like this relaunched and tailored for Ireland on Smartphones and Tablets perhaps.

http://www.actupparis.org/article3206.html
In France 2007 bicycle saddles were covered with an important message. "And you, what do you do to protect yourself?" Could be a novel idea given the increasing number of cyclists. Dublin has the rent city bikes if I'm not mistaken could do it to them.

https://npin.cdc.gov/stdawareness/gyt-materials/Flyers/GYT_ReallyFlyerBW_8.5x11.pdf

This type of posters (tailored to Ireland) combined with free testing days perhaps at GP levels to reach wider audience Instead of just the clinics, MSM Clinics and GUM/STI clinic's.

More information on what to do if your exposed, and what exposures carry risks should also be part of the education package - Post exposure prophylaxis (PEP) It halt's and reduces the chance of HIV development in the first 72 hours after exposure. So in situations like unprotected sex or the condom broke, or they were accidentally stabbed with an HIV-infected needle how to get PEP and that it's available (I suspect many don't know about PEP)

However I think funding for any plan or idea would be an issue.

Ten of Swords

jimdublin15 wrote: »

I am often told: "I got my bloods done when I was last in hospital, and nothing was mentioned" Sadly what people do not realize is HIV is not included in the standard test panel, yet people think that because a hospital took bloods and said nothing they are HIV Negative .... This is a real danger... It's simply not the case that they have been tested for HIV and to be honest I for one think by default the answer should be that it should be included in testing for all patients

St. James's hospital have now said that all blood samples they collect in the A&E department will be tested for HIV, Hep B and Hep C as standard. I think that's great news and I hope other hospitals follow suit. One of the issues at present is the fact that many people are being initially diagnosed at quite a late stage, hopefully this scheme can help reduce this as early diagnosis gives the best outcome

Irish Times

Also, good article in the Sunday Independent that is worth a read.

Sunday Independent

jimdublin15

Ten of Swords wrote: »

St. James's hospital have now said that all blood samples they collect in the A&E department will be tested for HIV, Hep B and Hep C as standard. I think that's great news and I hope other hospitals follow suit. One of the issues at present is the fact that many people are being initially diagnosed at quite a late stage, hopefully this scheme can help reduce this as early diagnosis gives the best outcome

Irish Times

Also, good article in the Sunday Independent that is worth a read.

Sunday Independent

Indeed this is a really good development and hopefully more Hospitals will take up similar policy

nozipcode

Joeytheparrot wrote: »

It's funny 5-10 years ago I think it was the complete opposite. Gay men were made much more aware of safer sex practices etc.

I agree. We've taken the eye off the ball.

But why such a sharp year-on-year increase wrt MSM? I am expecting the response 'Brazillians'. I am not saying this is the case. However the OP stats/report did refer to Latino guys.

>>>48% of the MSM category were born in Ireland (The next highest ethnic group is Latin America at 21%)

If our Latino gay brethren/foreign students/whatever are impacting transmission rates, what can be done to send the message to that group? I would say Irish based awareness campaigns have very little impact on this group?

SpaceTime

Aard wrote: »

I think transition year in schools is a good time to educate people. Most people start becoming sexually active around that time. Also they won't have developed any "bad habits" (to put it mildly) by then – having unsafe sex, risky behaviour etc.

This tends to be where you'll impact with the fact that 93% of Irish schools are Catholic & 98% are religious.

Sex education here is still a huge difficulty.

I went to school in the 1990s / early 00s and our sex ed class taught the abstinence and the rhythm method as contraception techniques. They didn't mention condoms and gave a few horror stories about STIs.

Zero advice on what to do if you thought you could have picked something up. No info on clinics, no info on testing.

They also mention homosexuality in this kind of very awkward "less said about that the better" kind of way.

That's as much sex ed as we got and several extreme parents withdrew their sons from the class as it was "filth".

I hope things have improved but I have my doubts!

For people on their 20s, 30s and older here - they've had vastly less sex ed than most western countries and anything they've learnt has been picked up outside of educational establishments.

That's why public campaigns in Ireland are extremely important.

It's unfortunate to have to say it, but from a sex ed perspective, Ireland is probably in line with the developing world and Middle East.

That's not because of 2015 Irish public opinion either, it's because of the highly unusual situation of not really having a public school system.

All of our schools are outsourced and close to 98% of those are to religious organisations.

Any rollout of education on safe sex will result in dealing with the most unrepresentative and conservative aspects of Irish society - nuns, priests, various conservative catholic groups the likes of whom we encountered in the marriage equality referendum etc etc

Not to go on a rant about the place, but it is a massive barrier to communication on safe sex. If this were France, Germany or even the U.S., it wouldn't be a major issue at all.

Locker10a

SpaceTime wrote: »

This tends to be where you'll impact with the fact that 93% of Irish schools are Catholic & 98% are religious.

Sex education here is still a huge difficulty.

I went to school in the 1990s / early 00s and our sex ed class taught the abstinence and the rhythm method as contraception techniques. They didn't mention condoms and gave a few horror stories about STIs.

Zero advice on what to do if you thought you could have picked something up. No info on clinics, no info on testing.

They also mention homosexuality in this kind of very awkward "less said about that the better" kind of way.

That's as much sex ed as we got and several extreme parents withdrew their sons from the class as it was "filth".

I hope things have improved but I have my doubts!

For people on their 20s, 30s and older here - they've had vastly less sex ed than most western countries and anything they've learnt has been picked up outside of educational establishments.

That's why public campaigns in Ireland are extremely important.

It's unfortunate to have to say it, but from a sex ed perspective, Ireland is probably in line with the developing world and Middle East.

That's not because of 2015 Irish public opinion either, it's because of the highly unusual situation of not really having a public school system.

All of our schools are outsourced and close to 98% of those are to religious organisations.

Any rollout of education on safe sex will result in dealing with the most unrepresentative and conservative aspects of Irish society - nuns, priests, various conservative catholic groups the likes of whom we encountered in the marriage equality referendum etc etc

Not to go on a rant about the place, but it is a massive barrier to communication on safe sex. If this were France, Germany or even the U.S., it wouldn't be a major issue at all.

Just my personal experience here and I know I've said this before but I had an excellent sexual health education all throughout my school years and I went to Irish catholic schools! It's unfair to tar all Irish schools with the same brush! It's the 21st century and Irish schools and Irish teachers are not the same as they were 20, even 10 years ago Catholic or not I think sex ed in Irish schools is great it was in my experience anyway!

SpaceTime

Locker10a wrote: »

Just my personal experience here and I know I've said this before but I had an excellent sexual health education all throughout my school years and I went to Irish catholic schools! It's unfair to tar all Irish schools with the same brush! It's the 21st century and Irish schools and Irish teachers are not the same as they were 20, even 10 years ago Catholic or not I think sex ed in Irish schools is great it was in my experience anyway!

Well, while some of the student population are getting stuff like this :

http://www.thejournal.ie/sex-education-sellotape-1310906-Feb2014/

I think I will tar the "system" (or lack there of) with the most appropriate brush!

What I'm saying is that a very large % of Irish sexually active adults in their 20s/30s and older had zero sex education and that is why the HSE cannot assume it was provided at school or rely on it to be provided at school (because of ethos of a lot of schools, yours may well be an exception).

It needs to be a public health campaign with actual public communication.

You have to make an assumption that a significant % of Irish people have had zero sex ex.

Annasopra

Locker10a wrote: »

Just my personal experience here and I know I've said this before but I had an excellent sexual health education all throughout my school years and I went to Irish catholic schools! It's unfair to tar all Irish schools with the same brush! It's the 21st century and Irish schools and Irish teachers are not the same as they were 20, even 10 years ago Catholic or not I think sex ed in Irish schools is great it was in my experience anyway!

Yea but how representative is your experience generally?

Locker10a

SpaceTime wrote: »

Well, while some of the student population are getting stuff like this :

http://www.thejournal.ie/sex-education-sellotape-1310906-Feb2014/

I think I will tar the "system" (or lack there of) with the most appropriate brush!

What I'm saying is that a very large % of Irish sexually active adults in their 20s/30s and older had zero sex education and that is why the HSE cannot assume it was provided at school or rely on it to be provided at school (because of ethos of a lot of schools, yours may well be an exception).

It needs to be a public health campaign with actual public communication.

You have to make an assumption that a significant % of Irish people have had zero sex ex.

Your article while shocking to read is still not representative of the Irish secondary School science, Home ec and SPHE teachers who actually teach sex ed in our schools! They are in my experience competent and intelligent and do an excellent job in this field! And most* are no more concerned with the teachings of the church than you or I ! Things will only improve as the teaching generation gets younger and education in this field improves

SpaceTime

Joeytheparrot wrote: »

Yea but how representative is your experience generally?

The issue is historical too. Many of us oddly enough remain sexually active beyond 21!

It's a shocking fact (you may need to brace yourself for it) but some people have been known to still be dating in their 30s!

It's just that it worries me that a very significant % of sexually active Irish people may not have had anything approaching the levels of information they would have been common place in say The Netherlands or even US in the 1980s, 1990s, 2000s etc

Even if things have improved somewhat in some (and I seriously doubt all) schools, there are a hell of a lot of people who will have had no information or sex ed classes.

It's that level of lack of knowledge that needs to be addressed through public campaigns aimed at 18 to 40+ audiences who may be taking unnecessary risks.

Annasopra

Locker10a wrote: »

Your article while shocking to read is still not representative of the Irish secondary School science, Home ec and SPHE teachers who actually teach sex ed in our schools! They are in my experience competent and intelligent and do an excellent job in this field! And most* are no more concerned with the teachings of the church than you or I ! Things will only improve as the teaching generation gets younger and education in this field improves

I would really be interested to know how representative your experience is really.

Locker10a

Joeytheparrot wrote: »

I would really be interested to know how representative your experience is really.

Ehh but you get my point! Which is that people in charge of teaching this to students are not Catholic bishops from the 50's ! They are ordinary people like you and I! Teachers are ordinary people aware of modern life especially for teens who they work with ! That's my whole point it's very very different to when my mum went to school and was taught by nuns!

SpaceTime

Locker10a wrote: »

Ehh but you get my point! Which is that people in charge of teaching this to students are not Catholic bishops from the 50's ! They are ordinary people like you and I! Teachers are ordinary people aware of modern life especially for teens who they work with ! That's my whole point it's very very different to when my mum went to school and was taught by nuns!

I wasn't taught by nuns and I wasn't in school here THAT long ago either. We had basically no sex ed.

And that nonsense with the sellotape and the religious stuff being taught as "sex ed" by that Pure in Heart crowd was going on in 2014.

It very much depends on the school and there's no 'standard' in Ireland as the schools are all privately run and there's no syllabus on sex ed.

Annasopra

Locker10a wrote: »

Ehh but you get my point! Which is that people in charge of teaching this to students are not Catholic bishops from the 50's ! They are ordinary people like you and I! Teachers are ordinary people aware of modern life especially for teens who they work with ! That's my whole point it's very very different to when my mum went to school and was taught by nuns!

No. I don't actually. Yes you had good sex ed but realistically is your experience that widespread?

Locker10a

Joeytheparrot wrote: »

No. I don't actually. Yes you had good sex ed but realistically is your experience that widespread?

Chill out man! And yes I do think my experience for my generation is more widespread actually!! Certainly for today's generation and going forward perhaps in the past No! But I just don't believe that people my age in Ireland know less about sex than anyone of the same generation my age in America or the UK