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Image courtesy of Terrence Higgins Trust Image courtesy of Terrence Higgins Trust


How to end the transmission of HIV

Image courtesy of Terrence Higgins Trust



I caught up with Matt Horwood, from UK health charity Terrence Higgins Trust, to talk about how their campaigns are shaping the health conversation for gay men.

How is THT helping to educate people about the U=U message?

Our Can’t Pass It On campaign focuses on educating audiences to understand that those on effective treatment cannot pass on HIV.

We’re currently working across a range of communities, with media outlets, policy-makers, and local groups to get this message across to as many people as possible.

What are some of the barriers that you’re encountering in getting the U=U message out there and understood?

Many people still can’t get their head around U=U, which produces a real barrier for the work we’re trying to do around combating stigma.

Thankfully we have the PARTNER study to use as evidence — a landmark study that found that where the HIV positive partner was on effective treatment that had reduced the amount of the virus to ‘undetectable’ levels, there were zero cases of HIV transmission — but conveying this in a way that’s clear and concise can be a challenge.

Are there any specific demographics or communities that are proving harder to reach?

We work among a range of communities throughout England, Scotland, and Wales, which is why we tend to tailor our engagement tools and approach depending on who we’re trying to reach.

For example, gay and bi men and black Africans are the two key demographics that are statistically the most ‘at risk’ of transmitting HIV, which is why our latest self-testing programme has been launched for those groups, as well as trans women.

Sometimes it’s also hard to engage with younger audiences — as HIV and sexual health isn’t the ‘sexiest’ of topics for them — so we have to think creatively about how to engage them. With STI transmission the highest among young people, and with 95 percent of young people saying they’d not learned about LGBT relationships in schools, this is obviously a real concern for us. That’s why we use a range of digital and social media platforms to engage and educate young people around HIV and sexual health, and ensure they know how to find the support they need. We also have contracts in certain parts of the UK to give free condoms and lube to younger people.

For older generations, social media often isn’t the best fit, and for these groups we look to use outreach and outdoor advertising to engage them. This is to help combat stigma within that age range, but also to offer support and services to older people who need it.

With the combined forces of U=U and PrEP we seem to have all of the tools required to dramatically reduce HIV transmission rates. Is that being reflected in the statistics?

For the first time ever we’ve seen a decline in HIV diagnoses among men who have sex with men. There were 2,810 new HIV diagnoses among this group in 2016 compared to 3,570 in 2015.

While there’s no provable correlation between these figures, U=U, and PrEP, we’d like to assume these combined forces are indeed having an impact on the reduction in HIV transmission rates.

However, it’s crucial to remember that PrEP is currently hard to get hold of in the UK as a whole, and while the proposal by the NHS to add 3,000 extra places to the PrEP Impact Trial would be helpful, we need the decision made on this as soon as possible, and we need routine commissioning of PrEP on the NHS.

There’s been some concerns raised that because of a reduction in the use of condoms that we’re seeing dramatic spikes in transmission rates of STDs. Is that accurate?

There has been an overall increase in STI diagnosis throughout the UK, for all groups, and this is certainly the case among men who have sex with men.

Obviously, condomless sex increases the chances of STI transmission, but these figures could also be attributed to an increase in testing.

Are we seeing reduced funding for sexual health services in the UK?


Spending by local authorities on sexual health services has been cut by £30 million during 2016/17. This, coupled with no mention of funding for public health in Theresa May’s recent NHS speech, means that we now risk facing a sexual health crisis across England. Over 11,000 people were turned away from accessing clinics in one part of London between April and September 2017.

Overall, we’re worried that the closure of sexual health services could lead to less people testing, which can result in an increase in transmission of STIs.

The Government urgently needs to prioritise the funding of sexual health services across England and ensure that no one is turned away from a clinic.

What’s the key health message that THT is currently projecting to gay and bi men in the UK?

Right now, we’re about to relaunch our Can’t Pass It On campaign, which is all about ending the stigma that people living with HIV face.

A huge part of our work, and one of our aims as an organisation, is to end HIV transmission. To do this, we need to ensure that all people — in particular ‘at risk’ groups like gay and bi men — understand how to best protect themselves from HIV.

We also need people to ensure that they’re testing regularly, to ensure that they know their status and aren’t potentially passing on HIV, or any other STI, to anyone else.

With combination prevention, including treatment as prevention — being ‘undetectable’ — together we can work toward ending HIV transmission here in the UK.

Find out more about how THT is working to end HIV transmission

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We want to hear your opinion



“My first thought was — I’m dead.”



D-REK (image supplied)
D-REK (image supplied)

In 1985, Derek Canas underwent heart surgery to correct a congenital anomaly — he was three months old.

The surgery was a success, but 16 years later Derek was diagnosed with AIDS — he had acquired HIV as a result of a blood transfusion during the heart surgery.

Derek is now a DJ and a campaigner for HIV awareness. Derek shared his story with Mainly Male.

When you were first diagnosed, how much did you and your family know about HIV?

The only thing I knew at that time was a few memories of a Nick News episode years before. I was diagnosed in 2001. My first thought was — “I’m dead.”

Thankfully, I had a great doctor who told me that I would that I would be going to his funeral, that he wasn’t going to mine. I had an AIDS diagnosis and wasting syndrome — I was weeks away from death.

What sort of counselling and support was available to you when you first diagnosed?

Just at doctors’ appointments. I live in a small town, there were no support groups close by. Family and close friends became my support system.

Have you encountered any stigma or discrimination as a result of your status?

Yes — especially in the early days after diagnosis. It’s just part of living in a small town. The understanding of the virus is still stuck in the mindset of the early-90s. Sadly, that’s nationwide — public knowledge is really lacking in terms of HIV.

You speak publicly about HIV and educate people about the virus — do you ever feel like taking some time out? Do you ever feel like you don’t want to have to explain your status to people that you meet?

I don’t take time out for myself. My cardiologist hates that — I’m on my fifth pace-maker. I always welcome the opportunity to explain my HIV status. I wear it like a badge of honour. The virus nearly killed me, and I’ve fought back — I’m the one that’s kicking its ass now.

What advice or guidance would you give to someone who has been recently diagnosed with HIV?

The days after are rough — don’t be ashamed of the breakdown. You’ll feel better as your health gets better. It just takes time and patience.

Do you have any hints or tips for people on how to respond to HIV stigma or discrimination?

I use music to get me through. I’m a DJ, so I know how powerful music is on our minds and bodies. I always encourage people to find their music or movies — something that helps them laugh or get hyped-up.

Keep a calendar — put things on it, no matter how small — always look forward. Tomorrow can and will be better.

Everyone gets knocked down in life. It’s about how you stand back up.

Follow Derek’s blog

Follow Derek on Twitter


Sharing the stories of our community
It’s not easy to talk about HIV, but talking about your experience can help to build your confidence and understanding of what HIV means for you. Your story can also help others who are processing their own experiences with HIV.

If you’d like to share your story with the readers of Mainly Male, please email [email protected]

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