The body tackling the UK’s biggest HIV outbreak in 30 years has welcomed new research showing the scale of the outbreak in Glasgow.
A seven-year study by experts from Glasgow Caledonian University and Health Protection Scotland, working in collaboration with us and the University of the West of Scotland, outlines the combination of key factors which led to the HIV outbreak in 2015.
The study has been hailed by Glasgow City Health and Social Care Partnership (HSCP) for its understanding of the complex issues faced by the vulnerable public drug injecting group as well as support for a Safer Drug Consumption Facility (SDCF) and Heroin Assisted Treatment (HAT) in Glasgow.
In recent years Glasgow has been at the centre of outbreaks of anthrax, botulism and, most recently, HIV infection in people who inject drugs.
More than 130 people in this group, as of the end of March, have been infected with HIV since 2015 and current rates of new infection are higher than pre-outbreak levels.
Dr Saket Priyadarshi, Associate Medical Director Addiction Services, Glasgow City HSCP, said: “This study covers a seven year period and has a very strong understanding of the complex range of issues faced by this vulnerable group.
“This public injecting group has high rates of hospital admissions, incarceration and homelessness. Conventional treatment and services have not been as effective as we would want in reducing health risks and demonstrates the need to focus on all harm reduction initiatives.
“Our Blood Borne Virus (BBV) treatment services and community pharmacy staff have responded extremely well resulting in them managing to engage people in treatment.
“This work is highlighted by the Injecting Equipment Provision (IEP) work in the city which saw 166,000 clean needles and 70,000 sheets of foil, which has potentially led to 70,000 less injecting episodes, supplied in the city centre alone.
“We also have pharmacy BBV testing, wound care and a mobile IEP van following the enforced closure of the country’s busiest needle exchange in Glasgow Central Station.
“This crucial work is highlighted in today’s report which highlights that ‘Over 90% of the individuals diagnosed as part of the outbreak have been successfully engaged in HIV treatment as a result of the multidisciplinary response implemented by the health board’.
“However, it is important to realise that we are decades behind other countries in the way we tackle this problem. In line with our current research, it’s clear we need to move beyond the current model in order to meet the needs of our communities and this very vulnerable group.
“A large body of international evidence, from well established SDCFs and HAT facilities around the world, demonstrates the benefits of these facilities to both the individuals using those services and the wider community.”
Susanne Millar, Chief Officer for Strategy and Operations, Glasgow City HSCP, said: “This study is published in The Lancet and provides further credible evidence for looking beyond current methods for helping this very vulnerable group.
“We anticipate opening a HAT facility in Glasgow later this year which will benefit heroin users who inject cocaine also, one of the groups most at risk of HIV transmission.
“Prescribing Diamorphine is an evidence based treatment option and is the next progression for people for whom current treatments have been ineffective, and who continue to use street drugs, with all the risks that entails – injecting-related infections and overdose.
“This involves licensed doctors prescribing Diamorphine injections, which are supervised under strict controls, and is a legal method of treatment in the UK.
“Research trials have shown that it substantially reduces people’s need for street drugs, reduces crime and leads to more engagement with healthcare and addictions services.
“The Glasgow Alcohol and Drug Partnership, along with the Integration Joint Board, has well developed proposals for a SDCF in the city which we would be keen to pursue with the necessary agreement of the Home Office.
Unfortunately, addiction and homelessness often go hand-in-hand. People with chaotic lifestyles due to addiction can find it hard to maintain tenancies and end up repeatedly homeless. This becomes a vicious circle as chaotic drug and alcohol use combined with homelessness can have a major detrimental impact on physical and mental health.
“That is why Glasgow has moved to a Housing First model for people with complex needs including addiction and its associated health problems. This multi-agency, rapid rehousing model was successfully pioneered in Europe and the US and was introduced in Glasgow last year.
“People are being found flats and provided with intensive wrap around support to handle daily essentials like ensuring you’re in receipt of benefits, paying your rent, liaising with utility companies as well as attending medical appointments to combat your addiction.
“It is helping people with addictions keep a roof over their heads and rebuild their lives. In tandem with medical interventions, including where necessary, Heroin Assisted Treatment and the Safer Drug Consumption Facility, Housing First aims to help people improve their lives and their health.”