Nieuwsuur: In search of the last 400 people in Amsterdam who have HIV (and don’t know it yet)
In search of the last 400 people in Amsterdam who have HIV (and don’t know it yet)
In Amsterdam, approximately 400 people are walking around with an HIV infection without knowing it. They are the ones causing new infections, helping the epidemic to continue. A special team [the H-TEAM, ed.] is trying to track down this last group of HIV patients.
The team, consisting of HIV specialists, the Public Health Service of Amsterdam (GGD) and GPs, thinks they are to be found among gay men and migrants, among which African migrants who have lived in Amsterdam for a long time.
In migrants, it’s mostly men who are in a relationship with a woman, but also have sex with men, says Silke David, program manager HIV for the National Institute for Public Health and the Environment (RIVM). ‘Those men are extra vulnerable’.
They often can’t find their way in the medical world, says David. These men often lack knowledge about how to protect themselves from HIV and don’t know where they can get tested.
And there’s another problem: among migrants, HIV is still taboo. ‘People don’t want to know whether they’re infected because of the discrimination that would follow. If you say you’re HIV positive, they immediately think you have been sleeping around with everyone’, says Eliane Becks.
Becks, a Burundi native, got infected with HIV fifteen years ago in an African hospital. She was sent home without medication. ‘Basically, that doctor sent me towards certain death.’ These days, in the Netherlands and under good medical treatment, she informs migrants about HIV.
Becks notices that they often have outdated views on HIV. ‘They have this idea of diseases from the time when medicines were not yet available. That you became very ill, would waste away and die.’ For these people, it helps when they meet Eliane, online or in real-life, and see a healthy looking African woman.
This is where HIV isn’t tested enough
In certain places in Amsterdam, HIV tests aren’t performed often enough. Internist Godelieve de Bree of the Amsterdam University Medical Center shows it on a map. ‘In red, you see the amount of HIV tests that GP’s are performing. In the blue areas you can see that the number of tests is limited.’
These are parts of Amsterdam where people are tested late and thus also receive a late diagnosis. GP’s in those areas should be more attentive in recognizing the symptoms that could indicate an HIV infection, such as a skin disorder, says De Bree. ‘Improved detection and offering accessible HIV tests are both necessary.’
An HIV self-collect test could offer a solution for the migrant group, says Silke David of the RIVM. In the Netherlands however, such a test can only be provided by a doctor or pharmacist. This is outdated, David says. ‘A pity’, she adds, since there is a group for whom going to a doctor is a challenging step.
New HIV infections revealed
Apart from migrants who don’t know they are infected, the research team looks for homosexual men who are unaware of their infection. This group sometimes presents itself at the GGD when applying for PrEP, a pill that can prevent an HIV infection. The pill is meant for people who don’t have HIV but who are at an increased risk of getting infected.
Recently the government decided to start a 5-year trial in which PrEP is distributed to men in a high-risk group. In this way, the minister hopes to prevent 250 new infections on a yearly basis. Amsterdam actually already knows that the trial with PrEP can also help in bringing existing infections to light.
Before someone is prescribed PrEP, the GGD first performs an HIV test. Those with an unexpected positive result, receives HIV medication instead of PrEP, so that the virus is no longer sexually transmissible.
Read the full article and watch the report on the Nieuwsuur website (Dutch only).