Tom Curtis, Scotsman.com
HIV CASES have rocketed to an all-time high in Glasgow because of the number of people recently arriving in the city from Africa either as asylum seekers or immigrants.
But health chiefs are deliberately failing to collect and publish detailed figures on the record increase because they fear they will fuel prejudice towards groups of people coming from the areas of Africa which are currently rife with HIV and Aids.
However, critics last night condemned this decision, saying health officials have an overriding duty to give the public as much information as possible to try to stem the alarming rate at which the infection is spreading.
New figures show that in Greater Glasgow, which is home to the majority of Scotland’s 6,000 asylum seekers, there were 85 new diagnoses of HIV in 2002-2003.
The total is the highest since records began, representing a massive increase of 77% on the previous year, and is more than double the 2001 figure.
In Scotland as a whole there were 259 new diagnoses, the highest number since the mid-1980s when the original Aids epidemic was at its height.
Of the Glasgow cases, 48 (56%) were infected abroad, mainly in central and southern Africa where Aids is rife in several countries. The corresponding figure for Scotland was 92 (36%). In Lothian there were 78 new cases, of which 30 are thought to have originated abroad, while 26 cases were recorded in Grampian, of which 16 were people infected abroad.
However, the Scottish Centre for Infection and Environmental Health (SCIEH), the official monitoring agency, last night admitted it did not know and had not tried to find out how many of these ‘foreign’ cases involved Scots who had visited Africa and other overseas countries, and how many were among immigrants to Scotland or foreign nationals working or studying in Scotland.
SCIEH’s guess is that eight out of 10 involve immigrants, but that is based on anecdotal information from individual doctors. NHS Greater Glasgow said it was not certain what the exact figure was, and there is also no breakdown of the figures for Lothian.
No one therefore knows what the scale of the ‘immigrant HIV’ problem is, or how many Scots are being infected on holiday or business trips.
The cost of treating immigrants with HIV is also not known as a result.
Professor David Goldberg, who oversees HIV and Aids monitoring at SCIEH, said: “We don’t hold identifiers such as name and address. We may get additional information about patients, such as ‘Zimbabwean’ or ‘South African’, or ‘student from Zambia’.
“However, that is information that we have not published because it is felt that is not appropriate. We have to take into account the potential for racism, xenophobia, etc.”
He also said “we can’t say with absolute certainty” what the exact figures were, admitting that data was “incomplete”. Goldberg said even if SCIEH wanted to get accurate statistics, many doctors were unwilling to provide such details.
Dr Syed Ahmed, a consultant in public health medicine at NHS Greater Glasgow, said: “Quite often people will tell you they have been exposed in Africa, but we don’t know if they are from Africa or indigenous Scots who have spent time in Africa.
“We don’t ask people where they come from because our role is purely to provide health care.” Ahmed said the problem was being dealt with properly, however, with outreach programmes to immigrants designed both to ensure the best treatment and to minimise the risk of further transmission.
He also said the risk of transmission from migrant communities to the existing Scottish population was low, since many of those infected arrived with their families and were in stable relationships.
No-one was available for interview at NHS Lothian. The organisation said in a statement: “In Lothian, the majority of heterosexually acquired HIV infections are reported in people who have been exposed to the virus while out of the UK. The number and proportion of infections acquired in this way have increased over recent years.”
Last night the Commission for Racial Equality agreed that despite the problems already faced by asylum seekers and other immigrants, the figures should be made known.
A spokeswoman said: “The public have a right to be aware of this information. It should be out there for public consumption.” She urged sensitivity in how the information was reported, however.
David Davidson, Tory spokesman on health in the Scottish parliament, said: “The Scottish Executive needs to come clean on this, admit that it could get hold of the figures, get them and publish them. We have a right to know.
“There is a duty to protect the rest of the country from any diseases, whether Aids or Sars or anything else, that are brought into Scotland. If they don’t know what the figures are, how can they make policy decisions on tackling the problem?”
Davidson also repeated the Conservative party’s call for immigrants to be routinely screened for health problems when they arrive in Britain.
The idea is being considered by the government but no decisions have yet been made.
SNP health spokeswoman Shona Robison said: “Public information should be provided to the maximum and the fact that there has been an attempt not to put these figures out may simply mean the issue gets more attention than it otherwise would have. That could be considered counter-productive.”
However, Robison said she also believed the greatest danger was that HIV positive immigrants would be further stigmatised by the perception that they were responsible for “importing” HIV.
Sheila McLean, professor of medical law and ethics at Glasgow University, said the only purpose she could see for knowing the HIV figure was to encourage people to get even more phobic about ethnic minorities.