Jonathan Mann

Jonathan Mann was an inspirational person whoplayed a central roleinthe early global response to HIV and STIs.He was a doctor, activist, human rights advocate, epidemiologist, public health specialist and infectious disease expert. He set up and then directed UNAIDs.

Jonathan Mann’s contribution was to highlight:

•Stigma must be addressed ifSTI and HIV are to be overcome

•Human rights are central tostopping the HIV epidemic

•The particular impact of HIV for Women

His vision is as relevant now as it was in the 1980’s.

He died in 1998 in an airplane crash in New York. Hisdeath was a huge losstothe fight against HIV and wider global health. Harvard University in the USA established the first(andprobably still the only) health and human rights centre in his memory. As far as we know our clinic will be the first memorial to Jonathan Mann in the UK

Looking after people living with HIV

Homerton Sexual HealthService

Tel 020 8510 7837

Opening Times:

Monday 9:00 am—4:00 pm

Tuesday9:00 am—4:00 pm

Wednesday1:00 pm—5:00 pm

Thursday9:00 am—4:00 pm

Friday9:00 am—3:30 pm

Contacting us:

Main telephone number:

020 8510 7837 (nurses, appointments, reception)
or 020 8510 7988 (health advisers)

Urgent Medical care and emergencies

If you have an urgent medical problem, please call

Reception on: 020 8510 7837. A nurse will assess your situation and give you advice. This may include being asked to see your GP or going to an emergency department. If it is necessary, we will offer you an appointment to see a doctor within 48 hours. This may not be with your regular doctor and you may need to wait.

Out-of-hours medical problems

If you need medical advice when the clinic is closed you can

call 999 if it is an emergency
Call NHS111, when you need help fast but it is not a 999 emergency
and/or go to A&E or NHS Walk-in Centre
If not urgent, contact your GP, local Pharmacy.

The JMC team

We will ask you to come to clinic for a consultation with a doctor or a nurse about every three or four months. You will have an appointment for your blood tests about two weeks beforehand so that we have your latest results ready for the doctor’s appointment.

There might be times when we need to get hold of you to invite you for an earlier appointment to discuss results and/or repeat investigations.Please make sure that you tell us promptly of any changes in your contact details.

A range of people may be involved in your care and treatment:

Doctors and Nurses

Health Advisers

Pharmacist

Dietician—for dietary advice

Psychologist

Psychiatrist

Community Clinical Nurse Specialist

Dermatologist—for help with skin problems

Specialist Midwife

Social Care Coordinator

Voluntary Organisations, such as Positively UK and

Positive East

Health Advisers are here to:

Give you a safe space to work through difficultiesadjusting to your diagnosis and any concerns that arise infuture
Discuss issues around forming new relationships and having sex
Listen to your thoughts and feelings about disclosing topartners, friends and family

Pharmacist:

Counsels and provides information and education on treatment options
Helps to identify and manage any problems associated with your medication
Offers adherence support and helps with medicine management techniques
Highlights potential drug interactions with anti-retroviral medications and gives advice on how to manage them safely
Offers advice on using complementary or alternative medicines whilst on anti-retrovirals
Offers advice on appropriate travel medicine
Helps to make sure you get your medicines in the easiest way and helps with our local delivery service

Social Care Coordinator:

Offers support and information regarding a variety of issues relating to your social care needs, such as: housing, finances/benefits, immigration, isolation/peer support.
Works closely with specialist agencies, statutory and voluntary, to ensure you can access quality advice to enable you to make informed choices about your circumstances.

If you would like an appointment with the Social Care Coordinator, please discuss this with a member of the team.

Specialist Midwife

All pregnant women who are HIV positive receive their full antenatal care from our Specialist Midwife. The Specialist Midwife and Pregnancy Doctors run joint antenatal/ HIV services in the Homerton Antenatal Clinic once a week. This means that women can receive their care mostly in one place throughout pregnancy.

The HIV Pregnancy Team liaises closely with each other and includes Consultant Obstetricians, Physicians and Pediatricians, Health Advisors, and the JMC SocialCare Coordinator. The team also have excellent links with peer support and voluntary sector providers e.g. Positively UK, and women can be referred if they wish. Our aim is to enable women and their families to have optimal care in pregnancy to ensure the best health for the mother and her baby, with a good birth experience, as well as addressing any specific needs along the way.

Social Care Coordinator:

Offers support and information regarding a variety of issues relating to your social care needs, such as: housing, finances/benefits, immigration, isolation/peer support.
Works closely with specialist agencies, statutory and voluntary, to ensure you can access quality advice to enable you to make informed choices about your circumstances.

If you would like an appointment with the Social Care Coordinator, please discuss this with a member of the team.

Clinical Nurse Specialist for HIV (CNS) The Clinical Nurse Specialists(CNS) team aims to provide seamless holistic care to people living with or affected by HIV.We can meet people by appointment at our offices or other clinical environment, such as a hospital, community clinic or in your own home.

The clinical nurse specialist team can help you with the following:

Link you into the HIV services
Information about antiretroviral treatment
Support to manage any problems with your treatment
If you are finding it difficult to take your prescribed treatment
Talking about HIV to partners/family/friends
Helping Partner/family membersto access HIV testing and support
Support with adjusting to living with HIV and referral onto counseling or psychology services
Access to other services – we offer support in areas, such as benefits, housing and immigration. We work alongside other services such as social care and the voluntary sector
Access to statutory or voluntary services to help you live well
Refer to other agencies as appropriate
Advice on healthy living and referrals to smoking cessation support, exercise programs and dietary advice
Sexual health advice, contraception advice, conception advice and appropriate onward referrals

To access the Clinical Nurse Specialist team you can:

Ask your HIV clinic doctor or nurse for a referral

Voluntary Organisations Patients may experience difficulties related to their HIV status at any time following diagnosis.

Worries and concerns may include:

Practical Problems:

Employment
Finances/Benefits
Housing
Homecare
Childcare
Respite
Immigration
Transport

Psychological/Emotional Issues:

Relationships (family, friends, partner)
Loneliness/Isolation
Depression
Worries about the future
Difficulty accepting diagnosis
Concerns about stigma/confidentiality

There are a number of statutory and voluntary organisations that can offer help. This may range from basic information and advice to practical and emotional support. You can get support from some of the voluntary organisations, either in the clinic or at their locations.

See the ‘Useful contacts’ section on the back page for further information about these organisations

In-patient care

If you need to be admitted to hospital for investigations or treatment it is important to tell the doctors you have HIV, in the same way as you would tell them if you had previously experienced a heart attack, as it may have a bearing on your diagnosis. Your medication may not mix with any other medications given to you. As an in-patient you will be reviewed by the HIV team and maybe transferred to a specialist unit at another hospital (for examplethe Royal London Hospital, or, University College Hospital)

Patient Forum

This is a group for people attending the clinic who meet regularly each month, to discuss among themselves issues affecting patients, how they could improve the services provided by the clinic, and to discuss issues around HIV with a variety of speakers.The group is also a source of peer support for people attending the clinic. Please ask a nurse or health adviser for details and the dates of the next meeting.

Research

Research studies have contributed to a number of important advances in the treatment of HIV and AIDS.

The JMC and the Centre for the Study of Sexual Health and HIV offer an opportunity for people to get involved in research studies. These vary from studies into the latest HIV medication to those which are gathering information on the social and health issues facing people living with HIV.

You may be asked if you are willing to participate in research studies at Homerton University Hospital. It is your choice and if you decide not to take part your decision will be respected and it won’t affect the care you receive.

Research Outreach Clinics and Shared Care

We know it may be difficult to come in to clinic for appointments, especially if you have a lot of other appointments to keep. For this reason, we offer shared care with a number of other clinical services in Hackney. We try to deliver your HIV care alongside your other medical care, reducing the number of different clinics you need to attend.

We can deliver shared care in the following venues:-

Specialist Addiction Unit and the Community Drug Team

Donald Winnicott Centre

Anita House

TB clinic

Antenatal Clinic

CHYPS + (for people aged under 20)

Some GPs in Hackney.

If you use any of these services and wouldlike to have your HIV care delivered there, please let us know

GPs (General Practitioners)

We highly recommend that you register with a GP and that you disclose your HIV status to your GP.

Primary care teams play an important role in diagnosing and treating illness, in helping people manage their health and coordinating access to other health and care services. Using GP services can help you to stay well.

Benefits of having aGP

You are very likely to have health needs apart from your HIV and your GP is best placed to help with these other problems.

Your GP surgery may have longer opening hours and can provide out-of hours services, during the night and at the weekend
Your GP surgery may be closer to home and easier to reach, important if you are unwell
GPs may do home visits if you are too ill to come to a clinic or surgery, and they may also do telephone consultations
GPs are able to refer you to a wide range of specialist care.

The benefits of disclosing you HIV status to your GP

Your GP can provide better, more informed advice about how to manage your health
Your GP will be aware of any HIV treatment you are taking, making easier for them to prescribe other medications safely
Your GP can help screen for any HIV-associated health conditions
Your GP can effectively manage other health conditions you may have
You can arrange for your GP and your HIV doctor to communicate about your health
You can receive certain vaccinations, including some travel vaccinations, free of charge
Your GP can help you with your Housing/Benefits claim

Knowing about any health condition you are living with will help your GP provide you with the right advice and treatment.

Eligibility to access GP services

GP services are provided free of charge to everyone in need of care. Your immigration status should not affect your ability to register with a GP.

Registration is at the discretion of the GP. You can register

as a PERMANENT patient, more than 3 month;
as a TEMPORARY patient, less than 3 months
Important points:
Do you live within the GP catchment area?
Is the GP practice currently accepting new patients?

Do you have problems registering with a GP services?

If a GP practice has refused to register you, they are still required to provide any urgent treatment and care for up to 14 days.

And while you are trying to register as a permanent patient, you can register as a temporary one. You don’t need a permanent address to do this and you can use a2care of address2, such as a friend or day centre.

You can also use NHS Walk – in Centres.

How to find a GP?

If you live in City and Hackney, call City & Hackney Clinical Commissioning Group (CCG) on 020 7683 4659 for the list of Hackney GP surgeries.
Or if you have access to Internet and you know your post code, visit NHS Choice website for the nearest GP Surgeries ( )
Or ask family and friends for a practice that they recommend

Letters You may need letters from the clinic to support applications you have made, for example to the Home Office. Please advice your lawyer to make a formal request for such a letter so that he/she can indicate the information required. Please note that the clinic needs time to respond to letters and therefore the requests for letters should be made in good time and well before any application deadlines.

Delivery Service

We are delighted to be able to offer patients the option of having their medicines delivered to their home, work or alternative address. If this is not suitable patients can also collect their medicines from their local Boots or Lloyds chemist.

This initiative is proving very popular with patients as it has many obvious benefits. It speeds up the patient journey as there is no reason to go to pharmacy and it also saves considerable money for our clinic which can help improve the service we offer you.

For more information speak to the HIV pharmacist at your next visit.

Testing Children

Any baby, child or young person who is at risk of HIV infection, including those with parent(s) or siblings who are HIV positive needs a test for HIV.

Babies need to be tested as a matter of urgency.

Why?

Babies with HIV can become unwell very quickly and should be given treatment as soon as possible.
Children with HIV can appear well for many years, but also can become ill very quickly.
Early diagnosis help prevent serious complications in later life.

What does it mean for you?

We would like to discuss with you whether an HIV test is recommended for your child/ren. If so, we can try to ensure you this is done as quickly and easily.

Your Clinic doctor/Nurse/Health Adviser will need to take some additional details so we can arrange this.

We understand that this may be a difficult decision and may bring up complicated and sometimes scary issues. This is why your named Health Adviser will be able to talk to you at your own pace and answer any questions you may have.

If you wish, we can arrange for you to talk with other parents who have been in the same position.

Although testing your children for HIV may be stressful, it is very important: infants and children with HIV are much more likely to remain healthy when diagnosed early.

Useful Contacts

Positive East

159 Mile End Road

London

E1 4AQ

02077912855

Body & Soul
99 Rosebery Avenue
London EC1R 4RE

02079236880

Terrence Higgins Trust
314-320 Gray's Inn Road
London
WC1X 8DP

0808 802 1221

Author: P Ruffolo, Nurse Specialist, Jonathan Mann Clinic

Produced: April, 2013

To be reviewed: June 2018.

1Jonathan Mann Clinic