One of the key driving forces throughout the whole campaign has been the Brownlee patients themselves. Their involvement and direction has led to the creation of two innovative pieces of work.
HIV stigma… what’s all the drama?
When exploring and developing ideas to tackle HIV Stigma the Brownlee HIV Patient Forum suggested that drama might be an excellent way to reflect and validate HIV+ people’s lived experiences. Collaborating with Scottish Youth Theatre we have produced four short dramatic scenes that were developed by a BAFTA award winning writer and Brownlee Centre patients.
All the dramatic clips and one detailing how we developed them can be found on the YouTube videos below.
HIV Stigma 1: Prejudice
HIV Stigma 2: Stigma
HIV Stigma 3: Sharps
HIV Stigma 4: HorribleIV
HIV Stigma 5: Collaboration
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Have you experienced or seen HIV stigma or discrimination taking place within NHS Greater Glasgow and Clyde (NHSGGC) health services? Have you or someone else been treated differently or with a lack of respect because you/they are living with HIV? If you have we want to hear about your experience.
This could be any health service in Greater Glasgow and Clyde, we hope and probably not related to HIV care. It could have happened any time in the last 3 years.
It doesn’t matter if you don’t remember all the details just tell us as much as you can.
Collecting these experiences helps us to work together to ensure people living with HIV are treated with the dignity, compassion and respect that all patients in NHSGGC can expect.
There are several ways to feedback the experience:
Discuss with the service/clinician
We advise that in the first instance, you speak to the person or team responsible if you are not happy with your treatment, or the treatment of someone you care about. For example, this can the nurse in charge of a ward, or the practice manager at a GP surgery.
We have developed a stigma reporting form [REDEVELOP THE FORM IN M365 FORMS] that the peer support engagement manager views so they can support you. They will contact you if the contact details have been completed however you can complete the form anonymously.
It is important to note that if you do not give contact details you will not receive a direct response to the specific issues you raise, however your comments will be used to drive forward change.
Anonymously tell your story on Care Opinion
Patients and families can use Care Opinion site to provide anonymous feedback about their experiences. The incidents are reviewed by the Patient Experience and Public Involvement Team at NHSGGC who will feedback incidents to service managers. You will receive a response from NHS Greater Glasgow and Clyde.
Feedback to Patient Experience Public Involvement Team (PEPI)
You can give feedback whether good or bad, in a confidential user friendly way to the NHS GGC Patient Experience Public Involvement Team. You simply complete the form found on the NHS GGC website with as much information as you can and the PEPI team will make sure this goes to the right services. It is that you will not receive a direct response to the specific issues you raise, however your comments will be used to drive forward change.
The advice is that you speak to the person or team in the first instance and then escalate if you are not happy with the outcome. The complaints team can help you to do this if you need help. They can give you advice about where to get independent help in making your complaint.
The e at the end of Brownlee HIVe stands for engaged and this is about the services that are led by patients, or the opportunities for patients to be more involved and have a say in how services are delivered.
Above all the Brownlee HIVe services aim to connect people living with HIV to share what it’s like living positively.
Brownlee HIVe Patient Forum
The Brownlee HIV Patient Forum is a safe space where patients attending the Brownlee Centre can discuss HIV-related issues and challenges affecting their lives.
The focus is on HIV treatment, care and associated programmes within NHSGGC. The Forum provides a way for patients to formally communicate with the Health Board and they provide input and consultation on the delivery of local services.
They work hard to ensure as wide a range of patients are consulted and have their say about the services they receive. They also want to encourage and empower patients to make better healthcare choices.
If you’d like to participate in the Forum or find out more about it you can email us at ggc.brownlee.hiv@nhs.scot. Alternatively you can ask any member of staff when you are next at the Brownlee.
Peer Support
“I have hope for the first time (since diagnosis). It feels less traumatic. They really understood me.”
– Brownlee Patient
Many people have questions surrounding their diagnosis, treatment or other issues related to living with HIV. Unless they know someone else living with HIV they often struggle to speak to someone who really understands things from their perspective.
The Peer Support Project provides a confidential environment for one HIV positive individual to meet with another more experienced HIV patient, who will listen to your concerns and fears and share what it’s like living positively.
The service is open to all current HIV positive patients in NHSGGC, regardless of how long they have been diagnosed, and who could benefit from speaking to another person living with HIV. This could be related to issues such as; shock of diagnosis, stigma, relationships, disclosure, work, social isolation, beginning treatment and other constraints or questions a person might have related to living with HIV.
“I was cynical…I did not expect the impact meeting the peer has had. It has changed my outlook totally.”
Brownlee Patient
To access Peer Support, or find out more about the service, get in touch with us:
Alternatively, you can ask any member of staff when you are next at the Brownlee.
Peer Volunteers
Peer Volunteers are HIV positive people who attend the Brownlee Centre for their own treatment and care. They have valuable first-hand experience of the physical, psychological and emotional support needs that others with HIV might face. After training, they are able to share their knowledge and experience to support, and build confidence in others living with HIV.
To meet with a Peer Volunteer or if interested in becoming a Peer Volunteer yourself, get in touch.
Alternatively, you can ask any member of staff when you are next at the Brownlee.
Seminars & Events
Regular seminars and events with the content determined by people living with HIV, take place throughout the year. Previous topics have included the basics of HIV, HIV and the law and ageing with HIV.
These free, informal sessions are a way to connect with others, learn more about HIV and speak directly to the experts. You can register for future events by emailing us at ggc.brownlee.hiv@nhs.scot or alternatively you might want to get in touch with an idea for a seminar.
You will see a range of staff when you come to the Brownlee Clinic for your appointments. Every HIV patient has a named consultant physician (doctor) and a specialist nurse allocated to them when they are diagnosed and referred. Most routine appointments are with the nursing and medical staff. You might see one of the department’s speciality doctors instead of the consultant at some of your visits. Each person’s care is closely monitored by their consultant and in addition to the medical management of your HIV there is a wide range of other staff on hand including:
The Brownlee Centre is named after Dr John Brownlee who was born on 21st June 1868 in Rutherglen. Originally a student of mathematics and natural philosophy at the University of Glasgow, he graduated with first class honours in 1889. He then went on to study medicine and qualified as a doctor in 1897. By 1914 he had established a reputation as a public health officer and an expert in infectious diseases.
Little is known of John Brownlee’s personal life. He was described as a likeable, somewhat eccentric man who had various quirks that endeared him to his friends. He died suddenly from bronchopneumonia in 1927 aged 59 years.
In 1951 at Ruchill hospital, the initial site of HIV care in Glasgow, a Research Laboratory was named after him to honour his work on infectious diseases. The hospital was closed in 1998 when the Brownlee Centre opened at Gartnavel General Hospital.
The Brownlee Centre officially opened on the 22nd of June 1998 at a time when combination therapy had radically changed the outlook and life expectancy for people living with HIV. However, planning took place three years before this, at a time when there was little effective treatment for HIV, and most people still died from their infection. As a result, the out-patient department was designed to manage a maximum of about 400 HIV+ patients at any one time.
Since 1996, treatment has become very effective and the number of deaths related to HIV in the UK, and Glasgow, is very small. Now there are approximately 2,000 people attending the Brownlee Centre for HIV care. So if you ever find yourself thinking the waiting room seems a bit small, then it’s worthwhile considering why.
Here you will find information for people living with HIV who are attending the Brownlee Centre for their treatment and care. The information on this page is intended to help you with managing your HIV. However; if you have any issues or concerns about your HIV then please get in touch with the clinic.
HIV Treatment
Treatment for HIV involves taking a combination of anti-HIV (antiretroviral) drugs. This treatment has a very powerful anti-HIV effect and stops the virus from reproducing. This allows the immune system to strengthen and fight infections effectively.
To get the most benefit from your HIV treatment, you need to take it as prescribed, every day. This is often called “Adherence” or “Compliance”.
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The only way to know if you have HIV is to have a test. Everyone in Scotland, including refugees and asylum seekers, can access free and confidential HIV testing. HIV treatment and care is available from the National Health Service.
An HIV test can only tell you about your HIV status. It cannot tell you if your current of previous partners are infected. Other people can only find out if they go for a test themselves.
Who should test for HIV?
You can’t tell by looking at someone if they have HIV so the only way to know is by having a test. You should have a test for HIV, if you have:
had unprotected sex with a man or a woman
ever injected drugs, even if it was a long time ago
had unsterile medical treatment abroad, or treatment in countries where infection control procedures are sub-standard
had tattoos or body piercing in circumstances where infection control procedures are suboptimal
were born or who have lived in a country that has a high prevalence of HIV
Where can I get an HIV test?
Testing is free and confidential in all NHS services. There are a range of places to get a test including:
After someone is infected with HIV, it can take some time for their body to develop antibodies to the virus. It is these antibodies that a test looks for. This is known as the ‘window period’. This means that if you were infected shortly before you have a test, it might not show up. Most of the HIV tests used are very sensitive and will detect HIV one month after someone is exposed, so a negative test is highly likely to be accurate. However, it is recommended that an additional HIV test is offered at 12 weeks to everyone who tests to make sure that they were not in the window period and are not infected.
If you are asked to have a follow-up test, you should take the following precautions while waiting for your second result:
The Brownlee Centre is based at the Gartnavel General Hospital, Glasgow. The Brownlee Clinic looks after approximately 2000 people living with HIV infection, as well as many people with other medical conditions. The Kantilal Sleep Investigation Unit is also based at the Brownlee Centre. All adult outpatient HIV care in NHS Greater Glasgow and Clyde is based here and is free of charge. Paediatric HIV services are delivered at the Royal Hospital for Children Glasgow.
To change an appointment, to cancel an appointment or to leave a routine message with any member of staff please call the Brownlee Clinic Reception on 0141 211 1074 or 0141 232 2175.
If you feel unwellor are in need of urgent medical help: please contact your GP or NHS 24 (PHONE 111). If necessary, they will contact staff at the Brownlee Centre for specialised medical advice.
Nearest to the Brownlee Centre, the Gartnavel General Hospital sanctuary is situated just inside the main entrance of the hospital (ground floor), on the right-hand side before the Deco Coffee Shop.
The chaplain’s office is in the corner of the Gartnavel General Hospital sanctuary.
Clinical nurse specialists can be found across a range of different medical specialties and long term conditions e.g. Coronary Heart Disease, Rheumatoid Arthritis and Diabetes. They are nurses who are trained and focus on a particular disease and are qualified to provide clinical input to patient care in place of a doctor. Every patient attending the Brownlee Centre is allocated a CNS and their role is to link that person to the department. The CNS can be contacted for any enquiry that is related to the management of HIV.
Nurse led clinics
Patients attend nurse-led clinics when they are considered to be stable and they have a less clinical and more holistic approach that focuses on lifestyle choices and health improvement. These include alcohol intake, diet, exercise, smoking, recreational drug use, sexual health and social circumstances.
At the nurse led clinic you will be reviewed by one of the nurse specialist team, not necessarily your allocated nurse.
Our goal is that all patients can develop a relationship with the care team that is built on trust and clear communication. If you have an issue related to your HIV treatment and care, we encourage you to get in touch as early as possible – don’t wait until you have reached crisis point!
First Visit
At your first visit to the Brownlee, you will be seen by the out-patient nursing staff who will carry out initial blood tests and a few other checks. You’ll meet your specialist nurse and sexual health advisor, and you will be given written information about HIV and the support services available.
You will then be given an appointment to be seen at the consultant clinic to review your blood tests.
Consultant Physician in HIV Medicine
What is HIV medicine?
The aim is to control and suppress the HIV virus completely to levels where it is undetectable in the blood – an undetectable viral load. This is done by making sure each patient has the correct course of antiretroviral medication. You will need to take this medication for the rest of your life, so decisions are based on a number of things, including evidence that will affect the future e.g. will a person’s work affect how and when they can take their medication?
What is the role of an HIV consultant?
The consultant leads a patients care and has overall responsibility for making sure a long term plan is in place. They check and double check all the information relevant to your care through review, reflection and ensuring safe systems are in place. Your named consultant will be either an infectious disease or genitourinary medicine consultant, who specialises in HIV medicine.
What other doctors might a patient see?
You won’t always see your named consultant when you attend and this might be because of rotas, other clinical commitments and to allow trainees to gain experience. You might see registrars who are fully qualified doctors that are training to become HIV specialists.
However, all the decisions about your care ultimately lie with your named consultant.
What is the most important message you have for patients?
Engage with the whole service – all of your appointments are important and enable us to work with you to provide the best possible care. If you are unable to attend, please get in touch with us. Don’t wait until crisis point or until the last tablet. Provide feedback and communicate with us.
Counselling
The counselling team at the Brownlee provides help to people who are infected or affected by HIV and/or Hepatitis C. We offer a range of psychological interventions that aim to maintain positive emotional health and wellbeing.
The counsellors offer a confidential, safe and non-judgemental space where clients can talk through their issues and concerns. Clients can refer themselves or ask any healthcare professional to refer them.
Some of the services the counselling team provide are:
Urgent psychological support and advice
One-One counselling: face to face, by video or by telephone
Group counselling
Patient support groups
Person centred counselling
Integrative therapies
Trauma counselling
Addiction therapies
Dietitian
Dietitians are health professionals who can assess, diagnose and treat dietary and nutritional problems.
The Dietitian service at Brownlee can help people with:
Advice on a healthy, nutritionally balanced diet
Assist in maintenance of healthy weight and muscle stores
Optimise nutritional status
Encourage a positive approach to eating
If you have concerns about any aspect of your nutrition you should discuss this with a member of the Brownlee team who can then make a referral on your behalf.
Free Condoms Service
Free Condoms Service
Free Condoms are provided to anyone who lives, works or studies in the NHS Greater Glasgow and Clyde area.
The service has been designed to be user friendly for both the service user and condom distribution outlets. It is discreet and simple with no requirement to register or answer questions. You can get your free condoms and lubricant from one of the many participating outlets. Go to the Free Condoms Website for more information.
HIV and Pregnancy
If you or your partner are living with HIV and thinking about having a baby we would encourage you to discuss this with your doctor or Specialist nurse beforehand or let them know as soon as you know you are pregnant.
We can give advice on antiretroviral medication in pregnancy, how to become pregnant safely, how to ensure you remain well during pregnancy and how we will work together to prevent mother to child transmission of HIV.
During pregnancy, the HIV team work closely with the Blossom team based in Princess Royal Maternity and we recommend women living with HIV attend PRMH for antenatal care. We provide a joint clinic with the HIV doctor and nurse, obstetric doctor, midwife and a neonatal doctor (who will look after the baby at birth) and can provide all your care in one place during pregnancy and in the weeks after baby is born.
There is good evidence that a range of psychological interventions can make a considerable difference to the long-term health and well-being of someone living with HIV, including how well they manage their condition and adhere to treatment.
We offer each patient an appointment with a member of the counselling team for a WELL-BEING assessment which is an opportunity to find out if there are emotional and psychological issues that may require support and treatment. It is also an opportunity to identify social, financial or indeed any other problems that you may need help with.
Treatment may be in the form of ongoing counselling, anxiety and stress management, attendance at a support group, or mental health care and treatment.
Occupational Therapist
The Occupational Therapy (OT) service provides specialist assessment and treatment to help individuals develop, regain or maintain the skills necessary to participate in all areas of their lives. Occupational Therapy gives people the ‘skills for the job of living meaningful and satisfying lives’.
At the Brownlee, the OT service receives a wide range of referrals, commonly related to memory, fatigue, anxiety, depression, sleep problems and social isolation. The OT service can be accessed through any staff member and individuals can self refer.
OT service may include:
Assessment and management of fatigue
Anxiety Management training
Advice and support to access work, leisure and community facilities
Liaison with Community Occupational Therapist for environmental adaptations
Advice and support for carers and families
Liaison and referral to community services and projects ie Impact arts, flourish house, access to work, Waverly Care,
Assessment of activities of daily living eg meal preparation, self care, shopping
Provision of equipment to improve functional status, and increase independence.
During your appointment with the Occupational Therapy service you will be given the opportunity to discuss any issues you are experiencing and work collaboratively with the OT to develop goals and strategies. The majority of appointments will be one to one with the Occupational Therapist or Assistant Health Practitioner, however there are sometimes opportunities for group work.
Outpatient Nurse
As some of the first friendly faces you will meet at your visits here at the Brownlee, the Outpatient Nursing Team are committed to providing care and support to patients and their families and friends. The Outpatient Nursing Team are the central “link” in the multi-disciplinary team. Managing the lists of separate clinics, we carry out a very varied role, helping co-ordinate a patients journey as well as
Referring to most appropriate part of the service
Running a nurse led phlebotomy (blood testing) service
Co-ordinating nursing tasks such as vaccines, return appointments, diagnostic monitoring such as weight, BP and urinalysis. Routine sexual health screens are also carried out by the OPD nursing team.
Supporting and caring for patients
Peer Support
“I have hope for the first time (since diagnosis). It feels less traumatic. They really understood me.”
Brownlee Patient
Many people have questions surrounding their diagnosis, treatment or other issues related to living with HIV. Unless they know someone else living with HIV they often struggle to speak to someone who really understands things from their perspective.
The Peer Support Project provides a confidential environment for one HIV positive individual to meet with another more experienced HIV patient, who will listen to your concerns and fears and share what it’s like living positively.
The service is open to all current HIV positive patients in NHSGGC, regardless of how long they have been diagnosed, and who could benefit from speaking to another person living with HIV. This could be related to issues such as; shock of diagnosis, stigma, relationships, disclosure, work, social isolation, beginning treatment and other constraints or questions a person might have related to living with HIV.
“I was cynical…I did not expect the impact meeting the peer has had. It has changed my outlook totally.”
The pharmacy team dispense medications and make sure they are safe and effective. They also ensure that your HIV medication is compatible with other medicines you might take or any other health conditions you may have.
Drug interactions are very common with antivirals and it is important for us to check in advance that medication is compatible to reduce the risk of treatment failures or drug toxicities. Patients and other medical professionals (eg GPs) are encouraged to check with the specialist pharmacy team before starting any new medicine including those purchased at the supermarket or community pharmacy or even any herbal products.
When a new antiviral is supplied, both at the outset of treatment or if changes to your medicines are required, a member of the team will discuss this with you. The aim of this is to provide you with practical information relating to how to get the best results from your medicines but also to give you the opportunity to ask any questions you may have about your new medicines or the service we provide.
We also offer a medication delivery service, which allows antivirals to be delivered to your home. It is only available to those patients who are stable on their antivirals, after discussion with their consultant. The company is called Lloyds Homecare – Tel: 0345 263 6135
If you have any questions regarding your medicines, your supply or taking other medicines, please don’t hesitate to call us on 0141 211 3383. Our opening hours are Monday, Tuesday, Wednesday and Friday from 9.00am to 5.00pm, and Thursday from 9.00am to 4.30pm.
Sexual Health Advisors
Attending the Brownlee Centre for HIV care there will be many opportunities to talk about your health and HIV treatment. However, you may wish to discuss other issues such as sex, relationships, condoms, or telling a partner about your diagnosis, but may not find there is the time or the opportunity to do so with your doctor.
Here are some of the areas that we can help with:
Safer sex and condoms
Negotiating safer sex with sexual partners
Telling someone (perhaps a sexual partner) you are HIV positive
Concerns about your sexual health and sexually transmitted infections
Lifestyle issues and living with HIV
Worries or concerns about your care and treatments
Using condoms
Using condoms when having penetrative sex (anal or vaginal) is the best way to significantly reduce the risks of HIV transmission. We now have lots of information available that condoms, used correctly and consistently, can prevent passing on HIV and just as importantly other sexually transmitted infections.
Using a water-based or silicon-based lube makes anal sex safe for both the insertive (top) and the receptive (bottom) partner. Using lubricant is not recommended for vaginal sex.
You can pick up a wide variety of condoms and lube completely free from a range of services and pharmacies. For more information see the Free Condoms Glasgow website.
Lower risk sex
There are some sexual activities that carry little or no risks of passing on HIV. For example oral sex (mouth to genital contact) is very low risk in terms of HIV transmission, as long as the mouth is healthy and no other infections are present. Activities such as kissing, hugging, touching or stroking, mutual masturbation, and rimming (tongue to anus contact) carry no risk of HIV transmission.
The risk of other sexually transmitted infections needs to be considered, particularly through oral sex.
Undetectable viral load
The information you get from your test results and discussions with your doctor about your viral load can help inform your choices around having sex. If your viral load has been undetectable for several months and you continue to take your anti-HIV drugs correctly without problems, the risks of HIV transmission during unprotected penetrative sex (anal or vaginal) is much reduced.
However not everyone is in agreement about how much the risk is reduced. Risks of other sexually transmitted infections and pregnancy issues also need to be considered when having unprotected sex.
You should discuss your Viral Load with your doctor or Sexual Health Adviser before making any decisions. More information on this is available from the National AIDS Manual (NAM) website.
What if my partner is HIV positive too?
It may seem obvious to think that if your sexual partner is HIV positive then there is no need to consider how you have sex together. This is not quite true. Apart from the risks of other sexually transmitted infections, the concern is the possibility of infection with more than one strain of HIV – or superinfection.
This could mean for example it is less likely to achieve undetectable viral load with anti-HIV drugs but the implications of this for your future health are not clear and not everyone is in agreement about the effects of this. Another concern is resistance to anti-HIV drugs being passed from person to person.
Re-infection or superinfection is less likely if you both have an undetectable viral load.
If this issue affects you it may be helpful to talk this through with your doctor at the Brownlee.
The following videos outline healthy lifestyle and pregnancy.
Eating Well in Pregnancy – Plus the Right Vitamins
Eating the Right Amount for You and Baby
Moving More for a Healthier Pregnancy
Drinking Enough Water When You’re Pregnant
Eating with Awareness – What is Mindful Eating?
Understanding Blood Sugar and Pregnancy Diabetes
Advice for Gestational Diabetes
Video 1: What is Gestational Diabetes?
In this video, we will answer some important questions about gestational diabetes; discussing what it is, the symptoms it can cause, how it can affect you and your baby, and the ways in which it can be treated.
Video 2: Healthy Eating, and an overview of the food groups
In this video, we will be discussing healthy eating, the Eat Well guide, an overview of the food groups and providing a detailed overview of carbohydrates.
Video 3: Portion sizes, smart swaps and meal patterns
During this video we will be discussing portion sizes, smart swaps, snack ideas, meal patterns and foods to include or avoid during pregnancy
Video 4: Breastfeeding, post-birth and lifestyle
In this video, we will be discussing breastfeeding, the benefits of breastfeeding, what will happen after your baby is born and general lifestyle changes.
Video 5: Frequently asked questions, links and contacts
In this video, we will answer some frequently asked questions, share useful links to access further information, and provide the best contact details for the NHSGGC Diabetes Dietitians.
Information in other languages
The Gestational Diabetes patient education videos were created by NHSGGC Diabetes Dietitians and have been translated into 5 languages. Each of the 5 videos will automatically play in sequence. They focus on healthy eating with Gestational Diabetes. Patients can contact or be referred to the Diabetes Dietitians for more detailed advice, if required
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