In the final episode of the series, Susan Cole and Dr Naomi Sutton tackle stigma faced by persons living with HIV (PLWH), the historical narratives of HIV and misinformation still negatively influencing how some clinicians and some of the public perceive HIV, and utilising the power of U=U against stigma and misinformation. Susan shares her own story of being diagnosed and living with HIV. "One of the most powerful things in terms of dealing with stigma or perceived stigma is actually getting the U=U message out there." "‘Telling’ is definitely better, and I think that it really takes away some of the stigma, because when you talk about disclosing, it’s like a shameful negative thing that you're trying to say." Susan Cole is an award-winning HIV activist, broadcaster, writer and public speaker, who has advocated for people living with HIV for over two decades. She leads community engagement and broadcasting activities for NAM aidsmap, including producing and hosting aidsmapLIVE. Susan is also a member of the 4M network of Mentor Mothers, and a founding member of the Global HIV Collaborative. She was awarded 'Woman of the Year' at the 2020 NAZ OSCARS. Follow her on Twitter @susancolehaley.UK-UNB-2654 Hosted on Acast. See acast.com/privacy for more information.

Dr Shalini Andrews and Dr Naomi Sutton help listeners navigate their patients through issues of sexual pleasure and (dys)function, in the light of U=U. Their discussion covers a lot of ground, from the biopsychosocial model as a framework for sexual function; the impact of hormones, medication and relational factors; erectile dysfunction as a harbinger of cardiovascular disease; the clitoris; vaginal pain syndromes and re-orienting orgasms."Undetectable is Untransmittable. People on effective treatment do not transmit the virus anymore, and finally we can shift that conversation from all that sex negativity to sex positivity.""The main thing is to not dismiss people. Not to have a look and say ‘Everything looks okay, we don’t know why you're feeling this, go away or deal with it’. Which is not very helpful."Dr Shalini Andrews is a Consultant in Genitourinary and HIV Medicine and the clinical lead for HIV in Surrey. Shalini has a special interest in sexual dysfunction and promoting a positive attitude towards sexuality to prevent sexual ill health. She is the chair of the BASHH Sexual Dysfunction Special Interest Group and President of the British Society of Sexual Medicine.Shalini can be found on Twitter @DrSAndrews.UK-UNB-2653 Hosted on Acast. See acast.com/privacy for more information.

In this episode, Dr Naomi Sutton is joined by Dr Michelle Croston to discuss the mental health continuum and the exacerbated symptoms of depression and anxiety that people living with HIV are more likely to experience than the general population. Their conversation gives listeners ways to think about what we need as individuals to sustain our health and wellbeing, and working in a trauma-informed way with patients. For healthcare professionals, they delve into the psychological burden of caring and the value of good quality support and self-care. Michelle also points listeners to some "gamechanger" resources, namely the Hub of Hope"It’s really hard just to sit with somebody and witness their distress but there is something really powerful for that person being listened to.""I'm definitely not afraid to say ‘I'm not sure about this right now, can you help me to understand what would make things easier for you?'"Dr Michelle Croston is an Associate Professor of Nursing at the University of Nottingham, with a clinical background in HIV care and extensive post graduate qualifications in mental health and psychological trauma.She holds a fellowship with European Society of Person Centered Healthcare (ESPCH) and is an associate member of the International Community of Practice for person-centred practice (PCP-ICoP). Michelle is a qualified Mental Health First Aid Instructor and Crisis Counsellor for a Mental Health charity that specialises in working with healthcare workers.Michelle also hosts the podcast HIV Matters, developed in collaboration with the National HIV Nurses Association. It can be found on Spotify, Audible and wherever you get your podcasts. You can also find HIV Matters on Twitter @HIV_Matters.UK-UNB-2652 Hosted on Acast. See acast.com/privacy for more information.

In this episode Dr Vanessa Apea joins Dr Naomi Sutton for a frank discussion on health inequalities, their social and economic determinants, and how they are further compounded for persons living with HIV (PLWH). Vanessa offers listeners some practical advice on how healthcare professionals can improve patient care and services while better advocating for PLWH: provide safe spaces for people to share their individual lived experience, display cultural humility, and use the 4 As (Acknowledge, Advocate, Amplify and Activate) to support and empower patient voices."We have inequalities and inequity in experience because there is differential power, so whenever there is an opportunity to shift, share power, foster true inclusion and belonging, that’s where we will see change."Dr Vanessa Apea is a Consultant Physician in Genito-urinary and HIV medicine and the clinical lead for Sexual Health at Bart's Health NHS Trust. She is also an Honorary Senior Lecturer at Queen Mary University of London. Vanessa received an NHS 70 Windrush Award for her contributions to improving health equity, a central focus of her clinical work.She is a member of the London Fast-Track Cities Initiative stigma subgroup working to get London to zero HIV stigma. She is also the medical director of NAZ, a charity advocating for high quality sexual health and HIV support services for BAME communities. Vanessa is a fellow of the Royal College of Physicians and a Fulbright scholar with a Master's in Public Health from Harvard University.She can be found on Twitter @vanessa_apeaUK-UNB-2651 Hosted on Acast. See acast.com/privacy for more information.

Dr Tom Levett and Dr Naomi Sutton shift the conversation on ageing with HIV, urging a move away from 'frailty' towards a proactive, healthy ageing model. They address misconceptions about "normal ageing"; ways to identify and mitigate against functional decline early in patients; the limitations of FRAX scores; and provide guidance on managing multi-morbidities and polypharmacy - all the while reminding listeners that older adults are still sexual beings."Falls are embarrassing, continence is embarrassing, saying you're struggling to get yourself washed and dressed is embarrassing. It’s just allowing a space to say ‘Do you know, actually since I saw you I'm falling over pretty much once a month and I don’t know what’s happening to me.’ In the clinic, I don’t do a lot of clever medicine. I stop a lot of tablets, I listen to people, and I reassure a lot of people that what they’re experiencing is wholly normal."Dr Tom Levett is a Senior Lecturer in Medicine and Frailty at Brighton and Sussex Medical School and an Honorary Consultant in Geriatric Medicine at the Royal Sussex County Hospital. He is the co-lead of the HIV-ageing Silver Clinic in Brighton, which takes a proactive approach to screening for frailty and reviewing patients with age-related issues with mobility, falls, multi-morbidity and complex polypharmacy - work that has been informed by Dr Levett's doctoral investigation of the prevalence and predictors of frailty in older adults living with HIV.Follow more of his work and advice on Twitter @DrTomLevettUK-UNB-2650 Hosted on Acast. See acast.com/privacy for more information.

Professor Donal O'Shea and Dr Ana Milinkovic take Dr Naomi Sutton deeper into the little understood world of metabolic syndrome, providing insight into the complex factors that can give rise to weight gain along an individual's life course. For people living with HIV, starting or switching medication may lead to unexpected and dramatic changes in body composition.In this episode, Professor O'Shea and Dr Milinkovic walk listeners through tried-and-tested ways to broach weight gain empathetically and non-judgementally with patients; the value of self-compassion in behaviour change; screening for metabolic syndrome; interventions for both the prevention and treatment of obesity; and the importance of lifestyle intervention in an obesogenic world"Body weight is not a choice for the majority of people.And just explaining that we understand it better and that their body weight is not their choice opens them up to a different way of thinking"Professor O'Shea is a Consultant Endocrinologist, Professor of Medicine at University College Dublin and the HSE's National Clinical Lead for Obesity Management. You can find his research group on Twitter @OSheaHoganLabDr Milinkovic is an HIV Physician and Clinical Trial Lead at Chelsea and Westminster Hospital. She also established and runs the hospital's HIV Metabolic Outpatient Service and Live Well Pathway Clinic for people living with HIV and complex body composition.UK-UNB-2649 Hosted on Acast. See acast.com/privacy for more information.

In this two-part episode, Dr Naomi Sutton and Dr Shema Tariq have a rousing conversation on a topic rarely discussed in public: menopause in persons living with HIV. The second episode picks up with the benefits of using systemic HRT in menopausal women living with HIV weighed up against its risks, before moving onto premature ovarian insufficiency, FSH testing, and what HIV clinicians can be doing better. Shema signposts listeners to invaluable patient resources at the Sophia Forum, aidsmap, Positively UK and the GROWS project."If a woman is in her 40s, start asking her proactively about menopausal symptoms. It doesn’t take long. You just need to ask her about hot flushes, ask her about her mood, and ask her about sex, because otherwise she’s not going to volunteer it.""Women who don’t have that exposure to oestrogen up to the usual age of 50-51 are much more likely to develop cardiovascular disease and osteoporosis and a whole host of other things. The treatment for that is HRT."Dr Shema Tariq is a Consultant HIV and Sexual Health Physician at Mortimer Market Centre, and Clinical Academic at University College London's Institute for Global Health. Her main clinical and research interest is the health and wellbeing of women living with HIV. She leads the PRIME Study - one of the largest studies internationally on HIV and menopause. Shema is also part of the GROWS team, developing information and peer support for older women living with HIV, and is a Trustee of Positively UK and Tommy's. Follow her work on Twitter @savoy__truffle and @prime_uclUK-UNB-2657 Hosted on Acast. See acast.com/privacy for more information.

In this two-part episode, Dr Naomi Sutton and Dr Shema Tariq have a rousing conversation on a topic rarely discussed in public: menopause in persons living with HIV. The first episode begins with Menopause 101: what is menopause and what happens to the body with oestrogen decline. Shema walks listeners through common symptoms like hot flashes, poor sleep, mood changes and dry vaginas; findings from the PRIME study; and how these menopausal symptoms interfere not only with wellbeing and sexual function but the ability of women to manage their HIV. We also learn that a little topical oestrogen goes a long way."One in four women will have hot flushes that are so severe that they impact their daily lives and we know it impacts women’s ability to work and also how they function in relationships.""If people listening to this just take home one thing, it’s to think about topical vaginal oestrogens."Dr Shema Tariq is a Consultant HIV and Sexual Health Physician at Mortimer Market Centre, and Clinical Academic at University College London's Institute for Global Health. Her main clinical and research interest is the health and wellbeing of women living with HIV. She leads the PRIME Study - one of the largest studies internationally on HIV and menopause. Shema is also part of the GROWS team, developing information and peer support for older women living with HIV, and is a Trustee of Positively UK and Tommy's. Follow her work on Twitter @savoy__truffle and @prime_uclUK-UNB-2656 Hosted on Acast. See acast.com/privacy for more information.