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White NHS nurses twice as likely as black and Asian colleagues to be promoted – study | NHS

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White nurses are twice as likely as black and Asian colleagues to be promoted in the NHS, with minority ethnic staff overlooked due to structural racism, according to research.

The Royal College of Nursing (RCN) said its study suggests racism is “endemic” in health and care. A survey of almost 10,000 nursing staff found that those who are white or of a mixed ethnic background are more likely than black and Asian colleagues to have received at least one promotion since the start of their career.

The difference is most stark among those aged between 35 and 44, according to the RCN, which published the report at its annual congress in Glasgow. While 65.9% of white and 64% of mixed ethnic respondents in this age group said they had been promoted, this dropped to just 38.3% of Asian and 35.2% of black respondents.

The college called on the government to take action to tackle racism, including a legal requirement to eliminate disparities in recruitment, retention and career progression, or a greater responsibility for employers to protect minority ethnic groups.

The RCN said structural racism is having a “devastating” impact on minority ethnic staff, highlighting survey findings that black respondents working in hospitals and community care are more likely to report experiencing physical abuse than respondents of other ethnic backgrounds.

Bruno Daniel, the RCN’s diversity and equalities coordinator, said: “Examples of racism experienced by nursing staff in the workplace are deeply shocking. The pandemic has shone a spotlight on structural racism in health and care services and we must seize this opportunity to stamp out this vile behaviour once and for all.

“The UK government and devolved administrations must properly acknowledge and address this problem and the devastating impact it has on black and ethnic minority staff and patients.”

Speaking at the conference about being sent to high-risk areas during the pandemic, agency nurse Roseline Sanni-Ajose said: “Covid-19 was a terrible situation for black and ethnic minority nurses in the country. Due to the shortage of PPE, we were not given adequate masks and were told to reuse our protective clothing and wear a gown all day, even if we’d been exposed to Covid-19 patients.”

Saffron Cordery, the interim chief executive of NHS Providers, said the findings represented fresh evidence of “the unacceptable presence of structural racism within our health and care system”.

“As the largest employer of black, Asian and minority ethnic people in the country, the NHS must recognise and confront the structural racism and discrimination that still exists within its ranks,” she added.

“There is also clear evidence that patients from ethnic minority backgrounds have worse experiences of healthcare than their white counterparts. This must be addressed as we bear down on waiting lists by having a particular focus on correcting inequalities of access to healthcare linked to ethnicity or deprivation.”

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Earlier this year, the Guardian revealed that a damning review commissioned by the NHS Race and Health Observatory had found that “vast” and “widespread” inequity in every aspect of healthcare it reviewed was harming the health of millions of patients.

Racism, racial discrimination, barriers to accessing healthcare and woeful data collection on ethnicity had “negatively impacted” the health of black, Asian and minority ethnic people for years, according to the study, which revealed the true scale of health inequalities faced by ethnic minorities for the first time.

“It is only by recognising these facts and having an honest conversation about racism, its structural roots and its impact, that change can be achieved,” said Cordery. “Every leader across the NHS and government has a duty to actively work to eliminate inequality based on race. NHS boards and senior leaders must demonstrate the behaviours expected and needed – collectively and individually – to dispel prejudices.”

An NHS England spokesperson said: “Having a workforce that best reflects the people we care for is good for our staff and good for our patients, so although it’s important that there are more BAME nurses in senior roles than ever before, the NHS recognises that more needs to be done.”

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‘I lost my retirement, my career, my home’: the HIV laws still criminalising Americans | US news

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Robert Suttle was 30 when he was arrested and imprisoned for the felony of “intentional exposure to the Aids virus”. He had met the man at a gay club on New Year’s Eve 2007 and they had quickly begun a relationship.

Suttle says he disclosed his status as HIV-positive to his partner immediately. However, when the couple separated a few months later, the man pressed charges claiming that Suttle had not disclosed his status. Suttle now views this as “retaliation” over the breakup.

Despite the fact Suttle was on treatment that brought his viral load low enough that he could not transmit HIV to another person, Louisiana police arrested him at his workplace and he was sentenced to six months in prison. The Louisiana law – like many across the US – focused on exposure and not transmission and did not require actual transmission for a conviction to occur.

HIV exposure or transmission is still criminalised in 33 US states under various laws, most of which involve disclosure and exposure. The laws fail to take into account that people like Suttle, on therapeutic medications, can be “undetectable” – meaning the risk of transmitting the virus is almost zero, while the HIV prevention drug PrEP reduces the risk of infection by 99% when taken correctly. Having sex with another person when you are living with HIV can land you with years of prison time even though, thanks to modern science, HIV is no longer a death sentence.

portrait
Robert Suttle. Photograph: Jennifer Doherty

Other HIV laws criminalise acts such as breastfeeding, biting and spitting. Many of these laws were instated in the 1980s, “when people were scared to death of HIV and didn’t know how HIV was transmitted”, explains Catherine Brown, executive director of the Elizabeth Taylor Aids Foundation, which runs the campaign HIV Is Not a Crime. The campaign does not aim to legalize rare cases of malicious contamination but to bring the laws up to date with contemporary science, specifically “U=U” – “undetectable equals untransmittable” – or the fact that HIV cannot be transmitted through saliva. It’s clear that these enduring laws are a result of HIV stigma, adds Brown, because other viruses are not criminalised in the same way.

“If you’re having sex and you know you’re HIV-positive in Louisiana, that is considered intent, it makes you criminally liable,” says Suttle. “We did have sex, so that’s the exposure – but they didn’t look into whether I was on treatment or used a condom. And if people say ‘did you disclose’, it doesn’t matter, because it’s one person’s word against the other’s.”

Although Suttle was incarcerated for six months over a decade ago, he is still paying the price. After leaving prison, he was placed on the sex offender’s register, a fact his neighbors were alerted to via mail notifications listing his “crime” and thus disclosing his HIV-positive status. “Being Black, being gay, being HIV-positive, then being an incarcerated person and a ‘sex offender’ in the conservative south?” he says over Zoom from his home in New York City. “I didn’t know how I was going to move forward.”

The overall number of people arrested under HIV criminalisation laws in the US is not tracked. However, HIV Justice counts at least 2936 cases to date, with the real number probably much higher. According to the Williams Institute, a thinktank at the University of California, Los Angeles, certain groups are disproportionately targeted.

“The data shows that Black transgender women and Black and brown men having sex with men are the two groups these laws disproportionately effect,” says Brown. Before Nevada updated its laws in 2021, for example, 28% of people living with HIV were Black, whereas 46% of convictions for HIV-related laws were against Black people. As of 2022, Black women are 290 times more likely to be on the registry for an HIV conviction than white men. Ten states also have laws specifically targeting sex workers, turning a prostitution charge – often a misdemeanor – into a felony for people living with HIV.

For those prosecuted under these laws, doing prison time or being placed on the sex offenders register can end up affecting their lives more than their diagnosis itself.

“I lost my retirement, my career, my home,” says Ken Pinkela, a former US army lieutenant colonel in his fifties who joined the military when it was illegal to be openly gay. Pinkela was convicted in June 2012 of an alleged aggravated assault for HIV exposure and spent 272 days in the military prison at Fort Leavenworth. Discharged from the military, and with an assault charge on the books (despite a lack of evidence), he struggled to find employment. “Once you’ve been convicted, it never goes away.”

Lashanda Salinas, 41, who was first diagnosed with HIV at 16, was convicted under HIV criminalisation laws in 2007. Her listing on the Tennessee sex offender’s register ranks highly among Google search results for her name.

portrait
Lashanda Salinas. Photograph: Handout

In 2006, Salinas – then on treatment – began a relationship with a man. “I told him I was HIV-positive and asked if he was OK with that and he said he was,” she says. They moved in together and later separated.

“About a month or two after our relationship ended, I’m at my job and a police officer walks in and says: ‘Are you Lashanda?’ I said, ‘Yes, ma’am,’ and she said, ‘You’re under arrest.’ I asked her what I had done and she said: ‘Your boyfriend says you did not tell him that you are HIV-positive and he’s bringing charges against you.’”

In the police car on the way to Nashville, Salinas tried to tell the officer that something wasn’t right; her partner knew she had told him. “But when I got in jail and those doors locked, I realised this is not a prank – this is what he is really doing.”

Salinas ended up doing nearly two months in jail, after accepting a plea bargain of three years’ probation. As in Suttle’s case, the judge did not tell her that upon release, she would be placed on the sex offenders register for 15 years because her crime was a sexual offence. She was required to take sex offender classes, must pay $150 a year to be on the register, and is not allowed around anyone under the age of 18. Her cousin graduates this year and she is unable to attend the ceremony. “I just want a normal life,” says Salinas. “My life is nowhere near normal.”

Since her conviction, Salinas has asked a partner to sign a written document attesting to her disclosure of her HIV status. In future, she says, she would consider videoing a partner as she discloses her status. “That’s the only way I can have some kind of stability so this won’t happen again,” she says.

As Pinkela points out, the laws put pressure on those who are living with HIV to disclose their status before they are ready, or when it might not be safe to do so.

Portrait in uniform
Ken Pinkela. Photograph: Handout

The American Psychological Association also notes the laws can also increase risky behaviour when it comes to HIV and therefore appear to do more harm than good. Brown agrees that these laws are stifling the fight against Aids, citing UNAIDS’s goal of eradicating HIV globally by 2030: “The issue with criminalisation is people are afraid they will be arrested if they test positive. Yet if we have the issue of getting them tested, then we can’t get them into treatment, and that’s a barrier to us ending the epidemic.”

The problem extends far beyond the US. On a global level, HIV Justice Network has recorded 270 arrests across 39 countries over the last three years, although the real number may be closer to 700. Conviction rates were highest in Uzbekistan, Russia and Belarus, followed by the US. Many countries also maintain travel restrictions against people living with HIV, while more than a dozen countries worldwide hold residency bans.

According to Ken Pinkela, who now campaigns against the laws, the work involves educating prosecutors and legislators about contemporary HIV science, as well as the UN’s recommendation for limiting HIV criminalisation to rare cases of intentional transmission, where malicious intent can be proven beyond a reasonable doubt.

S Mandisa Moore-O’Neal, a former civil rights attorney and now executive director at the Center for HIV Law and Policy (CHLP), agrees with this approach. “If we are serious about ending the epidemic, we must update these laws, including repeal if we can ensure that what is created in their place won’t have to be reformed 10 years from now,” she explains. She adds that we should “not fall into the trap” of using one’s undetectable viral load – which can change in a person’s lifetime – as the sole basis for modernizing these laws. “It should be based on a specific intent to transmit and actual transmission.”

In April 2022, a federal court ruled that the Pentagon’s restriction policies regarding service members with HIV were outdated and unconstitutional. Pinkela hopes this indicates the same approach may be applied to more state laws in the near future.

Since the Elizabeth Taylor Aids Foundation launched HIV Is Not A Crime in 2020, six states have updated their laws, with the help of awareness-raising from celebrities such as Andy Cohen and Paris Jackson. However, in November 2022, Pennsylvania’s governor, Tom Wolf, signed a new law charging people with a second-degree felony and up to 10 years in jail if they knew or “should have known” that they had a communicable disease after transmitting it to someone else. Nonetheless, “we’re continuing on campaigning in seven states in 2023”, says Brown.

In the meantime, what is devastating, Pinkela says, is that someone in the US reading this who has recently been diagnosed with HIV may be finding out for the first time that these laws exist. They may be wondering whether they can engage in sexual relationships at all. He reminds them that HIV is not a death sentence and advises them to talk to their doctor and get to know the laws in their area using resources such as HIV Justice and CHLP.

“Those three letters just still seem to invoke such fear,” says Pinkela of enduring HIV discrimination. He hopes that seeing the faces of healthy people living with HIV like himself helps get the message across that it should not be viewed differently from other chronic health conditions.

For Salinas, advocacy work has been a way to reclaim self-esteem and a sense of identity when it has been so difficult to get a job. “I got to the point where my voice needs to be heard, to affect somebody, somewhere, somehow. If not for me, I want these laws changed for the people behind me.”

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Kevin Durant gets MVP chants at Barclays Center in win vs Wizards

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It felt like a game the Nets should have won handily — probably because the last time they played the Wizards, they set a new scoring record at Capital One Arena.

Kevin Durant got hot early and Joe Harris broke free from his recent cold streak. The game felt like Brooklyn’s for the taking.

Rarely, if ever, though, is anything exactly as it feels or seems at Barclays Center. On an explosive scoring night that featured MVP chants raining down on the best basketball player in the city, the Nets had to scratch and claw their way to a 113-107 victory that moves them above .500 for the first time all season.

And they didn’t truly put up a fight until the bottom of the third quarter.

“[We stayed] disciplined not giving up too many easy ones, especially down the stretch,” said Kyrie Irving. “We had a pretty decent third quarter but I felt the fourth quarter we created that separation we really needed.”

Durant scored 39 points on 13-of-20 shooting from the field. Just weeks after he broke Wizards C Daniel Gafford’s ankles with a nasty hesitation-crossover-pullup combo, he had the remainder of the Wizards’ starters on skates.

Kyle Kuzma slipped to the ground as Durant split a double. Deni Avdija stumbled a bit before fouling Durant on an and-one jump shot. It was equal opportunity employment for any defender who applied to the job of the night: slowing down one of the most vaunted scorers in NBA history.

It’s impossible. Durant’s scoring numbers border on absolute. He scored 16 points in first quarter alone.

“Sometimes I have to make sure I don’t take it for granted. The fact that he shows up every single day. He’s ready to work. He’s ready to listen, he’s ready to be a great teammate,” said head coach Jacque Vaughn. “So our group is evolving and I keep stressing the ability to be flexible with the whole idea of trying to win and Kevin has that on his mind all the time. He steps on the floor. He wants to win.”

Therein lies the roadblock for this Nets team in pursuit of an ever-so evasive NBA championship — or a deeper playoff run than their “Seven-Eleven” era best second-round exit.

Durant is an all-world talent, and Irving is a threat to go for 30 any given night. The remainder of the pieces on a stacked Nets roster are still acclimating to one another.

Case in point: As Ben Simmons (calf) and Yuta Watanabe (hamstring) project to each miss another week of action, veteran forward TJ Warren is set to rejoin the action Friday against the Toronto Raptors.

As a result, the Nets look disjointed for stretches on both ends of the floor. They are fighting to survive the limited minutes Durant needs to rest on the sidelines in order to recharge to dominate his individual matchup. Even in the minutes Durant plays, the offense sputters when the ball leaves his hands.

In the minutes he’s on the bench, it becomes the Wild Wild West.

“I think this game we actually did show some composure and poise at the end, which was great to see,” Vaughn said. “We got in our sets, we got the ball where we wanted to, made them double team us, and for the most part, we were in the right position to make the right play. So overall, good win by our guys. We’ve been grinding our guys with minutes. And these games are coming fast and furious, but they’re answering the bell and I’ll give them credit.”

After Durant played the entire first quarter, Vaughn called a timeout 33 seconds into the second after Wizards G Monte Morris got to the rack unbothered.

That happened over and over again and was Vaughn’s third timeout in the game’s opening 13 minutes. Paint defense has been an Achilles heel for a Nets team with only one true playable big man.

Simmons plays backup small ball five in spurts and has played well. Markieff Morris also plays small ball five. Backup center Day’Ron Sharpe missed the game due to a non COVID-related illness, but he rarely plays outside of garbage time.

As a result of their roster construction, the Nets play small. It doesn’t always work, especially when Simmons is out.

“[Opposing teams going big] is always going to be a problem for us and we know it,” Vaughn added. “Before the game we showed the last time they played us, how they got offensive rebounds. And we’ll continue to show our guys.”

Star guard Bradley Beal came off a screen and drove freely to the rim with a one-handed dunk. Durant flailed his hands and shook his head in frustration.

That, and his scoring, were the constant for the night.

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Much of that frustration is in the team’s inconsistent ability to generate defensive stops — and if they do force a miss, the added grievance comes from this team’s inability to crash the glass. The Nets entered Wednesday night ranked second-to-last in rebounds. The Wizards won the battle on the glass, 51-35. Their 14 offensive rebounds translated into 25 second-chance points.

Nic Claxton finished with just seven points and eight rebounds. It became clear, early, he was going to struggle against the once lanky Kristaps Porzingis.

Porzingis has done what Claxton must continue: He has put on the body mass that allows him to be a force in the paint and on the glass. The ex-Knick tallied 27 points and 19 rebounds. Beal finished with 25 points on 10-of-20 shooting and Kyle Kuzma added 25 points.

A win is a win, and the Nets will take them as they come, especially after digging themselves a 2-6 hole to start the season. This season, though, is about more than beating a Washington Wizards tram projected to make the playoffs for the fourth time in five seasons.

It’s about being the last team standing and going toe-to-toe with teams like the Milwaukee Bucks and Boston Celtics.

Twenty-one games in, the Nets aren’t on that level. They still have a long way to go before arriving at the destination.

“We know we have high expectations for our team, but the process is more important than an end result,” said Durant. “So each day matters like I just said, and Jacque has been preaching that since he got the job.”

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Imprisoned for being HIV positive | podcast | News

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“The police come to my job, they’re telling me that this gentleman that I had dated is pressing charges on me because I didn’t tell him I was HIV positive.”

Lashanda Salinas faced criminal charges in Tennessee after her former partner accused her of exposing him to the HIV virus. Although Lashanda had been on medication since she was a teenager, and says she was open about her status, she was convicted and is now on the sex offender registry.

“I had to take a lie detector test every six months to prove to them that I [hadn’t] been around a child,” Salinas tells Hannah Moore.

“Everyone’s perception is that if someone’s having sex with someone who is HIV positive, they must be being deceived or they must be being tricked into doing that, and that is so not the case,” says Robert Suttle, who was also convicted in Louisiana after being reported by his former partner.

“You’re being arrested, you’re losing your job, you’re losing your livelihood, over something related to your status,” Suttle tells Moore. “So it’s almost like you’re guilty before you’re even proven innocent when it should be the opposite.”

Campaigners say these laws are reinforcing stigmas about HIV, and discouraging people who don’t know their status from getting tested. Edwin Barnard, the Executive Director of the HIV Justice Network, tells Hannah Moore how these laws, often relics of the 1980s before medication was available, are a danger to public health. Reporter Amelia Abraham explains why ethnic minorities and women are disproportionately criminalised.



Members of the Aids Coalition To Unleash Power (ACT UP), Housing Works and GMHC holding a protest outside the New York District Attorney's office in Manhattan, US.

Photograph: Erik McGregor/LightRocket/Getty Images

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