Woman's Hour - Pregnant women and the flu jab; HIV and BAME women; Autumn fashion trends; Debra Whittingham

Episode Date: October 12, 2020

The Royal College of Obstetricians and Gynaecologists and Royal College of Midwives are urging all pregnant women to take up the offer of a free flu vaccination this winter to protect themselves and their baby from complications caused by the flu virus. Sangita Myska is joined by Dr Jo Mountfield, Consultant Obstetrician and Vice President of the Royal College of Obstetricians and Gynaecologists, to discuss why this is so important. Three-quarters of women living with HIV in the UK are women of Black, Asian or minority ethnic background. Dr Rageshri Dhairyawan, a consultant in Sexual Health and HIV Medicine at Barts Health NHS Trust in London, wants to see a renewed focus on how to access those women, ensure that they have the healthcare they need to live long and healthy lives, and break down the stigma around HIV that is intense within some communities. She says South Asian women form a silent and often overlooked minority of women living with HIV, which is concerning as sexually transmitted infections are rising fastest in Asians compared to other ethnicities. Sangita Myska talks to Rageshri and two women living with HIV; Mina Kakaiya who is a mental health and mindfulness trainer of South Asian heritage, and Bakita Kasadha who is a British-Ugandan poet, activist and researcher.What are the new trends for fashion and make up this autumn, and has your approach to beauty changed with the pandemic? Sangita is joined by Edwina Ings-Chambers, beauty director at YOU magazine, Kaushal, a beauty and lifestyle content creator who has 2 million subscribers on YouTube and also to the Telegraph’s Shopping Editor Krissy Turner.Debra Whittingham spent over 31 years in the Royal Navy before taking over a role that is steeped in history. She became the first female Deputy Governor of the Tower of London in 2017. Debra is one of the stars in a new series of The Tower of London documentary to be shown on Channel 5 this Wednesday, and joins Sangita.

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2, and of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme, peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. This is the Woman's Hour podcast for Monday the 12th of October. Hello and welcome to Woman's Hour. Coming up in today's programme, a staggering three quarters of the women infected with HIV in Britain come from black, Asian and minority ethnic backgrounds. Intense stigma in some of these communities means we rarely hear from them. But today we'll be talking to one of the only British Asian women prepared to speak openly about her condition. Meanwhile, the leaves are turning, there's a chill in the air,

autumn is here and we'll be chatting about the latest fashion and beauty trends this season. Here's a clue, fashionistas are turning the clocks back to the 1980s. Not necessarily a bad thing, I say, given how 2020 is going. And what's it like being locked up in lockdown with 37 beef eaters? The woman who can tell us, the Deputy Governor of the Tower of London, joins us later. And as ever, we want you to join the conversation. You can get in touch over social media, our Twitter handle. I think you probably we want you to join the conversation. You can get in touch over social media, our Twitter handle, I think you probably know it, at Women's Hour, or you can get

in touch via the website. You'd simply have to consult Dr. Google. But first, if you're pregnant, this is really important. Midwives and doctors are urging pregnant women to get the free flu jab now. It's because for a minority of women, catching the flu during pregnancy can prove dangerous. Dr Jo Mountfield is a consultant obstetrician and vice president of the Royal College of Obstetricians and Gynaecologists. Jo, good morning. If a woman gets the flu when she's pregnant, what are the possible impact on her and her baby? Well of course it's variable like all these things so some women can get the flu and just have a more mild illness with a temperature and shivers and shakes the usual symptoms that one would expect sore throat runny nose but some women can become more severely affected. And that's because we know

in pregnancy, there is a change in the immune system, which means that you have a different response in pregnancy compared to when you're not pregnant. So some women can get a more severe form of the flu and can get some added complications. And this is more likely as you get later on in pregnancy because you've got a baby sitting in your tummy. And so that affects the way that your lungs can move because your diaphragm is being stopped from moving because you've got a baby there. So later on in pregnancy, there can be more risks associated with the flu. And it's the complications in particular, you can get a bronchitis and a pneumonia that can be really quite severe and make you very unwell. So that's why it's really important to try and prevent you getting the flu

by having a flu vaccination, which can reduce that risk. What were the take-up rates of the flu vaccine last year? Because I'm quite surprised, it's fewer than half, right? It is, yes, it is. So the sort of documented figures last year were under 50% around, just about 44%. And in fact, that was slightly lower, in fact, than the year before. And we're doing a huge amount of work to try and promote the flu vaccine and vaccination during pregnancy within maternity services.

And this year, for obvious reasons, we were particularly keen to try and encourage women to come and have a flu vaccination because it is safe for them and it's safe for their baby. And, you know, with all the things that's going on with COVID as well, we really don't want women getting flu with all the other risks that are around. And this is something that we can prevent, help prevent by having a vaccination. Do you think that what's keeping women away is the fear of the vaccine itself? Because interestingly, this isn't a live vaccine, is it? No, it's not a live vaccine. So what does that mean, Jo?

So that means that you can't get the flu when you have the vaccination so if you if you have the vaccination that in no way can give you the flu so it's very safe it doesn't cross the placenta to the baby either so it is a it's a it's been tested for many years and we know that very few people have adverse reactions to it so you can get a bit of soreness where you have the actual injection and for some people who are allergic to eggs you need to have a special sort of vaccination but where people report that they've had the flu when they've had the vaccination it's usually because they had it before they have the vaccination it's not because we it causes the flu so it is a safe vaccine to have and yes

i'm sure some of it is around um some anxieties about having anything you know obviously women when they're pregnant try and avoid medication they try and avoid putting themselves at risk but this really is a safe vaccination um for women to have and it protects them and their babies because if you become seriously unwell as a mum then that can affect your baby as well so it's rare but it happens and i'm only going to ask you this one more time there are absolutely no side effects right and there are mild side effects in terms of let's say a sore arm sometimes people a bit feel a bit achy afterwards but you really you really will not get a cold or a flu

because you've had a flu vaccination what i found really interesting actually is that there is a special urgency this year isn't there because there is talk now of a covid 19 vaccine possibly possibly coming on stream at the beginning of next year and as i understand it if you're pregnant the urgency is this you want pregnant women to get this vaccine done now. Am I right? So that they're in a better position to potentially, if there is a COVID-19 going on around COVID vaccine at the moment, and we haven't got one as yet. But the bottom line from our perspective is we really want to try and protect women from both flu and COVID. And so if you have your flu vaccination now, which is at the beginning of the season where the rates are still relatively low, then it's done for the season, basically. And then if the COVID vaccination comes along, you're ready to have that as soon as that comes online, because I'm sure pregnant women will be, again,

one of the groups that are prioritised. Once we know that we've got a safe vaccine that's able to be used, we're not there yet. And the obvious thing, how do you get it? How do you get this free vaccine? The flu vaccine. So, yes, how do you go and get it? get this free flu vaccine so yes how do you go and get it so your midwife talk to your midwife because they will absolutely know the best way

to get that through your maternity service but you can also get that get a flu jab from your GP and also pharmacists have this available as well so there's lots of different ways that you can access this and I really would strongly encourage women today to go and book themselves an appointment and go and have the vaccination. There really isn't a downside to it. Okay, thanks so much, Dr. Jo Mountfield, consultant obstetrician and vice president of the Royal College of Obstetricians and Gynaecologists. I'm just proud I managed to say that without tripping up entirely. Thanks very much, Jo. Now, as I say, we would love to hear your opinion on anything you hear in the programme today. Get in touch with us over Twitter at Woman's Hour or you can just log on to the website and message us there.

Now, I don't know about you, but seven months into lockdown and I now realise I might as well have just glued a pair of big knickers, stretchy trousers and anything with an elasticated waist to my body back in March because I have literally worn nothing else. But our very own fashion Easter producer, Lisa, tells me it's all changed. I have to break the habit. It's autumn. This season's fashion and beauty trends are here. Joining me to tell us what they are, Edwina Ings-Chambers, beauty director at You Magazine. Kushal, who has two million subscribers to her makeup tutorials on YouTube.

So they must be pretty good. And The Telegraph's shopping editor, Chrissy Turner. Do you know, ladies, before I get on to the trends themselves, can we just talk about attitudes versus trends? Because I kid you not, I feel as though seven months of lockdown, I've had a chance to effectively renegotiate my own relationship with my makeup, with my hair, with my clothes. It's not that I don't care so much. It's more that I just have a different vibe.

I'm just much more laid back. Is that something that you're getting, Edwina, from your readers? Definitely, and I would agree with that. But I also really don't even believe in beauty trends anymore. Really? That's you out of the job. So what do you believe in? I believe in wearing what suits you and what makes you feel good and confident. And if that's nothing at all, that's brilliant. And if that's a bit of eyeliner, fantastic. If it's a full-on blue eyeshadow, go for it. But I think fashion trends I believe in,

although I think they move more in sort of larger step changes than a seasonal element. And I think that's really genuinely how most of us shop. And beauty, I just just think especially as you get older you know wear what works for your face. Kajal is this something you're hearing as well and if so what are you telling the people that subscribe to your YouTube channel? I've always been an avid um makeup wearer but I've always worn makeup for a special occasion and I feel like the lockdown has solidified that even more that actually I've always worn makeup for a special occasion and I feel like the lockdown has

solidified that even more that actually I do love being makeup free and I do love painting my face and you know getting my full glam on when there is a reason to um I mean if you saw me right now I'm in my sweats my hair's tied up and I have not a single like dot of makeup on my face and I love it but um if you saw me on the weekend when we had like dinner, you know, we had a little dinner party on the weekend and, you know, I had I had my face on. So, yeah, I feel like my audience love to see the realities of that. And whenever they see me on Instagram stories, 99 percent of the time I have no makeup on. And I suppose that's that's where it gives it that realness of, you know, it's okay to not wear makeup. But Edwina, is this a post-lockdown thing that's happening

amongst the women that you're speaking to? Or is it actually just our overall attitudes towards makeup have changed? Is it kind of a new wave attitude towards just being a bit more natural, I think? Yeah yeah I think our overall attitudes have changed I mean absolutely there are times people are going to go full out and wear makeup and there are there are women girls of all ages who loves it I mean Zandra Rhodes is still rocking an amazing makeup look I think did she just turn 70 or 80 I can't remember sorry um so it's really it's very personal but I think increasingly yeah it is about how you feel and what you want to do it's very personal right I do think lockdown

probably has shifted our moods a little bit in terms of just feeling a bit more relaxed and at home in ourselves probably there's not so much at home I mean if only because we are just going out less there are fewer places to go out to at night. We're not on show in the office so much. Right. I'm going to use a bit of, I know you hate the word beauty, Edwina, even though it's your job. Very confusingly. But let's, I'm going to use your beauty speak. Let's talk about the canvas, the skin. We had a great debate in the office. I came across a term called mask knee, which for anybody sitting at home, is shorthand for the spots that people say that they're getting from wearing masks. Is it a thing?

Koshal, is it a thing? I think it's a thing. I've definitely suffered from it. And it's weird because I don't really, I mean, I never really went out much anyways during lockdown, but I haven't been going out that much again. And I've noticed that my skin has cleared up. And I've got a lot of doctor friends and like dermatologists who have said, you know, they've seen a trend that, you know, their clients are also suffering from it. And also my audience, I was like, I asked on my Instagram stories a few weeks back, maybe a month ago saying, guys, my skin is freaking out just in this region. And the amount of comments I got back saying, me too, like, it's maskne, we're all going through it. Like we're all trying to figure out, change, switch things up in our skincare routine to try and avoid getting that. But I definitely have suffered from it myself.

And I found certain products, certain ingredients that I'm kind of introducing into my skincare to help. Edwina, I'm going to carry on with this entirely unscientific endeavour very quickly and ask you if you are someone that believes you're getting more spots because you're wearing masks, what can we do about it? And I've got to be honest with you, spending more time home I've been picking I've been picking at the spots scars everywhere what do I do you know there are new little brands have new little things now where

they come with sort of spot patches which come in some star shapes and hot shapes isn't that what they used to wear in the 17th century when they're the pops I mean I'm not convinced this is the direction we want to go in. We've all been watching harlots too much. I actually had more spots during lockdown. And I think that was probably a slight change in diet, probably drinking more alcohol than I ever normally would. And stress, probably.

Definitely mask me is a thing because the humidity builds up behind the mask so that will clog pores and that is going to more likely bring out spots the one thing to remember is not just skin care but keep your mask clean right yeah don't just cleanse your skin but make sure you're also cleaning your mask wear a fresh one each day if you if it takes a while to wash yours or have several if you can afford to um but definitely it's also about keeping that mask clean not just the skin but it is definitely a thing there's so much humidity building up behind that thing okay well Chrissy you've just joined us on the line I hear um mask me is that a thing for you oh definitely and I'm so glad that there's a term for it because I've had I mean, I've had makeup transfer onto a mask, which is gross.

And then if you just think I put that back on my face, I am getting lots of spots around my chin and I'm so glad that there's a name for it. And I'm not alone. Thanks, Edwina. You're not alone. OK, let's move on to the trends this year. The 80s are back, I hear, Chrissie. They are back and it's so divided I feel like you're excited about it which is nice well only because I remember the first time around although I have to say it was a look that I could I could wear when I was 25 I'm not sure 20 years old and quite how I'm going to carry that off can I how yes of course I'm a size up I've got spots what am I doing with my 80s look?

So country style is a massive trend. So think like Princess Diana, the Duchess of Cambridge off duty. So it's those plaid shirts and knitted vest, a quilted jacket, chunky boots, but crucially not all at the same time. So you don't want to look like you're on the wrong train and you're meant to be in the countryside. You want to look okay on the wrong train and you're meant to be in the countryside you want to look okay on the tube so you're wearing these one at a time okay so this country this country style it's tricky one to pull off isn't it because it's quite easy to sort of go into kind of quite frankly looking a bit from frumpy right um yes how do you how do you stop that that's why i think it's key to wear one at a time so So instead of, you know, wearing this full get up at the same time and looking like you're about to head to a farm, which is fine if you are. But if you're in the city and you're going to work, you should be wearing a midi dress with chunky boots. And that's the key to ironically modernising your outfit is this fun country 80s piece.

Edwina Kushel, are makeup trends reflecting that, bringing the country into the city? Well, for me, that would be probably wearing no makeup at all. But I mean, there's definitely a, you know, you would keep it simple with something like that, maybe a nice blush. What do you think? Well, I love what you said about how you don't really believe in trends, because like I feel kind of like very with you on this. I feel like there's always like the dark lips that come out, the like eyeliner and all that that come out this time of year. But it's always packaged up in a different term. And I don't know, I just wear whatever I feel comfortable with. I'm not the biggest fan of eyeliner, but I know there's a huge eyeliner trend this year. But because I know it doesn't suit me and I know I'm not going to really do a graphic eye.

I'm just not going to do it. I'm going to go for whatever I feel like works for me. Yeah. And I think often you can use a show as a reference, if you like, for a mood of makeup that appeals to you. But strictly copying the look. Well, you could copy the look if you like that look. But in terms of a bigger trend, I just don't think that really works for beauty. And, you know, these looks on catwalk models look great on them. And I love being backstage. I love the creativity of a makeup backstage.

I love the makeup artists I don't mean to in any way diminish what they do or the part they play in the entire look of a fashion show which often with the big brands will then translate to directly to their ad campaign so hair and makeup is a really really important part of a fashion show and getting across the fashion designer's message but in terms of real women in real life and following a beauty trend I don't generally think it's appropriate. Do you know I absolutely love you two, Krishal and Agwina, we've invited you on, I was told to talk about beauty trends and what it is we're supposed to be wearing, you're both like well whatever you like, whatever you fancy, I, this is absolutely my kind of makeup tutorial. What can I say? Chrissy, colours, colours, obviously country style, lots of browns and greens. They don't suit everyone. What, Sonia, don't suit me. What do you recommend this season? Colour blocking is also a huge thing. And I'm very much in Edwina's cup of not.

What is that? What is colour blocking? I keep reading about it. It's basically like it sounds quite scary but I promise it's not it's very much like you're wearing a camel trouser suit to the office and you're wearing it with a burgundy knit that's literally as easy as it is and it's just blocks of colour so no print involved and it just looks very clean and stylish I think. It is easier than you might think. Anything else we should know about quickly? Also, you know, all of this is happening in a kind of financial reality, isn't it? Which is lots of people not really making big purchases because, frankly, we're all worried about our jobs.

Edwina, Chrissie, if you feel you need a bit of an uplift, if you want to buy one thing, one bit of makeup, one item that's going to see you through to the season, make you feel a bit better without absolute splurging, what would it be? I would say maybe a coat and you don't need to spend a lot. You can head to the high street and there are tons of nice ones under 200 pounds um under 100 even and you wear it every day so I think that's a thing to maybe throw a bit more money at if you can um it's not like a shirt that you'll wear you know on rotation it's a coat that you'll wear every day and I think it's worth but that will just spruce up your outfit and cheer you up I think okay Edwina I'd say either a really lovely sort of velvet matte lipstick, which I think at this time of year always looks sort of sumptuous and great if you like wearing lipstick,

or a bronzer is my always fail-safe that just makes me feel like I look slightly more alive. All right, thanks very much, Edwina Ings-Chambers. Kushal and Chrissy Turner, thanks very much for your time. Still to come on today's Woman's Hour, what's it like to be locked down at the Tower of London? The most senior woman at the Tower of London, Commander Deborah Whittingham, is the person to tell us,

and she's going to be coming on a little bit later on. And the drama, a new series of incredible women starring Rebecca Front. You may also have missed our conversation about Essex Girls, the butt of many a joke over the years. Jane spoke to food writer Jack Munro and the novelist Sarah Perry, who's written in praise of the Essex Girl. I was so sick of the stereotypes and the jokes about Sharons and Tracys that I sort of ignored it for most of my life.

And then a couple of years ago, I gave a lecture on radical political women and realised that I could sort of feel that I had companionship and an identity if I embraced the Essex girl instead of trying to pretend that I wasn't one. Had you been in denial about being an Essex girl? Oh, totally. I had, I think, a snobbish and unsophisticated response to the joke. Most Essex girls, certainly ones who grew up in the 80s and 90s, will be familiar with having been looked up and down with total contempt when you say that you're from Essex.

And there'll be immediately unrepeatable jokes and they'll ask if you wear white stilettos and so on. And so, like many of of us I sort of stopped admitting to it I would sometimes say that I came from London and I did live in London for 11 years but I certainly wasn't from there and then I started to look into it and thought actually this stereotype of women who are too loud and irritating and don't dress correctly and don't speak correctly maybe those are all extraordinary things maybe if and don't dress correctly and don't speak correctly. Maybe those are all extraordinary things.

Maybe if you don't care about your reputation and you don't care about annoying people in power, maybe you're capable of doing extraordinary things. So I went on the hunt for Essex Girls to admire and found more than I could fit into one quite slender volume. And Jack Munro, what do you make of the Essex girl trope thing? I went to an all-girls school in Essex and we were kind of brought up to feel as though we should detach ourselves from the Essex girl stereotype

as far as possible. We were basically taught to drop our accents in drama classes, we were taught to speak nicely, stand nicely, pronounce our T's. And that's something I carried with me right into my early career when I hit sort of the limelight as a single mum writing recipes. So if I look back at my early interviews and I've got a real kind of plummy accent because I was still holding on to the kind of shame of being from Essex.

I've got to a point where I'm comfortable and confident in myself enough now to just be like, you know what, this is who I am, this is my accent, this is how I talk. People want to write me off as thick or unintelligent or whatever because how I talk belies the place of my birth and they're not people that I want to

talk to. I think I'm proud to be from Essex. That ended a bit more abruptly than I expected. That was Jane talking about Essex girls with Sarah Perry and Jack Munro based on Sarah Perry's new book, All About Them. Now, don't forget, if you missed the live programme, you can catch up by downloading the BBC Sounds app.

You have to search for Woman's Hour, apparently, and you'll find all of your episodes there. This next item is something I'm really interested in, and it's because when I first read this statistic, I literally did a double take. Three quarters of the women who have HIV in Britain have black, Asian or minority ethnic heritage, with the vast majority coming from the black British African community. But there are concerns that this whole group of women are being left behind when it comes to accessing the right healthcare at the right time. Joining us is Dr. Rageshree Dherawan, who's a consultant in HIV medicine at Barts Health NHS Trust,

and she works out of the London Hospital. We also have Meena Kakaya, who is a British South Asian woman who's been living with HIV for the past 16 years, and has just begun talking about in the last few months. And Bakita Kasada, who's also HIV positive. She's a poet and an activist who campaigns on HIV issues. Dr. Ogeshri, if I could just come to you first. Do we know why BAME women are so overrepresented in the statistics? Morning, Sangeetan. Thanks so much for this opportunity. So yes, as you said, in the UK, probably about a third of people living with hiv are women although they make up a global majority and of women living with hiv in the uk we know that about

three quarters are from ethnic minority groups and i think it's an interesting question i think there's probably quite a few reasons for that um and we know that for example we know that some of it may be cultural we know that in some, talking about sex and sexual health and sexuality can be quite taboo. And this means that people may be less likely to think about their sexual health than getting HIV tests. And I think we also need to think about the way in which we, as public health and sexual health communities, really have the right information in the right languages for these communities so that women can access information about HIV. Do we know what the data is telling us about how Black and Asian, I think minority women, are contracting HIV?

So we know that the vast majority are getting HIV through sex. So we know that in the UK, 97% of people get HIV through sex, and you just need to have sex once to get HIV. Now, your biggest concern, and I think that you've been talking about a lot in the media, on Twitter, which is actually how I first came across you, is your worry that health outcomes for this group of women are poorer than they are when compared to other HIV patients. Just tell us a bit about that. So I think in terms of HIV, I think we just have a lot more knowledge about men than women.

And we have really great treatment for HIV in this country. Treatment is really successful. But most of the research trials, in terms of who takes part in them, it tends to be men. And that's not just in HIV, that's in many other disease areas as well. So as our treatment is more successful and we have women getting older living with HIV, we don't have as much research information about how well they do in terms of drug side effects, for example. So that's really where there is a gap at the moment and where we need to do more work. And this issue about what data we have, what data we don't have. I'm going to come back to you

on that because it's a real biggie. But I'd like to introduce Meena. Now, you've been living with HIV for 16 years. You've got a South Asian background, same as me. But it's only in the last few months you felt comfortable talking openly about it. And as I understand it, this is your first national radio interview. What is it that's brought about this change? Was there a turning point for you? I think it's been incremental. And I think like anyone living with any kind of long long-term condition particularly around HIV I think it's a journey of of yourself first that you have to kind of go through your own emotional barriers about

you know the barriers and stigmas that you have within yourself and the fear of being judged and not being accepted or being um you know approved by other people and I felt that for me it's been a journey where um yeah I think it's been one of those journeys where it's been emotional roller coaster it's been an emotional journey and I'm at a stage where as a I am myself a well-being coach and a mindfulness and mental health trainer that's my background in health and social care and a training and a life coach so for me it's been a journey of self-discovery to really now talk about it and obviously my family members know I have to say my mum doesn't know but I know

she doesn't listen to the radio so it's okay to this one anyway um but I think also it's I want to be a voice for people women as well you know because I've also been a peer mentor and that's somebody like myself living with HIV supporting other men and women living with HIV who are struggling with the status do you think that yeah I mean you know Rakesh you touched on this issue of increased stigma inside certain communities I mean you and I are both from a South Asian background do you think that's true of people from our background? I mean, I have to say, in my experience, it is true. I think it's, for me, it's been mixed, actually, where I've, I think it's really very much on the individual communities within the South Asian communities as well, where some are just like, it's no big deal. And I've dated an Asian guy who is no big deal with him, you know.

And there are others who it is a big deal. And I think it's universal, actually, because I think no matter where you come from, whether you're black, white, Asian, any woman from any case, you are going to either get that external stigma from other people, you know, and sort of prejudiced or not. And I think very much on an individual basis, but I think the key is really your own internal stigma around shame and guilt that I also felt, you know, living with it initially and

the fear of being rejected, not having a partner or not, you know, not being able to get married or have children. And, you know, and that's not the case. People with HIV can live normal lives. Yeah. And Bakita, I just want to bring you in here because actually, if we look at HIV, it's actually been a modern medical miracle. I remember growing up in the 1980s

and we were given the impression that, you know, this was going to be an illness that would affect a vast number of us. Actually, science has really pushed the boundaries. Anti-retroviral drugs are incredibly powerful. They have helped a lot of women. Vicky, what is your medical regimen? And how do you experience being HIV positive? Yeah, thank you so much for having me. So at the moment, I take and always have done take one pill a day. And I find the taking medication has worked for me.

It doesn't always work for everyone, but it has been all right for me. And I think, as you've mentioned, the medical advancements have been incredible. has worked for me. It doesn't always work for everyone, but it has been all right for me. I think, as you've mentioned, the medical advancements have been incredible and research has been key to that. And I'm a researcher at Terence Higgins Trust, and I know that especially when it comes to black and brown women living with HIV, it's crucial that we understand and conduct the research that will work well for us. So on medication, we can and are living long lives. We can't pass on HIV via sex. We are giving birth to babies without HIV. But there are other things that are important to women, such as the quality of that long life.

And there isn't enough known about what aging looks like for women living with HIV. So at the moment, I'm generally good and I'm very healthy, but I have a lot of questions around what life is going to look like when I'm older and living with HIV for many, many more years, hopefully. And it is a complicated subject, isn't it? Because you're talking really about, buzzword of the moment, that intersection between being a black British woman of African heritage, growing older, a lack of data, kind of data vacuum around all of that stuff. Why do you think that there are so few

voices talking about this within Britain, given the fact actually that there are a disproportionate number of black women with HIV status? It really touches on what Ragesh you were saying earlier on. I think, you know, as you're saying as well, the disproportionate impact on us has been spoken about for a long time. The majority of women living with HIV are black women and I think some of those barriers are definitely discrimination so the impact of patriarchy, sexism, transphobia, racism cannot be understated and I think it's one of the difficulties as to why this isn't being spoken about as much and why some of our experiences as black women as brown women living

with HIV are not humanized as much as well and I think it's really what do you what do you sorry because what do you mean by that because actually we often hear these these terms thrown around you know it's systemic it's the patriarchy it's blah blah what does that actually look like and feel like that's that's probably what I don't really understand yeah what it looks and it feels like it's how we engage and how we access sexual health services whether or not they are created for us in mind so for example if a healthcare professional is likely to offer um a black woman or a brown woman an HIV test based on how communities, different communities understand the impact of HIV may determine whether

or not we are likely to accept an HIV test, whether or not we think we are more at risk of living with HIV. So it's some of these, and all of those things are underpinned by, yes, those big terminologies, but are important to say the discriminatory barriers to accessing appropriate healthcare. And it's one of the reasons why there are collectives, say, for example, like decolonising contraception. It's one of the reasons why they are so important, because they're addressing some of these additional barriers that black and brown people face when accessing wider health care and services and research. saying is more effort needs to be put into accessing communities and communicating with them in a way that welcomes them in to the conversation. Is that right? And in data terms, in a medical sense, what difference would that make to the outcomes of these women? Yeah, I think what Bakita said is absolutely right. I think having focused

culturally targeted campaigns is really important. And for example, a sexual health charity in London called NAS has been doing culturally specific campaigns for communities for a long time. I think it would make a huge difference. So stigma is really important in terms of HIV. Stigma can put people off getting tested because they may not think that HIV could affect them or they may be worried about being diagnosed positive and what it may mean for their life. As a clinician, we still see people on the wards who have quite advanced HIV and AIDS-related diseases.

And these are people who are having difficulty living with HIV, taking their medication every day, attending clinic because of the stigma they're experiencing. So they may be living with their HIV in secrecy. And this means it's really hard for them to carry on engaging in their care and attending clinics, as I've said. So stigma is really important. And I think, you know, programmes like this today in terms of talking about these issues are just so important in terms of normalising HIV. You know, everyone should get an HIV test and know their status. The most important predictor of good health is knowing your status and getting on treatment.

And people can live long, healthy lives with that. Rakesh, I don't want to leave this without talking a little bit about PrEP. Now, that's already been rolled out in Scotland, Wales and Northern Ireland. It's soon to come to England. And that, of course, is a preventative drug. But you do have a few concerns about the way in which it's being marketed and how black and Asian ethnic minority women access that and what a life-changing drug that can be.

Yeah, so PrEP is a tablet that you can take every day to prevent you getting HIV. So it's a fantastic innovation and is now available in the NHS throughout the UK. It's about to be rolled out in England. So it's a really important way that people can protect themselves from getting HIV and it doesn't rely on the partner. So it's something that people can do for themselves. And in terms of the uptake, there was a recent large national trial called the IMPACT trial looking at prep, delivering prep in the UK. And it found that only 4% of the participants were women or transgender people, which really shows that this very effective HIV prevention tool is not being used enough by women.

Regassi, Bakhita, Meena, I could talk to you for a good few minutes more, but I'm afraid we have to leave it there. Thank you very much indeed for talking to us. And good luck, Meena and Bakhita, on your onward journeys. If you hear anything in today's programme that you would like to talk to us about, please do get in touch. You're very much part of the Women's Hour conversation. You can tweet us at BBC Women's

Hour or you can log on to the website and you can leave us a message there. Now, lockdown in lock up. What's it like to have spent most of the last seven months in an historic palace come prison with 37 beef eaters? The woman who can tell us is the Tower of London's

first female deputy governor and now reality TV star, Commander Deborah Whittingham. I hope you, I bet your Twitter handle's going mad, isn't it, at the moment? You're on this Channel 5 series, aren't you? Life inside the Tower. That's correct, I am. I never thought of me being a reality TV star. You'll be on Gogglebox next, believe me. Strictly is coming your way.

Oh, no chance. What has life been like? I mean, I was thinking about this. Is the Tower of London the best place to be in lockdown? Because you just literally pull up the drawbridge and you stay safe. Or is it actually the worst place to be? Because what makes it, when I've visited, is the fact that it's just full of life. Full of life people everywhere. Yeah, and I suppose in the first week, two weeks possibly,

there was a novelty to it in the fact that, you know, we had the place to ourselves. And it is a beautiful environment to be in. And we were very, very lucky. We had the moat to walk in. And you did feel quite lucky. But it soon wore off. And it became a very depressing existence because the tower isn't meant to be like that. The tower is meant to be full of people.

It's meant to buzz. It's got a heart of its own and it needs to, you know, it needs to have people around it. The whole atmosphere completely changed and it was quite depressing. I mean, that's incredibly tough. You've opened up now though, right? Oh yes we're we're open we're we're desperate for people to come and see us we we're not getting the numbers in at the moment now the children have gone back to school but we're hoping they'll pick up again towards half term but it is a wonderful wonderful time to come to the tower for those who haven't been, especially in the London area and in the UK as a whole,

because you can come and see it without the queues. There are no international tourists, which is not good for us, but it's very pleasant to visit at the moment. There are no queues for the Jewel House or the White Tower, and it is lovely. So I encourage anybody listening, if they haven't been and they've been put off in the past by hordes of tourists, now's the time to visit. But Deborah, you faced a lot of challenges in your career. You had 31 years in the Navy. You then become Deputy Governor at the Tower of London. Actually, I read something very

interesting in an interview that you'd done in which you'd said that the culture clash didn't come from the fact that you were the Tower's first female deputy governor. It was actually this kind of culture clash between your naval background and the army background of the wardens. Is that right? Well, it wasn't just the army background of the wardens because the wardens are from all three services now. and there were naval personnel there before me and still are today but no when I arrived the current governor at the time said you know I'm not really that fussed about you being a woman it's just what are we going to dress you in because the deputy governor has always been an army senior officer.

And we're just not sure how we're going to play this. So there's lots of discussions with the Ministry of Defence and about the tower officer's uniform. And I said, well, I don't want to be different. I'm now a tower officer. I'm not a naval officer anymore. So I want to be the same as you guys. So that's what I dress as. And I have the full frock coat and the chicken hat as we call it which is the bicorn with swan feathers and it's a very proud and lovely uniform it's a little uncomfortable to wear but it's it's it's a privilege to wear it and as I think I said in when I was asked you know was there any way we could make it a little bit navy and they wouldn't so I actually wear the rank of lieutenant colonel rather than commander but I do carry a naval sword. So the spotters amongst those watching can see that.

Well, that's certainly one way of keeping people in check. Commander Deborah Whittingham, thank you so much. And good luck with the new series, Channel 5, right? Is it? Yes, we're really excited. It's our third series. First episode is on Wednesday, and it's quite a different, yes's quite a different one this time. That was Deborah Whittingham and we've had a brilliant response from you all to today's programme. Picking up on the flu jab and pregnant women, Martha writes, We need to acknowledge the current shortage of the vaccine and difficulty in getting it. I've just managed to find one pharmacy locally who could do my jab this morning. My baby's due in January. My GP and all other local pharmacies

are out of stock with a 200 strong waiting list due to a massive increase in demand this year. I'm not sure if this is just a local problem, But unfortunately, had I not spent the morning phoning around all the local pharmacies, I'd be waiting until late November at the earliest for my jab. Unfortunately, we don't know where you are, Martha. But yeah, it is very possible that this is a local thing. As for autumn makeup and beauty, would you believe? Huge response from you guys. Amanda, relieved to hear that mask pimples are a thing. They are a thing,

as we established today. Christina writes, I used to wear a mask all day, every day as a dentist and struggled with dermatitis in the creases from the corner of my nose to the corner of my mouth. This cleared up when I stopped work. I was so pleased to think I'd never wear a mask again. It's a pain. I think it's due to the damp from exhaled breath and changing your mask frequently as I had to for each patient made no difference at all, Claire says. In terms of maskne, can we remember the NHS staff who were wearing masks for the whole of their 12-hour shifts? I have a dear friend who works in the NHS and her skin is suffering badly because of the continual mask wearing. I have to say, Claire, that does definitely put our moaning into some

perspective. And finally, Becca, would be great to hear the fashion world encouraging less consumerism and encouraging wearing the clothes we already have. The fashion industry has a lot to answer for in regards to climate change. They could really make a difference with their influence. You know, it's actually to be fair, Becker, I think that might be happening very, very slowly. I was having a shifty through the weekend papers and it's interesting as you do that now, there's almost always a page looking at clothes that are a bit more sustainably made. Tomorrow, Amity Reid joins Jane to talk about her experiences of being a midwife in an overstretched and underfunded NHS.

Join Jane tomorrow. For now, bye-bye. I'm Sarah Trelevan, and for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies. I started like warning everybody. Every doula that I know. It was fake.

No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story. Settle in. Available now.