ASHM Report Back
Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
Engagement in Care of Indigenous People living with HIV
Presented by Darren Russell: Associate Professor, Cairns Sexual Health Service
Darren mentioned in his report that of the 450 PLHIV attending Cairns Sexual Health service, 13% were Aboriginal and/or TSI. This number though not out of control, presented an issue for concern. In 2014, there was an outbreak in FNQ aka “the Cairns Cluster”. This outbreak was more predominant in the younger male population (18-30) and because these individuals are young and highly mobile, the threat of infection spreading was notable. Other reasons elevating the risks are social disadvantage propagating poorer health outcomes, increased drug and alcohol use and low health literacy.
The HIV care continuum was used to guide treatment from detection to viral suppression. This care model enabled the team to observe how their Indigenous clients moved in and out of the treatment cascade influenced by personal life circumstances at a given time. This constant shift though multi-factorial, revolves around the social determinants of health such as income, housing, education and family situation.
With gaps identified, the team came up with means on how to keep clients engaged in their treatment. An invidualised response is essential; support the client with their needs; have the consultation where the clients want it done (even under the tree!); utilise Aboriginal health workers to build trust and provide culturally appropriate care. The team also identified areas for improvement like expanding the multidisciplinary team to involve more members; Increasing contact tracing and linkage and finding novel approaches to make the service more available and appealing to the Indigenous members of the community.