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.

Kym Collins

Kym Collins

Kym works at Gosford, Albury and Wagga Wagga as a Sexual Health Physician.  She is interested in HIV and Sexual Health care in the regional setting.  She is looking forward to attending her first international conference as a blogger.

These are some stand out points from the  presentations at APACC covering issues related to HIV +ve youth.

#1 cause of death in 18-25 age group in Sub Saharan Africa is HIV/AIDS

#2 cause of death in 18-25 age group globally is HIV/AIDS.

In Asia, 37% of new infections are in adolescents.  HIV +ve adolescents include those infected by MTCT and those infected through sex and IDU. 

Rates of mental health diagnoses and neurocognitive issues are high in HIV +ve adolescents.  Dr Warren Ng, a psychiatrist from Columbia University, USA has worked with HIV +ve young people for many years.  He explained that the grey matter in the brain peaks during early adolescence.  This is also a time of increases in gonodal and stress hormones. Mental capacity continues to develop during the 20s.  Those most at risk of psychological morbidity include ethnic minorities, those living in poverty, or experiencing psycho-social trauma, substance abuse and inter-generational trauma. 

Age appropriate disclosure of HIV status requires teamwork and planning.  Transition to adult services needs to be staged and should only be commenced after the young person knows their status.  Dr Rangsima Lolekha, shared the data on a cohort of MTCT HIV +ve youth in Thailand. Transition to adult care usually occurs around age 21.  The risk of death at this time for these young HIV +ve people is five times that of age matched HIV -ve young people.  This vulnerable time is characterised by issues relating to transport, economics, health insurance and less rigorous systems to track continuing care.

Tagged in: APACC 2017

It is Saturday evening and the conference is over.  I have been sitting and reflecting on the experience of the last few days.  Our global political climate is becoming more conservative and less inclusive.  With summary executions of people who inject drugs in the Philippines, the leader of the opposition in Malaysia still in jail on "sodomy charges" and public whippings of male homosexuals in Banda Aceh, this shift is clearly gathering momentum in South East Asia.  

There is so much at stake.  The HIV and BBV sector in Health has spent decades studying and sharing the science around harm minimisation and access to healthcare for all.  We continue to champion the removal of stigma associated with HIV, sex work, same sex attraction, injecting drug use and transgender health. There are countless studies that show this approach is cost effective. Prohibition and punishment drive these behaviours underground, as people become too fearful of their safety, to access services.

Dr Adeeba Kamarulzaman, Dean of the Faculty of Medicine at University Malaya Medical Centre, was heading home after the APACC conference, to discuss these issues with a peak group of muftis in Malaysia.  She has been examining the Quran and has found many passages of the text that support the compassionate treatment of all people and the use of harm minimisation principles.  The tension between religion, health and politics has the potential to derail many of the public health gains we have made to date. 

We need to keep reminding our politicians and administrators of the Public Health principles that we know work. It is vital that we use our collective voice to call out stigma and discrimination when we witness it in our workplaces, communities and in the attitudes of our colleagues.  

 

Tagged in: APACC 2017

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