​Clinical Associate Professor Louise Owen

Louise Owen is a Sexual Health Physician who has been working in the area of sexual health for many years. She is currently the Director of the Statewide Sexual Health Service in Tasmania, based in Hobart. Her interest in sexual health and HIV began during her general practice roles at The Prahran Market Clinic and the Middle Park Clinic with Dr Peter Meese.

Louise is raising the profile of Sexual Health in Tasmania managing the service and encouraging GPs to be involved in HIV shared care. Louise lectures to Tertiary, Post Graduate and undergraduates around HIV, sexual health and related topics. She writes regularly for the gay press and sits on a number of steering committees covering matters such as nPEP, Syphilis and HIV.

Dr Louise Owen

Dr Louise Owen

Dr Louise Owen is a Sexual Health Physician and Director of the Tasmanian Sexual Health Service.  Louise has been working in the area of sexual health since 1996, and is passionate about education and aims to increase awareness around sexual health by providing education to GPs, Registrars and Medical Students on HIV prevention and management, STI testing, and transgender medicine.

The session . On. HIV and cancer  was a rapid overview anD quite  focussed on the French experience -

HIV and cancer - DR Jen Philippe Spano -france 

RIsk factors- Age, HIV, oncogenic infections (HPV, EBV, HCV, HBV, HHV8), smoking, inflammation, sun (melanoma), low CD4
 
cART relative risk -non AIDS cancer with inc risk - inc Hodgkins 19 RR, anus and liver and lung - often occurs at YOUNGER Age  than HIV neg counterparts (Not inc risk of breast ca, prostate or colon ca) 
 
SMOKING is the trigger for the oncogenic viral infections to have their effects; 
-HIV contributes to inc risk of non aids cancer when adjust for smoking and oncogenic viral infections cf the general population;
 
LUNG cancer-in HIV pos pt in France, this is the highest ca diagnosed; 
Screening in the Gen pop- - CT scan- false positive nodules, may lead to false pos, used for diagnosis;
One study showed (not specifically HIV pts) annual low dose CT scan was better than CXR and resulted in reduced mortality 
 
-in France did a study in HIV pos smokers , low dose CT annually, 400 pts, 10 pts were diagnosed with lung Ca, mean CD4 high, problem  is the high  rate of other pulmonary comorbidities and false pos rate and biopsy, anxiety etc to investigate these further 
 
SKIN malignancies- eg BCC, SCC - should have regular annual examination;
RFx -Sun , FH, aging 
 
IN France, all patients in Gen population diagnosed with these cancers recommended to have HIV test . 

PrEP case jean michel Molina

I  have  been  enjoying the  conference very much. a short session  on
PrEP- with 2 cases-
CASE 1 Discordant  couple HIV pos male, neg female wanting to be pregnant- him not yet on ART-
-enc partner to start ARV (This is more effective than PrEP) and cont using condoms, consider PrEP for her-PrEP-TDF alone risk reduction in women 71% in discordant couples when pos partner NOT on ARVs; if drug found in plasma, then inc efficacy to 80%; TasP more effective wth 96% reduction in linked transmissions.
 
HIV incidence was  0.2 per 100 yrs per person yrs when TasP and PrEP  used together 
Consider using condoms too;
 
-If they want a baby - and partner started on ARV but not yet fully suppressed- 
 could start PrEP-let them know that not yet fully studied in pregnancy, in real life, they present already pregnant' -does she need it? If partners VL is down to 60 copies/ml- depends on the risk they are prepared to take.
May take a bit longer til his VL undetectable and use PrEP
 
If parter has UDVL for 6 months, may not need PrEP to prevent infection, but if pt needs reassurance then can use PrEP 
 
HPTN 052 now has 5 yr follow up -93% reduction in incidence of linked transmissions. 
8 linked cases of linked infections- most early on day 35-84 after starting ART, no linked infection when HIV stably suppressed to <400copies/ml 

Please join us for a memorial event celebrating the life of one of Australia’s leading HIV advocates, Levinia Crook… https://t.co/N7dof5xaGa

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