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.

Usaiwevhu Munyengeterwa

Usaiwevhu Munyengeterwa

Usai is middle aged man who was born and bread in Zimbabwe. He migrated to Australia 12 years ago. He has Extensive experience in general nursing including medical, surgical, emergency, theatre, Hiv and Hepatitis nursing. He has attended several workshops and courses and has a Masters in Public health with the University of New Castle. He is currently practising as a nurse specialist with Justice Health. He coordinates HIV and Hepatitis clinics with the visiting specialists from POWH.

Barriers And Facilitators Relevant To An HIV-Testing Clinic Model Among Chinese And Thai MSM At Sydney Sexual Health Centre (SSHC)

Dr Mcnulty talked about a decrease in HIV diagnosis in Australian born MSM but with no change in non-Australian MSM. She stated the Sydney Sexual health center is increasing its testing options which are free, far from being judgemental with expert staff who are confidentiality conscious. The center introduced the express clinic to overcome waiting times. They complete a number of questions on the computer with a brief encounter with a nurse.It attracted a hard to reach people born overseas although she was quick to explore more testing options with emphasis on confidentiality, free and non-judgemental services.

 

Dr Eric Chow is Senior Research Fellow at Melbourne Sexual Health Centre

 

Risk factors for gonorrhoea in heterosexuals

 

Eric came in after Praveena a research fellow at Kirby Institute discussed the rise in gonorrhoea infections in women aged between 20-39yrs in the period 2007-2016. She did not have any tangible evidence as to why the increase. One of her to do list was to research as to why?

 Eric timely came in to give possible risk factors that might have prompted the rise of gonorrhoea infections in this group of women. Possible factors were sexual partners and condom use, bisexual men, dating sites/apps, alcohol and drug use, travel and other unexplored factors.

There was not enough evidence on 5 of these risk factors to prove that they were the reason for the rise in Gonorrhoea. More information is required and its still work in progress.

 

Travel and sex to or from a high place of prevalence was the only reason why there is a rise in Gonorrhoea infections. 

Dr Praveena Gunaratnam

Research Fellow at Kirby Institute, UNSW Sydney

 

 

Praveena spoke on Gonorrhoea infections in women across all major cities, WA being on top of the list. She mentioned an alarming increase of 118% based on 2007-2016 statistics of women aged between 20-39yrs. She mentioned that the increase was not based on the increase in testing but an increase in infections.

Rates in Aboriginal and Torres straight islander women are higher than non-aboriginal women in all major cities.

Gonorrhoea is the major cause of pelvic inflammatory diseases and infertility in women. There is also a concern for increasing antimicrobial resistance.

 

Investigations via research into the reasons why the increase is the next step. Contributory factors are:

-changes in sexual behaviours e.g. dating apps

-a particular strain of gonorrhoea

-lower socio-economic factors

 

-inadequate health care access or a combination of these factors.

 

Dr Anna McNulty is the Conjoint Associate Professor for the School of Public Health and Community Medicine, the University of NSW as well as the Director of Sydney Sexual Health Centre and NSW Sexual Health Info link.

DR A. McNulty spoke about the HIV Dried Spot test which is an internet-based self -sampling test. Participants actually test themselves. The beauty of this test is that it increases access to HIV testing and fits in well with NSW HIV 96Normal 0 false false false EN-GB X-NONE X-NONE elimination Strategy for 2016-2020.The strategy targets the Men having sex with Men and culturally and linguistically diverse background as high priority populations.They are difficult to come forward

The spot test is advertised on print, digital and print media, especially on dating websites. Participants then register on line and their kits are sent via the post. The instructions are simple and an additional lancet is added in case the first one is spoiled. The participants will send back the kit to the laboratory where the test is done. The results are provided by a nurse via the phone or SMS.

Those that are positive are linked to care.

The Self-collecting method attracted people who have never tested before or those who rarely tested to test in the comfort of their own homes. The young, gay and homosexually active men are in this bracket. it was noted that there was an increase in access to CALD participants especially women.

The disadvantage of this method is that sexual behaviours will be under-reported. 

 

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This afternoon we had an opportunity to listen to Ms. Barbara Telfer, an Epidemiologist for HIV support program Health protection in NSW.

 She spoke passionately about  NSW goals to Virtually eliminate HIV transmission by 2020. Increase in HIV testing, diagnosis and early treatment irrespective of the CD4 count are the tools used to drive this goal home.The aim is to start treatment at least six months of diagnosis, follow them up to ascertain initiation of ART, retention in care and monitoring of CD4 count and viral load.

The surveillance started in 2013 and is ongoing and information required from participants was the year of diagnosis, demographics, language spoken at home, risk exposure, past testing history, cd4 count, and HIV viral load at diagnosis.

Statistics between 2013-2015 showed a general increase in HIV early ART initiation which is a positive change in clinical practice. The results were not impressive enough that there is need to reduce time to ART and increase early ART to the newly diagnosed especially CALD and residence in metro Sydney. Participants with a high CD4 count and or low Viral load or those lost in follow up post-diagnosis were top of the priority list.

It will be good to achieve this goal by 2020, were HIV infection will be a thing of the past.

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Hello from the Australian 2017 Sexual Health Conference

 

The session started after the afternoon tea when everyone was tired and looking forward to going home. The two MCs Heather Mugwagwa and Praveena Gunaratham steered the group to life.

 The presenter Ms Victoria Sande is a current Masters of Public Health student at Curtin University. She shared the stage with her counterpart Corie Gray. They discussed Barriers to HIV testing in the sub-Saharan Africa and South-East Asia immigrants to Australia.  

 

They discussed the following in a nutshell:

 Immigrants were diagnosed at a very late stage

 

Access to ART is limited compared to Australians.

They discussed reasons forHIV late diagnosis as based on their original background in Africa and Asia.  The need to go to the hospital was required only when one is critically ill. There was no need to visit the hospital when one is fit and strong. Their background discriminated against people with HIV. It associated HIV with bad behaviour were sufferers are labelled as prostitutes and unfaithful. Since HIV was incurable and the disease itself was referred to as a death penalty and this brought a lot of emotional issues and anxiety. It was best for one not to know his/her status because knowing was more killing than not.

 

Australia did not make it easier for them.They read in the media about their immigrant’s counter parts’ HIV positivity status being publicised in both electronic, digital and print media. They became worried about their privacy, stigmatisation and racism that comes with it. These factors further distanced them from testing, diagnosis and getting treatment early. They prefered to remain ignorant than to know their HIV status. They were also afraid that the Australian Government criminalises HIV infection, quarantines them, and denies them Permanent residence. They are also limited HIV treatment access as compared to their Australian counterparts.  It became more unattractive for them to know their status thereby delaying their early testing and treatment.

Their issues require immediate attention via accurate dissemination of information via their  Peers and immigrant educators. There is a need for other groups to understand their background and adjust so as to help them.

 

Early testing and diagnosis are important so as to reduce and limit the spread of HIV infection. There is need to broaden HIV testing e.g. by use of rapid testing, self-collection kits, and oral testing.

 

RT @hepqld: Curing #hepatitis C is easy, and no longer needs a specialist to prescribe treatment. Community doctors play a pivotal role in…

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