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.

Young, Deadly and Syphilis free is an aspect if the Young Deadly and Free campaign focused on improving STI infection rates amongst young Aboriginal and Torres Strait Islander people living in remote Australian communities. The outcomes are to:

  • Increase age specific syphilis testing among young people in remote communities affected by the syphilis outbreak
  • Increase awareness  and understanding of syphilis, its transmission, testing and outcomes among young people
  • Improve awareness of the syphilis outbreak among clinicians and understandings of syphilis testing for remote clinicians

The components of the campaign include a media strategy involving television commercials, radio advertisements and other media; supporting posters and multi-media education materials; a social media campaign for peer to peer delivery of key messages about syphilis, and; a health service engagement strategy towards testing promotion. The media strategy also includes messaging local languages and Kriol.

Using analytics for Facebook, the platform where the majority of resource sharing is taking place, it is apparent that the videos developed for the campaign are having the most reach. This is followed by image-based resources. It is difficult to measure the extent of links being shared as Facebook's analytics do not prioritise accounting for these. Instagram is being used although currently the account only has 54 followers.

Unfortunately, getting info to really remote areas is still proving difficult.

Moving forward, the campaign is investigating the use of online ambassadors who would be paid to guide others in their social networks towards information.

To develop the literacy capabilities of clinical service providers, an electronic newsletter sent via email is sent fortnightly to over 350 health service staff. These act as reminders about campaign services, the outcomes of the campaign, key messages and stories from health services highlighting strategies for testing On average, about 38% of these are opened which is on par with other forms of electronic newsletter clinicians may receive. .

 

Young Deadly and Free is a culturally responsive campaign, targeted to combat the prevalence of STIs amonst Aboriginal and Torres Strait Islander youth. The campaign has been developed by the Aboriginal Health Team at the South Australian Medical Research Institute. The rationale for the campaign is based on increasing rates of STIs experienced by Aboriginal and Torres Strait Island people and strategies toward providing appropriate educational tools. Recent findings from the Kirby Report released 6 November 2017, indicates a 33% increase in diagnoses of HIV amongst Aboriginal and Torres Strait Island people between 2011 and 2016. In Aboriginal and Torres Strait Islander communities, young people and women feature prominently in STI infection data. 

Young Deadly and Free is an attempt to enhance the knowledge, awareness and skills surrounding sexual health literacy, with a focus on Aboriginal and Torres Strait Islanders aged between 16 and 29, living in remote and very remote Australia. The components of the campaign include:

  • Clinician resources
  • Animations, infographics and fact sheets for young people
  • People of influence resources
  • Peer education

In terms of Clinician resources, the campaign has developed a resource audit to help clinics ascertain the things that work and find gaps in service provision. As well, new knowledge-bases have been built to help clinicians feel more confident in their approaches to testing for opportunistic infections and skills in talking to young people about blood-borne viruses. Resources for young people have been developed for visual appeal and utilise forms of communication that young Aboriginal and Torres Strait Islander can relate to. Enlisting people of influence within communities enables strength-based ways of sharing knowledge within communities. Peer education strategies pay young Aboriginal and Torres Strait Islander youth to facilitate peer education programs, with between 4 and 8 sixteen to twenty-four year olds facilitating at different sites throughout Australia.

http://youngdeadlyfree.org.au/

Wonderful talk by Prof. Gracelyn Smallwood who brought in her wealth of experience and activism to elucidate the sexual health burdens faced by the indigineous populations resulting from inequities in health care due to unfavorable governmental policies that has long disadvantaged the ATSI

 

Everyone will agree that for equity in health care to be achieved in the country as a whole, governmental policies has to be aligned to carter for the disproportionate distribution of social determinant of health which includes; social/physical environments, education, access to health services, health literacy, housing and employment amongst the ATSI

The team from SAHMRI gave 3 presentations of which this was the last. The first 2 gave a good background to the service. Katy who gave this talk is from Broome so covers the Kimberley region.

This presentation was focused on the 'Young Deadly and Syphilis Free" campaign, recently launched.

The campaign aimed to deliver a multifaceted education and awareness campaign of syphilis in remote areas.

Components included media strategy (examples were played - including a great TV commercial and a radio advertisements linking themes of testing during pregnancy and general testing - which are also being developed in local languages), posters and education materials, social media strategy (e.g. Facebook page) and health service engagement strategy (e.g. there is a fortnightly electronic email for HCW. (available via This email address is being protected from spambots. You need JavaScript enabled to view it. )).

(Syphilis animation and other TV ads are available on youtube, website, links from Facebook page).

Stakeholders were young people and health services/youth agencies.

Considering social media - 

Of Facebook posts the video postings seem to be the most popular/greatest % reach of all postings. 'Likes' of the page were mainly 25-34yo group. 

Some data presented about some remote FB pages not being active, and that Facebook use potentially overstated in initial consultations.

Diva Chat messaging is popular in remote areas - provided free by Telstra. This platform offers advertisement appearing as banners across young people. Diva Chat is used for hooking up a lot there. High usage rates across stages.

Instagram - less engagement with this group of young people in remote areas. Only 54 followers. Bust most popular on this is condemn, and lubricious.

YDSF website went live on 1st July this year (part of the STI/BBV page). Some google analytics were presented for this page including channels of traffic as well as visitors.

 Aboriginal & Torres Strait Islander Health (ABSTI) – HIV & STI’s in the Australian ABSTI health context.

 Presented by A.Prof. James WARD and Prof. Gracelyn Smallwood and other eminent panellist discussed these contemporary health issues with Australia’s ABSTI people.

 HIV – double the rate of Non- Aboriginal people

                   With 60 % - Men that have sex with Men (MSM)

                             20% - Injecting drug users

                             20% - Heterosexual     

                                                                                                                                                               Please note that  -  20 % of HIV Diagnosis are Women and 12% live in remote and rural & communities.                                                                                                                                                                                                                                                       33% late diagnosis with 21 % having advanced HIV. In the general Population – 90% are diagnosed.

MEDICATION and adherence and co-morbidities are a huge burden.                               Mental Health/ depression – 12% report feeling depressed, with 9.6% of the general population report this.

The social determinates of health – ABSTI have poorer general health with unique challenges in addressing ABSTI HIV care and treatment. Medication burden.             Complex health.

 the effects of ongoing racism and discrimination.

 Feel “SHAME” and their spirits is low.

 Stigma from HIV.                                                                                                                                                                             Need to trust clinicians and respect for clients confidentially is utmost important.  

  

Needle Syringe Program (NSP) – 

ICE/Crystal has become a big issue.  

We can’t wait for an outbreak to occur, so we need to increase access to NSP services, such as in outreach programs.  

 Health and Community Partners/organisation to work with the community needs, in culturally appropriate ways, including not driving it (program & service health delivery) with experts  without consulting, involvement & input from respected key community stakeholders.

Partner’s organisations needs to ask local people to teach cultural norms. 

PANEL DISCUSSION –

90 % of the general population know HIV Status

80% of the ABSTI know their status (20% don’t!).

Reduced life expectancy (estimates 20 years compared to non-aboriginal Australia people).

need a grass roots approach, need to empower the local people by using their knowledge and expertise about their own local communities and support solutions at local levels.

Funding been cut by Governments with 75 % of Funding is going to non-grass roots, such as University Research & government bureaucracy.  

3% population in jail, 

                                                                                                                                          

food prices are increasing in local and remote communities 

Poor sanitation

No jobs, lack of career pathways

 

Cairns Doctors advised that the syphilis epidemic came first, then linked with HIV.  

Recently 1 female and 4 males (MSM) aged from 18-25 years HIV +                                  young mobile, homelessness (is a major barrier), couch surfing, staying with Aunties, not taking medication as forgets due to constant moving. Finances - Centrelink – cut off.

 Aboriginal Medical Service (AMS) – Aboriginal controlled services across Australia -      there can be an issue of taking blood in ABSTI Peoples.                                                          Non-Aboriginal Health care workers need to provide better cultural translations -           explanations as to why blood is needed (MEDICALLY) to be taken.

With young people there is a better acceptance of outreach programs that deliver rapid testing for Syphilis.  

Issues in screening STI’s in prisons

Aboriginal Community Health Workers – not getting paid and recognised properly.

Some Clinicians can be uncomfortable offering a HIV Test.

Clinicians needs to be flexible in care delivery. Work to ‘hold confidence’ with Clients.

How can Services be friendlier to ABSTI Peoples?

Building good working and trusting relationships is everything. Keeping rapport and people engaged.

Service providers need to become more effective!

Burden of disease/s, reluctant in accessing care, complex family dynamics, isolation.

Family worries, social issues, turning up for appointments and reminders.

Shame aspect – needs to be taken out of HIV. Of not having housing, which prevents people from becoming stable and stay on treatment.

 

 

 

 

 

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RT @GregDore2: Great news for New Zealanders with #hepC. Pangenotypic regimen unrestricted access from Feb 2019 with $0 co-payment. GP pres…

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