Day 5 - Friday 18/11/2016 - Dr Valerie Delpech - delivering & ensuring high quality and equity of care in HIV, Dr Gail Matthews - HEP C and closing Plenary.

Looking at inequity and qualitative care data measures in UK for People Living with HIV min 2015, in the UK.

HIV – 98% diagnosed retain in care.

5-6 thousand new diagnosis yearly. 3,000 are gay men. 3,000 heterosexuals (people that acquired HIV abroad or late diagnosis, mostly new arrivals/immigrants).  

Most linked to care in first year of diagnosis

An early diagnosis in a high resourced country, shows similar lengths of life expectancy as the general population.

Many people feel (or experience) stigma and discrimination around social gatherings and settings.

Dental and Healthcare/GP’s are 2 areas the people living with HIV avoided.

Dr Gail Matthews, Sydney. HEP C Updates –

200,000 to 300,000 people living with HEP C in Australia.

2-3 thousand people living in Australia co-infected with Hep C and HIV.

Since the new Hep C Treatment begun 12% of the Hep C population.                             40,000 (20% of this Hep C population) expected to be treated by the end of 2016. Predominately genotype 1. Genotype 3 (less).

Updates to Census Guidelines for Hep C – 2016.

Gastroenterologists (Specialist) treatment rates have fallen to 50% with other Dr’s/Prescribers accounting for an increasing amount in March to June, 2016.

Possible Risk of HBV reactivation on DAA therapy. The risk levels are unclear. Prescribers can discuss with Specialist about Serology or treatment concerns.

CLOSING PLENARY - looking towards 2020!

President Elect Donald Trump accession in US and Global politics was discussed, with unanimous concerns of the possible impacts on marginalised groups, such as people living with HIV.

PEPFAR – is a major global initiative, assisting those with HIV/AIDS. It was thought funding may be less sustainable and diminished under Trump Presidency.

PrEP – Pharmaceutical Benefit Scheme - (PBS) Australia, hopefully rolled out next year. Need to target Aboriginal people, CALD Communities.                                                         There is an over-representation of ABSTI with HIV.                                                                     STI rates are climbing.  Condom use needs to remain as valued!

Partner with Aboriginal lead services to effect better outcomes for ABSTI Communities. Need high level engagement to focus on ABSTI chronic health conditions, mental health, HIV, STI’s and long term future funding arrangements.

ABSTI community lead primary healthcare in partnerships/collaboration with agencies.

Need better national co-ordination. Invite all stake-holders to assist in managing – Treatment as Prevention (PrEP) collectively.

Equitable care

Develop greater sense and involvement with communities.

Challenge the ‘spitting law’ that is been brought up by 3 states. This is NOT Evidence based practice. A motion agreed by all was held at the end of the Conference today.

Focus now needs to be on other priority populations, such as Woman and heterosexual males to be seen as a priority populations.

Develop internationally agreed best policy – basic guidelines of care and treatment.

There is a lack of engagement with governments and communities. This needs to change NOW!

Speak up and challenge funding cuts. We need to INVEST MORE.

Non-Aboriginal people to ‘speak up and be a voice’ for ABSTI plight and their needs.  

Migrants Medication and medical needs to be covered.  

Collaborate with local communities. How do we reach out to others less engaged?

What resources do we have and how can we mobilize them better?

Look towards Aboriginal Medical Service (AMS) for leadership in Primary Care delivery.  

Globally, The United Nations (UN) is under threats by been constantly undermined by States with vested interests.  

Next step in HIV care and treatment is a vaccine. Injectable is expected 4 + years away.

See you all in Canberra, ACT in November 2017 J