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.

Opening Plenary and HPV et all

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Opening plenary was powerful  and a good example of the need for constant reflective practice:

with Khadija Gbla's ;

Discovering Sexual Health from a CALD perspective, addressing Sexual Health as a Human right, the need to reach out to all, LGTB et all, the need to be all inclusive

SexualHealth as a Western construct and the need to unpack that

Information is power!

The need to for currency of practice

Basil Donovan as ASHA Distinguished Service Awardee

Reflected on the past differing approaches by Family Planning,Sexual Health and organisations and how finally Service providers with ASHA are uniting  resources

Basil reflected on the need for the community to be more involved centrally

 the new shared  STI guidelines

the past work to decriminalise CSW

Looking back to the AIDs fear from 1983 

His early  Lancet articles and their timeliness

Indigenous Health review

Increasing POCT

ACCESS SURVEILLANCE :50 CLINICS Monitoring National trends and problem solving

The introduction and massive impact of the HPV vaccine: which carried through the days HPV presentations

The syhilis outbreak in Remote Australia

and the work needed ie chlamydia and less than 1/4 diagnosed

His message was TIMING is better than data

Again that strong message of ensuring reflective practice, and currency of practice

 

The plenary then aunched into all about HPV; oral to anal

Amber D' Souza; Rethinking HPV and Related Disease prevention

The changing epidemiology of HPV

Despite the HPV vaccination still greater than 5% of global cancers

Mindful that Australias HPV vaccination roll out and screening programme remarkable with 71% vaccinated zand acheived a herd immunity

UK 60.4%

USA 33.4%

Now evaluate to be able to continue in light of cost effectiveness 

Reseatch shows Number of vaccinations required for same HPV Ab response ;probably  2

What resource poor countries could use as rollout

The look at female and male vaccination in light of Public Health and cost effectiveness

Oral HPV 6x more common in males

Oral sex with females Increasing risk factor

.? HPV VL higher in cervical fluid than on penile shaft

Or reduced immunity

Males less likely to clear infections

But that sexual behaviour does not explain differnce re sex and HPV incidence

 

Marion Saville The National Cervical Screning Program; On the Cusp of Change,giving a VERY comprehensive overview on the new guidelines post the introduction of Gardasil in 2007

Giving caution of a global overview regarding discrepancy in surveillance between countries

Aust surveilance good

National Register for vaccination

High school coverage

GPs under notified older women

Still work to do in Indigenous and CALD communities as a continuing theme

Lowest 10% socio economic not getting to school

Safety of vaccine

Evidence of high levels Antibody response probably sufficient for life

Now vaccination offered to prevent secondary recurrence HPV

Looking at the 2 dose schedule

USA 9 valent vaccine approved

Hard to measure success, more adjuvent more pain

Probably will be the same in future for Aust re cost effective

Outstanding success cervical screening program

BUT Took 40 years from pap to be recognised as imporant scrreening tool

Frazer and HPV vaccination

But now need to address EQUITY

Modelling suggests 30% reduction cervical cancer on top of vaccination

Outlined new guidelines with new technologies

Self collection

Caveat no change to incidence adenocarcinoma only squamous cell Ca

Discussed quality improvement and COMPASS Trial

Carried through to afternoon session Clinical Sexual Health and Epidemiology:Anal HPV

And non clearance of Anal HPV in males esp HPV16 increased with age

No difference if HIV

2 HPV tests at least 6 months a part may identify male with persisting chronic HPV and the increased risk of Anal cancer

screening moving to HRHPV testing 

Ongoing research toward cost effectiveness and best practice and equity...

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