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.

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 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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Day 2: A Changing Sexual Landscape of Gay Asian Men in Sydney: Implications for HIV/STI Prevention

 Day 2: Rapid Fire Session Sexuality and Reproductive Health:

Tim Chen – Asian Gay Men’s Project Officer ACON NSW ‘A Changing Sexual Landscape of Gay Asian Men in Sydney: Implications for HIV/STI Prevention’.

Tim discussed the results from a survey conducted between September 2015 and June 2016 for Asian gay and bisexual men.  The survey was printed in English and Thai languages and conducted at sexual health services (including a[test]), sex-on-premises venues, forums, workshops and through partnership networks.  Some similar research had been conducted in 1999 and 2002 and it was decided there was a need to repeat this survey due to the rising incidence of HIV and STIs among Asian MSM. 

The survey this time round was more ethnically diverse than previous years .  Although the overall number of Chinese respondents did increase compared to previous years, the proportion of Chinese respondents decreased and a greater proportion of Thai, Indian and Filipino guys completed the survey.  

HIV and STI testing rates had increased but less guys were testing at GPs with increased rates of testing observed at community-based testing sites (eg a[test]) and hospitals.

In regards to condoms use, guys reported less anal sex with their regular partners but similar levels of condoms use with these regular partners.  More anal sex with casual partners was reported than in previous years with more condomless anal sex.

In conclusion, sexual practices and health-seeking behaviours have changed among Asian MSM in recent years with an increasing rate of condomless anal sex with casual partners (it is worth noting that this study took place before the commencement of the EPIC PrEP trial in NSW).

Community-based testing sites were also shown to be of great importance in ensuring high rates of HIV/STI testing in this population.

 

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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