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.
Hello my name is Jeffrey. I am a Clinical Nurse on the infectious Diseases Unit at the Royal Adelaide Hospital. My main ambition as a nurse has been and is to reduce the stigma associated with HIV. I hope to achieve this by educating other colleagues and the general public.
Most of my lunch periods have been taken up listening to the various speakers and organisations that have appeared here during the conference.It has been both thought provoking and engaging.
I hope this continues at every conference .
I shall look forward to it.!!!!!!
I attended an excellent talks this morning by Steven Philpot on the fine line in changing agreements between gay men when it was about monogamy.Steven utilised the Monopoly results that gay men will negotiate changes in relationships,there was also a lot of internal conflict about this subject with a lot of couples,most men usually change their relationship from monogamous to an open relationship.
At the conclusion of the talk Steven reiterated that communication was vital in all relationships.
Benjamin Bavinton also provided an excellent talk during the session on the Definition of Partners.
Partners are either described as either regular or casual,but I would like to know when a f!ckbuddy becomes a relationship.
Approximately 60% of gay men have a regular partner,half of these were monogamous while the other half have a regular partner and casual partners.Most gay men in the Monopoly study were found to be in an open relationship. Condoms were much less likely to be used in an relationship,than they were with f!ck buddies.The majority of me met there partners online.Transmisions were more likely to come from f!ck buddies.
Garret Prestage provided a good talk on age and relationships and it was heartening to hear that us oldies are much less risk takers than our younger counterparts.Garrett once again reiterated that most regular partners didn't use condoms.That being said it means the risk of transmission is greater if we trust each other in a relationship.
Martin Holts talk was perhaps the most engaging as he spoke about the use of Viral Load undetectable as a means for condom less sex,he also identified serous orating as another means for condomless sex. Martin identified that at least 75% of men are practising at least one strategy to avoid HIV.Serosorting is now common as a means for condo less sex.
1 in 5 gay men now have condo less sex
41% of these are HIV positive
21% are HIV negative
19 % are untested.
The most common strategies employed by groups for condo less sex are if positive utilising an undetctable status and Serosorting ,if negative utilising Serosorting and condoms
Benjamin reiterated at the end of the lecture that with guys who have an undetectable viral load the risk of transmission is low.
A very thought provoking session
Jeffery Klausner provided an excellent talk on new methods in the US and around the world.
Jeff spoke about the need to utilise modern media eg YouTube to better engage with people; it seems the days of brochures and information sheets are soon to go.
The internet now can provide condom delivery within an hour in most big capital cities.
There is the ability now to have your HIV Status verified by medical companies on gay websites to prove that you are telling the truth. You can also allow blood results to be verified so that you can prove you have an undetectable viral load.
The younger generation all seem to like gaming and there are now Apps which emphasise Playing it Safe and promoting condom usage and increasing adherence to taking your medications.
I know in Adelaide we have very little like these education initiatives and you usually get handed a brochure.
In regards to testing Jeffery discussed the importance of status awareness and that San Francisco had the highest on the world for this.
It seems in Australia we have been very slow to even introduce rapid testing, but thankfully now this is happening.
We should also be considering the HIV self test, thus creating more options for people
In San Francisco they placed self tests in Sex Clubs, Saunas and provide vouchers to get free self test kits at pharmacies.They also provided the means to order a free self test kits online thus creating even more status awareness.The utilisation of these test kits was good and seemed to encompass the people who would not or could not get to a testing centre.
A hugely interesting talk outlining the need for us to utilise new methods in educating and engaging with people
New technologies include:
A hugely interesting talk!!!
There seems to be a high risk of Cardiovascular Disease in HIV positive clients,even without cardiovascular risk factors.
Abacavir causes a platelet reactivity in HIV infected clients,this increases risk of thrombus,thus increasing risk of Myocardial Infarction.
Dyslipidaemia is now actually lower now than previously.Cholesterol levels now in clients with HIV now lower and better monitored than HIV negative clients.
I have always had doubts about PrEP and social responsibility, but after listening to some of these very informative talks,it has occurred to me that people have the right to access this treatment.I listened with interest that it has yet to be approved by the PBAC for this reason but it raises the question that if it was a socially acceptable disease would PrEP be approved by the PBAC straight away.
It seems the eligibility to qualify for PrEP is high risk behaviours, but if I am HIV positive should my negative partner not be able to qualify for PrEP? Could not making PrEP widely available be a means to ending the stigma associated with HIV.
These talks have raised many issues with me:
1) Do people now stop using condoms (I know some people who have utilised PrEP for this !!!)
2) If a high risk client is not adhering to safe sex, then will their adherence to PrEP be any better?
These talks has left me in two minds: that we seem to be encouraging a society of little or no responsibility.
But on the other hand people have the right to have sex without a condom.
a good start to the day with great welcome by Aunty Carol Currie, there was an interesting talk by the QLD minister for health on future directions for health care in the sexual health sector.
Robert Mitchell provided an excellent insight into future directions for HIV care and the big need for people with HIV to be included on any decision making authorities
Bridget Haire highlighted the poor uptake of the use of PreP by government Authorities
Professor Cohen provided a talk on the prevention of utilising antiretrovirals to prevent HIV,his trials have shown that with antiretrovirals and counselling ,96% of trial couples did not become HIV positive.
Transmissions have plummeted with the use of antiretrovirals as a preventative measure
Hurrah finally some form of preventative measure,but you do have to think about the side effects of the antiretrovirals and the accessibility of these melds to the people that most need them.
Hello Everyone
Cant wait to get to Brisbane on Tuesday and join at the ASHM Conference Wednesday
See You Then
Jeffrey