A summary of today (Thursday 17 September 2015)

Jeffery Klausner - new technologies and innovations to facilitate HIV prevention, testing and care

The future of health care is with mobile technology.

Primary prevention - exposure reduction

Directed us to look at a YouTube video (Willie and Twinkle) as being a good example of sexual health education for young people.

Healthvana - An app that acquires data from laboratory or clinician as evidence of health status. The app keeps the info for 3 months and men can use the information for sero sorting.

Gamesmanship is a way to engage people in health - gave example of a quit smoking game. Below are some other examples

 Play itsafe - on line game, with an avatar

Epic allies - game to improve medication adherence for young HIV pos black MSM.  Good for hard to reach populations, who don't have strong social support.

I got your back 

Secondary prevention

Testing

HIV and testing locators - to find and make appointments on line

Self testing - modest uptake in USA. Placed vending machine in car park of West Hollywood gay and lesbian centre. Is an option for people who don't want to engage with clinician. 

Vouchers - developed voucher system in partnership with pharmacy chain. 

Banner ad on Grindr - people don't take notice of banner ads so bought Blast ads which people have to click thru - and then can select which method they wish to receive self test.

Adherence

Weekly SMS messages improved viral load outcomes - the use of SMS messages emphasised the importance of caring for the patient

Oregon reminders - can set up own messages

Vancouver research - sent weekly SMS reminders to people with Viral load >200 - this intervention improved VL rates over time

At the AFAO Community Hub at lunchtime the panel of Max, Dean and Harry provided Victorian perspectives on their community conversations, strengthening PrEP in the next NSW HIV Strategy,  and Max on personal and professional perspectives of PrEP and the importance of men having a range of different prevention strategies. 

Issues discussed by the panel were accessibility, cost and standards of imported drugs.

Challenges - Max reported many conversations helping people find the words to start the conversation with their doctor- many have a fear of being judged by their doctor.

Key messages from today are the importance of community involvement in prevention programs, and the usefulness of new technologies to work with at risk groups of people.

Great session on the HIV Treatment Cascade and moving towards the elimination of 

HIV in New South Wales.

The HIV cascade: a review of methodology and data sources

Nick Medland from Melbourne sexual health reminded us of the components of the HIV treatment cascade and importance of measuring those components.

He said that the cascade should be able to allow comparisons over time, place and sub populations.  

He reported on the review of published and unpublished cascades in March 2015 - found 13 cascades. The differences in the methodology and data sources of the cascades limited comparison.

Dr Kerry Chant, Chief Health Officer, NSW Health

Dr Chant reported on working toward virtual elimination of HIV in new by 2010.

Test more, treat early and prevent are the targets.

She said that the principles underpinning their work are building on strong partnership and strong community involvement. She also acknowledged the work of community partners such as ACON.

She highlighted the importance of real time monitoring and quarterly reporting, in order to be responsive. She presented NSW HIV testing data - showing sustained year on year testing increases, and reported on new HIV diagnoses up to June 2015 - noting a drop in MSM notifications.

What NSW is doing

Promoting HIV testing and making it easier to have a test.

Looking at reducing missed screening opportunities - eg Emergency Departments and General Practitioners

Support ART update - a lot of community mobilisation.

Prevention - condoms and PrEP

Revision of NSW Sexual Health Strategy involves 

Improving access to PrEP

Improving contact tracing for contacts of HIV

Supporting HIV testing in general practice as GPs are important case finders

Early treatment uptake

Ensure people living with HIV are linked and retained in care

Dr Chant concluded by stating the importance of the States and Territories working with clinicians; Knowing each State's epidemiology; and importance of better data by more investment in data collection.