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.

Karinne Andrich

Karinne Andrich

I am the Refugee Health Nurse for Hunter New England LHD which covers the geographical size of the UK.  I am very humbled & privileged to be in this role and meet all refugees and asylum seekers on their arrival to Newcastle. My previous education in Paediatrics, Child & Adolescent Mental Health and International Health has given me the foundations I need to build upon. More recently I have commenced in Sexual Health as a casual nurse.

Enjoyable last day, great morning sessions discussing PrEP and The way forward. I managed to sit through all presentations as I felt that I may pick up on some information which I found interesting and I could take home. I have truely enjoyed this conference and feel I have learnt so much and can't wait to share to anyone who will listen.

I feel I could make a difference in Refugee Health as I would like to commence education on my return. Where and how could I commence this? Currently, I believe NSW refugee nurses aren't discussing Sexual Health to the extent it needs to be discussed. I am going to talk about HIV and STI's at my initial nurse assessment and would like to talk about this conference to other Refugee nurses. Humanitarian refugees have already had a HIV test prior to coming to Australia. Depending on the country of origin, depends on the clients sexual health knowledge and from experience, I have found that most refugees and the CALD populations have had no sex education prior to coming to Australia. 

I would invite other organisations such as FPA and the Sexual Health service to help with education. Another possibility would be to educate at my outreach clinic at TAFE Newcastle. I am unsure of the numbers of NESB clients living in the Newcastle area with HIV. Don't forget to use interpreters for NESB's and give houndouts in their first language.

My role will now include discussion around safe sex, sexual health, informing clients of services which can provide testing, online websites and Apps and to provide this information in their first language if they are literate. 

2017 celebrates 30 years of ART's and I look forward to immersing myself in new literature and research. Very exciting research and clinical trials looking at durable remission/cure which may also include the 're-building of the immune system'.

Thankyou to ASHM for this scholarship which has made me so excited and full of energy to go and educate Refugee nurses around Australia in all that is offered regarding sexual health. There are so many exciting trials happening around the world and I am optimistic that someone will find a cure. I also want to look into the App world more to see how we can use the tool for research. Since HIV has been classed as a chronic illness, I wonder how clinicians are keeping their clients on a happy, healthy pathway since the clients are living longer? This is a discussion that we should have later. It is difficult to motivate clients to continue medication regimes when they feel well and we see this in psychiatry and clients with diabetes. Just 'food for thought' . Cheers Karinne

Tiring but another interesting day at the conference. I am noticing two interesting themes which are coming from most presentations and that is - as the HIV population become older, more co-morbidities are occurring like cardiac, psychiatric, renal, bones, pain and all the issues that become apparent as we grow older. The presenters have pushed the message for these clients to be seen by the specialities that care for each complex issue and that all specialties communicate between each other. 

The second theme was the fact that the younger generation are becoming infected with HIV and how do we engage this cohort in taking care of their health? Tandeep Anand from Thailand gave an interesting talk and statistics are as follows, 1 in 3 in Thailand have HIV and the majority use their mobiles between 7 - 8 hours per day and a high proportion monitor their health needs via their phone. Jennifer Whetham from Brighton, UK had also stated that >90% of 16-24 year olds have mobile phones. Reminders and Adherence is currently what Apps are used for and we must continue looking at ways Apps can be better utilised for health information.  Francois Houyez from France spoke about privacy issues for medical Apps which was also interesting. He asked, do health Apps loose real contact?, Apps shouldn't replace face to face consults and probably could be used for the stable client and not to forget that our "data belongs to business". I am really enjoying soaking up all the evidence and research that is being done from around the world, this conference has been a real eye opener and one that I look forward to discussing with my peers on my return.  Cheers Karinne

Was greeted by a Scottish Piper this morning on my way into the SECC. Really enjoyed the morning sessions and particularly enjoyed the 'Transition to adult care' by Pablo Rojo, PaediatricIan from Spain. His clinic tends to hold onto young patients until they are possibly more mature and are more likely to make their own appointments and continue their own care. Depending on their maturity and knowledge of their health care needs depends on them transitioning across to adult care. With over 350 posters to view after lunch, I spent the afternoon perusing and soaking up what I thought was interesting. I did met a lovely young Dr/researcher  from Mumbai a few days ago and he was exhibiting his poster. He wanted to explain his fabulous work to me. Title of his poster "Association of SLCO1B1 521T>C (rs4149056) with darunavir/ritonavir (DRV/r) plasma concentrations in HIV-infected individuals enrolled in the NEAT001/ANRS143 Study". Once he had finished explaining his research, I thanked him for his patience in explaining his very in depth and scientific work to me. I still can' t get over the lecture yesterday given by Dr Andrew Hill from London, his work inspired the audience and I want to research more about his work on my return. I look forward to tomorrow's sessions in PrEP and the way forward. I suspect I will enjoy these sessions. Cheers Karinne

Amazing 1st day at this conference, enjoyed most of the sessions, very scientific and to be totally honest, some of it 'over my head'. What did I learn and want to bring back to my peers in Refugee/Sexual health?

1) the push to have more community HIV clinics, where clients can access without the stigma attached to hospital clinics.

2) some research is looking at 'inplanontype devices which leak the drug slowly over a 12 month period and could be removed if unable to tolerate.

3) some research also showed that clients would prefer to self administer injections rather than taking tablets for their illness. Clients were able to forget about their daily regime of tablet taking, were able to be more spontaneous, felt the injections were safe and the fear of needles was not a major concern.

4) Implantable PrEP (silicon tubing implant) which would have a minimum 1 year insertion and then dissolve!!

5) Lower cost of medications for the treatment of cancer, HIV & Viral Hepatitis by Andrew Hill was very interesting. He discussed the cost of drugs in reality if made in India which is far cheaper than other options. I think we should all be looking at his research/discussions and possibly buying our drugs from India which I believe is legal in Australia.

Lastly, as you know, there has been an increase in Australia in HIV cases and I wonder if we are doing enough to educate our population? Clearly not. The last speaker of the evening was Linda-Gail Becker who talked out the 'kids born after 2000' the 'i-generation' who are using technology for everything. Maybe we should be educating  this population via devices!!

If there is something you would love to know and couldn't be here, let me know and I will endeavour to find out for you. Cheers Karinne and thanks to ASHM for my scholarship.

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