HIV quality of life with stigma and treatment adherence has been well established

Quite often we see poor mental health, isolation and co-morbidities associated with stigma and discrimination.

(WHO) declared 90% diagnosed, 90% on treatment and 90% with viral suppression by 2020. We should look at adding another 90% Good health and quality of health.

Overall health testing should be offered at regular intervals in HIV care with the individual referred onto other services as needed, to improve the quality of health

A PoZ QoL survey was developed with 4 domains that included 13 questions about health*

*Psychological, Social, Functional and Health Concerns. with the survey results/outcomes being higher than expected. 

Looking at PrEP and HIV/ART treatments as prevention in the 6 months prior to the 2016-17 Gay and Periodic Survey, showed an increase of casual sex being reported by those using medical prevention.

There was a decline in the use and frequency of condom use 39% (2016) - 32% (2017) and a reported increase in casual anal intercourse (CAIC) 22% (2016) - 27% (2017) as more MSM joined in the uptake of PrEP.

Socioeconomic demographics showed PrEP users were more likely to be Uni educated, in full- time employment and engaged with Gay men networks

PrEP users reported to be more sexually active than when they were not taking it and more likely to engage in condomless sex due to reduced anxiety of HIV risk.

The Periodic Survey in Melbourne ans Sydney reported PrEP users had 11% more partners and 11% less condom use.

* PrEP users becoming more sexually active reflects the successful targeting of PrEP

Presenters:  Dr Llloyd Einsiedel, Shane Schinke, Professor Damian Purcell, Dr Genoveffa Franchini, Professor Graham Taylor, Dr Fabiola Martin

A truly amazing and well rounded session on a disease which has been around since the 1980’s.  Although it’s endemic to many parts of the world, including a high prevalence area in Central Australia, causing high burdens of morbidity with progressive and irreversible neurologic, pulmonary, inflammatory and immune diseases, there are no targeted therapies and it is not widely known in Australian health sectors.

All the speakers had considerable knowledge in identification, treatment and research of HTLV-1.  We were truly fortunate to hear from Shane Schinke, a long serving remote area nurse, who shared his own story of HTLV-1 associated HAMS/TSP which currently has him wheelchair bound. 

Key Points:

·      Endemic in central Australia (HTLV-1c subtype), and many tropical regions of the world

·      Causes adult T-cell lymphoma, pulmonary, neurological changes

·      If suspecting: Diagnose with a Western blot and request HTLV-1 pro viral load

·      More awareness and research is vital

Key points from the HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2017

• Gonorrhoea and syphilis are increasing while HIV is stable for the fifth year in a row.
• the biggest increases in gonorrhoea rates are in young, urban heterosexuals
• The HIV notification rate is rising in Aboriginal and Torres Strait Islander people while decreasing in the non-indigenous Australian born population. 
• Asian born MSM were disproportionately diagnosed with HIV in 2016
• Over 30 000 people were cured of hepatitis C last year
• 63% of people living with chronic hepatitis B in Australia were diagnosed in 2016. Only 17% were receiving care and 7% were receiving treatment.
• Rates of STIs in the Aboriginal and Torres Strait Islander population compared to non-indigenous populations: gonorrhoea (7 times as high), infectious syphilis (5 times as high) and chlamydia (3 times as high)
• The number of newly diagnosed hepatitis B cases has halved in Aboriginal and Torres Strait Islander people over the past five years but has remained stable in non-indigenous populations

Self-Perceived Problematic Relationship with Drugs and the Use of Alcohol and Other Drug (AOD) Services among Gay and Bisexual Men

Professor Adam Bourne

Statistics show drug use, including cannabis, cocaine, ecstasy and methamphetamine for example, is up to three times higher among the Gay and Bisexual male population, nationally and globally.

Drug related harms occur from risky drug use, increasing the risk of disease transmission. For example, methamphetamine use and erectile dysfunction has been reported to increase the odds of HIV infection among this population.

Other drug related harms among Gay and Bisexual males have been observed from the use of GHB and crystal meth. Of concern is the increased mortality rates attributed to GHB overdoses in London, with one death reported every 12 days between 2014 and 2015 in addition to poor ART adherence secondary to crystal meth use.

The Flux study aimed to understand how drug use is situated among gay and bisexual men. How comfortable are they engaging with alcohol and other drug (AOD) services? What are the barriers? One point of note was that there was a fear of judgement and the perceived lack of understanding from AOD services in terms of the synthetic types of drugs being used and the different ways Gay and Bisexual men use the drugs compared to other populations.

A comment from the audience triggered the response that a move forward may be to try to meet the needs of people who are sexually active and who chose to use crystal meth, exploring ways of how to use it safely.

The overall aim is to reduce disease transmission and improve engagement with AOD services for all, but in particular for those who believe their drug use is problematic.