In August 2012, Royal Darwin Hospital (RDH) issued a new guideline recommending HIV testing be considered as part of routine assessment of all adults admitted under the Division of Medicine (DoM). We performed a retrospective audit of testing uptake following six months implementation.
Methods: Data will be retrospectively extracted from hospital electronic and laboratory databases to determine number of HIV tests performed and number of patients admitted under the DoM over six months prior to and post implementation of the guidelines. Additionally we will examine demographic and medical data of those whom tested positive including age, gender, country of origin, CD4 count and presenting diagnosis.
Results: Since implementing the new HIV testing guideline approximately 1,500 people have been tested and 5 (0.3%) tested positive to HIV. Detailed results including analysis of changes in testing rate before and after implementation and characteristics of those testing positive will be presented.
Conclusion: RDH has successfully implemented an HIV testing policy tailored to the local epidemiology of HIV. It appears the overall positivity rate is 0.3% which is within the range at which testing is recommended in some global guidelines. Further data will enable comment on uptake rate and feature of those testing positive, including the number who meet standard Australian testing criteria.
The majority of HIV diagnoses including delayed diagnoses in Australia occur among men who report homosexual contact – hereafter called gay and bisexual men (GBM). Delayed diagnosis is strongly associated with increased HIV-related mortality and morbidity. People who are unaware of their HIV-positive status may also be unwittingly transmitting HIV. We assessed trends in delayed HIV diagnoses among GBM in Australia.
HIV-associated leishmaniasis, endemic in the Mediterranean basin is a growing problem in India, Brazil and East Africa. Despite surviving for than 20 years, the clinical course of our visceral-leishmania (VL)-HIV co-infected patient illustrates several management challenges including diagnosis, speciation and drug resistance; monitoring burden of disease; access to and use of VL-treatments; end-organ toxicity and the combined immunosuppressive effects of HIV-VL.
Adherence to combination antiretroviral therapy (cART ) plays an important role on treatment outcomes. The TREAT Asia Studies to Evaluate Resistance – Monitoring Cohort Study (TASER-M) collects patients’ adherence based on a Visual Analogue Scale. The aim of this analysis was to assess the rates of, and factors associated with, suboptimal adherence in the first 24 months of initial cART in Asian patients.
REACH was a collaborative research and practice initiative to develop evidence building frameworks, capacity, tools and resources with the Victorian HIV community partnership.
HIV disease is associated with chronic inflammation and activation of the innate immune system. This state, as measured using plasma markers of inflammation, persists following suppression of HIV viremia using antiretroviral therapy, and may increase risk of non-AIDS co-morbidities. The causes of innate immune activation in the setting of virological suppression are unclear. Natural killer (NK) cells are innate immune cells that kill virus-infected and transformed cells without prior sensitization. We have shown that NK cells are activated both phenotypically (elevated expression of HLA-DR) and functionally (increased spontaneous degranulation measured by CD107a surface expression) in virologically suppressed (VS) HIV+ individuals. NK cells also lose expression of CD16, the receptor which mediates antibody-dependent cellular cytotoxicity.
Regular HIV testing is recommended in men who take sexual risks. We assessed the relationship between perceived barriers to HIV testing, and frequency of testing among men who engaged in unprotected anal intercourse with casual partners (UAIC), to inform HIV testing strategies.
Gay men remain the primary population affected by HIV in Australia. While recent attention has been focused on increasing HIV testing and the use of antiretroviral-based prevention to reduce infections, it is equally important to sustain safe sex and other risk reduction practices. Increases in unprotected anal intercourse (UAI), for example, may counteract any beneficial changes in testing and treatment.
This presentation, "Responding to the needs of consumers with complex trauma histories a consumer perspective" focuses on the needs of adult survivors of child abuse, highlighting the frequent