People from culturally and linguistically diverse (CALD) backgrounds have been identified in NSW as a population at greater risk of HIV infection. This study aims to describe the epidemiology of newly diagnosed HIV infection in New South Wales residents born overseas, to inform health promotion and clinical service delivery efforts.
Methods: HIV notification data were used to compare Australian-born and overseas-born NSW residents who were newly diagnosed with HIV infection between 2003 and 2012. Notifications of people born overseas were further grouped into one of eight regions of birth. Risk factors for HIV infection and characteristics of testing history and diagnosis were examined.
Results: There were 3667 notifications of newly diagnosed HIV infections in NSW residents between 2003 and 2012. Of these, 2001 (54.6%) were Australian-born, 1349 (36.8%) were born overseas and 317 (8.6%) had an unreported country of birth. The overseas-born group were younger, with a median age of 34.1 years compared to 37.0 years in the Australian-born group. The regions of birth with the highest number of notifications were: Europe (359, 9.8%) and South-East Asia (320, 8.7%). Homosexual contact was the most commonly reported risk exposure for those born in Australia (82.4%) and those born overseas (64.6%). The median CD4+ count at diagnosis was 480 cells/µL in the Australian-born group, higher than that in the overseas-born group (391 cells/ µL).
Conclusion: Overseas-born NSW residents who are newly diagnosed with HIV infection are generally younger and more likely to present at a later stage of HIV infection than their Australian-born counterparts.
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