A brief snapshot will be provided of “ Testing Point”, a new Healthy Communities’ community based clinical service that aims to provide a Medicare bulk billing after hours HIV/STI testing to the LGBT community on a weekly basis.
Method: Testing Point is operated by volunteer nurses and volunteer private GPs drawn from the community who work collaboratively with health educators and promoters to create a unique peer based service. The service provides comprehensive STI testing using private pathology services and Medicare. There is also the option for people to take part in a trial of the Alere Determine Rapid HIV Test, and results are made available to persons within 20 minutes. This trial has allowed for Point of Care (POC) HIV testing to be available within a community non-clinical setting supported by peer based health workers. The clinic operates as both an appointment or walk-in service operating every Tuesday evening.
Results: Over the 7 months the clinic has been operating, over 50 individuals have been seen. During that period, 1 cases of HIV, 2 cases of syphilis, 1 cases of gonorrhea have been detected. 49 POC HIV tests have been administered, returning 1 new diagnosis. Of the people tested through this clinic over 12% have never had a previous HIV test.
Conclusion: The Testing Point Clinic operated by Healthy Communities is demonstrating a significant role for community controlled sexual health services and the viability of community/ private partnerships. The ease with which POC HIV testing has been administered within this non clinical setting provides a foundation for future community and peer based testing programs.
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.