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Sik bilong wanem? Language and the challenges of researching cultural etiology of cervical cancer and the acceptability of HPV vaccine in Australia’s nearest neighbour.

Sik bilong wanem? Language and the challenges of researching cultural etiology of cervical cancer and the acceptability of HPV vaccine in Australia’s nearest neighbour.

Methods: As of June 2013, 148 interviews (women n = 98), 32 semi-structured interviews (women n=20) and 19 focus group discussions which employed body mapping (women n=78) have been conducted in in two field sites (Western Highlands & Eastern Highlands).

Results: The majority of participants had never heard the term ‘cervical cancer’ and did not know what or where the cervix was. Phrases commonly used by participants in Tok Pisin (a PNG lingua franca) to describe cervical cancer do not directly and unanimously refer to cervical cancer. When people described what they believed was cervical cancer they were more likely to be referring to chronic untreated sexually transmitted infections (STIs) or pelvic inflammatory diseases (PID). Most participants’ knew about STI, albeit not specific aetiological agents. Only a few well-educated young women knew where the cervix was and knew that HPV, an STI, caused cervical cancer. Despite the difficulties of language participants’ were unanimously in favour of a vaccine that prevented cancer in PNG women.

Conclusion: The metaphoric nature of Tok Pisin is an obstacle to discussing the biology of cervical cancer; although it can be done. Despite this, there was high acceptability for a vaccine. If a HPV vaccine is introduced, care must be taken to build health literacy using appropriate and accurate Tok Pisin to ensure the differentiation of different illnesses, their aetiology and importantly their treatment and prevention.

Angela Kelly-Hanku replaced V. Fiya

Speakers: Angela Kelly
Conference: ASHM 2013
Areas of Interest / Categories: Australian Society for HIV 2013

Australian Society for HIV 2013

Delayed HIV diagnoses among gay and bisexual men in Australia

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.

Complex case report that illustrates the paucity of data for long term management of Visceral Leishmania-HIV co-infection.

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.

Clinical factors associated with suboptimal adherence to antiretroviral therapy in Asia

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.

Reinvigorating evidence for action and capacity in community HIV programs (REACH Project)

REACH was a collaborative research and practice initiative to develop evidence building frameworks, capacity, tools and resources with the Victorian HIV community partnership.

Men who take more risks avoid HIV testing due to structural barriers

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.

The impact of immune activation on natural killer cells in the setting of HIV infection

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.

Behavioural trends among Australian gay men pose increasing challenges for HIV prevention: findings from the Gay Community Periodic Surveys, 2003-1

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.