Antiretroviral therapy (ART) became available in the Pacific Islands in the early 2000s, yet many people living with HIV (PLHIV) continue to turn to alternative therapies. ART is used to treat HIV infection, whereas for many people alternative therapies offer the hope of a cure or less harmful side effects. Use of alternative therapies in some cases leads people to forgo ART. This paper explores the use of alternative therapies among Pacific PLHIV including the types used, reasons for using them and why some respondents refused them.
A qualitative and participatory methodology was employed for this study, where a team of eight PLHIV peer researchers worked in collaboration with the lead researcher to carry out the study. In-depth interviews were used to explore HIV-positive people’s experiences of treatment, a total of 49 interviews were conducted with participants from five Pacific Island countries and territories including Fiji, Guam, Kiribati, Samoa and Solomon Islands.
Alternative therapies were used in every country and more than half of the respondents had tried an alternative therapy at some point since being diagnosed HIV-positive. Approximately half of those who tried alternative therapies ceased ART at the same time. The alternative therapies used were often a combination of herbal medicines, faith healing and traditional medicines. People mainly used alternative therapies because they were seeking or offered a cure. Yet, many participants also described how they choose not to use alternative therapies when they were offered because they had been cautioned by health workers or they simply did not believe in them.
This presentation will elaborate on how health workers in the Pacific Islands have an important role to play in cautioning PLHIV from using alternative therapies instead of ART.
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.
In recent years there has been a widespread uptake of smartphones with internet access and location services and the development of mobile ‘apps’ for gay men to meet each other. We reviewed data collected in the Sydney and Melbourne Gay Community Periodic Surveys (GCPS) to identify which men were relying on mobile and internet methods to meet each other and whether these methods were associated with different risk practices.
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