STI and BBV control in remote communities: Clinical practice and resource manual

SAHMRI / Young Deadly Free, 2019

This manual was developed by SAHMRI as part of the Young Deadly Free project, to support clinicians in efforts to boost STI and BBV testing rates for young people living in and visiting remote communities.

The manual provides tips on offering STI and BBV testing as part of routine consults with young people; collates the various STI and BBV clinical guidelines relevant to regional and remote communities; catalogues induction and training resources; and features Young Deadly Free health promotion resources for use in community education. The manual is designed as an induction and training kit, and for daily use by doctors, nurses and Aboriginal Health Workers.

Trans health and the risks of inappropriate curiosity

BMJ, September 9, 2019

Care providers need to be aware of the damage of inappropriate curiosity when working with people who are transgender, say Adam Shepherd, Benjamin Hanckel, and Andy Guise.

Encountering inappropriate curiosity is a common experience among people who identify as LGBT. This kind of behaviour shouldn’t happen in a healthcare facility, yet recent reports from Stonewall and the government’s Equalities Office confirm that this is a problem in healthcare and that it particularly affects people who are transgender.

What do we mean when we say that a healthcare provider is showing “inappropriate curiosity?” Researchers provided insight into what this is in a study where they describe trans participants being asked intrusive questions about their personal lives and being subjected to invasive physical examinations. Participants felt that these were irrelevant to why they had sought out medical care, and that their only purpose was to satisfy the personal interest of the healthcare practitioner. Imagine, for example, going to your GP for a chronic cough and being asked what genitals you have, or going for a foot X-ray and the radiographer making comments about your breasts.

HIV & the Law: updated content from ASHM

Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, 2019

The NEW Guide to Australian HIV Laws and Policies for Healthcare Professionals includes two new sections on Mandatory Testing for HIV and My Health Record.

This resource aims to provide health care workers with information on legal and ethical responsibilities under various laws and regulations related to human immunodeficiency virus (HIV). It does not contain legal advice. Those seeking advice on individual cases should contact their health department, solicitor or their medical defence organisation as appropriate.

In the interests of brevity, laws have been summarised and re-written specifically as they relate to HIV. In many instances key legislation is more broadly targeted at a range of infectious diseases (with definitions varying by state).

All efforts have been made to ensure the content is current at time of publication.

Increased screening for syphilis and HIV in SA – new advice for clinicians (video)

SHINE SA,  

SHINE SA have released a short video resource for health professionals providing advice on the current syphilis outbreak in South Australia.

Syphilis is a sexually transmitted infection (STI). It presents a serious public health issue as it causes harm to the developing foetus and increases the transmission and acquisition of HIV.

The 5 minute video SA Syphilis Outbreak – Advice for Clinicians urges health professionals to be aware that syphilis is increasing rapidly in SA and that there is a need to respond with increased screening.

A community perspective: On Human Papillomavirus (HPV)-related cancer among women and, trans and gender diverse people

Positive Life NSW & Femfatales, April 2019

Authors: Liz Sutherland, Lance Feeney, Katya Samodurov

Human papillomavirus (HPV) is a common virus which can be passed through skin to skin contact during sexual activity. Evidence to date shows that women living with HIV are 3 to 6 times more likely to develop cervical cancer than the general female population. They are also at greater risk of developing anal, vaginal, oropharyngeal and vulvar cancers.

There are other groups who may have a higher but preventable risk because they are often left out of the conversation about HPV and related cancers. Trans men are less likely to be up-todate with Pap tests to screen for cervical cancer. Furthermore, several studies have highlighted that trans and gender diverse people, and lesbian and bisexual cis-gendered women are often disregarded as not being at risk.

Positive Life and Femfatales developed a cross-sectional study to:

• Assess awareness and knowledge of HPV infection and risk for 4 HPV-related cancers (cervical, vaginal, vulvar, and anal) among women and, trans and gender diverse people in Australia;

• Assess the knowledge gaps to inform the development and implementation of population-specific educational resources to increase community and healthcare professional awareness of HPV and related cancers;

• Assist with the prevention of morbidity and mortality by increasing screening, early detection and treatment of HPV-related cancers, and;

• Assess rates of HPV vaccination in women and, trans and gender diverse people

KEY FINDINGS:

1. The results from this survey highlighted a lack of awareness of risk, prevention,
symptoms, and early detection of HPV-related vaginal, vulvar, and anal cancers.

2. Approximately 28% of HIV-positive respondents were unaware that a vaccination
against HPV exists and 71% of HIV-positive respondents had not been vaccinated
against HPV.

3. Over half (60%) of HIV-positive respondents believe their risk of anal cancer was either‘about the same’, ‘lower’, or ‘much lower’ than the general female population’s risk.

4. While all HIV-positive respondents had screened for cervical cancer at some point in
their lives, 91.7% had never had an anal examination for anal cancer.

5. Among HIV-positive and HIV-negative but immunocompromised respondents who had undergone staging or treatment for either cervical, vaginal, or vulvar cancer, none had ever screened for anal cancer.

6. Of the HIV-positive respondents who do not receive screening reminder notifications, none were aware of the new 3 yearly National Cervical Screening Guidelines and changes.

7. Qualitative responses indicated that respondents generally preferred having clinician-initiated conversations with female doctors or nurses who were non-judgemental, non-dismissive, clear, and made them feel comfortable.

8. In an open-ended short-answer question, more than 25% of qualitative respondents felt that more awareness and normalising talking about HPV in the public realm would help increase their chance of detecting HPV-related cancer early.

Updated blood borne virus guidelines for health professionals in SA

SA Health, 11 April 2019

The ‘Australian National Guidelines for the Management of Healthcare Workers Living with Blood Borne Viruses and Healthcare Workers who Perform Exposure Prone Procedures at Risk of Exposure to Blood Borne Viruses’ have been updated. They can be viewed on the Commonwealth Department of Health website.

The guidelines are in two parts:

Part A provides information and recommendations for all healthcare workers, in particular:

  • healthcare workers who perform exposure prone procedures
  • healthcare workers living with a blood borne virus, and
  • doctors treating healthcare workers with a blood borne virus.

Part B provides information and recommendations for public health authorities including, but not limited to, hospitals and jurisdictional health departments, when managing or investigating a situation where a healthcare worker with a blood borne virus was not compliant with these guidelines and/or may have placed a patient(s) at risk of infection.