Smoking and HIV: what are the risks and what harm reduction strategies do we have at our disposal?

AIDS Res Ther. 2018 Dec 12;15(1):26. doi: 10.1186/s12981-018-0213-z.

Abstract

The World Health Organization estimates that smoking poses one of the greatest global health risks in the general population. Rates of current smoking among people living with HIV (PLHIV) are 2-3 times that of the general population, which contributes to the higher incidence of non-AIDS-related morbidity and mortality in PLHIV.

Given the benefit of smoking cessation, strategies to assist individuals who smoke to quit should be a primary focus in modern HIV care.

Tobacco harm reduction focuses on reducing health risk without necessarily requiring abstinence. However, there remains uncertainty about the safety, policy and familiarity of specific approaches, particularly the use of vaporised nicotine products. Evidence suggests that vaporised nicotine products may help smokers stop smoking and are not associated with any serious side-effects. However, there is the need for further safety and efficacy data surrounding interventions to assist quitting in the general population, as well as in PLHIV specifically.

In addition, official support for vaping as a harm reduction strategy varies by jurisdiction and this determines whether medical practitioners can prescribe vaporised products and whether patients can access vaporised nicotine products. When caring for PLHIV who smoke, healthcare workers should follow general guidelines to assist with smoking cessation.

These include: asking the patient about their smoking status; assessing the patient’s readiness to quit and their nicotine dependence; advising the patient to stop smoking; assisting the patient in their attempt to stop smoking through referral, counselling, pharmacotherapy, self-help resources and/or health education; and arranging follow-up with the patient to evaluate their progress.

Drug and alcohol report uncovers burden in regional Australia

ABC Central West, 15/03/2019

A report from the Australian Institute of Health and Welfare (AIHW) has revealed alarming statistics about drug and alcohol use in regional Australia, and the difficulties faced by those seeking treatment.

The report found a 41 per cent increase in drug-induced deaths in regional and remote areas in the decade to 2017, compared to a 16 per cent spike in major cities.

Researchers said this could be attributed to opioid overdoses.

The report found there was a higher rate of people seeking drug and alcohol treatment in regional and remote communities in 2016–17, but they were likely to travel one hour or more to receive treatment.

It also said people in country areas were more likely to smoke, drink heavily, use drugs, and avoid exercise.

Media coverage of methamphetamine use in SA “demonising”

InDaily Adelaide, August 1, 2018

The head of South Australia’s drug and alcohol services network says recent reports on the use of methamphetamine in the workplace are misleading and could cause people to turn away from seeking treatment.

 

Language matters when working with people who use alcohol and other drugs…

Network of Alcohol & other Drugs Agencies (NADA) and the NSW Users and AIDS Association (NUAA), 

Language is powerful—especially when discussing alcohol and other drugs
and the people who use them.

A new resource from the Network of Alcohol & other Drugs Agencies (NADA) and the NSW Users and AIDS Association (NUAA) has been launched

Stigmatising language reinforces negative stereotypes. Person-centred language focuses on the person, not their substance use. It is a simple and effective way of showing you respect a person’s agency, dignity and worth.

This resource has been developed for people working in non government alcohol and other drugs (AOD) services. It has been developed in consultation with people who use drugs.The purpose of this resource is to provide workers with guidelines on how to use language to empower clients and reinforce a person-centred approach.

 

Changes to CNP services in SA

SA Health, October 2017

From 1 January 2018, Mission Australia Hindmarsh Centre after-hours Clean Needle Program (CNP) service component (Monday to Friday 5pm to 8pm) will discontinue. However, the daytime CNP service at the Hindmarsh Centre, provided by Hepatitis SA staff will continue Monday to Friday 1.30pm to 5.00pm, with syringe vending machine services available 24 hours per day 7 days per week until 30 June 2018.

The following expanded after-hours CNP service options will become available to clients in the Adelaide metropolitan area in October and November 2017:

  1. NEW  Uniting Communities Hendon CNP service details – opening Monday 9th October 2017:
  • 45-47 Tapleys Hill Rd, Hendon (ph) 8202 5610
  • After-hours CNP service Monday to Sunday 5.00pm to 12.00am (midnight).
  • Daytime CNP service Monday to Sunday 9.00am to 5.00pm.
  • 1 x syringe vending machine available 24 hrs per day 7 days per week from mid-October onwards
  1. NEW Thursday night DASSA Central Stepney after-hours CNP service details – opening Thursday 16th November 2017:
  • 91 Magill Rd, Stepney (ph) 7245 5080
  • After hours CNP service Thursdays only 5.00pm to 9.00pm
  • Daytime CNP service Monday to Friday 9.00am to 5.00pm
  • 2 x syringe vending machines available 24hrs per day 7 days per week.

Syringe vending machines continue to be available 24hr per day 7 days per week at the following locations in SA:

  • NORTH – DASSA Northern Service, 22 Langford Drive, ELIZABETH.
  • SOUTH – Noarlunga Health Village, Alexander Kelly Drive, NOARLUNGA
  • EAST – DASSA Central Service, 91 Magill Rd, STEPNEY
  • WEST – Hindmarsh Centre, 35 Richards St, HINDMARSH.

Free community CNP sites across South Australia:

  • For a complete list of all free community CNP sites across South Australia, type “Clean Needle Program SA” into the Google search bar and then click on the link for “Clean Needle Program Sites List – SA Health”.
  • OR  call  the Alcohol and Drug Information Service (ADIS) on 1300 131 340

For further information:

Please contact the Clean Needle Program by phoning (08) 7425 5080

 

 

Australian Needle and Syringe Program Survey: National Data Report 2012 – 2016

The Kirby Institute, UNSW, May 2017

The Australian Needle and Syringe Program Survey (ANSPS) provides serial point prevalence estimates of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) antibodies and sexual and injecting risk behaviour among people who inject drugs (PWID) in Australia.
Conducted annually over a one-two week period in October, all clients attending participating needle and syringe program (NSP) services are invited to complete a brief, anonymous questionnaire and to provide a capillary blood sample for HIV and HCV antibody testing.
This report presents national and state/territory data for the period 2012 to 2016.

Key findings:

  • In 2016, 50 Australian Needle and Syringe Programs (NSPs) participated in the ANSPS and 2,210 NSP attendees completed the survey. The response rate was 41%.
  • Over the period 2012 to 2016, the median age of survey respondents increased from 38 years to 42 years, with a concurrent decrease in the proportion of young injectors (aged <25 years) from 7% in 2012 to 4% in 2016.
  • HIV antibody prevalence remained low and stable nationally, ranging from 1.2% to 2.1% over the period 2012 to 2016
  • Hepatitis C virus (HCV) antibody prevalence was stable over the period 2012 to 2016, ranging from 51% to 57%.
  • Nationally, the proportion of respondents who reported recent (last 12 months) initiation of HCV treatment was low and stable at 1-3% between 2011-2015, but increased significantly to 22% in 2016, with substantial increases observed in all jurisdictions.

Download Australian Needle and Syringe Program Survey: National Data Report 2012 – 2016 (PDF)