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.

The Ban on ‘Amyl’

Australia’s Therapeutic Goods Administration (TGA) recently postponed its decision on whether or not to change the law around alkyl nitrites (the active ingredient in ‘amyl’ or ‘poppers’). Currently, the TGA is conducting public consultations into the proposed amendments that could see amyl recategorised as a ‘prohibited substance’.

The legal consequence of this decision could see amyl fall into the same category as prohibited drugs like heroin, methamphetamine and cocaine, with serious penalties for their possession, use or supply. This issue has raised concerns within our communities where amyl is used during sex.

Submissions to the TGA

The deadline for written submissions to the TGA closed on 15 January 2019; however, a number of organisations expressed their concerns including:

Earlier this month, the Nitrites Action Group (comprised of community health advocates, researchers, and clinicians) released guidelines around community submissions to the TGA.

 

Policy Consultation Forum: LGBTIQ and youth community feedback sought

SHINE SA, August 2018

LGBTIQ and youth community feedback is sought on SA Health Equity and Access in Health Care Policy Directive & Southern Adelaide Local Health Network (SALHN) Adult Community Mental Health Model of Care. 

Members of the lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) communities and young people (under 30) are invited to an information session to learn about the draft Equity and Access in Health Care Policy Directive for SA Health as well as the draft SALHN Adult Community Mental Health Model of Care. SA Health and SALHN, in partnership with SHINE SA, are facilitating an information and feedback session about these important documents. We look forward to hearing your views on the policy and model of care.

The SA Health Policy aims to provide a comprehensive overarching framework which consolidates equity and access requirements for South Australia’s diverse health consumers consistent with the South Australian Government Universal Access and Inclusion Guidelines (the Guidelines). The Policy is intended to provide strategic direction to SA Health employees, or persons who provide health care services on behalf of SA Health, to ensure that access to public health services is equitable for all South Australian health consumers.

The central purpose of the SALHN Adult Community Mental Health Model of Care is to provide high level guidance pertaining to the provision of safe and high quality care to Southern Adelaide Local Health Networks diverse mental health consumers. The core principles speak to the provision of person centred, evidence based recovery oriented care that is provided by an appropriately diverse multi-disciplinary team. Strong emphasis has been placed upon care delivery within the context of a culturally and linguistically safe service that engenders strong collaborative partnerships across agencies and between consumers, carers and health professionals. A Service Plan is being developed to operationalise the Model of Care, and both elements will be implemented in parallel once development is complete.

Tuesday, August 28 at 5:30 PM – 7:30 PM

At SHINE SA, 57 Hyde Street, Adelaide 5000

Free event

Light refreshments will be provided

Image may contain: 2 people, people smiling, hat and textmodel of care

Australian sex education isn’t diverse enough. Here’s why we should follow England’s lead.

The Conversation, 7 August 2018

By David Rhodes, Senior Lecturer, School of Education, Edith Cowan University

How children are taught about sex, relationships and sexuality at school is shaping up to be a political hot potato in Australia (again).

It’s already been slated to be an issue in the Victorian state elections later this year. That’s just a short time from being on the agenda during the same-sex marriage debate.

Now a radical shift in how children in England are taught about sex, relationships and sexuality promises to be the biggest reform of its kind in nearly 20 years. Here’s what Australia can learn from the new English system.

 

‘Changing the picture’ of violence against Aboriginal and Torres Strait Islander women

Our Watch, July 18th 2018

Our Watch has today launched a resource aimed at tackling the horrific prevalence of violence against Aboriginal and Torres Strait Islander women.

Changing the picture contains a set of clear actions that are needed to address the many drivers of violence against Aboriginal and Torres Strait Islander women, and is aimed at encouraging, guiding and supporting a national effort to prevent this violence.

Download report:

Report Changing the picture
Six-page executive summary
Background paper

Read more of article:

‘Changing the picture’ of violence against Aboriginal and Torres Strait Islander women

 

Evaluating interventions related to violence against women

ANROWS, Thursday, 28th June 2018

This guide, Evaluating interventions related to violence against women, is a resource for community and health workers, clinicians, as well as educators, activists, policy-makers, academics and others. It is designed to help them evaluate interventions related to violence against women (VAW), so they can use the findings to improve services, secure funding and acknowledge the quality of work delivered by practitioners.

Key steps in evaluating interventions related to violence against women is a quick reference resource which provides a summary of the eight key steps over three stages presented in A guide to evaluating interventions related to violence against women