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.

Imagining HIV In 2030

Imagining HIV In 2030: Exploring Possible Futures And Charting A Path Forward

ACON, 21/08/2019

What does HIV look like in 2030? How do we make sure people living with HIV age healthily and well? What needs to be done so that everyone benefits equally from NSW’s leading HIV response? These are some of the issues explored in a new discussion paper developed by ACON.

Imagining HIV in 2030 speculates about possible futures over the next decade, examining how current trends and future developments will impact the HIV landscape in NSW. In doing so, it delves into what needs to be done to ensure community, sector and government responses to HIV prevention, treatment and support in NSW remain on course.

Healthcare providers should discuss U=U with all their HIV-positive patients

aidsmap/nam, 18/03/2019

Healthcare providers should inform all patients with HIV they cannot transmit HIV to a sexual partner when their viral load is undetectable, argue the authors of  a strongly worded comment in The Lancet HIV.

The authors note that despite overwhelming scientific data supporting the undetectable = untransmittable (U=U) message, significant numbers of healthcare providers do not educate their patients about U=U when telling them their viral load is undetectable.

 

 

 

HIV and Trans Women: A Literature Review

Transgend Health. 2018; 3(1): 239–250

Abstract:

Trans women are a key, yet under-researched, population in the HIV epidemic. However, there remains a paucity of data on the health and wellbeing of trans women at risk of, or living with, HIV in the United Kingdom.

This article provides a narrative review of key empirical research into HIV among trans women. In an effort to explore individual and social factors in relation to HIV in this population, we outline key tenets of identity process theory from social psychology and the concept of structural violence from medical anthropology.

We focus on published studies around the following themes: (1) epidemiological data, (2) syndemic factors (3) barriers to social support, (4) HIV and gender transitioning, and (5) access to and engagement with health care.

We identify lacunae and thus call for United Kingdom-based research in the following areas: (1) the prevalence and incidence of HIV in trans women, (2) the impact of syndemic factors on HIV risk and acquisition in trans women, (3) the nature of social support for coping with syndemic factors, (4) the interface of gender transitioning and HIV, and (5) barriers to accessing HIV prevention and care services.

There is great scope (and urgency) for research into HIV among trans women, especially in the United Kingdom, to reduce incidence in this group, to enhance engagement in HIV care across the care continuum, and to improve the health and wellbeing of those living with HIV. A tentative model for HIV prevention and care is presented in this article.

Gaps And Policy Barriers To Engagement With The HIV Cascade Of Care

Identifying and Plugging the Leaks: Gaps And Policy Barriers To Engagement With The HIV Cascade Of Care

CTAC (Canadian Treatment Action Council), 2018

This project explored what issues impact engagement by people living with HIV with healthcare in Ontario. The goal was to identify policy issues that impact treatment access for people living with HIV, and to identify opportunities to make the healthcare system more accessible.

The HIV Cascade of Care is a useful description of the different steps that a person living with HIV will need to take in order to achieve an undetectable viral load and optimal health outcomes, from infection and diagnosis through to Antiretroviral Therapy (ART) initiation and viral suppression.

We know people drop out of the HIV Cascade of Care – e.g. why those starting treatment don’t stay on it. By seeking out policy barriers and developing solutions we can enable people to live long, healthy, and happy lives.

The project has five recommendations around barriers to engagement in the HIV Cascade of Care.

Download report here

 

HIV diagnoses hit seven year low: Australia’s annual HIV figures released

Kirby Institute, UNSW, Monday, 24 September 2018

Australia has recorded its lowest level of HIV diagnoses in seven years, according to a new report from the Kirby Institute at UNSW Sydney.

The report, released at the Australasian HIV&AIDS Conference in Sydney, found that there were 963 new HIV diagnoses in 2017, the lowest number since 2010.

Researchers are attributing the promising results to more people getting tested for HIV, more people living with HIV starting treatment which reduces the risk of HIV transmission to effectively zero, and an increased use of pre-exposure prophylaxis (or PrEP, an HIV prevention pill).

However, it is not all good news. According to the report, a quarter of new HIV diagnoses in 2017 were among heterosexuals, with a 10% increase in diagnoses over the past five years.

Among Aboriginal and Torres Strait Islander populations, HIV diagnoses have been increasing over the past five years, with rates almost two times higher than the Australian-born non-Indigenous population in 2017.