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.

One in six Australian women experience abuse before they are 15, data shows

Damning new data about Australia’s rates of domestic and sexual violence reveal that one in six women experience abuse before they are 15 and one woman is killed by her partner every nine days.

Based on national population surveys and set against a backdrop of declines in overall violence, rates of partner violence and sexual violence have remained relatively stable since 2005, a new report from the Australian Institute of Health and Welfare shows.

SHINE SA and FPAA condemn Alabama law to ban abortions (media release)

On 17 May 2019, Family Planning Alliance Australia (FPAA) released a statement condemning a new law in Alabama which makes abortion a crime in almost all cases. This is the most restrictive abortion law in the United States and follows a wave of anti-abortion laws in 2019¹.

FPAA state:

“The restrictive and extreme abortion ban violates women’s reproductive rights and penalises health care practitioners for providing basic health care. As an organisation committed to empowering reproductive choice and improving access to health care, we find this law disturbing and unjust.”

Natasha Miliotis, SHINE SA’s Chief Executive Officer said that:

“SHINE SA supports the FPAA statement and recognises that access to safe abortion services reduces the mortality and morbidity that occurs as a result of dangerous and illegal abortion. This is evidenced by a higher frequency of abortion-related deaths in countries with restrictive abortion laws than in countries with less restrictive laws².

SHINE SA, a member of FPAA, advocates for reproductive freedom and for provision of legal, safe, affordable and accessible abortion in Australia and worldwide. We recognise that trans, gender diverse and intersex people may also need access to abortion, but also that measures such as this disproportionately affect women.

SHINE SA believes that both medical and surgical abortion are safe and effective health interventions and that abortion is a private medical decision that should not be politicised.”

To read the FPAA statement visit this link. For further information contact Tracey Hutt, Director Workforce Education and Development via email. 

 

¹ https://www.theguardian.com/world/2019/may/17/we-have-to-fight-alabamas-extreme-abortion-ban-sparks-wave-of-activism

² https://www.researchgate.net/publication/26677181_Unsafe_Abortion_Unnecessary_Maternal_Mortality

Liver cancer death rate rising: study

SBS News, 9/4/19

The rate of liver cancer deaths and diagnoses has increased substantially in the past three decades, yet researchers say little has been done to help Australians most at risk.

While it is considered a relatively rare type of cancer – nearly 2000 people were diagnosed in 2014 – the high mortality rate and increasing incidence of diagnosis has been concerning, researcher Barbara de Graaff says.

Rates were highest in the Northern Territory, mostly due to a higher prevalence of hepatitis B and C.

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.