Expanded HIV PrEP implementation in communities in NSW (EPIC-NSW): design of an open label, single arm implementation trial

BMC Public Health 
https://doi.org/10.1186/s12889-017-5018-9

 Published: 2 February 2018

Abstract:

Background

The New South Wales (NSW) HIV Strategy 2016–2020 aims for the virtual elimination of HIV transmission in NSW, Australia, by 2020. Despite high and increasing levels of HIV testing and treatment since 2012, the annual number of HIV diagnoses in NSW has remained generally unchanged. Pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV infection among gay and bisexual men (GBM) when taken appropriately. However, there have been no population-level studies that evaluate the impact of rapid PrEP scale-up in high-risk GBM. Expanded PrEP Implementation in Communities in NSW (EPIC-NSW) is a population-level evaluation of the rapid, targeted roll-out of PrEP to high-risk individuals.

Methods

EPIC-NSW, is an open-label, single-arm, multi-centre prospective observational study of PrEP implementation and impact. Over 20 public and private clinics across urban and regional areas in NSW have participated in the rapid roll-out of PrEP, supported by strong community mobilization and PrEP promotion. The study began on 1 March 2016, aiming to enroll at least 3700 HIV negative people at high risk of HIV. This estimate took into consideration criteria for PrEP prescription in people at high risk for acquiring HIV as defined in the NSW PrEP guidelines. Study participants receive once daily co-formulated tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) and are followed for up to 24 months. Follow-up includes: testing for HIV at 1 month, HIV and other sexually transmissible infections three-monthly, HCV annually and monitoring of renal function six-monthly. Optional online behavioural surveys are conducted quarterly. The co-primary endpoints are (i) HIV diagnoses and incidence in the cohort and (ii) HIV diagnoses in NSW.

Discussion

EPIC-NSW is a population-based PrEP implementation trial which targets the entire estimated population of GBM at high risk for HIV infection in NSW. It will provide a unique opportunity to evaluate the population impact of PrEP on a concentrated HIV epidemic.

Emotionally Safer Sex – event

Sarah K Reece / SHINE SA, January 2018

Safer sex’ can be about much more than preventing unwanted infections. For many people, sexual experiences risk leaving emotional bruises, and sometimes our struggles and differences can make good sex seem out of reach.

Sarah K Reece is the SHINE SA Artist-in-Residence. We would like to invite you to Sarah’s SHINE SA launch screening of her TEDx video and exhibition of related art works, titled ‘Emotionally Safer Sex’.

It will be held on Friday 9th February at 5.30pm at SHINE SA – 57 Hyde Street, Adelaide. (NB: This is a free event, but please RSVP via link below, for catering purposes).

This is Sarah’s first ever TEDx talk – and she has ‘gone global’ bravely sharing personal stories, beautiful artwork, and practical advice about how seeking to make sex emotionally safer has helped her navigate challenges such as a trauma history, anxiety, queer identity, mental illness, chronic pain, and physical disability.

Her artworks are an intimate exhibition of 8 ink paintings exploring our physical relationship with our own bodies and our partners. The artworks are hand gilded with 24k gold embellishments and show very human, diverse experiences of the joys and sorrows of sex. The artwork does not display graphic sex acts, nudity, or abuse and is suitable for viewing by children.

Hepatitis B testing infographic now available

Hepatitis NSW, October 2017

With the increasing visibility of hep B, Hepatitis NSW felt there was a need to make information about hep B testing clearer. It can be a complex subject to grapple with and there’s lots of misinformation and confusion out there.

This hep B testing infographic aims to give both doctors and patients a clearer understanding of what tests to do as well as what the test results mean. On one side, we have an explanation of what the tests results mean which a doctor can use to explain a person’s results. On the other side, we have the reminder for the doctor to test the 3 key hep B tests. It’s really important to get all three done at once.

The aim is for people to take this infographic with them when they go and see their doctor about hep B testing – whether that’s checking their immunity, seeing if they’ve ever been exposed, or seeing if they have a hep B infection.

People can also call the Hepatitis SA Infoline on 1800 437 222 for further information.

  • Download infographic in English, Korean or Mandarin here 

Punishing one person for STI transmission weakens public health efforts

The Conversation, September 21, 2017

Is one person to blame if another gets a sexually transmissible infection (STI)? In most Australian states, if you have certain STIs, you have a legal responsibility to notify your potential sexual partners.

The idea that punishing STI exposure or transmission will decrease rates of infection is not supported by global research on HIV, and there is no reason to believe this would be any different for other STIs.

Latest Adelaide Gay Community Periodic Survey results released

Centre for Social Research in Health, UNSW, 2017

The Adelaide Gay Community Periodic Survey is a cross-sectional survey of gay and homosexually active men recruited at a range of gay community sites in Adelaide. The major aim of the survey is to provide data on sexual, drug use and testing practices related to the transmission of HIV and other sexually transmissible infections (STIs) among gay men.

The most recent survey, the eleventh in South Australia, was conducted in November and December 2016 to coincide with the Adelaide Feast Festival. In total, 923 men participated in the 2016 survey.

Key points:

  • „ The proportion of men who reported ever having beentested for HIV has remained stable (and was reported by 82% in 2016).
  • „ Among non-HIV-positive men, the proportion who reportedtesting for HIV in the 12 months prior to the survey remained stable (and was reported by 69% in 2016).
  • „ The use of HIVtreatment by HIV-positive men has increased significantly over time (and was reported by all HIV-positive men in the 2016 survey).
  • „Mobile phone apps remain the most common way that men meet male sex partners (and was reported by 38% in 2016).
  • „ The proportion of men with regular male partners reportingcondomless anal intercourse with those partners has remained stable over time (and was reported by 59% in 2016).
  • „ The proportion of men with casual male partners reportingcondomless anal intercourse with those partners has increased over time (and was reported by 42% in 2016).injec
  • „ Use ofPrEP increased between 2014 and 2016 from 1% to 3% of non-HIV-positive men

Download report: Adelaide Gay Community Periodic Survey 2016 (PDF)

Harm reduction should address the specific needs of couples who inject drugs

nam/aidsmap, 21 March 2017

The sharing of drug injecting equipment most often occurs between sexual partners, but the ways in which couples manage risks and care for each other have been largely ignored by harm reduction services, say Australian researchers.

Read more here