It’s time to lift the restrictions on medical abortion in Australia – Professor Caroline de Costa

The Conversation, April 1, 2019 6.13am AEDT

Over the past thirteen years, many Australian women have used the drug mifepristone (RU486) to bring about a medical abortion.

Rather than undergoing a surgical abortion in a clinic or hospital operating theatre, a medical abortion is induced by taking drugs prescribed by a doctor.

But while mifepristone has been available in Australia since 2006, only some women, in some parts of the country, are able to access it. Professor Caroline de Costa argues in the Medical Journal of Australia that this needs to change.

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.

Clinical Education Forum Recording: Contraception Update

SHINE SA, November 2018

Clinicians:  SHINE SA is pleased to present the following Clinical Forum by Dr Amy Moten on the topic of Contraception.

This recording is available free of charge, and access is limited to three months only.

This forum covers emergency contraception and new formulations of the Pill.

3 Category 2 RACGP Points can be awarded on completion of the forum.

Recording length: 1 hour 18 minutes

HIV PrEP update & HIV prescriber update in Adelaide

ASHM, October 2018

HIV PrEP Update for GPs and Practice Nurses

This training will provide GPs, Nurses, and Health Professionals working in primary care an update on strategies available for the prevention of HIV transmission, focusing on prevention particularly pre-exposure prophylaxis (PrEP).

– Date Tuesday, 23 October 2018
– Venue Mercure Grosvenor, 125 North Terrace, Adelaide SA 5000
– Time 6:15pm – 9:30 pm (Registration from 6:15pm, webinar broadcasts from 6:45pm)

At the end of this update, participants will be able to;
– Describe HIV epidemiology in Australia and the different HIV prevention
strategies
– Explain the role of HIV treatment and management
–  Provide patient education on the effectiveness and appropriate use of
PrEP/PEP
– Identify the prescribing pathways of PrEP within your local jurisdiction

This evening educational session will be presented by Dr Charlotte Bell, Sexual
Health Physician – Royal Adelaide Hospital.

This course is also available as a webinar, please contact Emma Williams here
for webinar registration

Register for this course at:
http://www.ashm.org.au/training/
Registrations close: Friday, 19 October 2018

Download flyer here: HIV PrEP Update_23Oct2018


HIV s100 Prescriber Dinner Update: 2018 IAS Conference Report Back and
Complex HIV Case Discussion

ASHM would like to invite HIV s100 Prescribers and medical practitioners in South Australia to attend this dinner training.

– Date Wednesday, 24 October 2018
– Venue Mercure Grosvenor, 125 North Terrace, Adelaide SA 5000
– Time 6:15pm – 9:30 pm (Registration starts 6:15pm, Webinar from 6:50pm)
– Cost FREE, Dinner and refreshments will be provided on site

This dinner workshop will bring attendees an overview of the content showcased at the
2018 International AIDS Conference held in Amsterdam, as well as a number of complex HIV cases to discuss. The first session is a conference report back
session. Professor Mark Boyd will provide an update on the latest studies, important
developments and best research methods in the ongoing battle against HIV, AIDS and
related infectious diseases from the IAS Conference 2018.

The second session will be an interactive panel discussion, focussing on the
management of complex HIV cases. Panellists include Professor Mark Boyd, Dr Russell Waddell (Consultant Sexual Health Physician and Clinical Director STD Services, Royal Adelaide Hospital) and Dr Andrew Beckwith (Senior Consultant Psychiatrist, Director of Training, HIV/Hep C Liaison Psychiatrist, CALHN Mental Health). The session will be hosted by Dr Samuel Elliott (Principal General Practitioner, Riverside Family Medical Practice).

This course is also available as a webinar, please contact Emma Williams here
for webinar registration

Register for this course at:
http://www.ashm.org.au/training/
Registrations close: Friday, 19 October 2018

Download flyer here: HIV Prescriber Update_24Oct2018

New study suggests risk of birth defects in babies born to women on HIV medicine dolutegravir

European Medicines Agency, 18/05/2018

The European Medicines Agency (EMA) is evaluating preliminary results from a study which found 4 cases of birth defects such as spina bifida (malformed spinal cord) in babies born to mothers who became pregnant while taking dolutegravir. While EMA is assessing the new evidence it has issued the following precautionary advice:

  • Dolutegravir HIV medicines should not be prescribed to women seeking to become pregnant.
  • Women who can become pregnant should use effective contraception while taking dolutegravir medicines.

The study, which looked at babies born to 11,558 HIV-infected women in Botswana, showed that 0.9% of babies (4 of 426) whose mothers became pregnant while taking dolutegravir had a neural tube defect, compared with 0.1% of babies (14 of 11,173) whose mothers took other HIV medicines. Final results are expected in about a year.

Women who have been prescribed dolutegravir should not stop taking their medicine without first consulting their doctor.

EMA will update the recommendations as necessary when it concludes its assessment.

HIV PrEP available on PBS in Australia from 1 April / Links to Clinical Resources

Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM), 21 March 2018

ASHM congratulates the Federal Health Minister, the Hon. Greg Hunt’s announcement of a landmark in HIV prevention to approve HIV-prevention drugs – tenofovir with emtricitabine, known as PrEP – on the Pharmaceutical Benefits Scheme from 1 April, thereby providing broader access for any doctor or general practitioner to be able prescribe PrEP to an Australian resident who holds a current Medicare card.

“The public health benefits are clear, undeniable and transformative benefiting individuals at medium- to high-risk of HIV infection and towards driving a substantial reduction in HIV transmissions in Australia,” said ASHM President, Associate Professor Bloch.

Access Links to Clinical Resources supporting the HIV workforce

  • The definitions of risk for HIV, guidelines and procedures for the appropriate administration and monitoring of PrEP can be found here: ASHM HIV pre-exposure prophylaxis: clinical guidelines
  • The Australian Federation of AIDS Organisations (AFAO) and ASHM have produced a PrEP Fact Sheet to assist PrEP users and people with an interest in using PrEP to understand what subsidised access to PrEP through the PBS means. Access the factsheet here
  • ASHM continues to support the workforce to ensure access to PrEP and best practice in guidelines, training and resources. Access information here
  • The Pharmaceutical Society of Australia has a range of training to support pharmacists in preparing for PrEP on the PBS: www.psa.org.au