MAKING PROGRESS ONHIV AND MOBILITY

The WA Partnership Response

WA AIDS Council in conjunction with the WA Department of Health

Presented bySimon Yam and Beth Hodge

WA Partnership Response• Epidemiology • Operational Directive OD 0391/12 - Provision of treatment of

Medicare ineligible patients in WA Public Hospitals• WA Health’s Sexual Health Resources for CaLD Communities• WA AIDS Council (WAAC) Initiatives

• End to HIV in WA Strategy• Sex on the Table : GP’s Information And Networking Cocktail

Function • Sex in Other Cities

• WAAC – Metropolitan Migrant Resource Centre (MMRC) Partnership• African Diaspora in WA• Your Cultural Lens : Online Cultural Competency Training

HIV EPIDEMIOLOGY IN WAOVERSEAS BORN / OVERSEAS ACQUISITION

2.5M

WA HIV notifications by place of birth/acquisition 2004-2013

5.3 : 1

11.9 : 1

5.8 : 1

1.3 : 1

0

10

20

30

40

50

60

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Nu

mb

er

of

no

tifi

ca

tio

ns

Year of notifications

Aus born_Aus acquired Aus born_Overseas acquired

Overseas born_Aus acquired Overseas born_Overseas acqured

Male : Female ratio

WA HIV notifications, 2004-2013: Overseas-acquired cases by place of birth

Europe, 17, 13%

South-East Asia, 73, 57%

Sub-Saharan

Africa, 16, 12%

Other, 23, 18%

Europe, 33, 10%

SE Asia, 124, 36%

Sub-Saharan Africa,

146, 42%

Other, 41, 12%

Australian-born overseas-acquired HIV (n=129)

Overseas-born overseas-acquired HIV (n=344)

WA HIV Notifications by Place of Birth2004-2013

0

10

20

30

40

50

60

0

10

20

30

40

50

60

70

80

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

% O

ve

rse

as

bo

rn

Nu

mb

er

of

no

tifi

ca

tio

ns

Year of notification

Australian born

Overseas born

% Overseas born

From 2007, overseas-born > Aus-born cases

15

52

WA HIV Notifications by Place of Acquisition 2004-2013

0.0

10.0

20.0

30.0

40.0

50.0

60.0

0

10

20

30

40

50

60

70

80

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Australia acquired

Overseas acquired

% Overseas acquired

Year

15

52

Provision of treatment ofMedicare ineligible patients in

WA Public HospitalsOperational Directive OD 0391/12

Issued : 4 October 2012

Operational Directive OD 0391/12•Patients requiring emergency treatments will be provided care regardless of Medicare eligibility status.•Aim is to assist and support access to treatments during migration processes, and /or until partial Medicare is granted or full access achieved.•Each hospital has differing processes, but work within the directive guidelines. Quite a grey area of practice and is always tailored for the individual. There is some flexibility within the directive. •Clients can be exempted from costs for HIV consultancy, pathology & medications up to $10,000•If this is in excess of $10,000, Clinical Director of hospital will have to provide written authorisation.

Sexual Health Resources for the CaLD Communities (WA Health)

WA AIDS Council’sEnd to HIV in WA Strategy

Sex on the Table – Creating Sexual Health Champions

• GP Information and Networking Cocktail Function on the 25th November 2014

• Engage with the personal experiences and challenges of GPs who work closely with population target groups at risk of HIV and/or STIs, especially with people from Culturally and Linguistically Diverse backgrounds

• Promotion of our Pre and Post Test Informed Consent Discussion; Edith Cowan University’s online STI learning program; and the Metropolitan Migrant Resource Centre’s Your Cultural Lens – the training resource for cross-cultural communication for sexual health and blood-born viruses.

SEX IN OTHER CITIES

Project Aim: This project aims to address the growing trend of overseas acquired notifications of HIV in Western Australia. Project objectives: •Raise awareness by 10% of the overseas epidemic and prevention methods amongst Australian travellers aged 18+ by the year 2016. •Increase the uptake of packing condoms by 10% amongst Australian travellers aged 18+ by the year 2016. •Increase the usage of condoms whilst travelling by 10% amongst Australian travellers aged 18+ by the year 2016. •Increase sexual health testing before travelling by 10% amongst Australian travellers aged 18+ by the year 2016. •Increase sexual health testing after travelling by 10% amongst Australian travellers aged 18+ by the year 2016.

WA AIDS Council’s Sex In Other Cities

• Target Population: • Men travelling overseas for

work/expatriates (both heterosexual and gay/MSM)

• Tourists (young men and women); Middle aged single men (and women); Sex tourists (heterosexual and gay/MSM); Backpackers travelling in Australia

• Visa holders visiting countries of origin (Permanent residents; Refugees; Temporary workers; students).

WA AIDS Council’s Sex In Other Cities

• Airports• Travel companies • Travel Doctors and

STI clinics• Social media• FIFO living zones • SIOC Website

WA AIDS Council’s Sex In Other Cities

Sex In Other CitiesHealth Promotion Strategywww.sexinothercities.com

•Create supportive environments – the promotion of local and international sexual health clinics to build an environment that supports pre & post travel testing through targeted social media and SIOC website. •Create supportive environments – enabling people to learn to prepare themselves for travel and safe sex with up to date information and tips. This will be achieved through the SIOC website and SIOC print advertising in a range of settings.

Additional Health Promotion Strategies•Advocating for healthy public policy in neighbouring countries – The WA AIDS Council identifies public policy as an enabler to the adoption of safe sex practices overseas ie; standardising condom use amongst bar girls. This will be achieved by building partnerships with relevant international travel and sexual health organisations and companies. (planned) •Strengthen community actions – drawing on community champions; existing expats and Australian bar owners overseas (in places like Indonesia) to enhance self-help and social support, and to develop a system for traveller’s participation in safe sex practices. This will require full and continuous access to information and condom distribution. (proposed)•Create supportive environments – facilitating sexual health discussions in the online forum settings. (proposed) •Reorient health services – Directing travel doctor’s/health services increasingly towards sexual health promotion, beyond its responsibility for providing clinical and curative services like travel vaccinations. This will be achieved through professional education and training plus on going support with SIOC promotional resources and print advertising. This will also be achieved by building partnerships with relevant international travel and sexual health organisations and companies. (planned)

AFRICAN DIASPORA

Rank Country% of people with HIV in the world

1 South Africa 18%

2 Nigeria 9%

3 India 6%

4 Kenya 5%

5 Mozambique 4%

6 Uganda 4%

7 Tanzania 4%

8 Zimbabwe 4%

9 USA 4%

10 Malawi 3%

Remaining countries 39%

Top 10 countries: People living with HIV

61%

Zambia

Source: UNAIDS Global Report 2014

33%

MMRC: Your Cultural Lens

AIDS 2014 : Global Village

(Photo credit: AFAO)

Acknowledgements

• Lisa Bastian, Sue Laing and Sean Brennan, Sexual Health and Blood Borne Virus Program, CDCD, WA Department of Health

• Carolien Giele, Byron Minas, Epidemiology and Surveillance Program, CDCD, WA Department of Health

• Anne Sorenson, Project Coordinator, Metropolitan Migrant Resource Centre (MMRC)

• ConAds Australia• All stakeholders involved in, and contributing to our programs listed

within our An End To HIV In WA Strategy.• AFAO for this opportunity to present at the HIV Forum 2014.

Websites• OD 0391/12 - Provision of treatment of Medicare ineligible

patients in WA Public Hospitalswww.health.wa.gov.au/circularsnew/circular.cfm?Circ_ID=12895

• WA Health’s Sexual Health Resources for CaLD Communitieswww.public.health.wa.gov.au/2/1716/2/multicultural_sexual_health.pm

• Sex in Other Citieswww.sexinothercities.com.au

• Your Cultural Lenswww.mmrcwa.org.au/ycl

• What an AFAO member learned Under the Baobab Tree (African Diaspora)http://bit.ly/1w7GP6F