State of the positive nation - changes and emerging issues

Day two of the Positive Services Forum opened with a breakfast session focusing on scientific and social research about people living with HIV. The session was  facilitated by AFAO Executive Director Rob Lake; presenters outlined a range of current and emerging issues for PLHIV based on current research.

L-R: Martin Holt, David Wilson, Rachel Koelmeyer, Rob Lake.

David Wilson (Kirby Institute) provided an overview of HIV epidemiology across Australia, noting that HIV is becoming more widespread throughout Australia, not only in urban areas.  By 2020 diagnoses are projected to be much more evenly spread across Australia, with a higher proportion of HIV-positive people over 50.

David framed treatment as prevention as an exciting opportunity to achieve the UN goals of reducing HIV transmission. He provided modeling that showed significant decreases in transmission when either testing and/or treatment rates increase. Download presentation

Martin Holt (NCHSR) outlined findings from two major social research studies: StraightPoz and the gay community periodic surveys over a ten year period. The surveys showed that HIV-positive men are an ageing cohort - now at an average age of 42 years old. The surveys showed that there were small but significant increases in workforce participation, and a doubling of the proportion men attending university over the last 10 years.

In terms of behavioural measures, survey findings showed the likelihood of UAIC being reported with casual partners has increased, which places a emphasis on the health promotion and risk reduction; other findings included and a decline on the number sexual partners reported by both HIV-positive and HIV-negative men in the last six months, and an increased incidence of men having a regular same-status partner. Download presentation

Rachel Koelmeyer (ARCSHS) discussed changes in data over time from the HIV Futures survey as well as presenting a brief overview of the Tracking Changes study and the Lifetime Study.

Key areas of improvement that Rachel onlined include: an increase in the number of people on antiretroviral treatment; a reduction in the number of people reporting experiencing difficulties taking medication; and an increase in treatments optimism among people living with HIV. Other positive findings included an upswing of PLHIV in paid employment, although further improvement is needed in this area.

Areas that have not improved  include: self-rated health (with 70- 75% of respondents reporting good or excellent health); 25-30% of PLHIV reported taking medications for mental health conditions, such as depression or anxiety; and around 40% of PLHIV reported that they were living below the poverty line.

Rachel also noted there has been an increase in PLHIV who reported no sexual relations over the last six months. While reasons for this could include ageing and reduced libido caused by side effects from medications, she said more investigation about why this was occuring is needed.

Reports of HIV-related discrimination also remained constant (at around 40%); the most commonly reported experience of discrimination was experienced by PLHIV when attending a health service, with around 10% of people reporting a recent incident of discrimination. Download presentation.