March 9, 2019 will be the fourth National Day of Women Living with HIV (#NDWLHIV). Coming the day after International Women’s Day, this awareness-raising day was created by Femfatales, a network of women living with HIV of the National Association of People with HIV Australia (NAPWHA).
“We are aiming to create a greater awareness of the needs of women living with HIV in Australia, “said Femfatales Chair, Katherine Leane. “It’s hard to believe that in 2017 some people don’t think that there are women living with HIV in this country. But there are around 3,000 of us, or about 10 per cent of the HIV-positive population.
“Because of the perception that women are not at risk of HIV, women don’t test for it. Many women who are diagnosed with HIV here have never tested for it previously, not believing they were at risk. This can present them with serious health challenges as a late diagnosis can mean that they have developed a compromised immune system and sometimes, an AIDS-defining illness.
“On top of this, many suburban and regional GPs have never diagnosed someone with HIV, do not always recognise the symptoms or risk factors and are not sure where to refer patients for specialist care. It is very important that women diagnosed in these settings get referred to appropriate medical care and to the peer support agencies that can help people with their diagnoses.
“The more people talk about HIV, the more we encourage women to test for it, the more we will be able to diagnose and treat women appropriately. This is the aim of this special day, “said Kath. “We encourage all agencies involved with and concerned about women’s sexual health to hold a morning or afternoon tea or other event to help raise awareness of HIV agencies that support women living with and affected by HIV.”
NAPWHA Executive Director — Aaron Cogle — 0468 438 214
NAPWHA is Australia’s peak non-government organisation representing community-based groups of people living with HIV. NAPWHA provides advocacy, policy, representation, health promotion and outreach at a national level.
In this video episode of Let Women Talk, HIV community advocate Sarah Feagan speaks with Dr Deborah Bateson — Medical Director at Family Planning New South Wales, who presented at the 2019 Australasian HIV&AIDS Conference held in Perth on 17-19 September, about contraception, choice and women living with HIV. In this video, Deborah mentions that while all contraceptive methods are potentially suitable for women with HIV, that its important for clinicians to be informed of potential antiretroviral (ART) drug interactions in order to support informed decision-making for their patients. Sarah and Deborah also make mention of the contraceptive injection (sold as Depo-Provera® or Depo-Ralovera® in Australia) and also another injectable which may be on the Australian market soon (see: Sayana Press). In terms of a male contraceptive option that is in the pipeline for Australian consumers, but still far from approval, Vasalgel, a long-term reversible contraceptive gel injected, has been in the works since 2010.
About the presentation
Women living with HIV who wish to plan or avoid a pregnancy require information about all methods of contraception and should be supported in making an informed choice about the method that best suits their individual needs. Considerations that are common to all individuals such as desire for non-contraceptive benefits for acne or menstrual symptoms, the need for discretion, religious beliefs, costs and personal preference remain relevant.
However, in relation to HIV, specific consideration needs to be given to the effect of the contraceptive method on disease progression and transmission, antiretroviral drug interactions, the presence of other chronic medical conditions and the need for protection from other sexually transmissible infections (STI). The presentation provided an overview of the current (and future) contraceptive options recommended for women living with HIV in order to support informed decision-making.
Let Women Talk is a NAPWHA community-led health literacy initiative where HIV community advocates incorporate their rich perspectives and diverse lived HIV experiences back into strengthening community health responses — where women design and develop the health content and interventions that they want to see and hear. The initiative is one of many activities forming part of the HIV Health Literacy Framework Project, a NAPWHA project supported through the funding of ViiV Healthcare Australia.
Deborah Bateson is the Medical Director at Family Planning New South Wales. She has an undergraduate degree in Biochemistry from Oxford University (MA Oxon), a Masters degree in Human Nutrition from the London School of Hygiene and Tropical Medicine and a medical degree from the University of Hong Kong. Deborah was Chair then Co-chair of the Australasian Sexual Health Alliance from 2015 to 2017.
Sarah Feagan is a queer women who has been living with HIV since 2008. She is the previous chair of Positive Women Victoria and has recently joined the team at Living Positive Victoria as a Peer Navigator. She also the Vice President of NAPWHA. Sarah is a co-facilitator of Phoenix for Women and the Positive Leadership Development Institute (PLDi). Sarah has unique approach to her advocacy and is inspired by the lived experience of the body positive to inform her practice. Sarah’s advocacy spans from the grass roots all the way up to high level governance. She has a global outlook with a local focus to bringing the community along with her.
In this video episode of Let Women Talk, HIV community advocate Sarah Feagan speaks with Mina John who is a staff consultant in a large HIV service provided by the Department of Immunology at Royal Perth Hospital where 32% of the program’s clients are women. She presented at the 2019 Australasian HIV&AIDS Conference held in Perth on 17-19 September about HIV infection in women.
About the presentation
One of the topics which Mina presented spoke of disproportionate HIV burden among young women globally. In Western Australia, although HIV notifications have fallen since 2016, there is a relative increase in new HIV diagnoses in females, with higher proportions in this number of women who were born overseas, or women acquiring HIV overseas. Also, why are females are more likely to acquire HIV with fewer sex partners versus males? Some of the factors are biological — meaning that there is a higher risk of HIV infection per sexual exposure for females compared to males. For example, due to the large cervical–vaginal mucosal surface area, semen can stay in the vagina for up to 3 days; and microabrasions can occur during coitus that allow an entry for the virus.
There are challenges and barriers for women and their retention in HIV care. In an Australian study of approximately 500 women who were surveyed across all states/territories, those barriers included transport, carer responsibilities, financial pressure, language, health beliefs and concern about stigma or disclosure.
Let Women Talk is a NAPWHA community-led health literacy initiative where HIV community advocates incorporate their rich perspectives and diverse lived HIV experiences back into strengthening community health responses — where women design and develop the health content and interventions that they want to see and hear. The initiative is one of many activities forming part of the HIV Health Literacy Framework Project, a NAPWHA project supported through the funding of ViiV Healthcare Australia.
Mina John is a Clinical Immunologist and Immunopathologist. She is a staff consultant in a large HIV service provided by the Department of Immunology at Royal Perth Hospital and holds a research appointment with the Institute of Immunology and Infectious Diseases (IIID) at Murdoch University.
Sarah Feagan is a queer women who has been living with HIV since 2008. She is the previous chair of Positive Women Victoria and has recently joined the team at Living Positive Victoria as a Peer Navigator. She also the Vice President of NAPWHA. Sarah is a co-facilitator of Phoenix for Women and the Positive Leadership Development Institute (PLDi). Sarah has unique approach to her advocacy and is inspired by the lived experience of the body positive to inform her practice. Sarah’s advocacy spans from the grass roots all the way up to high level governance. She has a global outlook with a local focus to bringing the community along with her.
In this video episode of Let Women Talk, HIV community advocate Sarah Feagan speaks with Janet Gare who is the first woman from the Papua New Guinea Institute of Medical Research (PNGIMR) to obtain a PhD for her research into HIV drug resistance in the PNG Highlands. Sarah and Janet speak about the context of HIV in PNG from the 2019 Australasian HIV&AIDS Conference held in Perth on 17-19 September.
More about Dr Gare’s work in PNG
Dr Gare’s four years studying at Burnet Institute on a Department of Foreign Affairs and Trade (DFAT) scholarship were split between fieldwork in PNG and time in the laboratory in Melbourne. But her aim was always to return to her hometown of Goroka in the Eastern Highlands Province. Upon returning from studies in October 2015, Dr Gare was appointed as the Laboratory Co-ordinator of the Sexual and Reproductive Health Unit of the PNGIMR.
It’s PNG’s principal laboratory for research into HIV and other sexually transmitted infections such as gonorrhoea, chlamydia, trichomoniasis, and syphilis. Recently, the laboratory has embarked several integrated studies aimed at understanding the epidemiology of human papilloma virus in PNG and its relationship to cervical cancer, the leading cause of morbidity and mortality in women in PNG.
“The problem of HIV and STIs is not just limited to the Eastern Highlands Province,” Dr Gare said. “In Papua New Guinea, there’s a high rate of infections among young people. In fact, PNG has the highest rate of STIs including HIV in the South Pacific, and is among the top five in the South East Asian region, so we have an important role to play to address a serious problem.”
Find out about Igat Hope Inc — the peak organisation representing and advocating for people living with HIV in PNG
Find out about Let Women Talk
Let Women Talk is a NAPWHA community-led health literacy initiative where HIV community advocates incorporate their rich perspectives and diverse lived HIV experiences back into strengthening community health responses — where women design and develop the health content and interventions that they want to see and hear. The initiative is one of many activities forming part of the HIV Health Literacy Framework Project, a NAPWHA project supported through the funding of ViiV Healthcare Australia.
Janet Gare is the first woman from the Papua New Guinea Institute of Medical Research (PNGIMR) to obtain a PhD for her research into HIV drug resistance in the PNG Highlands. She is a highly-skilled and passionate infectious disease research scientist, well-equipped with necessary skills to conduct bio-behavioral field surveys, clinical research, design laboratory experiments and monitor disease outbreaks in human population in low- and middle-income countries.
Sarah Feagan is a queer women who has been living with HIV since 2008. She is the previous chair of Positive Women Victoria and has recently joined the team at Living Positive Victoria as a Peer Navigator. She also the Vice President of NAPWHA. Sarah is a co-facilitator of Phoenix for Women and the Positive Leadership Development Institute (PLDi). Sarah has unique approach to her advocacy and is inspired by the lived experience of the body positive to inform her practice. Sarah’s advocacy spans the from the grass roots all the way up to high level governance. She has a global outlook with a local focus to bringing the community along with her.
In this video episode of Let Women Talk, HIV community advocate Sarah Feagan speaks with Professor Jennifer (Jenny) Hoy — Director of HIV Medicine at The Alfred in Melbourne, Victoria, who presented at the 2019 Australasian HIV&AIDS Conference held in Perth on 17-19 September. Professor Hoy presented research findings from a clinical study which showed that switching from tenofovir disoproxil fumarate (TDF) to raltegravir (RAL) is not associated with weight gain over 96 weeks.
About the presentation
Integrase inhibitor (INSTI)-based antiretroviral therapy (ART) has been associated with unexplained weight gain. Minimal information has been presented regarding a switch to raltegravir-based ART in patients with an undetectable viral load. Professor Hoy is a co-investigator in a clinical research of 37 HIV-infected adults, which retrospectively evaluated serial weight data from a non-randomised study that evaluated changes in bone mineral density (BMD) over 96 weeks after switching from tenofovir disoproxil fumarate (TDF) 300mg daily to raltegravir 400mg twice daily.
Conclusions: In this virologically-suppressed population, switching from TDF to raltegravir 400mg twice daily resulted in an increase in bone mineral density without a change in weight. Weight change after baseline mainly reflected regression to the mean. Weight gain may not occur with switch to INSTI-ART in virologically suppressed individuals, and may not be associated with all INSTIs.
Let Women Talk is a NAPWHA community-led health literacy initiative where HIV community advocates incorporate their rich perspectives and diverse lived HIV experiences back into strengthening community health responses — where women design and develop the health content and interventions that they want to see and hear. The initiative is one of many activities forming part of the HIV Health Literacy Framework Project, a NAPWHA project supported through the funding of ViiV Healthcare Australia.
Jennifer Hoy is the Director of HIV Medicine at The Alfred in Melbourne, Victoria. has over 30 years’ experience in HIV clinical research and patient care, and established the Clinical Research Unit at The Alfred. Prior to this, she established and directed the Infectious Diseases Clinical Research Unit from 1988-2008, building it into an internationally recognised research program. Professor Hoy has been co-principal investigator on five large studies investigating ARV therapy and bone loss, including the SMART (Strategies for Management of Antiretroviral Therapy) study and START (Strategic Timing of Antiretroviral Treatment) study on which she was the Principal Investigator for Australia.
Sarah Feagan is a queer women who has been living with HIV since 2008. She is the previous chair of Positive Women Victoria and has recently joined the team at Living Positive Victoria as a Peer Navigator. She also the Vice President of NAPWHA. Sarah is a co-facilitator of Phoenix for Women and the Positive Leadership Development Institute (PLDi). Sarah has unique approach to her advocacy and is inspired by the lived experience of the body positive to inform her practice. Sarah’s advocacy spans the from the grass roots all the way up to high level governance. She has a global outlook with a local focus to bringing the community along with her.
