Three resolutions were passed unanimously at the closing session of the AFAO/NAPWA Gay Men's HIV Health Promotion Conference in May 2012:
- Resolution on the breakdown of the Queensland HIV Partnership Response
- Resolution on HIV Treatments Access
- Resolution on HIV Testing Access
2. Resolution on the breakdown of the
Queensland HIV Partnership Response
The Conference notes with alarm the Queensland Government’s announcement on 20 May 2012 to remove funding from Healthy
Communities for its HIV prevention work with gay men and its other health promotion programs.
The decision was made without consultation and will seriously disrupt the provision of services to prevent HIV transmission in one
of Australia’s most populous states. The Queensland HIV epidemic has unique characteristics, but, as is the case all around the
country, the majority of the epidemic is directly affecting gay men. To stop working programs, to sack employed staff and destroy
community networks will set back HIV prevention efforts both in Queensland and across Australia.
The conference supports the call by Healthy Communities for Minister Springborg to work with them and other members of the
HIV partnership in Queensland to review the approach, and consider the impact of changes in the patterns of sexual transmission
of HIV in Queensland and make decisions about funding on the basis of the review, rather than pre-emptively defunding Healthy
Communities.
It is internationally recognised that HIV prevention has always worked best in a partnership approach between affected
communities, government, clinicians and researchers. The Conference calls on the Queensland Government to return to working
in partnership with all sections of the HIV response, and to recognise that those affected by HIV are best placed to determine their
health promotion needs.
The conference affirms its support of the HIV prevention work of Healthy Communities and their success over more than 20 years
in limiting the transmission of HIV among gay men in Queensland and providing effective HIV education, and contributing to the
Australian HV response.
3. Resolution on HIV Treatments Access
This Conference notes that barriers exist for PLHIV to readily and easily access HIV antiretroviral medication (ARV). These barriers
include cost, access to dispensing sites, clinical guidelines and some commonly held inaccurate perceptions of the burden of
treatments use.
The conference notes that in Australia the median CD4 level at which PLHIV commence ARV therapy is currently significantly
below 350, a level at which clinical guidelines recommend ARV to avoid immune system damage and to avoid the development of
opportunistic infections and comorbidities such as cardiovascular disease. This conference recommends that barriers to
treatments access be removed for PLHIV who wish to access ARV therapy, and in doing so increase the median CD4 level of PLHIV
commencing treatment to at least to 350, and preferably towards 500 CD4, or higher.
These access issues need to be addressed to provide PLHIV an enhanced quality of clinical health and subsequent improvements
in overall quality of life. The Conference notes that there may be a broader health dividend from lower levels of community viral
load; however, the primary decision to use ARV is based on an individual’s health decisions, including the impact of reduced
infectiousness on their mental health and wellbeing. Voluntary, informed, personal decisions are fundamental to the choice to
commence and sustain ARV therapy over a lifetime.
This Conference notes that adherence support programs vary around Australia and recommends NAPWA and AFAO investigate
opportunities to promote best practice ARV adherence support programs.
4. Resolution on HIV Testing Access
The Conference notes with concern that HIV testing rates among priority populations are lower in Australia than some
comparable countries. The Conference also notes that the majority of people diagnosed with HIV in Australia each year have no
regular HIV testing routine.
The Conference recommends that barriers to testing be addressed as a matter of urgency. These include improving the
convenience of current testing processes, appropriate and expedited introduction of rapid testing technologies and programs that
promote regular voluntary testing for people at risk of HIV infection. The conference supports research into self-administered
home-based testing.
This Conference notes with alarm that rapid testing technologies are approved for use in comparable developed countries and
have proven useful in addressing HIV transmission rates, yet remain unapproved for use in Australia in 2012. This Conference calls
on all parts of the HIV partnership to proactively work towards making rapid HIV testing routinely available in Australia.