Partner Notification for Chlamydia ProjectIn response to increasing numbers of Chlamydia positive diagnoses in Western Australia, the Australasian Society for HIV Medicine (ASHM) and the West Australian Department of Health are working together with WA general practice on a project to encourage partner notification at the point of diagnosis.

The project aims to try and reduce rates of Chlamydia by increasing the likelihood that sexual partners of people who have Chlamydia are also treated. In collaboration with GP, nursing and health care organisations, ASHM has developed a brief educational intervention for general practitioners and their clinic staff to better equip them to discuss partner notification with patients at the point of diagnosis. Aware of time constraints and high work loads in general practice, ASHM also developed two Chlamydia fact sheets for general practice and patients/partners to be used as additional support. Other print and non-print resources are in development.

Based on a survey conducted by Combined Universities Centre for Rural Health (CUCRH) amongst GPs who have recently notified a case of Chlamydia, ASHM finalized the course materials and piloted the Chlamydia partner notification training resources on December 2 in Perth. 

The survey confirmed that the Department of Health has not communicated clearly with medical practitioners about contact tracing and partner notification for Chlamydia cases. Chlamydia contact tracing is not routinely performed by WA public health and community nurses. Minor changes to the instructions on the cover of WA Health disease notification pads will be made to reflect the role of general practitioners in encouraging partner notification for Chlamydia. The changes are currently in draft form and state that: "If your patient has Chlamydia, ask him/her to contact as many of their sexual partners as possible and recommend that they see a doctor for testing +/- treatment. For complex and/or hard to reach contacts, please contact disease control nurses for advice or assistance?." As the draft text clarifies, public health and community nurses in the North and South metropolitan areas will provide assistance with complex cases, but as a rule diagnosing doctors are encouraged to get their patients to notify their partners.

In addition, ASHM in partnership with Western Diagnostic Pathology will begin to pilot the introduction of an automatic reminder to discuss partner notification linked to the pathology report. The pilot seeks to complement existing information on the Chlamydia positive pathology report by providing GPs with a reminder about partner notification and other essential information at the point of diagnosis, including a web address where they can access the Chlamydia fact sheets for patients/partners. ASHM is now contacting other pathology labs in Western Australia for inclusion in the pilot.

ASHM is currently planning the roll out of four training sessions on Chlamydia Partner Notification. The first session is being organised in partnership with the West Australian Practice Nurse Association (WAPNA) and will be held in Perth on February 10. Other training sessions are currently being planned in collaboration with the Rockingham Kwinana Division, the WA Australian Medical Association (WA AMA) and the Practice Nurse Clinical Education conference (PNCE). For further information about this course and other courses or to register, please visit http://www.ashm.org.au/courses/or contact Simona Achitei at simona.achitei@ashm.org.au.

Contact Tracing ProjectThe Contact Tracing Project aims to develop a contact tracing package focusing on the needs of health care workers servicing hard to reach populations, including Indigenous Australians, people in rural and remote settings, people from culturally and linguistically diverse backgrounds and people who are highly mobile as a function of their employment or other factors. This project is run in conjunction with the Combined Universities Centre for Rural Health (CUCRH) and is funded by the WA Department of Health.

After a process of extensive consultation with stakeholders across the state, an information-sharing workshop in September 2008 brought together for the first time a group of health care providers working in contact tracing to share ideas for the training package. Based on their recommendations, ASHM in collaboration with the Combined Universities Centre for Rural Health (CUCRH) is currently developing the content of the package directly into online/multimedia format with provision for face-to-face delivery. Key issues to be covered include getting contact details, managing personal security, confidentiality and privacy, and assessing the quality of work.

We anticipate this experience-based, ?how to? guide for contact tracing will be piloted in February 2009. ASHM is currently seeking interest from individuals and organisations in rural and remote WA who may be interested in participating in the pilot.  For further information please contact Simona Achitei at simona.achitei@ashm.org.au.

HIV Training
The final training session, organised in collaboration with the Perth Primary Care Network, has been scheduled for 25 March 2009. ASHM has conducted 15 introductory training sessions in HIV medicine across Western Australia in partnership with the WA GP Network. There have been 147 attendees at these meetings including GPs, nurses and allied health workers, 112 of whom are practising in non-urban locations.

Models of Access and Clinical Service Delivery
WA Health, along with all other state and territory Health Departments and the Commonwealth are collaborating with ASHM and NAPWA in a two part National project looking at:
? models of access to and delivery of clinical services for people with HIV in Australia that will be suitable in the next 5-10 years, as the complexity of HIV care and the age of the population with HIV increases, and
? the changes to the health workforce (numbers and training) required to achieve this.

The project started in July 2008 and a meeting was held in Perth in September. A number of papers have already been commissioned looking at models of access and clinical service delivery for chronic conditions, and for HIV nationally and internationally, existing HIV services across Australia, the demographics and clinical service needs and preferences of people with HIV and workforce issues, including capacity, deficiencies and adaptability to the changing nature of HIV.

Of particular interest has been the observation that a significant number of doctors who diagnose patients with HIV are doing this for the first time. In NSW this is about 25% of all new diagnoses made and in WA it appears to be about 30%. ASHM is examining ways of providing information and support to those doctors at the time of diagnosis. For further information about this project, please contact Dr. Jan Savage at jan.savage@ashm.org.au

ASHM welcomes A/Prof Patricia Price as the new ASHM Board member
Patricia Price began as a laboratory-based immunologist with an interest in problems facing the majority of the world - malnutrition, parasite infections and finally viruses. After almost 20 years in the Department of Microbiology (U WA) working with laboratory mice, Patricia moved to Department of Clinical Immunology & Immunogenetics (RPH) in 1996. Her work there began with the mapping and characterisation of polymorphic immunoregulatory genes in the central MHC - this has continued to include characterisations of TNF haplotypes and associated with disease in Asians and Caucasians. She also established a collaboration A/Prof Martyn French (Head of Communicable Disease Service, RPH) to investigate the immune responses of HIV patients undergoing potent anti-retroviral therapy. They are looking for markers which define "Immune Restoration Diseases" and reasons why some patients fail to restore CD4 T-cell numbers or function. The team in Perth now includes three post-doctoral scientists Sonia Fernandez, Silvia lee and Andrew Lim.