Asia Pacific AIDS & Co-infections Conference 2018 kplhs

I have thoroughly enjoyed the opportunity to attend the APACC conference. It has been a very inspiring conference, motivating and very relevant to my practice. The key themes throughout the conference are applicable and relevant in the Australian context. Concerns about confidentiality, stigma and discrimination from people at risk of, or living with HIV, are present within the Asia Pacific region. It is humbling to see the difficulties faced by affected communities throughout the region and the significant challenges of funding, discrimination, poverty, access to inclusive healthcare and treatment. However, it is invigorating to see the passion, dedication and creativity of communities and health care providers to provide these services in their culturally diverse settings.

Day 3 opened with ASHM presenting the goal of the 4^th 90 – Good Health. I found this particularly relevant given over the past two days presentations we have heard the commonality of adverse health issues we are now seeing emerge with an aging HIV population with multimorbidity across the entire Asia Pacific region.

Sepi Maulana Ardiansyah is a National Coordinator of Indonesia Young Key Population Network and talked frorm a personal and professional perspective about living with HIV and the challenges of being MSM in Indonesia. His presentation was from the heart and showed his passion and his concerns about the negative effect of stigma, discrimination and abuse towards MSM and people living with HIV in his own country.

David Cooper Memorial Lecture: Current efforts to control the epidemic in the region, Nittaya Phanuphak

This was a very powerful and fast-moving presentation. The main message would appear to be if we want to control HIV we need to get in there and do it! Nittaya advocated strongly that we need to highlight the gaps in our HIV prevention, particularly to PEP and PrEP provision and ensure that all at risk of HIV can access PrEP. She highlighted that in Thailand 4000 people are taking PrEP, but it is they estimated that to reduce HIV infection rates 1 million would need to be accessing it. The challenge is how to provide access to marginalised and hard to reach groups. Nittaya advocated for the de-medicalisation of HIV treatment and prevention through multidisciplinary working nurse led PEP, PrEP and treatment initiation. But key to the de-medicalisation is the inclusion of peers to provide support and treatment navigation service and facilitate same day provision.

The first day of the APACC 2018 for an Australian participant highlights the challenges we face in the Asia and Pacific region. As a first-time HIV conference attendee and low-caseload HIV prescriber, I was worried I wouldn't be able to follow the science and intricate complexities of antiretroviral prescribing. I didn't need to be concerned. The message was that we need to progress more at a political and social level to "End HIV" in our region. We have enough evidence in the basic science of HIV and therapeutics. We don't need more statistics to get it done. We need a greater understanding of social science.