Characteristics of Individuals with Heterosexually-acquired Compared with Homosexually-acquired HIV and Implications for Clinical Practice

A report on Simone Herbert’s presentation on day 2 of the Conference.

Today I wanted to reflect on the findings presented in the session looking at differences in characteristics of individuals with heterosexually acquired HIV compared with homosexually acquired HIV. We heard yesterday how newly diagnosed men who acquired HIV heterosexually in Australia has increased, yet knowledge by this population remains that of the time of the grim reaper. There is a lot of fear and misconceptions about HIV in this sub-population.

This group have not heard about the advances in treatment nor of changes such as TasP. This group are less likely to initiate a conversation with their doctor nor have their doctor initiate a conversation with them about risk. The findings from the study reported by Simone Herbert were derived from the AHOD observational data. This is data collated over 12 years in Australia. By admission the data is limited not only by small sample size but by missing data.  However, they found that males who reported acquisition heterosexually living in Australia were more likely to be born overseas. Typically this group were diagnosed late and therefore had lower CD4 levels at diagnosis and commencement of treatment. Maybe because of this they don’t reconstitute their CD4 levels to former levels despite viral suppression.

What are the implications of these findings for practice?

 In the multicultural existence that is Australia these findings are important. In the Cairns region, which is where I am from, we see a lot of folk from SE Asia and PNG along with many other individuals born overseas in a variety of countries. The findings of the rise of HIV in heterosexual populations highlights the importance of a good sexual health history exploring risk and performing BBV screens for those who have risk or who request one. Early detection means better outcomes for the individual. There is a need for identification of acquisition sooner to enable these individuals to have the benefits of starting treatment as early as possible. There is also a need for more general population education.

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Additional note: On adolescents and HIV

Just a short note about the afternoon session on Tuesday about adolescents and HIV and in particular the session by Nathan Butler, Growing up Positive: The Adolescent Edition. I would like to express my thanks to Nathan for sharing his experiences of being a teenager and being HIV positive. I found this session very thought provoking and informative. A clear demonstration of how what is going on for the person at the time will affect adherence and that the issues can be complex and then there’s the complexity of adolescence on top.  If you didn’t haven’t’ had a chance to hear Nathan speak I would recommend it if you get the opportunity.

 

Author bio:

I am a clinical nurse with 30 years experience. I have over 10 years experience in sexual and reproductive health. I hold a Masters in Advanced Practice (sexual health).  I have extensive experience working in remote communities with Aboriginal and Torres Strait Islander people. Currently I work at Cairns Sexual Health. I wear two hats at Cairns Sexual health. I work as part of an outreach service team and additionally do some hours as Research Co-ordinator.