ACTION PLAN HIV QUEENSLAND - Queensland Health - AWS
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Queensland Health QUEENSLAND HIV ACTION PLAN 2016–2021
Foreword HIV at a glance In the past few years, there has been unprecedented progress in the prevention elimination of HIV transmission. Consultation with primary healthcare providers, community-based HIV AIDS and treatment of HIV across the world and the organisations, specialised sexual health and HIV The human immunodeficiency virus (HIV) is the ability to end the world-wide epidemic is services, and key stakeholder communities has virus that can result in Acquired Immune Deficiency identified the following priority actions: Syndrome (AIDS) if left untreated. People who are now a real possibility. infected with HIV are said to be HIV positive, even if their infection has not resulted in AIDS. • transforming HIV prevention by taking a This action plan reflects the Queensland combined approach of promoting safer Government’s commitment to the new HIV prevention practices, together with overarching goal, endorsed by the Australian Health Ministers’ in the 20th International AIDS Conference Legacy Statement, of working improving access to HIV medication as a preventive measure 17% decrease in new towards the virtual elimination of new HIV • prioritising voluntary testing, including diagnoses in 2015 transmissions in Australia by 2020. To achieve community based testing In 2015, there were 203 new diagnoses of HIV in this, the Queensland Government is committing • providing support for those newly diagnosed Queensland, representing a 17 per cent decrease to a comprehensive approach to prevention, with HIV to engage in treatment and care from 245 new diagnoses in 2014. testing and treatment focused on meeting the • promoting access to immediate treatment United Nations 90-90-90 targets that: 90% of after an HIV diagnosis and support to adhere people living with HIV know their status, 90% of to treatment The majority of the people diagnosed with HIV are on treatment and • taking a zero approach to stigma and recently acquired HIV+ 90% of people on treatment have a suppressed infections in 2015 were discrimination. in men who have sex with viral load so their immune system remains strong men or bisexual men. and minimises the risk of transmitting HIV. This action plan will be enhanced by statewide campaigns and supported by research and As community ownership is essential for this surveillance. It aligns with both the Queensland fast-track approach to the 90-90-90 targets, Sexual Health Strategy 2016–2021 and the the Queensland Government is committed to Seventh National HIV Strategy 2014–2017 to supporting strong relationships between partner improve health outcomes for all Queenslanders. agencies in order to achieve the goal of the virtual Modern antiretroviral treatment (ART) is so The Hon Cameron Dick MP effective at suppressing HIV within a person’s body, that people consistently using ART are Minister for Health and unlikely to ever develop AIDS. Minister for Ambulance Services Success factors Achieving the United Nations 90-90-90 targets: • 90 per cent of all people living with HIV (PLHIV) will know their HIV status • 90 per cent of all people diagnosed with HIV will receive sustained antiretroviral therapy 90-90-90 • 90 per cent of all people receiving antiretroviraltherapy will have durable viral suppression.
QUEENSLAND HIV ACTION PLAN 2016–2021 Working with the community to minimise the personal and social impact of HIV and GOAL achieve the virtual elimination of new HIV transmissions in Queensland. Outcome 1. Implement a 2. Increase voluntary 3. Increase treatment uptake 4. Increase awareness 5. Improve surveillance, comprehensive preventive testing for HIV by people with HIV of HIV transmission and monitoring, research and approach address stigma and evaluation discrimination Target Gay men and men who have sex with men, Gay men and men who have sex with men All people living with HIV, including people Gay men and men who have sex with men Queensland HIV action plan stakeholders, including sexually adventurous men. including sexually adventurous men. ineligible for Medicare. including sexually adventurous men. HIV/STI workforce, national HIV/STI strategy populations Other target populations: Aboriginal and Other target populations: Women, Other target populations: GPs, whole-of- stakeholders. Torres Strait Islander people, culturally and Aboriginal and Torres Strait Islander people, population, Aboriginal and Torres Strait linguistically diverse people, people who culturally and linguistically diverse people, Islander people, culturally and linguistically inject drugs, sex workers, young people, people who inject drugs, sex workers, diverse people, people who inject drugs, people ineligible for Medicare, people in young people, people in custodial settings, sex workers, young people, people in custodial settings, travellers and mobile travellers and mobile workers, and people custodial settings, travellers and mobile workers, and people living with HIV. ineligible for Medicare. workers and people living with HIV. Key Community, healthcare and PHNs, general practitioners (GPs), PHNs, GPs, authorised s100 Community and healthcare settings Community and healthcare settings custodial settings authorised s100 prescribers, Hospital and prescribers, HHSs, pharmacies and settings Health Services (HHSs), pharmacies and community-based sites community-based sites
Queensland HIV Action plan 2016–2021 Outcome 1. Implement a 2. Increase voluntary 3. Increase treatment uptake 4. Increase awareness 5. Improve surveillance, comprehensive preventive testing for HIV by people with HIV of HIV transmission and monitoring, research and approach address stigma and evaluation discrimination Priority 1.1. Promote and encourage provision and 2.1. Increase access to and uptake of 3.1. Investigate options to improve timely delivery 4.1. Address stigma and discrimination 5.1. Develop and implement a monitoring uptake of HIV medication as a preventive voluntary HIV and other STI testing that of baseline HIV testing results to improve through implementing whole-of- and surveillance plan aligned with the actions measure for those at high risk of facilitates early diagnosis, including access to early treatment. population and targeted HIV awareness National HIV Strategy. contracting HIV, through the provision of conventional and point-of-care testing 3.2. Improve uptake of HIV treatment by newly campaigns with a focus on: 5.2. Develop and implement a pre-exposure prophylaxis (PrEP). across the healthcare system and diagnosed PLHIV through: targeted education community-based sites to encourage • awareness of HIV transmission coordinated Queensland HIV and 1.2. Promote and improve timely access to HIV campaigns that promote the individual regular testing for HIV and STIs as • prevention and testing with STI research strategy across all medication for those who may have been health benefits and reduced risk of further clinically indicated. high risk groups relevant disciplines including social, exposed to HIV through the provision of transmission, promotion of training to post-exposure prophylaxis (PEP). 2.2. Increase the number of health become authorised s100 prescribers and • LGBTI communities behavioural, epidemiological and practitioners and peer educators able to associated training and mentoring programs, clinical disciplines. 1.3. Increase access to and promote and • Aboriginal and Torres Strait encourage other HIV preventive carry out HIV and STI testing. and implementation of PLHIV peer-based Islander related issues 5.3. Identify and improve data for key activities, including the use of condoms 2.3. Promote regular HIV testing of those navigation models. populations, such as rural and remote • promotion of treatment with PLHIV and water based lubricants and sterile at high risk of HIV to encourage early 3.3. Support newly diagnosed PLHIV and their and healthcare professionals. areas and Aboriginal and Torres Strait injecting equipment. detection and address barriers, in line primary care providers through: information, Islander people. 1.4. Implement evidence-based HIV and STI with the Australian Sexually Transmitted clinical education, contact tracing, referral 4.2. Support implementation of resilience building programs for PLHIV. 5.4. Extend surveillance systems awareness campaigns. Infection and HIV Testing Guidelines 2014. for HIV specialist assessment, case management/care coordination and to accommodate scientific and 1.5. Implement comprehensive evidence- 2.4. Implement routine HIV testing in targeted 4.3. Provide information and support for peer-based support. technological advances and based peer education and outreach HIV GP settings in areas of high prevalence. people who have experienced HIV- related stigma and discrimination. innovation. and STI risk-reduction programs, and 2.5. Investigate access to testing models 3.4. Examine and advocate the removal of activities for key populations. which address the wide diversity of barriers to HIV treatment access. 4.4. Support improvement of the legal 5.5. Explore improved and innovative cultural and sexual behavioural needs, 3.5. Examine and improve models of treatment literacy of PLHIV. approaches to measuring testing 1.6. Implement peer-based strategies to enable sexually adventurous men to including among Aboriginal and Torres and care to support the management of HIV 4.5. Address barriers to evidence-based and treatment rates among priority maintain personal health and safety, Strait Islander people. in the community by: continuing existing prevention, treatment and care populations. including addressing the interaction 2.6. Promote personal and public health specialist HIV capacity through sexual strategies. 5.6. Investigate and implement systems between alcohol and other drug use and benefits of early diagnosis and the health and infectious disease clinics while 4.6. Support improved awareness of HIV for monitoring treatment uptake, risky behaviours to support safer sexual testing options available through reviewing case management and shared care and associated legal issues among ongoing clinical monitoring and viral decision making. targeted health promotion, marketing arrangements between the treating clinician, PLHIV, healthcare providers, police, suppression. activities and clinical engagement. GPs, other medical specialists, nurse 1.7. Promote the public and personal health lawyers, HIV and legal support practitioners, pharmacists and community- 5.7. Investigate research to measure benefits of HIV testing and early treatment 2.7. Promote routine HIV testing for all organisations and media. based organisations. the health impact of stigma and as a prevention strategy. pregnant women. 3.6. Implement strategies to improve the health discrimination on priority populations. and well-being of PLHIV to: increase the number of PLHIV who are under the care of a primary care health team, increase the number of PLHIV engaged in specialist HIV care, adherent to treatment and maintain an undetectable viral load, re-engage those PLHIV disengaged from HIV care, manage PLHIV who pose an HIV transmission risk to others and improve the health literacy of PLHIV through peer education and support. 3.7. Deliver training to HIV service providers to support culturally appropriate evidence- based clinical practice.
Queensland HIV Action plan 2016–2021 Outcome 1. Implement a 2. Increase voluntary 3. Increase treatment uptake 4. Increase awareness 5. Improve surveillance, comprehensive preventive testing for HIV by people with HIV of HIV transmission and monitoring, research approach address stigma and and evaluation discrimination Indicators Proportion of men who have condomless Type of HIV tests available CD4 count at HIV diagnosis Number of targeted campaigns to raise Weekly, year-to-date and annual anal intercourse with casual male and HIV test settings Source: Communicable Diseases Branch, awareness of HIV in specific settings or reporting of HIV notifications partners in the previous six months Source: Communicable Diseases Branch, among specific populations Source: Communicable Diseases Branch, Department of Health Frequency: Annual Source: Queensland Gay Community Department of Health Source: Funded service provider reports Department of Health Frequency: Weekly, Periodic Survey, Centre for Social Research Frequency: Annual Proportion of people who commence treatment Frequency: Annual annual in Health Frequency: Annual within six weeks, three months and six Number of HIV tests undertaken, including months of HIV diagnosis Number and type of research activities Amount of sterile injecting rapid point-of-care tests—with a particular Source: Communicable Diseases Branch, undertaken as part of a coordinated equipment distributed focus on monitoring the number of HIV tests Department of Health* Frequency: Annual HIV research strategy Source: Queensland Needle and Syringe undertaken by men Source: HIV/STI Professorial Chair, Program, Communicable Diseases Branch, Source: Communicable Diseases Branch, Proportion of PLHIV who report adherence to University of Queensland Department of Health Frequency: Annual Department of Health treatment with suppressed viral load Frequency: Annual Frequency: Annual Source: Communicable Diseases Branch, Proportion of people who inject drugs Department of Health* Frequency: Annual reporting re-use of a needle previously used Proportion of gay men and MSM who by someone else in the previous month have been tested for HIV in the Number of people ineligible for Medicare- Source: Australian Needle and Syringe previous 12 months subsidised HIV antiretroviral therapy who Program Survey, The Kirby Institute Source: Queensland Gay Community are able to be maintained on medication, Frequency: Annual Periodic Survey, Centre for Social Research with a suppressed viral load in Health Frequency: Annual Source: Communicable Diseases Branch, Number of occasions people access HIV PEP Department of Health* Frequency: Annual Source: Communicable Diseases Branch, Department of Health Frequency: Annual Proportion of PLHIV who report their general health status and wellbeing as excellent or good Number of people on PrEP Source: HIV Futures Study, La Trobe University Source: Cairns and Hinterland Hospital and Frequency: Biennial Health Service Frequency: Annual Number of health professionals authorised Proportion of people on PrEP undertaking as HIV community-prescribers three-monthly STI testing Source: Communicable Diseases Branch, Source: QPrEPd Annual Report, Cairns and Department of Health Frequency: Annual Hinterland Hospital and Health Service and HIV/STI Professorial Chair, University of *Work is in progress by Communicable Diseases Branch, Department of Health to Queensland Frequency: Annual identify data sources for these indicators to enable standardised reporting In monitoring the effectiveness of this action plan, priority will be given to those indicators required for reporting against the 90-90-90 targets.
QH 845 1611 Disclaimer: HIV Action Plan 2016–2021 The content presented in this publication is distributed Published by the State of Queensland by the Queensland Government as an information (Queensland Health), November 2016 source only. The State of Queensland makes no statements, representations or warranties about the This document is licensed under a Creative Commons accuracy, completeness or reliability of any information Attribution 3.0 Australia licence. contained in this publication. The State of Queensland disclaims all responsibility and all liability (including © State of Queensland (Queensland Health) 2016 without limitation for liability in negligence) for all You are free to copy, communicate and adapt expenses, losses, damages and costs you might incur as the work, as long as you attribute the State of a result of the information being inaccurate or Queensland (Queensland Health). incomplete in any way, and for any reason reliance was placed on such information. For more information contact: Strategic Policy Unit, Department of Health, GPO Box 48, Brisbane QLD 4001 strategicpolicy@health.qld.gov.au
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