- Treatments for HIV have evolved and dramatically changed the approach to clinical HIV management.
- HIV is now considered a manageable chronic condition requiring lifelong treatment.
- ASHM provides clinical guidance on the management of HIV including texts, guidelines, training, accreditation and continuing professional development activities to ensure that people treating HIV have access to contemporary evidence-based research and best practice.
HIV Management in Australia
There are approximately 26,800 Australians thought to be living with HIV (31,900-24,500). Of these, 17,700 are diagnosed and on treatment (15,200 – 20,500).1
Antiretroviral treatments (ART) have evolved, reducing side effects and making HIV easier to clinically manage.
Newer ART drugs attack HIV on a number of fronts — stopping viral replication, proliferation and the entry of HIV into host cells. This is a chemically complex process that has been simplified by the co-formulation of compounds into a single pill taken once daily for many people.
The reduction in treatment side effects and the benefits accompanying suppressed viral load have encouraged new international targets outlined in the UN Political Declaration on HIV to reduce HIV transmissions by 50% and to increase the number of people living with HIV on suppressive ART to 90%.
Australia is a signatory to the Declaration and these targets are reflected in the National HIV Strategy and a number of jurisdictional strategies.
ASHM-Trained HIV s100 Prescribers
Effective 3 March 2017, here is a list of ASHM Trained HIV s100 Prescribers located throughout:
- Australian Capital Territory
- New South Wales
- South Australia
- Western Australia
What does ASHM do in HIV Management
As well as offering training and professional development courses, ASHM produces a number of guidelines and resources in HIV management. These include:
ASHM plays an important role in providing guidance to clinicians on HIV management. ASHM maintains the Antiretroviral Guidelines Panel which provides Australian-specific commentary on the USA DHHS Guidelines for HIV management in Adults and Adolescents. This is delivered through the ARV Guidelines website, which also provides a comparison between leading international guidelines and a summary of preferred initiation regimens.
This text is used to support our HIV S100 Prescriber Course. The monograph is now available on-line as a website and is no longer published as a manual.
The new website can be accessed at: http://hivmanagement.ashm.org.au
This is our primary care text on HIV. This resource is available for order as a hard copy book and can also be downloaded in full or by chapter. This is used as a reference for much of our training and is provided free to participants.
This laminated A4 decision making tool outlines the basic model of HIV management. It depicts an annual cycle of care and itemised common tests and points of review. The tool is currently under review.
A 42-page book last released in 2010. The book is divided into four chapters and covers the epidemiology of HIV and viral hepatitis co-infection; the management of HIV and hepatitis C co-infection; the management of HIV and hepatitis B virus co-infection; and antiretroviral therapy-related hepatotoxicity predictors and clinical management.
These online guidelines have been developed by a consortium of Sexual Health organisations: the Australasian Sexual Health Alliance which is a committee supported by ASHM to provide expert input into STI policy and resource development. The Guidelines, launched in October 2014, are available at sti.guidelines.org.au
ASHM Training and Professional Development
HIV medicines are regulated by section 100 of the Health Act. Under this legislation, any specialist or appropriately trained professional is able to prescribe HIV medicines.
ASHM currently provides prescriber training to general practitioners in New South Wales, South Australia, Australian Capital Territory and Northern Territory in accordance with the National Standards for community HIV s100 prescribers.
Initial training and ongoing professional development for prescribers is delivered through our HIV Prescriber Program which equips general practitioners to prescribe HIV ART and maintain their accreditation.
ASHM maintains lists of currently accredited prescribers in New South Wales, South Australia, Tasmania, Victoria, Australian Capital Territory, Queensland and Northern Territory.
National Standards for HIV Training and Accreditation
ASHM maintains the National HIV Standards, Training and Accreditation Committee (NHSTAC) which sets standards for training and ongoing professional development requirements for HIV s100 prescribers.
NHSTAC sets the national training curriculum as well as the level of continuing professional development required to maintain accreditation. NHSTAC reviews the HIV s100 training curriculum on an National Standards for Training and Certification
1 The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2016. The Kirby Institute, the University of New South Wales, Sydney