ASHM provides support to the HIV, viral hepatitis and sexual health workforce
It formed initially as a self-help and self-education organisation for clinicians at the forefront of HIV and was first known as the Australian Society of AIDS Physicians.
ASHM has expanded its interest to include viral hepatitis and sexual health and to embrace the range of individuals in the health workforce and those in professions may need to respond to HIV, viral hepatitis or sexual health issues.
Origins and Early Years
In 1988, Australian clinicians attending the Stockholm AIDS conference realised that Australians would benefit from having a Society for professionals that would support them in learning about and responding to HIV. What we now know as ASHM was born.
It immediately started to arrange an annual scientific conference and to collaborate with the Australian Government.
In 1990, the Australasian Society for HIV Medicine was incorporated, following representation and advocacy from New Zealand clinicians and non-physicians working in HIV Medicine.
Soon after, it collaborated in the development of a multidisciplinary Heath Maintenance and Monitoring Project, which saw the coordinated development of education for clinicians, community sector agencies and people living with HIV. This provided ASHM with its National HIV Education Program for Doctors.
Could it Be HIV?
Could it Be HIV? was the first national resource developed by ASHM and published by the Medical Journal of Australia (MJA). A copy of Could it be HIV? was delivered to each doctor's desk in 1993 and the first five chapters were published in the MJA between January and March 1993.
A second edition was release in 1994. These publications were designed to equip all doctors with sufficient understanding to identify HIV.
At the time, many people with HIV were being identified late in their infection. HIV management was very complex, rapidly changing, and treatment very limited. Antiretroviral therapy was not in use and management focused on treating opportunistic infections (OI) and initiating prophylaxis. It seemed as one OI was controlled another nastier one emerged. Not all doctors would go on to care for patients with HIV but those that would required a much more in-depth understanding.
Managing HIV tried to fill the educational need of doctors managing HIV. Again, this resource was produced as a collaboration with the MJA and funded by the Commonwealth Department through the National HIV Education Program for Doctors.
Managing HIV had a number of related resources, including a slide-set to assist with education, a number of journal articles and items in the medical press, and a supplement called Principles of HIV, which was a simple introductory journal supplement and used commonly in undergraduate teaching.
The nascent society was instigated by specialists and it largely developed like a specialist society of the College of Physicians. However, this was never formalised as the breadth of disciplines working in HIV was great. The role of general practitioners in identifying infection and caring for patients was also great.
Although full membership was initially restricted to consultant physicians and general practitioners, other disciplines including researchers, epidemiologists, laboratory scientists, nurses, social workers, psychologists and allied health professionals were admitted as affiliate, non-voting members.
In 1994 a decision was made to allow general practitioners full voting membership of ASHM. But it was not until 1997 that the membership was further broadened to allow nurses full membership and in 2006 the membership was further broadened to allow full membership to all who supported the objectives of the organisation.
Expanding clinical interest
HIV was a watershed in the development of the health landscape. Consumer participation and advocacy had never been seen like it before.
A partnership developed that valued the contribution of affected communities, health consumers, clinicians and researchers and government. Attempts were made to engage other areas in responding to the pandemic.
Education focusing on prevention among young people; correction looking at the needs of prisoners; attorneys, general and right- based organisations and government departments focusing on the legal and enabling environment; and the Department of Foreign Affairs and Trade looked at international and development responsibilities. Australia is recognised internationally for this partnership approach.
There was an attempt to replicate this approach in the hepatitis C area. Many of the organisations, particularly within government, were asked to take on hepatitis C. Some community agencies did this as well. Sexual health, which had languished in some areas and been developed as a backbone to HIV service delivery in others, also came under the umbrella of the partnership approach.
To determine its approach, ASHM asked its members where their interests lay and responded to that:
A survey of members in 1998 found that the majority had an interest in and some responsibility for hepatitis C management.
Regular evaluation of course attendees indicated that they wanted information on viral hepatitis and sexual health and had need for this in their clinics
In 2001, users of Could it be HIV? indicated they wanted to include viral hepatitis. This was support by the RACGP and steering committee for the project and a new resource HIV and Viral Hepatitis: A Guide for Primary Care was born. In collaboration with the Commonwealth Department of Health and Australian Medical Publishing Company, it was made available to every doctor.
Following a subsequent evaluation, members requested that sexually transmissible infection also be included in the book. The book, HIV, Viral Hepatitis and STI: a guide for primary care is now in its fourth edition.
ASHM was Incorporated in NSW in 1990 and managed by an elected voluntary Executive Committee. An early decision was made to become an Australasian Society in response to advocacy from New Zealand members.
The HIV clinical workforce was not large and ASHM tried a number of approaches to attract and represent members from all states and New Zealand. It attempted to have formal chapters in each state but the administrative burden of this made it difficult. It also tried to link jurisdictions so that South Australia and the Northern Territory, Tasmania and Victoria and New South Wales and the ACT could work together, but in reality this was difficult. The majority of clinicians working in HIV were from NSW and Victoria and these jurisdictions played a major role in the development of the Society.
In 2008, ASHM took the decision to become a company as our expanding role in multiple health areas and particularly our active running of programs and activities in multiple states as well as regionally meant that we had outgrown our incorporation framework. This gave the Society an opportunity to review its constitution, which had changed somewhat over the years and generally allowed us to bring our legal framework in line with our practices and our plans for further development, particularly our increasing role and engagement in the region. The change came into effect in September 2009 when ASHM became a company limited by guarantee.
Another change taking place at that time was to use the acronym and tagline ASHM: Supporting the HIV, viral hepatitis and sexual health workforce as this was seen to better reflect the breadth of our work.