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HIV prevention and sexuality sensitive health care


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A community-based clinical liaison project to support HIV prevention and sexuality sensitive health care in General Practice and government clinics across Queensland

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HIV prevention and sexuality sensitive health care

  1. 1. A community-based clinical liaison project to support HIV prevention and sexuality sensitive health care in General Practice and government clinics across Queensland<br />Bernard Gardiner<br /> Clinical Liaison Co-ordinator<br />
  2. 2. Purpose<br />To introduce the rationale, activities and context for the QAHC Clinical Liaison project<br />
  3. 3. Part time officer funded as part of Qld reinvestment in HIV prevention<br />Qld one of most decentralised States – decades of Gov policy. <br />About half HIV tests done with low case load GPs. <br />
  4. 4.
  5. 5. Low case load GPs a risk – homophobia, low competence<br />Many do not come out (Private Lives - 1/3rd), leading to missed opportunities. “a marker of higher numbers of sexual partners & higher sexual risk”<br />In regional areas LGBT friendly GPs often have books closed <br />Data base of LGBT friendly GPs has to be build from scratch – privacy laws restrict interagency sharing of contacts<br />GPs not wanting to be identified as the Dr that sees any particular group – bad for business<br />
  6. 6. But, not just GLBT getting poor service<br />STIs in general <br />Not a first tier Fed Gov prevention priority (despite National HIV Strategy, Nat Syphilis Strategy etc)<br />No funding to Colleges of GP/Division as exists for smoking, weight etc – no contact person re sexual health<br />Always trying to negotiate discretionary effort…lack of suitable events to piggy back on (Avian flu?)<br />Cannot compete with drug companies (who do occasional HIV related events)<br />Need to reach en masse – 4,000 door to door not an option, gatekeepers<br />
  7. 7. Issues even if well intentioned<br />MSM, coming out<br />Sexual history taking, appropriate language, LGBT cultural competence<br />HIV tests without STI screen<br />STI screen without HIV test<br />STI screen without anal and throat swabs<br />Hep A & B warts vaccination etc<br />Lack knowledge for referral <br />Lack practice network – quality?<br />
  8. 8. Empower the client<br />Lesson learnt from HIV <br />A partnership<br />DDU materials ‘Ask your Dr to get behind testing”<br />
  9. 9. Prepare the Dr<br />Inclusion in training events – Uni Q, FPQ, Divisions of GP?? Drug companies???<br />Own events – points<br />Longer term LGBT cultural sensitivity course, good models from ATSI. <br />Dr specific materials e.g. DDU. Conversion of anal swab flier to a client education tool in Medical Manager. STIGMA DDU easy reference.<br />
  10. 10. Improve Systems<br />PEP<br />Ultimately ‘social determinants of health’, even though not recognised or funded, YET<br />As Aust Health Reform progresses, focus from hospital to primary health care (more room to move for GPs/Nurse Practitioners), and Prevention, then Sexual Health and LGBT wellbeing more likely to come onto the agenda, get funded<br />Push to create, and get ready (as ATSI did re ‘Close the Gap’)….National LGBT Health Alliance<br />Nurses likely to be a key to quality<br />
  11. 11. In summary,<br />To ensure the health and wellbeing of gay men are promoted, a two pronged approach is taken by the Queensland Association for Healthy Communities.   <br />Firstly, the gay community and other MSM are empowered and educated so they know how to engage their doctor in a partnership for health. <br />At the same time materials and other supports for doctors are produced to better prepare them to meet the specific health needs of gay men and other men who have sex with men.  <br />