Government launches critical new weapon in fight against syphilis

Source: National Indigenous Times, Wendy Caccetta, 8 August 2018

The Federal Government has begun rolling out what it says is a critical new weapon in the fight against the deadly syphilis outbreak which has gripped northern Australia.

Federal Indigenous Health Minister Ken Wyatt said from today on-the-spot syphilis tests would be available in three high risk regions — Townsville, Cairns and Darwin.

The instant tests allow people to be diagnosed straight away and to be treated immediately, rather than have to wait a fortnight for results from traditional blood tests.

“These tests are a critical weapon in the fight to curb and control the spread of syphilis,” Mr Wyatt said.

Three thousand test kits have been sent to the Townsville Aboriginal and Islanders Health Service, 3,000 to the Wuchopperen Health Service in Cairns and 4,000 to the Danila Dilba Health Service in Darwin.

Read the full story


Syphilis: How deadly disease has spread in Australia

Source: BBC News, Sydney, By Frances Mao

Less than a decade ago, doctors in Australia believed they were close to eliminating syphilis from remote indigenous communities - the centre of national efforts to fight the disease.

Since then, however, the sexually transmitted infection has grown into an outbreak spanning three states and a territory.

Doctors say six babies have died from congenital syphilis since 2011.

During the same period, they say the outbreak overwhelmingly affecting indigenous Australians has risen from about 120 people to more than 2,100.

Health experts have characterised it as a crisis, saying the nation faces a "big task" to bring the problem under control.

How did this happen?

The majority of syphilis sufferers in Australia are young Aboriginal and Torres Strait Islander people who live in regional areas in the nation's north and centre, doctors say.

Indigenous health experts, including Associate Prof James Ward, issued a call in the Medical Journal of Australia in 2011 to try to end syphilis in communities where it was a problem.

But Associate Prof Ward says it has instead "spiralled out of control", spreading from one Queensland community to elsewhere in the state, as well as to the Northern Territory, Western Australia and South Australia.

Read the full story


Syphilis shame needs to be eradicated too

Source: National News, © 4CA Cairns – 12 July 2018

Erasing a syphilis epidemic sweeping indigenous communities will not only require the distribution of rapid test kits but also ending the shame associated with the disease, a leading sexual health physician says.

The federal government will distribute on Monday, as part of an $8.8 million plan to tackle the outbreak, more than 60,000 rapid test kits across Townsville, Cairns and Darwin.

Cairns Sexual Health Service physician Dr Darren Russell, who is also an associate professor at James Cook University, says the kits were "long overdue" but only part of the solution.

Since 2011, more than 1000 cases had been recorded in north Queensland including 11 babies with congenital syphilis of which six have died.

"We've had an epidemic in Queensland … and that has spread across to the Northern Territory, Western Australia and more recently South Australia," he said.

Read the full story


Syphilis has returned to Queensland in epidemic proportions, and it's killing babies

Source: ABC News – 11 July 2018
A disease that once sent kings mad is now killing babies in Queensland

A 'medieval' disease infamous for devastating kings has returned in epidemic proportions in Queensland, and killed six babies in as many years, despite there being a cheap and effective cure.

In the last six years, six babies have died in the state from syphilis — a sexually transmitted disease that was nearly eradicated in the early 2000s.

In 2008, two cases were diagnosed in Queensland, and in the decade since, more than 1,100 other cases have been recorded in the north of the state, with about 200 new presentations each year.

The numbers continue to grow, despite penicillin being a cheap and effective cure.

Read the full story


Young Deadly Syphilis Free Resources

Source: Latest Young, Deadly, Syphilis Free Newsletter

Hello Everyone

We really wanted to extend our reach to community, we understand some of you may have already received this newsletter and we apologise for cross posting but please take this opportunity to share our newsletter with colleagues, friends and organisations in your area.

The team here at SAHMRI have compiled all of our syphilis health promotion and educational resources for you and included them here for you to use.

Within the link below you will find a syphilis and an STI educational animation, a series of syphilis info-graphics, 2 television commercials, radio advertisements, 2 posters, short and long fact sheets, and four clinician videos.

Click here: http://jmp.sh/b/Zf7jmoBPYvy7Sk8Dyjkr to download our resources.

If you are in an area where the internet may be lagging or connection is too slow to download, let us know. We would be happy to upload these resources onto a USB stick and send them on to you.

If you would like a USB and or any hard copies of our posters and also if you have any feedback on our resources please send us an email at ydsf@sahmri.com

Also don't forget to follow our Young Deadly Free Facebook Page and check out our Young Deadly Free website Young Deadly Free where you can find many more useful resources on STIs and BBVs relevant for Aboriginal and or Torres Strait Islander Communities.

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https://www.facebook.com/youngdeadlyfree/ &
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Syphilis jumps to Western Australia

Source: ABC News— 17 Mar 2018

Some sexually transmitted diseases are on the rise in Western Australia, with Aboriginal communities in the north hit particularly hard by a syphilis outbreak.

Across the population, Syphilis has more than doubled the five-year average, up 112 per cent. More than 95 per cent of cases reported in Perth were in men.

However the rate increased by 38 per cent among Aboriginal people, associated with an ongoing outbreak in the Kimberley region, and decreased by 13 per cent among non-Aboriginal people.

Australian Medical Association president Omar Khorshid said Aboriginal people in the north had been failed.

Read more at ABC News


Registered nurses take action on HIV/AIDS by producing documentary

Source: Regina Leader-Post— 26 April 2018

Responding to a growing epidemic in the province in a non-traditional way, registered nurses have produced a documentary entitled On the Frontlines of the HIV Crisis.

“We know that there is an epidemic of HIV — probably one of the largest epidemics there’s been in Saskatchewan in quite some time,” SUN president Tracy Zambory said in a recent interview. “We are seeing more and more people coming into the system affected, and we felt that it was time to shine a light on this crisis, and who better to do it than registered nurses?

“We’re the ones on the frontlines. We’re the ones who see it happening.”

Read more at Regina Leader-Post


Is Truvada (PrEP) the game-changer that will end new HIV transmissions in Australia?

Source: The Conversation— 29 March 2018

On Sunday, April 1, Australia will join only a handful of other countries in the world whose governments have made HIV pre-exposure prophylaxis (PrEP) readily available to populations at risk of HIV infection.

This step forward takes Australia much closer to achieving its pledge, made in 2014, to end new HIV transmissions by 2020.

What is prep and how does it work?

PrEP is the most powerful prevention tool currently available for people at risk of HIV infection. In people with high adherence to PrEP medication, it reduces the risk of acquiring HIV by 99%.

This compares to an HIV risk reduction of 70% for men who have sex with men (MSM) and 80% for heterosexuals who choose consistent condom use alone to prevent HIV infection. In 2015 the World Health Organisation declared that PrEP should be offered as an additional HIV prevention option to all populations at substantial risk of acquiring HIV.

In its current form, PrEP involves combining two antiretroviral drugs, tenofovir and emtricitabine, into a single tablet. PrEP is usually taken daily, but may be used just as effectively by MSM in an “on demand” fashion, taking tablets before and after sex.

What about side effects?

PrEP is generally well tolerated; in one study approximately 17% of people experienced mild side effects. These included headache, fatigue and gastro-intestinal upset within the first few weeks of starting PrEP.

These side effects mostly resolved over a few months. Only 5% of people ceased PrEP because of adverse effects. PrEP does cause a small decline in the health of the kidneys and bones, but these changes are reversible when PrEP is ceased.

People receiving PrEP see their clinician every three months to test for HIV and other sexually transmitted infections (STIs) and to monitor their overall health.

Early PREP study results in Australia

In Australia’s first PrEP study, VicPrEP, we observed a decline in condom use and a rise in sexually transmitted infections (STIs), which has been reported in other PrEP studies.

There are several reasons why STIs may rise in populations using PrEP. These include less condom use, but also simply that STIs are diagnosed more frequently because people on PrEP get tested for these every three months. More research and collaboration with the community are needed to better understand the relationship between PrEP and the incidence of STIs.

Despite PrEP only arriving on the PBS from April this year, Australia is already leading the world in its PrEP use. In Australia, 31,000 MSM are estimated to be eligible for PrEP.

Thanks to strong partnerships between community activists, peak Australian HIV organisations, doctors, researchers and state and territory health departments, approximately 16,000 MSM receive PrEP through state-funded PrEP trials. Several thousand more people are thought to be personally importing PrEP online thanks to dedicated community activists.

Early signs of success in PrEP’s ability to reduce HIV infections at a population level have come from New South Wales where, remarkably, about 9,000 people have enrolled in the PrEP implementation study, EPIC.

Recently, NSW reported a 32% decline in new HIV infections and a 25% overall statewide decline in new HIV diagnoses following the rollout of EPIC in 2016.

This remarkable progress should energise and provide impetus to other jurisdictions and countries, including Asia and the Pacific and particularly Eastern Europe and Central Asia where there is a dearth of PrEP use and the incidence of HIV has risen by 60% over recent years.

Getting PrEP through the PBS

From April 1 2018, people with a Medicare card who are at risk of HIV will be able to receive a script from their general practitioner or medical specialist for a three-month supply of PrEP.

The Pharmaceutical Benefits Advisory Committee approved PrEP in December 2017, which means the Pharmaceutical Benefits Scheme will subsidise its cost. People taking PrEP will pay up to $39.50, or $6.40 per month for concession cardholders.

The Commonwealth has provided funding to peak national HIV organisations to educate healthcare providers and the community about PrEP. This education must address and prevent the risk of people seeking PrEP - that is, people seeking a key preventive health measure - from being shamed and stigmatised in any healthcare setting. Hence a transgender man should be able to request and receive a vaginal swab to test for STIs in a pathology clinic in any Australian jurisdiction with impunity.

Broader PrEP awareness needed

To date, most people enrolled in Australia’s PrEP studies have been MSM. The immediate challenge is to make sure all populations at risk of HIV in Australia are appropriately engaged with, educated about and have access to PrEP.

Greater HIV prevention efforts, including PrEP, must occur urgently with Indigenous Australians. The rate of HIV transmissions among Indigenous Australians increased by 33% in 2016; the rate among non-indigenous Australians declined by 22% in the same period.

People who inject drugs, transgender people, heterosexuals and people who are ineligible for Medicare are other key populations who will benefit from PrEP.

The world does not yet have a vaccine for HIV, but Australia now has the other two pillars of biomedical prevention that are necessary to end HIV: HIV treatment, which renders an HIV-positive person’s risk of transmitting HIV to “effectively zero”, and PrEP.

Let’s work towards a “Vale HIV” for 2020.

This article was written by Edwina Wright, Associate Professor, Monash University and originally published in The Conversation.


Syphilis Outbreak Evolving

The syphilis outbreak occurring in remote areas of Australia continues to evolve.  

Data released by the Multijurisdictional Outbreak Group  shows that since the outbreak was declared in January 2011 over 1850 cases of infectious syphilis have been reported among Aboriginal & Torres Strait Islander people in affected regions of Queensland, the Northern Territory, Western Australia and South Australia. These cases are predominantly among young people aged 15-29 years, and equally among women and men.

So far there have been 5 congenital deaths, including last month where we learnt of a congenital death in Far North Queensland. 

"This data makes it clear that we need to ramp up efforts to increase syphilis testing for young people in the regions affected by the outbreak", said A/Prof James Ward, from the South Australian Health and Medical Research Institute. "In these regions it's crucial that all pregnant women and anyone who has had a recent partner change are made aware of the risk, and encouraged to test", he said.

Read more about the syphilis epidemic and the multi-jurisdictional response here.

 

 


Syphilis out of control in the north

SourceNational Indigenous Times - 7 February 2018

Wendy Caccetta: reporter@nit.com.au

Northern Australia is in the middle of the worst outbreak of syphilis in three decades and it’s having tragic consequences, with the recent death of another baby whose mother was infected with the sexually transmitted bacterial infection.

Even if extra medical support crews were placed on the ground now, experts say it would still be a decade before the outbreak was under control in remote communities in Northern Queensland, the Northern Territory, Western Australia’s Kimberley and South Australia.

The Royal Australasian College of Physicians said another baby was last month confirmed as having died of congenital syphilis, where the disease is spread from an infected mother to her unborn baby via the placenta.

The death was the sixth infant death from the disease in Northern Australia since the outbreak began in 2011.

RACP spokesman Professor Basil Donovan said syphilis had been on the verge of being eliminated from Australia eight years ago, but the Queensland Government – under former Premier Campbell Newman – cut health services to remote areas.

He said without adequate health services for the remote areas in the state and experts to intervene, syphilis had returned.

“Essentially we’re riding through the worst outbreak we’ve had in 30 years,” Prof Donovan said.

He said the sexual behaviour of people in the communities was not very different to non-Indigenous communities; the problem lay in not having enough health and medical staff to screen for the disease and provide treatment.

“We need more boots on the ground,” he said. “More sexual health staff, particularly based out of remote health services.

“Probably more importantly, these are very sensitive issues … issues like confidentiality are magnified in remote settings. That makes people wary of health services.

“We need a discreet health service model, but also staff who know the communities well.”

Prof Donovan said the Federal Government had promised funding to fight the outbreak, but so far it hadn’t been delivered.

“They keep saying there is a national strategy about to be launched and we’re saying where’s the funding and the plan – what are you going to do?

“The strategy tells us what you want to achieve, but not how you are going to do it. It’s a mystery.”

He said members of communities could help protect themselves by asking for a syphilis test even if they were going to the doctor or health service for something different.

He said it was important for pregnant women to turn up for their first antenatal screen on time.

“Probably the most common outcome of untreated syphilis in pregnancy is what is regrettably called foetal wastage,” he said.

“Which means the baby dies in the womb. We don’t know how much of that is going on.

“They could also be stillborn … or they might be so severely macerated by the infection that they die in the first few weeks of life or they may look quite normal at birth and over the next year or two they may start manifesting some nasty signs, mainly affecting the brain.”

Associate Professor James Ward is a Pitjantjatjara Nurrunga man, head of the Infectious Diseases Program — Aboriginal Health at the South Australian Health and Medical Research Institute and a member of the national Multi-jurisdictional Syphilis Outbreak Group, which was set up in response to the outbreak.

He agreed the outbreak would “take a while to turn around”.

“There’s been a constant call for additional resources to one, inform communities about syphilis and the importance of testing and two, to have increased resources on the ground to build the capacity of current health service staff to bring the outbreak under control,” he said.

Assoc Prof Ward said communities could help by learning more about the disease.

“What communities can do is know about it and have testing among the affected population, which are predominantly 15-35-year-old people who live in communities and are not in monogamous relationships,” he said.

Federal Indigenous Health Minister Ken Wyatt said curbing the syphilis outbreak was a top priority.

He said the government’s Strategic Approach and Action Plan endorsed in December was currently being rolled out. The action plan included workforce strategies and intensive work to reduce infection, such as point-of-care testing.

Mr Wyatt said the Turnbull Government had committed $8.8 million over three years to implementing the action plan.

More information on syphilis is available here.