Update from Melbourne - Aidan's Day 4

  • HIV Scotland team members George Valiotis and Aidan Collins have been sending updates about what they're seeing and hearing at the AIDS 2014 international conference in Melbourne. This update is from Aidan, giving an overview of the third day of the conference from his perspective.

Penultimate day of the IAC

"On the same day as the friendly games get underway in sunny Glasgow, the penultimate day of the IAC has also taken place in wintery Melbourne. I hear on good authority that the Commonwealth Games opening ceremony was a huge success with much tartan, haggis and bagpipes to be enjoyed. Not to be outdone, highlights at the IAC today included a conversation with Sir Bob Geldof about HIV and poverty and – of course – discussions in the Global Village about current developments in Scotland facilitated by George and myself."

"Before I get to that, I will share some details of a session that I attended this morning about HIV testing – discussing how this is a critical entry point for both treatment and prevention efforts. In this session Valerie Delpech of Public Health England spoke about testing strategies in the UK and the importance of these to emerging strategies such as treatment as prevention (TasP). Indeed, as Valerie pointed out, TasP simply cannot succeed without increased testing and primary prevention too."

At risk groups - how do we increase testing for these individuals?

"There are a range of testing options now available in the UK, with the roll-out of community based testing, home sampling and rapid point of care testing etc. Despite this around 25% of people living with HIV in the UK remain undiagnosed, and a large proportion of people recently diagnosed are being diagnosed at a late stage of infection. Valerie pointed out that, despite the range of testing options now available, these figures have remained stable over the past 10 years. There is now reliable modelling which shows that increasing testing to identity the undiagnosed 25% would go a significant way towards reducing incidents of new HIV infection, with improved outcomes for the health and wellbeing of all. Increasing testing is therefore absolutely key to preventing the spread of HIV and ensuring better health outcomes for people living with HIV."

"The big question is, how do we increase testing rates and particularly amongst high risk groups? To give an example of how this might be achieved Midnight Poonkasetwattana talked about community based approaches being adopted in Thailand. Here a testing campaign has been developed by and for young MSM called ‘suck, f*#k, test, repeat’ (testBKK.org). This sex positive approach speaks to young people in a way and through channels that are relevant to them. Information about testing has been promoted through social media and via the venues and organisations that young people access. The campaign has received a deal of praise for its bold approach and, critically, has proved popular with young people with increased testing as a result. Midnight explained that 1 in 3 MSM in Bangkok have HIV (which compares to 1 in 7 MSM in London) so any increase in testing is likely to deliver a significant public and individual health benefits."

Scotland and the impact of self-testing

"In Scotland, we have had similar campaigns and when it comes to testing we certainly aren’t afraid to speak candidly and honestly in a way which is relevant to key communities and groups. This brings me to instant result HIV self-testing and the recent change in the law which means that self-testing kits can now be distributed in Scotland. I believe that self-testing brings a valuable opportunity to reach people who are reluctant to test in healthcare settings and this was the focus of a discussion I led today in the European Networking Zone."

Aidan Collinns at 2014 AIDS Conference

"Our self-testing session was attended by a range of people from a range of countries; Germany, France, Finland, Sweden, Australia, England to name but a few. Different countries are at different stages, for example the distribution of self-testing kits has never been illegal in Finland while in Australia they are just on the cusp of distribution being legalised. Germany and France are at a similar stage to us – although it seems Scotland is leading the way with discussions already well underway about how we might distribute, monitor and evaluate self-testing kits."

"Within the session it was questioned how self-testing may impact on different groups. For example, a representative from a sex worker led organisation in Scotland raised concerns that the increased availability of self-testing kits may result in some sex workers being forced to take a test and then to have unprotected sex. This is a very real concern and hits home just how we need to ensure that all communities are empowered and have a voice in relation to issues such as self-testing. Especially those communities and people who may be more marginalised."

"We also discussed whether there were actions that could be taken forward on a European level in relation to self-testing and it was agreed that there certainly were – for example, developing a European wide consensus statement on self-testing and working together to try to reduce the cost of testing kits within the EU. It was concluded that we need to place human rights principles at the heart of any discussions on self-testing to ensure that it is the opportunities and not the concerns it presents which are realised."

"Tomorrow is the last day of the IAC but it feels like the discussions are just getting started. Never before have I seen so many people from so many places come together united by a common cause. I will keep you updated on tomorrow’s closing ceremony and trust you will likewise keep me informed of our undoubted achievements at the Commonwealth Games."

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Follow HIV Scotland and CEO George Valiotis on Twitter for real-time updates, and read more of his updates and about HIV Scotland and AIDS 2014.