A national study of the clinical management of HIV-positive women in Australia:What are the successes and where are the gaps?

Michelle L. Giles, Aleece Macphail, Charlotte Bell, Catriona S. Bradshaw, Virginia Furner, Manoji Gunathilake, Mina John, Sushena Krishnaswamy, Sarah J. Martin, Catriona Ooi, Louise Owen, Darren Russell, Alan Street, Jeffrey J. Post

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Women comprise ∼10% of people living with HIV in Australia, so are often underrepresented in research. Methods: This study invited clinicians providing care to women living with HIV to complete an anonymous survey containing questions related to four key areas: HIV (including diagnosis, treatment and virological outcomes), reproductive health (including sexual activity, contraception, pregnancy and outcomes) and linkage and retention in care. Results: In total, 484 surveys were received, with responses from all states and territories. Most women living with HIV in Australia are on treatment (>90%) and virologically suppressed (>90% have a viral load <50 copies mL-1). Almost 75% of women have had at least one switch in treatment (with toxicity almost as common as simplification as the indication). Treatment interruption is also relatively common, but is more likely the longer a woman has been diagnosed, if she is on benefits (P = 0.007) and is the primary carer of children without a partner (P = 0.001). In Australia, women living with HIV are a diverse heterogeneous group, with over 70 different countries of birth and almost half speaking a language other than English at home. Mental health diagnosis was the most common co-morbid condition identified. A total of 21% of women were post-menopausal, with 42% reporting symptoms to their healthcare provider, but only 17% were receiving treatment for symptoms attributed to menopause. Conclusions: As well as strategies to support women vulnerable to treatment interruption, important areas for future investment in research and clinical care include co-morbid mental health and menopause symptoms and treatment.

Original languageEnglish
Pages (from-to)282-288
Number of pages7
JournalSexual Health
Volume16
Issue number3
DOIs
Publication statusPublished - 1 Jan 2019

Keywords

  • antiretroviral treatment
  • interruption
  • menopause
  • reproductive health
  • switching

Cite this

Giles, Michelle L. ; Macphail, Aleece ; Bell, Charlotte ; Bradshaw, Catriona S. ; Furner, Virginia ; Gunathilake, Manoji ; John, Mina ; Krishnaswamy, Sushena ; Martin, Sarah J. ; Ooi, Catriona ; Owen, Louise ; Russell, Darren ; Street, Alan ; Post, Jeffrey J. / A national study of the clinical management of HIV-positive women in Australia:What are the successes and where are the gaps?. In: Sexual Health. 2019 ; Vol. 16, No. 3. pp. 282-288.
@article{90b22a0b0d7f4b63bfd586e3eb3d0913,
title = "A national study of the clinical management of HIV-positive women in Australia:What are the successes and where are the gaps?",
abstract = "Background: Women comprise ∼10{\%} of people living with HIV in Australia, so are often underrepresented in research. Methods: This study invited clinicians providing care to women living with HIV to complete an anonymous survey containing questions related to four key areas: HIV (including diagnosis, treatment and virological outcomes), reproductive health (including sexual activity, contraception, pregnancy and outcomes) and linkage and retention in care. Results: In total, 484 surveys were received, with responses from all states and territories. Most women living with HIV in Australia are on treatment (>90{\%}) and virologically suppressed (>90{\%} have a viral load <50 copies mL-1). Almost 75{\%} of women have had at least one switch in treatment (with toxicity almost as common as simplification as the indication). Treatment interruption is also relatively common, but is more likely the longer a woman has been diagnosed, if she is on benefits (P = 0.007) and is the primary carer of children without a partner (P = 0.001). In Australia, women living with HIV are a diverse heterogeneous group, with over 70 different countries of birth and almost half speaking a language other than English at home. Mental health diagnosis was the most common co-morbid condition identified. A total of 21{\%} of women were post-menopausal, with 42{\%} reporting symptoms to their healthcare provider, but only 17{\%} were receiving treatment for symptoms attributed to menopause. Conclusions: As well as strategies to support women vulnerable to treatment interruption, important areas for future investment in research and clinical care include co-morbid mental health and menopause symptoms and treatment.",
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author = "Giles, {Michelle L.} and Aleece Macphail and Charlotte Bell and Bradshaw, {Catriona S.} and Virginia Furner and Manoji Gunathilake and Mina John and Sushena Krishnaswamy and Martin, {Sarah J.} and Catriona Ooi and Louise Owen and Darren Russell and Alan Street and Post, {Jeffrey J.}",
year = "2019",
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doi = "10.1071/SH18070",
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Giles, ML, Macphail, A, Bell, C, Bradshaw, CS, Furner, V, Gunathilake, M, John, M, Krishnaswamy, S, Martin, SJ, Ooi, C, Owen, L, Russell, D, Street, A & Post, JJ 2019, 'A national study of the clinical management of HIV-positive women in Australia:What are the successes and where are the gaps?' Sexual Health, vol. 16, no. 3, pp. 282-288. https://doi.org/10.1071/SH18070

A national study of the clinical management of HIV-positive women in Australia:What are the successes and where are the gaps? / Giles, Michelle L.; Macphail, Aleece; Bell, Charlotte; Bradshaw, Catriona S.; Furner, Virginia; Gunathilake, Manoji; John, Mina; Krishnaswamy, Sushena; Martin, Sarah J.; Ooi, Catriona; Owen, Louise; Russell, Darren; Street, Alan; Post, Jeffrey J.

In: Sexual Health, Vol. 16, No. 3, 01.01.2019, p. 282-288.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - A national study of the clinical management of HIV-positive women in Australia:What are the successes and where are the gaps?

AU - Giles, Michelle L.

AU - Macphail, Aleece

AU - Bell, Charlotte

AU - Bradshaw, Catriona S.

AU - Furner, Virginia

AU - Gunathilake, Manoji

AU - John, Mina

AU - Krishnaswamy, Sushena

AU - Martin, Sarah J.

AU - Ooi, Catriona

AU - Owen, Louise

AU - Russell, Darren

AU - Street, Alan

AU - Post, Jeffrey J.

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N2 - Background: Women comprise ∼10% of people living with HIV in Australia, so are often underrepresented in research. Methods: This study invited clinicians providing care to women living with HIV to complete an anonymous survey containing questions related to four key areas: HIV (including diagnosis, treatment and virological outcomes), reproductive health (including sexual activity, contraception, pregnancy and outcomes) and linkage and retention in care. Results: In total, 484 surveys were received, with responses from all states and territories. Most women living with HIV in Australia are on treatment (>90%) and virologically suppressed (>90% have a viral load <50 copies mL-1). Almost 75% of women have had at least one switch in treatment (with toxicity almost as common as simplification as the indication). Treatment interruption is also relatively common, but is more likely the longer a woman has been diagnosed, if she is on benefits (P = 0.007) and is the primary carer of children without a partner (P = 0.001). In Australia, women living with HIV are a diverse heterogeneous group, with over 70 different countries of birth and almost half speaking a language other than English at home. Mental health diagnosis was the most common co-morbid condition identified. A total of 21% of women were post-menopausal, with 42% reporting symptoms to their healthcare provider, but only 17% were receiving treatment for symptoms attributed to menopause. Conclusions: As well as strategies to support women vulnerable to treatment interruption, important areas for future investment in research and clinical care include co-morbid mental health and menopause symptoms and treatment.

AB - Background: Women comprise ∼10% of people living with HIV in Australia, so are often underrepresented in research. Methods: This study invited clinicians providing care to women living with HIV to complete an anonymous survey containing questions related to four key areas: HIV (including diagnosis, treatment and virological outcomes), reproductive health (including sexual activity, contraception, pregnancy and outcomes) and linkage and retention in care. Results: In total, 484 surveys were received, with responses from all states and territories. Most women living with HIV in Australia are on treatment (>90%) and virologically suppressed (>90% have a viral load <50 copies mL-1). Almost 75% of women have had at least one switch in treatment (with toxicity almost as common as simplification as the indication). Treatment interruption is also relatively common, but is more likely the longer a woman has been diagnosed, if she is on benefits (P = 0.007) and is the primary carer of children without a partner (P = 0.001). In Australia, women living with HIV are a diverse heterogeneous group, with over 70 different countries of birth and almost half speaking a language other than English at home. Mental health diagnosis was the most common co-morbid condition identified. A total of 21% of women were post-menopausal, with 42% reporting symptoms to their healthcare provider, but only 17% were receiving treatment for symptoms attributed to menopause. Conclusions: As well as strategies to support women vulnerable to treatment interruption, important areas for future investment in research and clinical care include co-morbid mental health and menopause symptoms and treatment.

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