AIDS ACTION COUNCIL OF THE ACT
NEWSLETTER
OCTOBER 2014
I’m excited to tell you about a new initiative driven by the AIDS Action Council in partnership with ACT Health, ACT Medicare Local and Sexual Health & Family PLanning ACT (SHFPACT). As you would be aware, there has been a steady increase in new HIV infections in the ACT in recent years and on 1 November at Fairday we will be launching the inaugural ACT Testing Month campaign. The ACT Testing Month will be launched at Fairday on 1 November and will conclude on 1 December, World AIDS Day. The Testing Month will utilise the Ending HIV campaign. Ending HIV is an interactive social marketing, community education and engagement campaign being rolled out nationally. The campaign targets gay men, men who have sex with men, people living with HIV and other affected communities through innovative ways that reach target populations at risk of HIV. Ending HIV is a comprehensive community mobilisation campaign aimed at ending transmission of HIV in Australian gay and bisexual men by 2020. During November we will roll out the Ending HIV campaign and provide the community with increased testing opportunities. Testing will be available at a range of clinical and community settings throughout November. Increasing testing rates is vital because HIV is generally transmitted by people who don’t know they have it. However, many people have not been tested recently, do not know they are HIV positive, and are possibly transmitting HIV to others. During the Testing Month, we are encouraging people to check their HIV status, and also support the Ending HIV campaign by posting on their social media accounts. As part of STI/HIV Testing Month, the AIDS Action Council, the lead ACT agency for HIV prevention among gay men, together with ACT Health, Medicare Local and SHFPACT will advocate that making HIV testing easier as well as educating the community about the importance of testing more regularly are essential to ending HIV transmission. I trust that you will support this important initiative. If you need any more information please contact the AIDS Action Council on 6257 2855 or to find out where people can be tested during November visit www.aidsaction.org.au/testingmonth Philippa Moss Acting Executive Director
AIDS Action Council of the ACT Newsletter October 2014 Page 1
IT’S TIME TO MAKE TIME
HIV testing has become easier, quicker and less stressful. If you’ve put off having a test, it’s Time to Test – call your clinic or GP today.
www.timetotest.com.au
AIDS Action Council of the ACT Newsletter October 2014 Page 2
International Day To End Violence Against Sex Workers International Day to End Violence Against Sex Workers is observed annually on December 17 by sex workers, their advocates, friends, families and allies. Originally this day was a memorial and vigil for the victims of the Green River Killer in Seattle Washington United States (US), it has evolved into an annual international event. The day calls attention to hate crimes committed against sex workers worldwide, as well as the need to remove the social stigma and discrimination that have contributed to violence against sex workers and indifference from the communities they are part of. Sex worker activists also state that custom and prohibitionist laws perpetuate such violence. Background 2003 was the first year that International Day to End Violence Against Sex Workers was held. The founders were Dr Annie Sprinkle and the Sex Workers Outreach Project (SWOP USA), an American sex workers rights organization. In a public letter, Sprinkle states:
Red umbrella symbol
The red umbrella is an important symbol for sex worker rights and is used for events that are held on December 17. The red umbrella symbol was first used by sex workers in Venice, Italy in 2001. Slovenian artist Tadej Pogacar collaborated with sex workers to create the “Prostitute Pavillion” and CODE: RED art installation for the 49th Venice Biennale of Art. Sex workers also held a street demonstration, the Red Umbrellas March, to protest inhumane work conditions and human rights abuse. The International Committee on the Rights of Sex Workers in Europe (ICRSE) adopted the red umbrella as a symbol of resistance to discrimination in 2005. A corresponding march was organised as the closing event to the European Conference on Sex Work, Human Rights, Labour and Migration conference, held in Brussels, Belgium, at which almost 200 participants appeared.
“Violent crimes against sex workers go underreported, unaddressed and unpunished. There really are people who don’t care when prostitutes are victims of hate crimes, beaten, raped, and murdered. No matter what you think about sex workers and the politics surrounding them, sex workers are a part of our neighbourhoods, communities and families.”
Reclaim The Night 2014 Reclaim The Night is held on the last Friday of October. This year Reclaim The Night falls on the 31st of October. Reclaim The Night will start at 5:30pm in Garema Place in the city. There will be some entertainment followed by a short march. The very first rally was held in Rome in 1976. This was a reaction to the amount of rapes that were happening. Marches followed in Germany and into England in 1977. The first march in England was initiated by women in Leeds in response to the advice that as women they should stay
AIDS Action Council of the ACT Newsletter October 2014 Page 3
home after dark. Angry at this advice the women marched through town with lit torches and banging saucepan lids. In Australia Reclaim the Night started in 1978. The question most of us are now asking is why do we still have to be holding such marches? And the answer is: because we are still not safe walking by ourselves. We would like to invite everyone to join us and march in solidarity.
Notice of Annual General Meeting 12 November 2014 We invite the community and all members of the AIDS Action Council to share this year’s achievements and challenges at our Annual General Meeting. Date : Time : Location :
Wednesday 12 November 2014 5:30pm Room 6, Griffin Centre Genge Street, Canberra
Light refreshments will be provided. For more information call Ben Martin on 02 6257 2855 or email contact@aidsaction.org.au The 2014 Dr Peter Rowland Memorial Address: Back to our Roots Dr Peter Rowland was a key figure in the early response of HIV in the ACT and throughout Australia. The Council continues to honour Peter by hosting an annual address in his name. The 2014 address will be delivered by Fiona Patten, founder and leader of the Australian Sex Party. Fiona has spent the last 25 years advocating and lobbying for the rights of many organisations and groups including small businesses, sex workers, HIV/AIDS organisations, media outlets and online anti-censorship groups. She regularly meets with people at all levels of government and has been involved in discussing a wide range of issues from planning and licensing issues to immigration, censorship, drug law reform and social equity. Her media profile is extensive and she regularly appears in and on many of Australia’s major TV shows, newspapers and radio stations as an advocate for personal freedom and law reform. Fiona’s career began as an AIDS educator with ACT sex worker advocacy group, WISE. Since then she has held positions on the Board of the AIDS Action Council, as an AFAO (Australian Federation of AIDS Organisations) Committee Member and a Director on the Board of AICO (Adult Industry Copyright Organisation). She has been CEO of the adult industry’s national association, Eros, since 1992. Frustrated and deeply disappointed with the lack of social change from the major political parties, she set up and registered the Australian Sex Party in 2009 dedicated to civil libertarian and personal freedom issues.
AIDS Action Council of the ACT Newsletter October 2014 2 Page 4
RY ENT y b OIN C D N G O L AT I O DON
saturday
Westlund House
12 noon to 5pm
E: contact@aidsaction.org.au P:02 6257 2855 W: aidsaction.org.au/fairday
1 Nov 2014
16 Gordon St, Acton
Proudly supported by:
WESTLUND HOUSE COUNSELLING SERVICES The AIDS Action Council delivers a wide range of services for individuals, families and the community in Canberra and the surrounding region. Working in partnership with other service providers, our aim is to improve the physical, mental and social wellbeing of people who access our services. Counselling is available between 10am and 4pm from Monday to Thursday and appointments are also available on Thursday evenings. Who can access counselling? Counselling is provided for all members of the community, regardless of age, gender, sexual orientation, lifestyle choice, cultural background, religious belief or economic circumstances. Through counselling we provide assessments, support, advocacy and referral for a range of issues including: coming to terms with your sexuality, emotional and physical health, relationships, employment, education and accommodation. What can you expect? Talking with a counsellor can help clarify a situation, lead to new understandings and identify ways of learning or relearning coping strategies. Our counsellors offer a safe space, underpinned by professional and ethical boundaries, to explore why you came to counselling in the first place and to support you throughout this time.
Our counsellors take a holistic approach and you may be asked about your health and wellbeing in general, as well as the presenting issues. Most sessions are 50 to 60 minutes with the number of sessions negotiated when exploring your goals. Eligibility Our counselling service is currently free of charge. However, during busy periods we need to prioritise people who are: • Living with or impacted by HIV • Experiencing same sex domestic violence or homophobic violence • Same sex relationship issues • Sexual identity issues If you do not fit into any of the these categories and you would still like to access our counselling service, you will be placed on a waiting list until a counsellor can be allocated to you. If you are newly diagnosed with HIV, experiencing same sex domestic violence or homophobic violence please call us during business hours and one of our counsellors will contact you within one business day. If you would like to make an appointment please contact the Council to arrange an intake assessment to ensure we are the correct service for you. Call 02 6257 2855 or visit us at Westlund House to make an appointment.
AIDS Action Council of the ACT Newsletter October 2014 Page 6
HIV in the ACT: local data and national perspectives Dr Sarah Martin, Clinical Director, Canberra Sexual Health Clinic The AIDS 2014 Legacy Statement (the Legacy Statement) was agreed by all Australian Health Ministers in June 2014. The Legacy Statement includes a commitment from the Australian Government and the eight States and Territories to take all necessary action - in partnership with key affected communities and sector partners - to remove barriers to HIV testing, treatment, prevention, care and support, across legal, regulatory, policy, social, political and economic domains. This commitment includes working towards the virtual elimination of all new Australian HIV transmissions by 2020. This commitment is echoed in the Seventh National HIV Strategy 2014-2017, which includes an immediate target of reducing sexual transmission of HIV by 50% by 2015. An understanding of the current patterns of HIV diagnoses is crucial if we are to work towards these goals.
2500
2013: 1236 new infections
2000
1500
1000
500
0
1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012
Year Source: State/Territory health authorities
Figure 1: Newly diagnosed HIV infection by year. Source: State/ Territory health authorities
Gay and other men who have sex with men (MSM) continue to represent over two thirds of new diagnoses in Australia and account for 88% of infections acquired within the last 12 months at the national level.A further 26% of new HIV diagnoses in 2013 were attributed to heterosexual contact, almost half of which were in people from high prevalence countries or their partners. HIV acquisition through injecting drug use accounts for only 2.4% of Australian diagnoses in 2013, and maternal-child transmission remains rare at 0.8%.
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30 25 20
Number
15 10
5 0 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Source: ACT Health notification data Figure 2: NewlyHIV diagnosed ACT by year. Newly diagnosed infection, HIV 2004 infection – 2013, by in agethe standardised rate Source: ACT Health notification data in Australia, ACT, VIC, NSW 12
Age standardised rate per 100 000
The Kirby Institute provides detailed annual analysis of new HIV diagnoses in Australia. In 2013, there were 1,236 new diagnoses of HIV in Australia – almost as many as in 2012, when the number of new Australian diagnoses was the highest since the early 1990s (Figure 1). This gradual increase in diagnoses has occurred despite impressive advances in medication options and confirmation that with effective treatment, the chances of passing on HIV are greatly reduced.An estimated 26,800 men, women and children are now living with HIV in Australia (plausible range 24,500 to 30,900). Newly diagnosed HIV infection in Australia by year
Number
HIV diagnoses in the ACT have increased, most notably over the last 2 years (Figure 2). As a small jurisdiction, ACT data needs interpreting with some caution, but analysis by age standardized rates of infection confirms that ACT diagnoses of HIV per 100,000 adult population have increased and are now similar to neighbouring states (Figure 3). Further comparison between ACT and national data suggests a very similar distribution of diagnoses in terms of age, gender, sexual orientation, newly acquired infection and late diagnosis of infection (Table 1, next page).
Newly diagnosed HIV infection in the ACT, by year
New HIV diagnosis in 2013
HIV diagnoses
Late diagnosis of HIV remains common: 29.6% of diagnosed cases in 2013 presented late (as defined by a CD4 count less than 350 cells/μl). This is stable compared with previous years, suggestive of no substantial shift in the disease stage at which people are diagnosed despite recent initiatives to increase HIV testing. Living with undiagnosed HIV means people are unable to access treatment to maintain their health, and are unable to protect their partners.
10
8
6
4
2
0 2004
2005
2006
2007
2008
Year
2009
2010
2011
2012
2013
Figure 3: Newly 2004-2013, by age NSW diagnosed VIC HIV infection, ACT Australia standardised rate in Australia, ACT, VIC, NSW (adapted) Source: State/Territory health authorities Source: State/ Territory health authorities
New diagnoses of HIV: ACT compared to whole of Australia Newly diagnosed HIV
Australia 2013 n=1236
ACT 2013 n=24
ACT 2011-2013 n=52
Male
1074 (87%)
20 (83%)
45 (87%)
Female
162 (13%)
4
7 (13%)
Age range
0-60+ years (33 <20 years)
20-72 years
19-72 years
Median age
37 years
36.5 years
36.5 years
Transmission by: Sexual contact between men
70% (4% MSM + IDU)
67%
69%
Heterosexual sex
26.6%
34%
(17%)
25% reported#
Not reported#
Injecting drug use
2.4%
Not
Aboriginal and Torres Strait Islander people Newly acquired
26
Not reported#
Not reported#
28% (88% MSM)
38% (67% MSM)
38% (86% MSM)
Late diagnosis CD4<350
29.6%
38%
31%*
Age standardised population rate
5.6 per 100,000
6.0 per 100,000
NA
Table 1: New HIV diagnosis nationally and in the ACT. Source: Data extracted from: The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2014 HIV Supplement. The Kirby Institute, UNSW, NSW 2052 and from enhanced data collected by the Surveillance Section of the ACT Health Protection Service. *Data only available for 49 of 52 cases other jurisdictions with a slightly increasing trend over time. Source: Data extracted from: The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance # Report Data not reported due to small numbers (<5) of collected respondents reporting an HIV of test 2014 HIV Supplement. The Kirby Institute, UNSW, NSW 2052 and The from proportion enhanced data by the Surveillance Section thein the 12 ACT Health Protection Service.
Why are HIV diagnoses to increase? *Data only available for 49 ofcontinuing 52 cases
# Dataisnotno reported to small numbers (<5) to this important There easy due or conclusive answer question, and the reasons are almost certainly multifactorial and include lack of testing, ongoing risk behaviours, levels of treatment uptake amongst people living with HIV and ongoing stigma and discrimination. The Seventh National HIV Strategy has six objectives which acknowledge these factors:
• reduce the incidence of HIV; • reduce the risk behaviours associated with the transmission of HIV; • decrease the number of people with undiagnosed HIV infection; • increase the proportion of people living with HIV on treatments with undetectable viral load; • improve quality of life of people living with HIV; • eliminate the negative impact of stigma, discrimination, and legal and human rights issues on people’s health.2 As gay and other MSM represent the majority of new diagnoses and recently acquired infections, studies that explore community norms and behaviours are useful in considering why diagnoses are increasing and in informing prevention approaches. Gay Community Periodic Surveys present a snapshot of behaviours of participating gay and other MSM and allow analysis of trends over time. The Gay Community Periodic Survey: Canberra 2013 demonstrates that in 2013, just under a third of men with casual partners reported any unprotected anal intercourse with those partners in the six month prior to the survey.6 This is similar to statistics from
months prior to the survey has been relatively stable since 2009 and was 67.4% in 2013.6 Ideally this proportion would be much higher. The Australian STI and HIV Testing Guidelines for Asymptomatic MSM recommend at least annual STI screening for all MSM.7
Whilst it is heartening that HIV is now a treatable chronic illness, this undoubtedly makes prevention more complex. With the focus on advances in HIV treatment, in particular increasing simplicity of treatment and the possibility of a normal life expectancy, it is possible that the many complex and often difficult aspects of living with HIV are overlooked. In light of this, it may be increasingly important for prevention initiatives to encourage more discussion about the potential impacts of an HIV diagnosis. Responding to increasing HIV diagnoses: lessons from NSW ACON, New South Wales’ leading health promotion organisation specialising in HIV and lesbian, gay, bisexual, transgender and intersex (LGBTI) health, designed the Ending HIV campaign, endorsed by NSW Health and launched with a major campaign across Sydney in 2013.8 The campaign rollout was followed by the first ever NSW HIV testing Week in July 2014, which focused on reminding and encouraging people to get tested for HIV. Ending HIV is an interactive social marketing and community education and engagement campaign which incorporates communication and community mobilisation initiatives aimed at ending the transmission of HIV among gay men. Ending HIV is based on three key messages: test more, treat early and stay safe.
AIDS Action Council of the ACT Newsletter October 2014 Page 8
most risk, but HIV medications are not approved for this use by the Therapeutic Goods Administration and access in Australia is limited to participants in research trials.
“Test more” includes promoting access to HIV rapid test trials targeting priority populations in Sydney. Nationally, an estimated 13.7% (plausible range 11.1-21.1%) of people with HIV in Australia remain undiagnosed.3 It is hoped that rapid tests (point of care tests when initial HIV testing is done in a clinic or outreach setting while the client waits for the result in about 20 minutes), will expand the reach and accessibility of HIV testing, with the potential to encourage people at risk to have an initial test, noting that is it also important to increase as well as the frequency of testing amongst those at ongoing risk. “Treat early” emphasises the reduction of risk to partners when treatment reduces HIV viral load to below detectable, as well as the individual health benefits of early treatment. Treatment benefits, including prevention, are discussed in detail in another article in this Bulletin. In practical terms, the decision to start treatment now rests between patient and clinician, as the Commonwealth Government removed CD4 count-based restrictions on treatment commencement in April 2014, allowing anyone with HIV to start treatment as soon as they feel able to. Despite this, individual readiness to start treatment remains crucial, given that all currently available treatments must be taken at least once daily, with little margin for error and the risk of drug resistance for those who struggle to take daily medication.
Gay and other MSM are not the only priority populations for HIV prevention. The Seventh National HIV Strategy identifies people living with HIV, Aboriginal and Torres Strait Islander people, people from high prevalence countries and their partners, travellers and mobile workers, sex workers, people who inject drugs and people in custodial settings. Prevention efforts are ideally tailored to suit these different groups, although some may be harder to target or more easily overlooked. Health professionals can play a key role initiating testing for HIV infection, but in the absence of easily identifiable risk factors, an HIV test may not be considered until late in the assessment of chronic unexplained illness. The Seventh National HIV Strategy stresses the role of primary care in the management of HIV and other sexually transmissible infections. Encouraging doctors to exclude HIV early in the investigation of non-specific symptoms may help reduce missed opportunities for HIV diagnosis and provide a more timely answer to those who do test positive.
Ongoing engagement in HIV care and staying on treatment are also important. In 2014, the Kirby Institute introduced national estimates of the proportion of people with HIV receiving treatment, concluding that 57-84% of people with diagnosed HIV are on treatment and have undetectable viral load. Reasons for not being on treatment are varied, and include short time since diagnosis, apparently slow disease progression, caution about commencing treatment and difficulties staying on treatment. Current Australian research aims to identify key reasons for adherence difficulties and treatment cessation. “Stay safe” emphasises the importance of condoms with partners of unknown status, and acknowledges and discusses other risk reduction strategies. Strategies used by gay men include condoms, serosorting, strategic positioning and withdrawal before ejaculation. Other prevention strategies include prompt access to HIV post-exposure prophylaxis (PEP) for those who may have been exposed to HIV (ideally as soon as possible after exposure and no later than 72 hours post exposure). Although knowledge of and uptake of PEP appears suboptimal, clinical care at the time of PEP use is an opportunity for discussion of other prevention strategies. HIV pre-exposure prophylaxis (PrEP) taken continuously or episodically before possible HIV exposure can also offer significant protection to those at
AIDS Action Council of the ACT Newsletter October 2014 Page 9
After hours STI checks for gay & bisexual men The M Clinic is a free walk-in clinic at Canberra Sexual Health Centre offering STI checks for men who have sex with men at a more convenient time. HIV results are available via SMS in less than 24 hours. 4:30pm - 7:00pm on the first business Monday of every month.
WORLD AIDS DAY 2014 MONDAY 1 DECEMBER Using the heart of Canberra to raise awareness of HIV in the ACT, Australia and internationally Community Breakfast & Stalls Garema Place, Civic 7:00am – 11:30am WORKING TO GET TO ZERO • Zero New Infections • Zero AIDS-Related Deaths • Zero Discrimination More information available aidsaction.org.au/worldaidsday
0
getting to zero
local research dating back to 2010. This research has included effectiveness in reducing HIV transmission, adherence to taking PrEP, costs, as well as the health and psychosocial impacts. Dr Tuck Meng Soo from the Interchange discussed the implications on the role of the Doctor in the administration of PrEP and how this might change and challenge the way that gay men approach their current relationship with HIV, but also their general sexual health care. Dr Soo also discussed the various ways that this can already be done, noting the limitations of the PBS and writing off-label scripts, and the different ways it might be made available into the future.
PrEP Community Forum The AIDS Action Council hosted it’s first PrEP forum on Thursday 25th September. In response to both the increasing amount of information available about PrEP and entering the conversations of the community, especially gay men, but also to keep the conversations of the AIDS2014 conference going - and PrEP was certainly topical at the conference.
Nic Holas, founder of TIM (The Institute of Many - a support and social group for people living with HIV) then presented a look at both modern and historical gay sexual cultures. Nic discussed the impact this already has had and will continue to have for some gay men, and also the reduced stigma currently faced by men who are living with HIV.
PrEP is Pre-exposure prophylaxis - medication taken before coming into contact with HIV to prevent transmission. In this case it is specifically the drug Truvada. PrEP has been recommended for use in the United States by the Centre for Disease Control & Prevention since July 2012. It is not subsidised in Australia and there are not currently any national guidelines for administering. There are a number of trials taking place or about to commence in NSW, VIC and QLD, and they have seen high levels of interest. PrEP has been controvesial to say the least. In the gay and bisexual male community, mostly in the US, conversations have been couched in moralistic terms of risk and pleasure vs responsibliity. This is best seen through the ‘Truvada Whores’ movement. There is also concern that the reality of the impacts, and their associated costs, not matching the claims of the research and pharmaceutical company Gillead. Poor media reporting led to claims in July this year that the United Nations World Health Organisation was suggesting that all gay, bisexual and homosexually active men should be put on PrEP. This was not the case but endorsement of the access to PrEP for those who wish to use it. Senior Community Education Coordinator, Keiran Rossteuscher provided an overview of HIV in Australia, the current knowledge of PrEP from both international and
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There was great discussion in the feedback session after the presentations. At the end of the day PrEP is happening, whether AIDS Councils, Public Health Officials or cultural gatekeepers like it. It is incumbant on us to make sure that we have the most up to date and accurate information so that people are able to make informed decisions. It is not our place to say ‘yes’ or ‘no’. As Keiran pointed out, this isn’t about ‘good gay citizens and bad gay citizens, this is about gay citizens who can make choices about their health’. This conversation is far from over, and we are keen to continue this dialogue with the community on this and many other topics. Thank you to Nic Holas from TIM, Dr Soo from Interchange General Practice, and Jenni Atkinson from TranzAustralia who assisted with the AV on the evening, and recorded both the audio and video of the presentation. We will be making those available on our website in the very near future for those who weren’t able to make it on the evening.
DATES FOR YOUR DIARY October 31:
Reclaim the Night
November:
SpringOUT Pride Festival springout.com.au
November: November 1:
ACT Testing Month (including STRIP Clinics) Fairday
November 5:
You Can Play Forum
youcanplay.com.au
November 12: AIDS Action Council of the ACT Annual General Meeting November 20: Trans* Day of Remembrance December 1: December 17:
World AIDS Day International Day to End Violence Against Sex Workers
December 18: Friends of Westlund House Cocktail Function December 24: (from midday) End of year leave commences January 5:
Council re-opens for 2015!
January 26:
Australia Day Public Holiday
February 14:
National Condom Day
May 17:
International AIDS Candlelight Memorial
May 17:
IDAHOT - International Day Against Homophobia and Transphobia
You Can Play An Anti-Homophobia in Sport Initiative 5 November 10.30am The You Can Play Forum will be facilitated by SBS news broadcaster Anton Enus and will raise awareness and inspire people to tackle homophobia and transphobia in sport. A panel of high profile sport people will share their thoughts and experiences, and contribute to a dynamic, engaging and informative discussion with both a live and online audience. • Watch the live-stream of the Forum • Join the conversation today on twitter and facebook • Provide questions for the panellists to answer www.youcanplay.com.au #youcanplayforum
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Are you stressed? Do you suffer from Anxiety or Depression? Are you experiencing relationship difficulties? Do you have sexual health issues? Do you understand, accept and value your sexual identity?
DO YOU NEED TO TALK TO A COUNSELLOR?
Counselling is available between 10 and 4pm from Monday to Thursday with evening appointments available during the week. If you wish to schedule an appointment time to meet with Pauline, Kate or Rodney, please contact us on 02 62572855 or visit us at 16 Gordon Street, ACTON.
AIDS ACTION COUNCIL OF THE ACT aidsaction.org.au GPO Box 229 Canberra ACT 2601 Westlund House 16 Gordon Street Acton ACT 2601 02 6257 2855