Positive Living - Autumn 2015

positiveliving A MAGAZINE FOR PEOPLE LIVING WITH HIV | AUTUMN 2015

Would you still date me if I was HIV-positive?

n ot e r ’ e w , g n i y d t o We’re n ng i t t e l t u b — s u o i infect w o n k e s l e e n o y ever . y k c i r t t i b a s i t tha

WHAT’S AHEAD?

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the latest single-tablet regimen available to people living with HIV in Australia

Twenty-five years after Keith Haring’s death his art still endures.

thepillbox

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ISSN 1033-1788 EDITOR Christopher Kelly

David Menadue Benson, Jake Kendall, David Menadue, Dr Louise Owen DESIGN Stevie Bee Design ASSOCIATE EDITOR

CONTRIBUTORS Rebecca

ON DATING AND DISCLOSURE

THE LIFE EXPECTANCY OF A 35-YEAR-OLD MAN LIVING WITH HIV IS REDUCED BY EIGHT YEARS DUE TO SMOKING.

Triumeq

positiveliving

SARAH POSITIVE VOICES PAGES 8-9 I did not want to be the only person in the world cured of HIV; I wanted other HIVpositive patients to join my club.

2015 6

TIPS ON HOW TO LIVE TO

Timothy Ray Brown (aka the Berlin Patient) PAGE 4

what’syourproblem?

PAGE 10 My partner and I would like to have children — how will HIV affect my pregnancy and my baby?

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Free subscriptions are available to HIV-positive people living in Australia who prefer to receive Positive Living by mail. To subscribe, visit napwha.org.au or call 1800 259 666. contributions Contributions are welcome. In some cases, payment may be available for material we use.

Contact the Editor EMAIL: christopher@napwha.org.au all correspondence to: Positive Living PO Box 917 Newtown NSW 2042 TEL: (02) 8568 0300 FREECALL: 1800 259 666 FAX: (02) 9565 4860 WEB: napwha.org.au Positive Living is published four times a year by the National Association of People With HIV Australia and is distributed with assistance from Gilead and ViiV Healthcare. Next edition: June 2015 subscriptions

n Positive Living is a magazine for all people living with HIV in Australia. Contributions are welcomed, but inclusion is subject to editorial discretion and is not automatic. The deadline is 21 days before publication date. Receipt of manuscripts, letters, photographs or other materials will be understood to be permission to publish, unless the contrary is clearly indicated. n Material in Positive Living does not necessarily reflect the opinion of NAPWHA except where specifically indicated. Any reference to any person, corporation or group should not be taken to imply anything about the actual conduct, health status or personality of that person, corporation or group. All material in Positive Living is copyright and may not be reproduced in any form without the prior permission of the publishers. n The content of Positive Living is not intended as a substitute for professional advice.

COVER IMAGE reproduced with kind permission from AIDES, the leading HIV organisation in France

positiveliving l 2 l AUTUMN 2015

thenews from the editor Welcome to the first Positive Living of the year — and you may have noticed a few design tweaks here and there. We’ve also upped the content and introduced some new features: ‘The Pill Box’ provides treatment news while ‘Calendar’ suggests events for your diary. Also, we welcome Queensland Positive People to PL. The team hopes you approve of the modifications; your feedback — glowing or critical — is always welcome. And if you would like to personally receive a hard copy of Positive Living or the e-magazine, email me at christopher@napwha.org.au Christopher Kelly, Editor

Medicare backpedal in a dramatic last-minute turnaround, the federal government has abandoned plans — for now — to cut the Medicare rebate for short visits to the Gp. The change, which was due to take effect from 19 January, could’ve resulted in patients paying $20 more for a consultation of ten minutes or less. Reacting to “significant concerns” from the medical profession, federal health

the government must scrap its potentially destructive Medicare changes.

– aMa minister Sussan Ley announced the contentious policy had been “taken off the table”.

It also appears that other Medicare changes due to kick in on 1 July (such as the much-

criticised $5 co-payment for standard consultations) are also in doubt after prime minister Tony Abbott said he won’t now go-ahead with the reforms without the backing of the medical profession — backing that appears to be wanting.

“The message from grassroots GPs is clear,” said Australian Medical Association president Brian Owler, “the government must scrap its potentially destructive Medicare changes.”

Asia-Pacific must do more delegates at the un asia-pacific Meeting on HiV in bangkok were warned that unless governments upped their game the region will fail to end the epidemic by 2030.

UNAIDS chief Michael Sidibé told the meeting: “I’m fully convinced that if you don’t . . . it’s impossible to end HIV/AIDS.” Last year, UNAIDS launched a

bold, fast-track plan to end HIV within 15 years. While the AsiaPacific region has the potential to achieve the goal, Sidibé said persistent underfunding of targeted programs, punitive laws and the low take-up of treatment all threaten to undermine the region’s response.

Almost five million people are

living with HIV and around 1,000 are infected every day in the AsiaPacific region. Although nearly all of the new infections are among men who have sex with men, transgender people, sex workers and people who inject drugs, less than 8 percent of HIV prevention programs specifically target these key populations.

According to UNAIDS, every country in the Asia-Pacific has laws that somehow hamper HIV prevention, such as criminalisation of sex work and same-sex relationships, or compulsory detention for drug users. “The legal environment in the region is often hostile to people living with HIV and has

discouraged them from seeking help,” said Sidibé.

Sidibé also noted that — despite India being one of the largest producers of generic HIV drugs — only 33 percent of people living with HIV in the Asia-Pacific are on treatment. If these issues aren’t addressed, he said, the region will “never control the epidemic”.

Fresh hope for a vaccine HiV vaccine the horizon,” said Dr Nancy a molecule that has shown Haigwood, a leading HIV an ability to block HiV could researcher at Oregon lead to an alternative vaccine.

University.

US scientists have Philip Johnson, a professor engineered a compound that at the University of shields CD4 cells by blocking Pennsylvania who has led the points where the virus earlier vaccine trials, said the binds to receptors. The primate data was outstanding. technique has successfully “It’s further validating the idea protected four monkeys that we should be thinking in against repeated attempts to alternative terms about how infect them with multiple to attack HIV vaccines.” doses of SHIV (a simian strain this is going to be much better It is hoped the discovery of HIV). will eventually lead to a Lead author Michael than any vaccine on the horizon. vaccine that will provide both Farzan from Scripps Research – nancy Haigwood long-term protection against Institute in California said the infection and sustained molecule was the broadest trying for three decades to remission in people already living and most potent entry inhibitor develop an effective vaccine, have with HIV. If further tests are discovered so far. “We are closer responded positively to the successful, researchers say they than any other approach to findings. “This is going to be want to proceed to human trials universal protection,” he said. much better than any vaccine on within a year.

Researchers, who have been

within 15 years?

reach. “We’re bill Gates pretty believes there optimistic,” will be a vaccine said Gates. and a new A vaccine is generation of seen as pivotal drugs to beat in preventing HiV by 2030. new infections If achieved, among such a vulnerable development bill and Melinda Gates at the populations, could while new potentially end World economic Forum intensive most new cases treatments could see the end of of the disease. The founder of people living with HIV having to Microsoft — whose philanthropic take lifelong medication. “We foundation spends tens of won’t see the end of AIDS,” Gates millions of dollars on medical said, “but [reduction] tools will research — told the World be invented during this 15-year Economic Forum in Davos that period.” the two “miracles” were within

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thenews

testing early is key a study has found that starting antiretroviral treatment (art) with a cd4 count of 500 or more within the first year of contracting HiV results in measurable and significant immunological benefits.

Whereas waiting for cd4 counts to fall before starting treatment decreases the likelihood of immune restoration.

US researchers studied 1,119 people living with HIV who had an estimated date of seroconversion (EDS). Those on ART within a year of infection

reached a normal CD4 level — considered to be around 900 in the general population — in almost 40% of cases compared with about 30% of those who began ART 12 months or more after EDS. Researchers found that participants had “the capacity for CD4 cell normalisation” if the duration of untreated HIV infection is minimised; and even greater capacity if the CD4 count when ART was initiated was 500plus. Delaying the initiation of ART beyond 12 months of EDS,

early treatment can result in an undetectable viral load, which can dramatically reduce the risk of passing on HiV to a regular sexual partner. concluded the researchers, “diminishes the likelihood of restoring immunologic health in HIV-1-infected individuals”.

berlin patient speaks out the only person in the world to have been cured of HiV has spoken out about his experience for the first time. timothy ray brown — aka the ‘berlin patient’ — was cured of HiV after living with the virus for 12 years.

During that period, Brown was diagnosed with leukaemia. His doctors decided to conduct a stem-cell transplant and — in a bold experiment — used a donor who was naturally resistant to HIV infection. Brown said, initially, he didn’t want to be a

"guinea pig" and refused the procedure.

However, "I received the transplant on 6 February, 2007 — my new 'birth date'. I stopped taking my HIV medication on the

day of the transplant.

After three months, HIV was no longer found in my blood,” said Brown.

The virus has never returned.

Brown admitted he was not ready for the publicity his case would bring, but decided to waive his anonymity in 2010. "I did not want to be the only person in the world cured of HIV; I wanted other HIV-positive patients to join my club,” he said. Brown has since dedicated his life to supporting research to find a cure for HIV.

Brown’s HIV cure replicated in mice Meanwhile, Timothy Ray Brown’s HIV cure has been replicated in mice. Researchers from the University of California have genetically engineered human stem cells to be HIV resistant.

These cells were then purified and implanted in mice. Six months after being infected with two strains of HIV, the mice

maintain normal CD4 cell counts and continue to test negative for the virus.

“This brings us closer to mimicking the results observed with the Berlin Patient,” said the study’s authors — who are now poised to evaluate the effectiveness of the gene therapy in human clinical trials.

The study chimes with what has long been suspected: treating early better positions PLHIV to directly fight off infections, tumours and disease. Early treatment can also result in an undetectable viral load, which has the potential to dramatically reduce the risk of passing on HIV to a regular sexual partner (this is particularly reassuring news for people whose sexual partners are HIV negative).

Another survey has found the benefits of early ART were jeopardised if treatment was later

interrupted. Those who started on ART early and maintained treatment adherence held an average CD4 count of 731; while those who interrupted treatment had an average count of 625.

THAILAND

Access to HIV drugs threatened on changes to the the cost of antiretroviral HIV treatment in trans-pacific partnership (tpp) drugs could increase Vietnam. If the intellectual could force almost four-fold, property around 50,000 proposal is people living with meaning the thai implemented, HiV in Vietnam to government would antiretroviral forgo lifesaving treatment. only be able to provide drugs would increase from The TPP is a HiV medication US$127 to multilateral freeUS$501, trade agreement to 30% of plHiV. meaning the between the US Thai government would only be and 11 Asia-Pacific nations, able to provide HIV medication to including Australia.

30% of PLHIV, down from its US and European trade current treatment rate of 68%. officials have been pushing for Activist groups and nonmore restrictive intellectual government community property rules that would limit organisations denounced the compulsory licensing of drugs move as “aggressive”. and grant big pharma new rights Conversely, the Obama to facilitate patenting — a move, administration has promised to campaigners fear, could fight high drug prices in the US. jeopardise access to cheap generic In particular, expensive specialty medications in developing medicines such as Sovaldi — a nations.

According to the UN, there are new hep C treatment that costs US$84,000. almost 90,000 people living with

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thenews

Survey of positive women released the laboratory in your pocket

Now that’s smart researchers have developed a low-cost smartphone accessory that can perform a rapid HiV test.

The innovative device — dubbed “the laboratory in your pocket” — was recently piloted by healthcare workers in Rwanda who were able to make a diagnosis from a finger prick of blood in just 15 minutes.

“Our work shows that a full laboratory-quality test can be run on a smartphone,” said lead researcher Samuel K. Sia. “This kind of capability can transform how healthcare services are delivered around the world.”

The device requires little user

training and needs no maintenance. It also achieves low-power consumption, a must in places where there is an erratic electricity supply. Almost all the patients exposed to the accessory said they would recommend it because of the fast turn-around time of the test and simplicity of the procedure.

Sia said the technology would allow a scale-up of HIV testing at a community level that, along with the availability of immediate antiretroviral therapy, “could nearly stop HIV transmissions and approach elimination of this devastating disease”.

could HiV affect hearing?

Findings have suggested that people living with HiV who are on antiretroviral treatment (art) may be more likely to experience hearing loss.

The study — conducted at the San Diego State University in California — set out to determine whether HIV and ART are associated with changes to pure-tone hearing thresholds, the softest sounds audible to most human beings.

Two cohorts of middle-aged positive and negative men and women were exposed to a wide range of audio frequencies, from 250 Hz to 1,000 Hz. Researchers discovered that low- and high-frequency pure tone averages were significantly higher among the HIVpositive participants, indicating their hearing was poorer than the negative group’s. “To our knowledge,” wrote the authors, “this is the first study to demonstrate that HIVpositive individuals have poorer hearing across the frequency range.”

results of an international survey regarding the sexual and reproductive health and human rights of women living with HiV (WlHiV) have been presented before a World Health organisation meeting in Geneva.

The survey — the largest of its kind ever conducted — found almost 90% of the respondents reported experiencing violence or fear of violence because of their HIV status. This resulted in respondents keeping their HIV secret from partners, family and health workers. More than 80% of participants reported experiences of depression, shame and feelings of rejection.

The 945 respondents — from 94 countries, and aged between 15 and 72 — also reported widespread difficulty in decisionmaking around when, how and with whom to have sex, and whether and when to have children. Partners and/or family

members were often making such decisions for them. The most prevalent fear for women around pregnancy was onward

transmission to a child or partner; this was compounded by stigmatising attitudes from healthcare staff.

Seroconversion, resistance can occur with PrEP a study has found that it is possible to contract HiV and become resistant to truvada while taking the drug as a preexposure prophylaxis (prep).

People have been found to become HIV-positive on PrEP in the past, but this was because they had begun treatment unaware their HIV test had produced false negative results.

Analysing plasma samples from the 121 people who contracted HIV while participating in the PARTNER PrEP study, researchers tested for resistance against emtricitabine

or tenofovir (the drugs found in Truvada). Five participants were found to have drug resistance — three of these were discovered to have been acutely infected when they started the trial.

This left two who became HIVpositive during the trial and who then went on to develop drug resistance to Truvada (most likely to the emtricitabine component).

Such an occurrence, say researchers, is rare and the findings should be weighed against the prevention of an estimated 123 new HIV infections over the entire course of the PARTNER study.

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Peer support from other WLHIV was found to be fundamental to respondents’ wellbeing but such support was limited. Concerns about punitive and repressive laws were widespread, and respondents voiced disappointment that the experiences of WLHIV went largely unacknowledged by decision-makers. The impact of poverty was emphasised, with the resulting strain on mental, physical and sexual health evident throughout the survey.

The survey’s authors’ recommendations include: healthcare providers adopting and upholding respectful policies and practices; health services implementing a holistic, womencentred approach to sexual and reproductive healthcare; gender equality and human rights principles embedded in all healthcare policies, practices and training.

‘important step’ toward eliminating mother-to-child transmission taking a three-drug regimen during pregnancy is the more effective option in preventing mother-to-child HiV transmission, a study has found.

The ongoing PROMISE study (Promoting Maternal-Infant Survival Everywhere) aims to determine how best to safely reduce the risk of HIV transmission from infected women to their babies during pregnancy and post-delivery.

In comparing two proven strategies, researchers discovered giving women a triple drug regimen throughout the pregnancy and delivery was more successful than giving women different drugs at various stages of the gestation period.

“This is another important step in our efforts to define the best approaches toward the goal of eliminating mother-to-child HIV transmission globally,” said Anthony S. Fauci of the US National Institutes of Health.

Packet in WHO KNEW? SMOKING IS BAD FOR YOU. JAKE KENDALL REPORTS THE OBVIOUS.

Y

et another study measuring the effects of smoking on positive people has thrown up predictable results: cigarettes kill. a joint us-european study has found the life expectancy of a 35-year-old man living with HiV is reduced by eight years due to smoking. eight years.

Chuffing on a ciggie increases the risk of death from cardiovascular disease and nonAIDS-related cancers. “Smoking was associated with a two-fold increase in mortality,” said the study’s authors. “More than a third of all non-AIDS-related malignant deaths were from lung cancer and all deaths from lung cancer were in smokers.”

And the benefits of not smoking were equally strikingly clear. HIV-positive non-smokers who were doing well on antiretroviral therapy had a similar life expectancy to nonsmokers in the general population. The study also showed that people who had stopped smoking had a markedly lower risk of death compared

With research suggesting that many positive people will live a normal lifespan (82 is the average for australians), david Menadue asks: "Why stop there?" Here are some tips on how to live a longer and healthier life.

1 a Good relationsHip WitH your doctor People with HIV need to see their doctor relatively frequently if they are to have a good handle on their health (viral load, CD4 and basic blood results). If you are able to have an honest discussion with him/her about anything that might be bothering you, from that funny toenail infection to concerns about your mental health or relationships, then you will feel more in control of your health and

staGe one: plan ahead. Set a date — and stick by it. Get rid of ashtrays and lighters. Ask mates for support.

Cut down the fags in the weeks before the big day. Identify your smoking triggers and patterns, and change your routine. staGe tWo: acute nicotine withdrawal.

Symptoms may include sleepiness, headaches, constipation, anxiety, irritability, tension, mood swings and gnawing at your elbows. The good news is this living hell will only last a week or so. with current smokers “pointing towards potential benefits of including smoking cessation interventions in HIV care”, write the authors.

They concluded: “HIV-infected individuals with long-term engagement in care may lose more life years through smoking than through HIV.” So the takehome message to positive smokers? Quit! Now! If only it was that easy.

Research suggests nicotine is as addictive as heroin and cocaine.

And for those scoffing at that, consider this: an addictive drug is defined as one that will be repeatedly self-administered, even though there is no medical reason for it — and even though the user is aware that the habitual use of the drug is causing them harm.

Smoking defies logic. And the logic is simple: by quitting you’ll

improve the quality and the length of your life.

There are various quitting methods you can try, such as nicotine patches and prescription medications. Alternatively, you could try hypnotherapy, or acupuncture. If you go cold turkey there are three quitting stages to be aware of (see right). Good luck. Keep at it. You can beat it.

Remember: eight years . . .

(See page 14)

HOW TO LIVE TO your life. And, if you see them often enough, a good doctor will pick up signs of potential illness and nip it in the bud.

2 Get oFF tHe coucH In days when people spend more time sitting around doing little, like trawling Facebook, we are doing our body no favours. Regular exercise has been shown to improve T-cell counts and a sense of wellbeing.

It helps produce hormones that help calm us down.

Physiotherapists recommend at least 30 minutes of exercise a day

— and it need not be strenuous to be beneficial: walking or dancing in the street is just fine!

3 nurture your Gut The lymphoid tissues in a person’s gut are filled with T-cells. Because of this, many people with HIV have gastrointestinal problems.

However, a healthy gut is crucial to the absorption of HIV medications. HIV dieticians can help with advice here but having a good diet (including lots of fibre) and taking probiotics and yoghurt can help improve these problems.

4 beatinG tHe blues Living with HIV can be stressful for many of us; for both physical and psychological reasons. Being proactive about avoiding depression and anxiety, knowing the symptoms and being willing to seek professional help — such as seeing an HIV-experienced counsellor — can really make the difference.

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5 MinGlinG liMbs Sex can be a fraught issue for positive people because of

staGe tHree: cravings become less frequent. But don't become complacent as most people relapse within three months. You’ll be at a party, say, and suddenly realise you’re puffing away like the Flying Scotsman. If you cave, don’t beat yourself up.

Instead, learn from failed attempts and think of them as practice sessions. It’s all part of the process. issues around disclosure, body image and fear of transmission.

But there is no doubt that it can be good for your immune system, help you sleep and reduce stress.

Getting partnered has been seen to be an even greater factor in living a long life; developing a network of close friends contributes a lot too.

6 enjoy liFe’s siMple pleasures We all need things to look forward to in life to help us keep up our moods. Having a glass of red wine at the end of the day has been proven to be good for your health. Listening to soothing music can be a great relaxant. Strolling on the beach or watching a sunrise/set releases serotonin too. It’s the little things that can make our day.

about the disease, aside from the fact it was a killer.

But for some time now, developments in treatment have ensured that people living with HIV are living well and living longer. Not only that, as major

easier drug collection From 1 July, people living with HIV will be able to pick up their HIV medications from community chemists. If you live in an inner city it’s likely that you’ll be able to collect your drugs on the spot with little fuss.

However, those living in regional Australia may find collection more problematic and will more than likely have to drop off a script and pick up the meds a few days later.

To accommodate the changes it’s expected chemists will extend dispensing hours — some may even open seven days a week.

Others may be able to provide a free delivery service. (Be assured that HIV medications are packaged discreetly.)

Whilst having more choice as to where you collect your meds from is undoubtedly a good thing, there are some legitimate concerns — particularly around privacy, especially in small towns.

If you have any worries, talk to your pharmacist. (See page 12)

prep trials All eyes will be on the Australian PrEP trials this year. There are currently three ongoing: the PRELUDE study in NSW; the VicPrEP study in Melbourne; and the QPrEP study in Queensland. The aim of the trials is to explore the acceptability, feasibility, uptake and impact of taking Truvada as an HIV preexposure prophylaxis.

Overseas studies have shown encouraging results: in trial after trial, Truvada — a single pill combining tenofovir and emtricitabine — has been found to be highly effective in reducing the risk of HIV transmission. It is expected the Australian trials will deliver similar results which will in turn, no doubt, lead to urgent calls for Truvada to be licensed for use as PrEP here.

testing, testing Last year, more than 40 rapid testing sites operating across Australia successfully attracted people who had never tested for HIV before.

There are two different

2015 FORESEEN

Rebecca Benson peers into the near future and assesses the hot issues and key challenges ahead. kinds of test: one collects oral fluids; the other involves a finger prick. In an effort to trace the estimated 7,000 cases of undiagnosed HIV, expect an increased roll-out of rapid testing sites over the course of the year.

In 2014, restrictions were lifted on HIV self-testing kits.

Already available in the US and given the go-ahead in the UK, the kits — likened to home pregnancy tests — will make HIV testing more accessible, particularly for Australians living in remote communities. It is hoped that the first DIY kits will be made available in Australia sometime this year.

new treatments Recently approved by the Therapeutic Goods Administration, Triumeq becomes the fourth single-tablet regimen available to people living with HIV in Australia (See page 10). It contains three

medications: dolutegravir, abacavir and lamivudine.

A decision by the Pharmaceutical Benefits Advisory Committee to list Triumeq on the PBS is expected within the coming months.

Cobicistat (or COBI) is a new ‘booster’ drug also awaiting PBS listing. It is currently being considered as a potential alternative to ritonavir in other HIV-drug combinations. While similar to ritonavir in composition, COBI has a much better sideeffect profile. It also has fewer HIV-drug interactions than ritonavir.

However, COBI has been found to adversely interact with drugs to treat erectile dysfunction such as Viagra. It may also increase levels of amphetamines including ecstasy, cocaine, speed and meth.

section 19a Responding to community advocacy, the LNP Victorian government last year announced its intention to “amend” Section 19A of the Crimes Act 1958. Section 19A establishes the criminal offence (punishable by up to 25 years’ imprisonment) of “intentionally causing a very serious disease” — “very serious disease” is exclusively specified to mean HIV infection. It is expected that sometime this year the new Labor government in Victoria will come good on its pre-election promise by repealing Section 19A altogether.

stigma It’s getting on close to 30 years since the Grim Reaper sent men, women and children hurtling down the bowling alley of death.

Back in the day, it was understandable for people to be scared of AIDS: little was known

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international studies have found — providing a positive person is on treatment and maintaining an undetectable viral load — there is almost zero risk of HIV transmission.

Yet stigma still persists. A New Zealand survey found that 47% of respondents said they would be uncomfortable sharing a home with someone living with HIV; 56% said they would feel uncomfortable having food prepared for them by someone living with HIV; while 87% of people were uncomfortable having sexual contact with someone living with HIV. It is 2015 — way beyond time for attitudes to have changed and for the wider population to have become aware of the facts about HIV. It should be regarded no differently to any other manageable chronic condition. To coin a phrase: ENUF.

ending HiV The key goal of the Australian National HIV Strategy is to increase efforts to realise the virtual elimination of HIV transmission by 2020. This target has been endorsed by every state and territory health minister.

A crucial step towards achieving the aim is to hit the interim target of reducing sexual transmission of HIV by 50% this year.

Another important target is to have 90% of people with HIV on treatment as soon as possible. Australia has led the way in locking in such targets — 2015 is the year in which achievements must match expectations.

POSITIVE VOICES POSITIVE PEOPLE SHARE THEIR EXPERIENCE OF DATING AND DISCLOSURE

Hey, I’m HIV-positive

Negotiating sexual relationships is tricky enough as it is without having to throw HIV into the mix.

Here, positive people share their experiences of playing the dating game.

CHARLIE i’d only just started dating this girl. We’d only been together a matter of weeks, it was very early days. I was keen on her and it was going really well so I wanted to do the responsible thing and I got tested. The positive result was a shattering blow.

I was torn. I really liked this

chick, but I didn’t know whether to disclose or cut her loose. I ended up cutting her loose completely. I just couldn’t go through with it. I decided to nip it in the bud and just move on. It was just too tough.

I made up some ridiculous story about needing to go back to the UK because a missing family

I was convinced I would never see her again

member had resurfaced. But she’s a smart girl and she saw right through it. She wrote me a long email saying, “Look, whatever it is I just need to know.”

She thought all sorts of things: that I was married, had kids; I was gay. I stewed on it for a couple of days and ended up replying back to her saying: “Let’s meet and I’ll tell you everything.”

But in the end I couldn’t go through with it.

Eventually we arranged to meet for a second time. I decided the only way I could tell her was in writing. We met in the middle

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of a park. I handed over the letter and walked away. I was convinced I would never see her again.

About five minutes later my phone rang. It was her and she said: “Don’t be so silly and get back here.” I was stunned. I couldn’t believe the reaction — it was a dream reaction, just incredible. I had tears in my eyes.

She was so calm and understanding. That was almost two years ago — and we’re still together. It was a really intense time. It felt like my whole life was on the line. But I took the gamble and it paid off.

Everyone needs an orgasm

SARAH i’ve copped everything when disclosing my status, from people being overtly nice — but not wanting to be sexually involved — through to people telling me i’m a dirty bitch and how dare i come near them. The heterosexual dating world can be quite gnarly.

Then I went through a phase of having someone who was okay with my status and being really lovely about it and breaking up with them because I thought they were too good to be in that situation with me.

At first I was really shocked by the rejection. I was such a sexual person before being diagnosed — living with HIV made me feel I was cut off below the knee. I felt I could no longer

be a sex-positive person.

That threw me into a massive depression; I didn’t know how to exist without sex. It put me in such a weird head space for so many years. But now the science is really heading in an amazing direction — we’re not dying, we’re not infectious — but letting everyone else know that is a bit tricky.

As a positive person you’re a full-on educator. I’m seeing a guy now and I’m the first person he’s known with HIV. At first, he was really confronted by it and it took him a long time to feel confident to even ask me questions.

What I’d say to other positive people is: you’re still allowed to feel sexy and have sex. Everyone needs an orgasm.

BILL before i became positive i went home with a guy i met in a nightclub and when he told me he was HiV i couldn’t continue with the encounter. Since I became positive 28 years ago I’ve had that exact same thing happen to me.

There’s a lot of fear around relationships because of that.

I’ve been with guys and haven’t disclosed — I would look after them but I wouldn’t disclose. But there is always the worry that the condom might break or I might in some way still infect them. So eventually I made up my mind that I wouldn’t have sex unless I disclosed. It’s liberating when you tell someone you are HIV-positive because then they share a part of the responsibility of the encounter.

If I’m interested in a guy I get to know them for a while before disclosing. I won’t have sex, I just get to know them and see whether they are worth disclosing to. I’ve always had fabulous

ng It’s liberati l el when you t e ou’r someone y e HIV-positiv

results doing it that way.

If you tell someone when you first meet them, they don’t know you; they don’t have any personal attachment to you so it’s easy for them to reject you. But if you’re interested in somebody and they’re interested in you, once you get to know each other there are often no barriers to having a relationship with someone you have feelings for.

So my advice to people is to get to know someone first. That way when you do disclose it’s not usually all that important any more.

i’ve been positive for ten years.

I’ve been partnered for some of that time and single too. I’ve been lucky and had some good experiences with disclosure. I’ve had a few boyfriends over the years and told most of them. Some have been a little bit frightened at first but once I’d explained everything they were okay.

There was one guy that I liked so much that I couldn’t tell. It was so difficult. I rehearsed it over and over in my head — that’s something you go through every time you disclose. You go through how you’re going to say it, what you’re going to say. And when and if. It’s always hard. You don’t know how people are going to react.

Then there are times when I’m in a casual relationship that — because my health is good and I’m a low transmission risk —it’s like, “Should I really tell that person?” There have been times when I’ve told someone and it

didn’t last and I’ve thought: “Maybe I shouldn’t have told them.” When you’re practising safe sex with condoms and your viral load is undetectable then it’s a question of your own judgement as to whether to disclose.

I believe somebody has to care about you before they’re ready to take on all that information about HIV, in order to do the work to understand the science. I also believe that it’s up to the positive person to do the research; it’s the positive person who has to be convinced. Your confidence and knowledge around HIV is important. Once you’re sure of all the evidence and the science; once you’ve read everything about it that you possibly can and informed yourself completely, you’ll come to the conclusion that the

Confidence and knowled ge around HIV is important

MEGAN

this was the first time i was disclosing to someone i could see myself dating. I had gone over my monologue in my head for weeks.

Naturally, nothing came out as articulately as I had planned, but it went a little something like this: “Um, so . . . my father died from AIDS. He probably got the virus from IV drug use. And since he was unaware of his status, my mother also has the virus. And since my mother was unaware, I got tested. And it came back positive. And . . .”

Then there was silence. I remember wishing that it was all just a dream, that I hadn't just done this to myself. I didn't even think about his response; I just wanted to take back everything I had said and get out of there, but I felt paralysed.

CHRISTINA

as soon as i was diagnosed i didn’t hold back. I was working behind a bar at the time and guys would hit upon me quite a lot and I’d tell everybody I was positive. It was never really an issue. I think it had a lot to do with how I came across. If you make a big deal of it then people will react as if it is a big deal.

I’ve seen other people stress out about it and by the time they do disclose that they’re HIV the person is already freaking out. If

you’re casual about your status people are okay. It all depends on how the positive person sets up the scenario.

A lot of the time the situations you put yourself in are of your own creation. So if you’re about to disclose, don’t start off

I disclosed, then there was silence Then he asked if he could hug me.

I answered his questions in a bit of shock that things were going so well. “So you have AIDS?” No, I have HIV, which is the virus that can develop into AIDS. “Are you mad at your dad?” No, I find it very difficult to be angry at a man who lost his own life

[transmission] risk is low.

In most of my relationships my partner and I have decided, with all the information currently available, to not use condoms. My current relationship has lasted almost three years and he remains HIVnegative, as have the others.

These days, the science is so strong that a [negative] person shouldn’t have a problem with HIV. If they do, maybe they don’t have the brain to understand — or the heart to care.

because of the lack of treatment and support during his lifetime.

“Do you take a lot of pills?” Yes, my medication has changed multiple times throughout my life, and yes, some have had terrible effects on my health.

“So, about the sex thing . . .”

They're called condoms, and they should be everyone's best friend, not just people living with HIV, since there's a whole list of infections and viruses that all sexually active human beings should try to protect themselves against. My boyfriend and I have now been dating for almost four years.

Disclosure is never easy. But opening up is the only way you can find support from others.

And sometimes, if it's with the right person, that moment of anxiety can lead to a lasting, loving relationship.

JASON

positiveliving l 9 l AUTUMN 2015

by making out it’s this huge doom and gloom thing.

Being HIVpositive is just a small part of who you are, so make sure that’s how you present it to someone. Don’t make the HIV thing any bigger than it really is.

HIV was never really an issue

DOCTOR LOUISE ANSWERS YOUR QUESTIONS

what’syourproblem?

HIV can be transmitted via breast milk. However, once again, this risk is significantly reduced when the viral load is undetectable — but it is not zero. In general, it is advised that HIV-positive women avoid breastfeeding and instead formula feed their babies. This is a discussion you can have with your healthcare providers.

So to wrap up: having a baby is something that is definitely possible for women living with HIV. Your doctor and treating team will be able to offer you information and assistance to ensure a safe outcome.

sue from adelaide writes: My partner and I would like to have children — how will HIV affect my pregnancy and my baby? dr louise replies: Thanks for writing, Sue. The question about having a baby enters many women’s minds at some time and if you are HIV-positive you may have concerns as to whether you can have a baby, what the risks are etc. In short — yes, you can give birth to a perfectly healthy bub!

Knowing your HIV status before you have a baby is a distinct advantage. This way you’ll receive specialist advice about conceiving, treatments and transmission risks. Regarding conception planning, if your partner is HIV-negative then timed intercourse when you are most fertile can be considered.

The negative partner may also decide to take PrEP (pre-exposure prophylaxis). Your clinic can provide more information on this. Some couples choose to use self-insemination at the time of ovulation to further reduce the risk of transmitting the virus to their partner.

It’s important to be on

Pregnancy and HIV

Keep your questions under 100 words and email them to pl@napwha.org.au.

treatment as HIV medications reduce the risk of transmission to the baby when the virus is fully suppressed. Without treatment, one in four babies born to HIVpositive mums will be HIVpositive themselves. This is known as vertical transmission

and occurs near, or at the time of labour and delivery. As with sexual partners, the risk of transmitting HIV to your baby is greatly reduced when the viral load is undetectable (i.e., when you’re on effective treatment).

As well, it is recommended that

all babies are given antiretroviral medications for some weeks after delivery to further reduce any risk of infection. This is standard management procedure and your obstetric team will discuss this with you.

It is important to be aware that

n Dr Louise Owen has been working as a sexual health physician in the HIV sector since 1993. Previously a director of VAC’s Centre Clinic in Melbourne, she is currently the director of the Statewide Sexual Health Services in Tasmania. Her advice is not meant to replace or refute that given by your own health practitioner, who is best placed to deal with your individual medical circumstances.

tHePIllbox

New STR gains TGA approval Hailed as an important step forward in treating HiV, triumeq is the latest single-tablet regimen (str) to have been approved by the therapeutic Goods administration for the treatment of HiV. the drug contains — the clue is in the name — three medications: 600mg abacavir, 300mg lamivudine and 50mg of dolutegravir.

Developed by ViiV Healthcare, and already approved by both the US Food and Drug Administration and the European Union, Triumeq (repeat after me: “Try-oo-mek”) becomes the fourth STR available to people living with HIV in Australia.

An important point of difference with Triumeq is that all

the other STRs — Atripla, Eviplera and Stribild — contain tenofovir, which has been found to be associated with an increase in kidney damage and a decrease in bone mineral density (BMD). Triumeq does not contain tenofovir, making it an attractive option for patients with, or who may develop, such conditions.

Tenofovir has been replaced with abacavir. While the drug is perfectly safe to take for most people living with HIV, it is estimated that up to 5% of PLHIV have a genetic hypersensitivity to abacavir which can result in serious allergic reactions

including fever, rash, nausea, vomiting, diarrhoea, and stomach pain. (A blood test will determine if someone has a genetic hypersensitivity to abacavir.)

Abacavir has also been associated with a build-up of lactic acid, changes in body fat, and liver problems. As well,

studies have thrown up conflicting results as to whether or not abacavir contributes to heart problems.

The star component in Triumeq is dolutegravir — a second-generation integrase inhibitor that has performed fantastically in every trial it has been tested in.

For those who have developed resistance to raltegravir or elvitegravir, dolutegravir provides an alternative option within the integrase inhibitor class of treatment.

In other tests, Triumeq has been found to show superiority over Atripla. This was based on higher tolerability due to fewer

positiveliving l 10 l AUTUMN 2015

side effects (the most common being insomnia, tiredness and headache). Another selling point for Triumeq is that it has been found to have a high barrier to drug resistance, meaning it can be expected to perform well for longer.

Also, Triumeq has no food restrictions (so it can be taken with or without) and people can take the STR regardless of their viral load or CD4 count (other drugs have constraints). Triumeq ticks another box by not causing drowsiness, so it can be taken any time of day. in a nutshell, triumeq is a highly effective, much-tolerated, easy-to-take, single-tablet regimen.

iconographywithaconscience

Twenty-five years after Keith Haring’s death his art still endures. Christopher Kelly reports.

1

2

3 1 Untitled, 1985 2 Untitled, 1988, featuring the devil sperm — Haring’s personification of AIDS 3 Ignorance = Fear a 1989 illustration Haring created for ACT UP (AIDS Coalition to Unleash Power) 4 Haring transforming the men’s room of the LGBT centre

All © Keith Haring Foundation

4

even before his diagnosis Keith Haring knew he was going to die of aids. For a gay man living in new york city in the late 1980s aids was all around. Haring had already watched many of his friends die when, in 1987, he wrote: “i don’t know if i have five months or five years, but i know my days are numbered.” the internationally renowned artist and activist had, in fact, three years to live.

Haring arrived in New York’s East Village in 1978 as punk made way for New Wave, and he quickly became immersed in the underground art scene — literally.

Inspired by the graffiti that covered the trains, Haring gained public attention with hundreds of chalk drawings he created in the depths of the city’s subway stations. “The subway became like a workshop to develop ideas and the vocabulary to expand,” said Haring. The drawings soon caught the eye not only of commuters but also of city authorities and Haring was arrested for criminal mischief on several occasions.

Soon, his work was being exhibited in galleries across Manhattan and, before long, around the world. Haring was now working with artists and performers such as Madonna, Grace Jones, Yoko Ono, William S. Burroughs, Boy George and Andy Warhol. In spite of the international recognition Haring always remained a street artist at heart, believing that “art is nothing if you don’t reach every segment of the people. It is not an elitist activity reserved for the appreciation of the few, but for everyone.”

For Haring it was all about keeping art accessible — when he was invited to pick a space in which to paint a mural within the Lesbian, Gay, Bisexual and Transgender Community Centre in the West Village, Haring chose the men’s bathroom. With hiphop and rap music blasting out of his ubiquitous ghetto-blaster, Haring would go on to produce more than 50 public artworks in dozens of cities around the world, including Melbourne and Sydney.

Haring was openly gay and his sexuality featured prominently in his work. As did AIDS, especially following Haring’s own diagnosis in 1988. Back then, AIDS was

positiveliving l 11 l AUTUMN 2015

widely considered a “gay plague”, divine retribution for engaging in immoral practices. Haring hit back at such ignorant dogma by presenting the disease through a prism of political power. In 1989, he established the Keith Haring Foundation to support AIDS organisations such as ACT UP. At a time when many people suffered in silence, Haring helped generate AIDS awareness by being completely open about his illness. “We got infected because we didn’t even know the thing existed,” Haring told Rolling Stone in 1989. “When people started getting sick, they had no idea where it was coming from, had no idea that it was out there. So you didn’t know how to be protective and prevent it. If you didn’t know about it, you can’t be responsible for it.”

Featuring bold lines and bright colours and created with frenetic energy, Haring’s signature images include dancing figures, a radiant baby, a barking dog and large hearts. Although Haring’s handdrawn symbols are simplistic, the messages fuelling them are anything but: Haring’s vibrant art represents responses to racial inequality, religious warfare, capitalist excess, political oppression, and homophobia. Yet despite exploring serious social issues, Haring’s work exudes an inherent joy and optimism.

During the last years of his life Haring’s imagery spoke about his own illness. A “devil sperm” begins to arise in much of his work — Haring’s personification of AIDS. Towards the end, however, Haring found his impending death strangely liberating: it pushed him to create at a prolific rate. “It adds another kind of intensity to the work that I do now,” Haring said at the time.

“It’s one of the good things from being sick.”

Keith Haring died on 16 February 1990 of an AIDS-related illness. He was 31. Since his death, Haring has been credited for creating a universally recognised visual language of the 20th century. He has been the subject of several international retrospectives — the most recent in San Francisco — and his work is still exhibited in major museums around the world today.

“When I die there is nobody to take my place,” wrote Haring. It’s been 25 years, and nobody has.

nswnews PositiveLifeNSW

Taking care of your mental health For someone living with HIV, maintaining good health is paramount. But, as David Crawford reports, it’s not just your physical health that you have to be mindful of.

The message is clear: know your status and commence treatment as soon as possible after testing positive. Sound advice. However, I am of the firm belief that social care and support cannot be underestimated and must remain as a cornerstone of the Australian response to HIV. Since starting with Positive Life NSW as treatments officer late last year, I’ve found there is a theme threaded among the conversations I’m having with counterparts within the sector.

There appears to be a constant stream of issues emerging around mental health and neurological (brain) diagnoses associated with HIV. How far-reaching this situation is we are not exactly sure as a lot of these problems present in people where mental health issues, like depression, exist even without HIV — especially within an ageing population. But what we do know is that depression and anxiety are experienced more commonly by people living with HIV than the general population. We also know that the sooner mental health problems are addressed, the better the long-term result.

What we do know is that depression and anxiety are experienced more commonly by people living with HIV than the general population.

The triggers that indicate an emerging problem can be quite subtle. They can also be part of what we all experience from day to day — we misplace our keys, miss the occasional appointment, forget our PIN, or walk into a room not quite knowing why we’re there. (Since the advent of the mobile phone I barely remember my own number!)

While often innocuous, such problems like difficulty remembering things, losing the train of thought, fatigue and mood swings can also be

symptoms of mild HIVassociated neurocognitive disorders, or HAND. So at what point should we be concerned? Well, when these things start affecting day-to-day functioning. When relationships with people, either at work or at home, seem out of control or volatile, and people are noticing you are out of character. When you are experiencing financial difficulties from over-spending or have been placed on a performance agreement at work — especially if you have been

achieving targets up until recently. These are all indications that something might be changing neurologically.

People often try to rationalise such experiences and attempt to work out what is going on by themselves or by confiding in friends. While talking to mates can be helpful, they won’t have the solutions or the tools that experienced professionals can provide. A mental health or neurological condition is complex so it is very important that you speak to an experienced

healthcare professional. Positive Life is currently working on developing strategies that address intricate neurological conditions.

If you are experiencing difficulties of this nature, we’d suggest you discuss your concerns with your GP or treating doctor. Positive Life would be happy to talk with you about what’s going on and help work out ways forward, should you need further assistance.

Here are some other organisations you could contact: l ADAHPS — a multidisciplinary team including psychologists and case managers for residents of NSW who have HIV-related cognitive impairment and complex needs. health.nsw.gov.au/adahps/ pages/default.aspx l Bobby Goldsmith Foundation (BGF) — providing financial and practical assistance support to people living disadvantaged by HIV in NSW. bgf.org.au l HIV/AIDS Legal Centre (HALC) — a not-for-profit, specialist community legal centre, providing specialist support to deal with the particular issues that HIV and the law create. halc.org.au David Crawford is treatments officer for Positive Life NSW.

Survey on greater access to meds From 1 July 2015, HIV medications will be dispensed from local chemists. Positive Life NSW is taking an active lead in this policy change and we want to hear your opinion about your

needs and preferences when accessing mainstream and specialist (GPs, chemists, S100 prescribers) healthcare.

We want to find out where you’re seeing HIV healthcare

providers (GPs, specialists, prescribers etc) and where you’d like to see HIV healthcare providers. We are also interested in your recommendations of what GPs, prescribers or

chemists you would like brought onto the NSW prescriber list.

The survey is confidential and will take about two minutes to complete. To participate, go to: surveymonkey.com/r/PK9ZWS9

Positive Life NSW is the public face and voice of all people living with and affected by HIV in New South Wales. We are a health promotion agency that makes a significant contribution to and positive impact across the spectrum of health and social issues that are experienced by people living with and affected by HIV. Positive Life NSW works collaboratively with HIV and mainstream organisations to improve the health and wellbeing of people living with and affected by HIV.

PositiveLifeNSW 414 Elizabeth Street Surry Hills 2010 | ) (02) 9206 2177 or 1800 245 677 | ø positivelife.org.au positiveliving l 12 l AUTUMN 2015

vicnews

Taking important steps to deliver bold targets

BY IAN MUCHAMORE Living Positive Victoria is committed to being a transparent community-led organisation in the HIV sector, one that is accountable to members and one that models excellent practices in management and governance. To further this aim our business plan can be viewed at livingpositivevictoria.org.au.

There are many activities laid out across the business plan, both those continuing and evolving from past activities as well as brand new initiatives. The plan also takes important steps that will be needed to fulfill our significant role in delivering on the bold HIV targets that politicians, clinicians and communities now share.

Living Positive Victoria is committed to partnerships and collaborations that strengthen the response to HIV prevention.

These must include the meaningful involvement of positive people.

In the coming months we

intend to review the partnership approach of two key collaborations — with the Victorian AIDS Council and as a member of Poz Action (a national collective of agencies dedicated to representing PLHIV). The outcomes of these reviews will support the further evolution and strengthening of the partnerships, which see

people living with HIV as central and vital to an effective reporter to HIV. We will also establish a Gender equality project Group, which will oversee a review of current practices, policies and services to determine how Living Positive Victoria can continue to improve to meet the highest standards of gender equity.

This activity, which will include substantial community engagement and opportunities for discussion and feedback, is due to be completed by the end of the financial year. Our board is committed to ensuring that all findings and recommendations will be made publicly available.

We are also committing to reshaping, in collaboration with

ENUF of summer Since its launch in October 2012, Living Positive Victoria’s ENUF anti-HIV stigma campaign has achieved significant status in the community through its presence online and at key public events.

This year, a new-look summer campaign was developed for ENUF and has been shown off at the recent Midsumma

Carnival and St Kilda’s Pride March.

“The intent of the summer campaign was to reinvigorate attention on the ENUF brand, raise new awareness of the campaign’s messages and most importantly, achieve increased levels of community participation in the campaign through pledges,” said campaign

coordinator Brenton Geyer.

Already, the summer campaign has resulted in a 25% increase in those having taken the ENUF pledge to stamp out HIV stigma and discrimination.

The ENUF team will also be present at the Chillout parade and carnival in central Victoria’s Daylesford over the upcoming Labour Day long weekend.

living positive victoria | Suite 1, 111 Coventry Street Southbank 3006 | )03 9863 8733 | ø livingpositivevictoria.org.au

positiveliving l 13 l AUTUMN 2015

our partners at Coventry House, how peer support for women living with HIV is delivered. A new hub and spoke model of peer support will improve the accessibility of these services.

Once fully established, this change should lead to efficiencies that will mean more peer support services can be delivered to more women across a wider diversity of backgrounds and geographic reach.

Finally, our Senior Voices Project — a commonwealthfunded collaboration with other organisations who represent and support people living with HIV — will soon commence implementing the next steps of project delivery with a facilitation manual to guide speakers visiting aged-care facilities and workplaces.

Ian Muchamore is president Living Positive Victoria

qldnews

Kicking butts in Queensland

BY DR CORAL GARTNER AND PETER WATTS Evidence is growing that the higher rates of smoking among people living with HIV is a major cause of preventable death and illness. A recent Danish study found that PLHIV who smoke are at greater risk of a heart attack than smokers who are HIVnegative. However, the good news is that PLHIV who have never smoked had no higher risk of a heart attack than HIVnegative non-smokers.

In addition to improving cardiovascular health, quitting smoking reduces the risk of osteoporosis and bone density loss, lowers cancer risk, and improves lung health and immune health. Nonetheless, quitting smoking is hard and may involve multiple attempts.

Quit support in Queensland To help PLHIV quit smoking, in 2009 Queensland Positive People (QPP) introduced the Positively Quitting Project.

Resources and supports include an encouragement booklet and card, reimbursement of 100% of the cost of standard nicotine replacement products (patches, gum, lozenges, inhalers) and 50% of the cost of self-help therapies (when approved by the treating HIV clinician). All Queensland HIV clinicians also receive a support kit (these can be found at qpp.net.au).

Pilot online peer workshops Additionally, QPP — in association with Living Positive Victoria (LPV) — recently undertook a pilot initiative to conduct Quit Smoking Peer Support Online Workshops.

The research aims to better understand the unique barriers that PLHIV experience in quitting smoking.

These audio-visual workshops were delivered over a four-week period during December 2014.

Four Queenslanders and one Victorian registered to participate. The primary purpose of the online workshops was to provide a peer-supported environment to help PLHIV to give up smoking. The reason for exploring this online model was to bring otherwise isolated people from various regional locations together in a face-toface workshop format.

Exploring new ways to reduce tobacco-related harm QPP has also teamed up with

researchers at the University of Queensland (UQ) to find new ways to help PLHIV stop smoking. The UQ research team is currently conducting focus groups with PLHIV throughout Queensland and Victoria.

This research aims to better understand the unique barriers that PLHIV experience in quitting smoking and also to explore what type of assistance would be acceptable to the population. The insights gained from this research will be used to develop a series of brief videos that

provide advice and tips on how to quit smoking.

Harm reduction As well as traditional abstinence-focused approaches, QPP is also exploring the potential for harm-reduction options to help those who find quitting difficult. It has been known for many years that nicotine is the main addictive ingredient in tobacco but it is not responsible for the majority of tobacco-related harm. Some researchers have estimated that most of the harm from smoking could be eliminated if smokers switched to clean forms of

Recently diagnosed?

Hosted by QPP, AWARE is a one-day workshop for recently diagnosed people to learn more about HIV and to meet other positive people in a safe, relaxed space. Topics include disclosure tips, treatment advice and much more.

For further information, or to register for the next AWARE workshop call 1800 636 241 or email info@qpp.org.au.

nicotine use.

In addition to established nicotine products, we are also looking at electronic cigarettes (or e-cigarettes). There is some controversy about e-cigarettes because they have been developed and marketed as recreational products rather than medicines. Many public health professionals are also concerned that aggressive mass-marketing of e-cigarettes could encourage non-smokers (particularly teenagers) to start using them.

Nevertheless, a recent systematic review found no evidence that short-term use of e-cigarettes was associated with any risk to health; some products are currently in the process of being approved as medicines in the UK. There is some uncertainty about potential risks from long-term use, but public health researchers agree that they are likely to be substanially lower than the risks associated with tobacco.

Future research To examine whether harmreduction approaches will also help PLHIV reduce their smoking, QPP hopes to conduct a clinical trial to examine whether adding harm-reduction advice (and access to an attractive nicotine product) to a standard quit smoking intervention is any more effective than just offering the standard intervention alone. We hope this research will translate into real health benefits for PLHIV. Dr Coral Gartner is senior research fellow, School of Public Health, University of Queensland; Peter Watts is health promotion and treatments officer, QPP.

Queensland Positive People (QPP) is a peer-based advocacy organisation committed to actively promoting self-determination and empowerment for all people living with HIV throughout Queensland. QPP recognises the importance and value in people living with HIV having significant input into Australia’s HIV response.

queensland positive people | 21 Manilla Street East Brisbane 4169 | )07 3013 5555 or 1800 636 241 | ø qpp.net.au positiveliving l 14 l AUTUMN 2015

Meanderings

—

The good ol’ cuppa!

A Harvard study found that people who drank five cups of tea a day for two weeks had ten times more virus-fighting interferon in their blood than those who drank a placebo hot drink. L-theanine — the amino acid responsible for this immune boost — is abundant in both black and green tea (decaf versions have it, too).

To get up to five times more antioxidants from your tea bags, bob them up and down while you brew.

QUOTEUNQUOTE

A planet without AIDS is possible, but to create that planet we must do away with the vestiges of the old planet where testing positive to the HIV virus effectively relegates an individual to the subclass of human society.

Broccoli is the business

FOR THE NEWLY DIAGNOSED n Tell someone you trust n Connect to a support group n Find a good doctor n Start treatment n Stay healthy

With its unique package of antioxidant, anti-inflammatory, and detoxifying micronutrients, broccoli turns other greens green with envy. broccoli also offers high levels of immune system-boosting vitamin c, bone-strengthening vitamin K, and folate, which plays a strategic role in regulating cell growth and reproduction. not only that, broccoli is also packed with glucosinolate compounds, such as sulforaphane and glucoraphanin, which help to fight cancer. by reducing inflammation, eating broccoli could also help lower the risk of stroke and heart disease. positiveliving l 15 l AUTUMN 2015

Oche Otorkpa

GOFIGURE q

35

THOUSAND people living with HIV in Australia

35 MILLION

people living with HIV worldwide

calendar2015 march 7

saturday

Join thousands of spectators for the 37th sydney Gay and lesbian Mardi Gras parade and joyously celebrate the hardwon freedom to be whoever you are.

Oxford and Flinders Streets, Darlinghurst, Sydney.

13

Friday

Positive Life SA hosts planet positive — a social event for PLHIV and their friends to mix and mingle with other positive people in a safe and relaxed environment.

From 6-9pm Seven Stars Hotel, 187 Angas Street, Adelaide. )(08) 8298 3700

26

thursday

18

saturday

Positive Life NSW presents the Quarterly, an inclusive social event for all people with HIV, their families and significant others.

From 7pm GT’s Hotel in Surry Hills, Sydney. )(02) 9206 2177

26

thursday

eat indulge connect — a gathering of HIV-positive people share the values of good nutrition.

From 5-8pm NTAHC, 46 Woods Street, Darwin )(08) 8944 7716

april 4

saturday

A young people’s catch-up organised

by POZHET. From 2pm Alfred Park, Sydney )1800 812 404

12

sunday

A group for culturally and linguistically diverse people living with and affected by HIV in the Brisbane region.

From 2-5pm QPP 21 Manilla Street, East Brisbane )(07) 3013 5555

17-19

Fridaysunday

Genesis — a safe, supportive weekend workshop for gay men who've been diagnosed with HIV within the last two years.

ACON, 414 Elizabeth Street, Surry Hills, Sydney. )(02) 9206 2025

POZHET presents Women’s day.

Join us for an opportunity to socialise and support positive women. )1800 12 404

CALD

may 2

saturday

QPP bbQ for people living with and affected by HIV in the Brisbane region.

From 11.30am 21 Manilla Street, East Brisbane )(07) 3013 5555

14

thursday

peer2peer — a support and discussion group for positive gay men in Sydney.

From 6.30pm ACON 414 Elizabeth Street Surry Hills, Sydney )(02) 9206 2177

17

sunday

candlelight Memorial From 5.30pm Australian National University, Campus East Road, Acton, Canberra. )(02) 6257 2855 candlelight Memorial Organised by Positive Life NSW from 8pm Hyde Park, Sydney

positiveliving l 16 l AUTUMN 2015

17

sunday

international day against Homophobia A rallying event offering an opportunity for people to get together and reach out to one another in the hope of creating a prejudice-free world.