TY - JOUR
T1 - A national study of the clinical management of HIV-positive women in Australia
T2 - What are the successes and where are the gaps?
AU - Giles, Michelle L.
AU - Macphail, Aleece
AU - Bell, Charlotte
AU - Bradshaw, Catriona S.
AU - Furner, Virginia
AU - Gunathilake, Manoji
AU - John, Mina
AU - Krishnaswamy, Sushena
AU - Martin, Sarah J.
AU - Ooi, Catriona
AU - Owen, Louise
AU - Russell, Darren
AU - Street, Alan
AU - Post, Jeffrey J.
N1 - Publisher Copyright:
© 2019 CSIRO.
PY - 2019
Y1 - 2019
N2 - Background: Women comprise ∼10% of people living with HIV in Australia, so are often underrepresented in research. Methods: This study invited clinicians providing care to women living with HIV to complete an anonymous survey containing questions related to four key areas: HIV (including diagnosis, treatment and virological outcomes), reproductive health (including sexual activity, contraception, pregnancy and outcomes) and linkage and retention in care. Results: In total, 484 surveys were received, with responses from all states and territories. Most women living with HIV in Australia are on treatment (>90%) and virologically suppressed (>90% have a viral load <50 copies mL-1). Almost 75% of women have had at least one switch in treatment (with toxicity almost as common as simplification as the indication). Treatment interruption is also relatively common, but is more likely the longer a woman has been diagnosed, if she is on benefits (P = 0.007) and is the primary carer of children without a partner (P = 0.001). In Australia, women living with HIV are a diverse heterogeneous group, with over 70 different countries of birth and almost half speaking a language other than English at home. Mental health diagnosis was the most common co-morbid condition identified. A total of 21% of women were post-menopausal, with 42% reporting symptoms to their healthcare provider, but only 17% were receiving treatment for symptoms attributed to menopause. Conclusions: As well as strategies to support women vulnerable to treatment interruption, important areas for future investment in research and clinical care include co-morbid mental health and menopause symptoms and treatment.
AB - Background: Women comprise ∼10% of people living with HIV in Australia, so are often underrepresented in research. Methods: This study invited clinicians providing care to women living with HIV to complete an anonymous survey containing questions related to four key areas: HIV (including diagnosis, treatment and virological outcomes), reproductive health (including sexual activity, contraception, pregnancy and outcomes) and linkage and retention in care. Results: In total, 484 surveys were received, with responses from all states and territories. Most women living with HIV in Australia are on treatment (>90%) and virologically suppressed (>90% have a viral load <50 copies mL-1). Almost 75% of women have had at least one switch in treatment (with toxicity almost as common as simplification as the indication). Treatment interruption is also relatively common, but is more likely the longer a woman has been diagnosed, if she is on benefits (P = 0.007) and is the primary carer of children without a partner (P = 0.001). In Australia, women living with HIV are a diverse heterogeneous group, with over 70 different countries of birth and almost half speaking a language other than English at home. Mental health diagnosis was the most common co-morbid condition identified. A total of 21% of women were post-menopausal, with 42% reporting symptoms to their healthcare provider, but only 17% were receiving treatment for symptoms attributed to menopause. Conclusions: As well as strategies to support women vulnerable to treatment interruption, important areas for future investment in research and clinical care include co-morbid mental health and menopause symptoms and treatment.
KW - antiretroviral treatment
KW - interruption
KW - menopause
KW - reproductive health
KW - switching
UR - http://www.scopus.com/inward/record.url?scp=85066931175&partnerID=8YFLogxK
U2 - 10.1071/SH18070
DO - 10.1071/SH18070
M3 - Article
SN - 1448-5028
VL - 16
SP - 282
EP - 288
JO - Sexual Health
JF - Sexual Health
IS - 3
ER -