Home' Australian Pharmacist : Australian Pharmacist September 2014 Contents Australian Pharmacist September 2014 I ©Pharmaceutical Society of Australia Ltd.
The conference presentations covered
a wide range of areas, from basic HIV
science, through to legislative and
access issues specific to key affected
populations such as MSM, transgender
women, people who inject drugs and sex
workers. Whilst some presentations were
Australia specific, the majority focused on
high HIV prevalence countries.
Dr Mark Dybul, the Executive Director
of the Global Fund to Fight AIDS,
Tuberculosis and Malaria, commented
in his plenary address on the ‘tyranny
of averages’, even in the context
of a generalised HIV epidemic.
He emphasised the need to identify high
transmission areas and focus efforts in
prevention and treatment towards these
areas, rather than necessarily delivering
an identical, broad approach to the
whole population. The rationale for this
argument is that it allows more strategic
concentration of energy and resources
to areas where there is the potential
for greatest benefit for invested time
and money. This approach is especially
relevant to countries that, like Australia,
have an epidemiological concentration
of HIV in specific populations.
In another session, this time a panel
discussion focusing on tuberculosis (TB),
Dr Dybul gave an interesting answer to a
British journalist when asked about the
TB situation in the Russian Federation.
He answered the question, and also
highlighted that the media can play
an important role in covering success
stories in HIV and HIV/TB control.
Celebrating successes in the HIV
area and in healthcare more broadly
is important, in spite of the many
legitimate challenges faced. A recent
example that comes to mind for
pharmacy in Australia is the success
of the Queensland Pharmacist
Immunisation Pilot. It has been good
to see this mentioned regularly in the
AIDS 2014 highlighted advances in
HIV basic science, with these working
towards a better understanding of
the development of natural immunity
to HIV and how this can translate to
potential targets for novel treatments
and vaccines. Antiretroviral therapy
(ART) is established as an effective HIV
treatment. However, the efficacy of ART
is highly reliant on patient adherence.
Reasons for non-adherence are not
always straightforward. Woldesellassie
Bezabhe from the University of Tasmania
is focusing on adherence to ART in
the Amhara region of Ethiopia. His
recently published work, also a poster
presentation at AIDS 2014, focused on
the barriers and enablers for adherence
to ART.5 Some interesting findings
included treatment with holy water
and the cessation of ART because of
this. To address this barrier requires
working with religious leaders and
communities to strike a compromise.
The ‘blue sky’ research presented at
AIDS 2014 explored different methods
whereby sustained remission of HIV
infection could potentially be achieved.
However, for now addressing barriers to
adherence seems to be the best way of
optimising HIV treatment outcomes.
An AIDS 2014 YouTube channel (www.
has many of the presentations from the
conference freely available to anyone
interested in finding out more.
One of the highlights of the week was
attending the Global Village. This was
the dedicated area in the Melbourne
Convention and Exhibition Centre for
the many community groups involved in
and/or affected by HIV around the world.
This area was open to the public and
hosted various performances and some
more unusual spectacles, including a
condom fashion parade. The community
presence at AIDS 2014 was felt outside
of the Global Village as well. Several
protests, of varying sizes, occurred
during the conference, including during
plenary sessions and during Bill Clinton’s
keynote address. These protests were
passionate, but polite and were very well
managed by the conference organisers.
It was refreshing to see the status quo
challenged, often by members of the
groups most affected by HIV.
A recurring theme through the six-day
conference was that working across
sectors outside of health and listening
to those most affected by HIV was
essential to making progress towards
the new UNAIDS targets of 90-90-90.6
These numbers refer to 90% of people
living with HIV knowing their HIV
status, 90% of those testing positive
being treated with ARVs and 90% of
those treated achieving sustained viral
Looking forward, the IAS Conference
on HIV Pathogenesis, Treatment and
Prevention (Vancouver 2015) and
AIDS 2016 in Durban, South Africa
will continue to catalyse the advances
highlighted in Melbourne at AIDS 2014.
At the closing ceremony of AIDS 2014,
Jon Manwaring spoke to a full plenary
theatre on behalf of those living with
HIV: ‘Every day, those of us living with
HIV have to contend with fear, and
the irrational, often cruel, reactions it
incites. But as I’ve heard people speak
over this past week, I have realized an
undeniable truth; we are more powerful
than we know. When those of us living
with HIV come out into the light and
share our stories, we dispel the fear, the
stigma, and the hate. In their eyes, we
are no longer stereotypes and statistics,
we are human’.
1. The Kirby Institute. HIV, viral hepatitis and sexually
transmissible infections in Australia annual surveillance
report 2014 HIV supplement Sydney, Australia: The Kirby
2. Australian Government Department of Health. Seventh
National HIV Strategy 2014–2017. Canberra: Department
of Health, 2014.
3. University of Liverpool. hiv-druginteractions.org Liverpool,
United Kingdom. At: www.hiv-druginteractions.org/
4. Australasian Society for HIV Medicine (ASHM). 2014
DHHS guidelines for the use of antiretroviral agents in
HIV-1 infected adults and adolescents with Australian
commentary. Darlinghurt: ASHM; 2014
5. Bezabhe WM, Chalmers L, Bereznicki LR, Peterson GM,
Bimirew MA, Kassie DM. Barriers and facilitators of
adherence to antiretroviral drug therapy and retention in
care among adult HIV-positive patients: a qualitative study
from Ethiopia. PloS one. 2014;9(5):e97353.
6. UNAIDS. Ambitious treatment targets: writing the final
chapter of the AIDS epidemic. Geneva: UNAIDS; 2014.
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