Hi everyone
The BBV News has supported the health and community workforce to keep up to date with the latest HIV and hepatitis news, resources, events, programs and research since 2008.
Given the extraordinary situation we find ourselves in, the frequency of the BBV News will increase from monthly to fortnightly. The bulletin will include service updates as well as short interviews with people working across the BBVerse. We hope that this will support the BBV sector to stay up to date with how BBV services and programs are adapting in the COVID-19 environment.
Please get in touch with any service updates, contributions or suggestions
j.johnson@latrobe.edu.au
Feature: Harm Reduction Victoria (HRVic)
Interview with Jane Dicka, acting EO
JJ So how are you folks at HRVic going? What programs and services will be able to continue? It’s such a strange time with nothing but uncertainty.
JD So we’re mostly working from home. It would be a good time for us to do planning, except we can’t plan for anything at the moment! Like our work in hepatitis C, we’ve been doing some great peer based projects all designed to get people into treatment but when I think about it, do we really need to be pushing more people toward a health system that is about to be over loaded? We might need to rethink that one.
It’s a nightmare. So much stuff has been put on hold, as we focus on our essential services. Our needle and syringe program and PAMs (the Pharmacotherapy Advocacy Mediation and Support Service) are seen as essential services. We can’t run any more of our face to face safe use, overdose prevention or education workshops because of social distancing. The rules around mass gatherings means that no music festivals are happening and that means that DanceWize can’t operate either.
We have got lots of new info on our website including 3 new posters. Everyone has been working really hard to get people the info they are asking for.
What are people asking? What’s the most pressing issue for your communities?
Well one of the biggest issues is pharmacotherapies. PAMS is very busy with calls from people asking for clear information about what they should do if their GP gets sick and can’t see them or if the chemist gets sick and has to close. It’s fair enough that people just want to know what’s happening with their medication, because the thought of not being able to access OST, on a good day is very unnerving. People need peace of mind by knowing that during COVID19 they will continue to be dosed.
Everyone is hearing that they need to stay home if they have signs or symptoms of coronavirus, and people are confused. Sometimes signs and symptoms of drug use or hanging out might look or feel the same as coronavirus.
What we need is a clear set of guidelines or instructions from the health department for the GPs around what they can do as far as prescribing for people in this pandemic. We suggest people ask their GPs for longer scripts so they can reduce the number of times they need to visit the doctor’s office but some GPs are reluctant to go against the guidelines. It would be great if we could increase the number of take away doses people can have too, there are people working on these issues as we speak and we are waiting to hear the outcome so we can let our community know what’s happening. There should be answers to all this and more over the coming days so I suggest people keep checking our website for up to date and credible information.
Video consult with doctors is now an option which is fine for established patients, but not so easy if you’re a new patient. And so where people might be looking to start OST because their drug supply has been interrupted, it will be a lot harder for them to do. Involuntary withdrawal is another thing, we have just put out this https://www.hrvic.org.au/covid19-methadone-suboxone-treatmen
If there was ever a time that legislation changes could be fast tracked, a state of emergency would be it so why not think about the possibility of relaxing the rules on prescribing of naloxone, pharmacotherapies, and even benzos for people who aren’t on OST.
There has been lots of info and resources coming out from other countries that are a bit further along the curve than we are. Are you using any of that stuff?
Yeah there’s lots of great stuff, have a look at our website, which we think is the most relevant stuff for people here.
Another thing we need to think about is overdose. With people’s use going up and down with changes in supply, there is a big overdose risk. And we are telling people to isolate, which is the opposite of the main rule of overdose prevention. And I don’t think we should assume our emergency services will be as reliable as we know them to be because they will already be under the pump . So there’s lots to do there, and lots of confusion.
What about NSPs?
NSP services are going to stay open, at the moment they’re all trying to work out social distancing and home deliveries especially for people with symptoms. We are telling people to take extra, but we are also hearing that some services are putting limits on the amounts people can take? Hopefully this isn’t happening a lot, because people really should be stocking up in case they have to stay home.
Another thing is that in lots of regional areas NSPs are in emergency departments. Hopefully these will still be seen as essential services!
We are definitely hearing that contacts (number of syringes distributed) has gone up in lots of areas, which is a good sign that people are getting more and that peer networks are doing their thing getting equipment for others.
We got all of our peer networkers to watch this short online course in infection control
Thanks so much Jane.
No worries Jen. We are keeping our website regularly updated, so head over to https://www.hrvic.org.au/
Hepatitis Victoria
As a community-based health organisation working with people who have chronic health conditions or compromised immune systems, Hepatitis Victoria is approaching the Coronavirus (COVID-19) pandemic with an abundance of caution in line with the recommendations of health experts.
The continued health and wellbeing of everyone involved in our organisation as well as the wider community is, as always, our absolute priority.
We have prepared some general advice for people living with chronic liver conditions and health care practitioners.
Hepatitis Australia has developed a Coronavirus COVID-19 factsheet to assist those living with hepatitis B and hepatitis C, or chronic conditions caused by a previous hepatitis C infection.
Hepatitis Victoria service information:
- The Hepatitis Infoline 1800 703 003 remains open (Monday to Friday - 9am to 5pm), staffed by trained professionals.
- Currently exploring digital solutions where face-to-face interaction is not advisable.
- The team is preparing to work from home but are available as usual via email and phone.
If you plan to visit the office, please call 03 9380 4644 to discuss.
AFAO
AFAO is producing a regular (daily) geared to sharing education and other materials being generated by our organisations that guide communities and partners on COVID-19, plus also to share resources as we trouble-shoot the challenges COVID-19 presents in sustaining and adapting critical services. To join the list contact rparker@afao.org.au
A snippet:
News from AIDS Councils, national peaks and beyond
- AIDS Council CEOs met this week to share and coordinate their work adapting LGBTI health programs (including community visitor schemes among others) and HIV programs. The Councils remain very much open for business with both critical face-to-face services continuing and other services adapted to online and other remote approaches. Their webpages and social media accounts are up to date on new service and support models.
- There’s good news in Victoria with financial help on the way for Thorne Harbour’s work supporting older LGBTIQ people and people with HIV at home. THH’s Well, Well, Well program on JoyFM also has some great recent recordings, including on sex and with Sharon Lewin from the Doherty Institute and Richard Keane at LPV.
- Scarlet Alliance is coordinating an emergency support fund for sex workers – donations are coming in and I’m sure they’d appreciate you sharing news of the fund.
- There’s also a fact sheet for PLHIV from the Victorian Department of Health and Human Services (downloadable at THH) and UNAIDS also has info for PLHIV.
- ACON has created a great video and blog on sex for gay men, and also for LGBTQ communities more broadly here and here. There’s also information from ACON on C19 for trans and gender diverse communities.
HIV Services at the Alfred
The Alfred has prepared an excellent factsheet about COVID and HIV.
The following bulletin was released 23 March 2020:
Due to the coronavirus pandemic our hospital services are needing to change significantly. This will impact the services we offer to people living with HIV. As the impact increases on The Alfred further changes in services will be implemented.
HIV Outpatient Services
We are advising our patients not to attend their outpatient clinic appointments unless urgent.
- Most appointments will be done via by telehealth.
- We will send each patient a link to the system to connect with the doctor via Healthdirect. People without IT access can have a phone consultation.
- Where your appointment is urgent or you require a physical examination at this point are still able to come in for their appointments
Post appointment medication scripts:
- Scripts can be posted to your home, following a telehealth appointment
- If you haven’t accessed your HIV medication at a local pharmacy before it may take a couple of days for them to get stock in
- Scripts can be picked up from ID OP to take to the private Pharmacy in the Alfred foyer or another community pharmacy
- Alfred pharmacy can mail medication direct to your home via express post. $11 charge will be waived for the next 3 months
- Please be patient - Alfred Pharmacy will be prioritising inpatient services and will have challenges filling scripts or sending medication during coronavirus pandemic
Blood tests and STI screens
- Pathology slip can be sent to your home address so you can go to your local, or any pathology service, to have your bloods and STI screens taken
- The Alfred will get a copy of the results for your patient record
- Alternatively you can come to ID OP clinic to have your bloods and STI screen taken when you pick up your script
- We are setting up a walk in pathology and STI screening time each morning and afternoon in our clinic for people just coming for those procedures
HIV Inpatient Services
No change – admissions will be prioritised as usual. Acute admissions will be impacted across Victoria due to the coronavirus pandemic
Fairfield House
Fairfield House will remain open. As bed pressures and bed utilisation changes in the hospital to respond to coronavirus admissions to Fairfield House will change
HIV Day Treatments
Nebulised pentamidine is a high-risk procedure for staff and is not being provided at this time alternative will be organized with each individual patient.
HIV elective admissions
For the safety of people living with HIV elective admissions to Fairfield House for sub-acute care will temporarily cease. Other alternatives will be explored on a case-by-case basis.
PrEP Outpatient Appointments
As per HIV Outpatient Clinic information above
Victorian PEP Service
No change in service. ED access likely to be impacted across Victoria due to coronavirus
Community focused HIV Social Work and Nursing within the HIV Outward Service
- Predominately telehealth and telephone support. Ability to provide other services with secondary consultation and support.
- Support for people newly diagnosed with HIV will continue.
- Ability to take on new clients needing telehealth or phone support during this period with reduced services.
- CALD services are telephone support only.
- HIV Assist telephone support and transport only
HIV Psychiatry - Telephone and telehealth appointment available
HIV Psychology and Neuropsychology
- Psychology - Telehealth appointments only
- Neuropsychology – appointments on hold
HIV Physiotherapy - All community-based programs have been put on hold. Home exercise programs are being encouraged.
HIV Clinical Research - Participants currently enrolled in clinical trials will be contacted by the clinical trial coordinators to facilitate clinical trial reviews and pathology testing.
Infectious Diseases Outpatient Clinic: Ph: 9076 6081
Department of Infectious Diseases/Victorian HIV Service: Ph: 9076 5436
Scarlet Alliance
STATEMENT OF IMPACT - COVID-19 Impact and Response for Sex Workers
Sex workers throughout Australia have been devastatingly hit by the impact of coronavirus. As a workforce, sex workers are predominantly a mixture of precarious workers and the self-employed, being independent contractors who work in or for sex industry businesses, or sole traders who work independently for themselves. As such sex workers are particularly marginalised in terms of the impact of the coronavirus and many will still be excluded from the stimulus packages announced by the government.
All eligible sex workers in Australia, including sex workers who work in brothels, strip clubs or massage parlours are advised to either apply for the income support available from the Commonwealth Government or register an intention to claim for that support.
While we welcome the announcement that from 27 April 2020 sole traders are included in the government’s Economic Response to the coronavirus, many sex workers will still be left without financial support. Sex workers’ needs for privacy and to protect themselves and their loved ones from stigma and discrimination can make it difficult, and in some cases impossible, for them to account for prior earnings if they now need urgent Government support to survive.
The impact of travel restrictions, business closures, self isolation and quarantine requirements have resulted in an unprecedented loss of work and income for sex workers. Sex workers, like most Australian workers have been facing a range of challenges, however for many of us, without access to current relief or support packages.
Immediate impacts to our community and our dependents include:
- Homelessness and housing instability
- Inability to buy food and basic items
- Inability to pay bills including essential utilities
- Inability to access medical services/prescription medicines
- Impact of loss of income, stress, social distancing and quarantine
As the rate of coronavirus continues to grow with no indication of timeframes, sex workers are placed in the impossible position of having to balance the need to protect ourselves and the community against the prospect of no income and no access to financial relief. It should be noted that sex workers are leaders in managing health and safety at work and this has been continually demonstrated in our leadership in responding to STIs, HIV and other BBVs. We are already working together through our own peer-based organisations to coordinate a community response.
Scarlet Alliance and our member organisations have called upon Government to provide targeted support to our community. The measures we have called for include:
- Crisis funding to Scarlet Alliance as the national peak organisation to work with our member organisations in the states and territories to distribute emergency relief funding to precarious workers, including but not limited to sex workers without a fixed address, sex workers without ID or otherwise ineligible for Centrelink
- Crisis funding to Scarlet Alliance state and territory member sex worker organisations, including those that are currently unfunded
- Further relaxation of barriers to income support for sole traders and independent contractors including requirement to provide evidence of earnings or work
- Access to healthcare for all sex workers, including migrant sex workers and other sex workers who are Medicare ineligible
- Prohibition of evictions on all forms of housing and workplaces during this crisis period
- No disconnections to any essential services including electricity, gas, water, telecommunications and internet
We urge the Government to ensure that all measures relating to sex work must be developed in consultation with Scarlet Alliance and our member organisations to ensure they are effective and do not have negative unintended consequences to either public health or the health and safety of sex workers in Australia.
Australia’s successful public health response to BBV’s and STI’s, especially to the HIV and AIDS pandemic, was predicated on a meaningful and full inclusion of the most marginalised communities in all responses. We would urge the Australian government to again include sex workers and sex worker organisations in the response to this pandemic.
Sex workers are committed to working together with the Australian Government to ensure this unprecedented crisis comes to an end.
SCARLET ALLIANCE COMMUNITY FUNDRAISER
Scarlet Alliance and our state and territory member organisations have joined together to create an ongoing fund to make donations directly available to sex workers who need emergency financial relief in order to support them to stay safe, housed and fed during the COVID-19 pandemic. This fund is being overseen by sex worker organisations and run by sex worker organisation staff and volunteers across Australia. All money donated goes directly to sex workers in need.
If you are able to donate please go to https://chuffed.org/project/emergency-support-sex-workers-australia
Sex workers don’t get sick pay and holiday pay, and many have no superannuation or savings. The stigma and discrimination that they face mean some have no proof of earnings to access government support. This fundraiser will provide emergency relief for sex workers in Australia who do not meet eligibility criteria for government or other financial support or are unable to meet government requirements. All proceeds go directly to sex workers in need. However, this will not be enough to meet the demand but will assist in bridging the gap until essential government support is provided.
If you are a sex worker who needs financial support and cannot access the Federal income support available through Centrelink, you can apply to receive a payment here.
RESOURCE DEVELOPMENT
In addition to raising funds for our sex worker community, we are developing a resource for sex workers addressing the COVID19 pandemic’s impact on sex work and what individual sex workers can do to adapt to working and/or surviving during this time. This will include up-to-date legal and health information and advice for accessing financial support. Please watch this space for regular updates.
Vixen, Victoria’s peer-only sex worker organisation, remains unfunded at this time, but are able to take donations to our community bank account to continue our support to Victorian sex workers and assist in keeping our core services - including peer support - running during this time, via:
Account Name – Vixen Collective
Bank – Commonwealth
BSB – 063 170
Account Number – 1035 0157
Positive Women Victoria
All PWV staff are now working remotely and we have suspended our regular face-to-face events — such as our group lunches and Women’s Health Days — and we will re-schedule our social calendar as soon as we are able.
This of course is very disappointing, but highly necessary, as other organisations are also following this most recent strategy to support the hugely important project of minimising the spread of COVID-19 in the community.
Along with Living Positive Victoria and Thorne Harbour Health, we have communicated to all our members the important news that people living with HIV who have no additional health concerns and well-controlled HIV through treatment are not considered at additional risk of a poor health outcome from COVID-19.
However, each of our organisations does have members potentially in more vulnerable circumstances — those who may be older, or have additional health issues like cardiovascular or respiratory concerns. For many, this period is stressful and they are already choosing (or being advised) to take additional precautions.
What we’re doing during this time:
- Positive Women’s peer support staff and health promotions and communications staff are continuing to work with our members, and we are offering support via phone, online (e.g. Zoom or FaceTime), by email, or through text messages.
- We are also ensuring we check in through phone calls on a number of members receiving ongoing support and can continue this weekly or on any schedule preferred by that member.
- We are continuing with our policy and advocacy work, all member communications through our website and electronic direct mail to members, and via Facebook.
- We are continuing to engage with the sector via online meetings and participating in all advisory groups and advocacy work.
- Planning is underway for a set of activities that we are rolling out to reduce the burden and impact of stigma for women, including website activities and a media guide.
We’re of course staying well-informed of all the developments in relation to COVID-19, which will help inform our rescheduled events and our return to office. Until that time, we'll continue working remotely, but don’t hesitate to call me if you would like any additional information, and I wish you and your own staff and members all the best at this time.
Warm regards,
Kirsty Machon (on behalf of the Board and staff of Positive Women Victoria)
Mobile: 0478 827 217
Penington Institute
Penington Institute has produced another COVID-19 information resource for NSP workers and people who use drugs, and have a dedicated COVID-19 resources page.
Please speak to every NSP client, hand them the resource and encourage them to take additional sterile injecting equipment and sharps containers to cover a period of self-isolation.
Try to communicate the following messages to every client:
Victoria is closing down. Changes to drug supply are likely. READ and SHARE THIS INFORMATION I AM GIVING YOU. Will you need more equipment for the next few weeks???? We are here if you have any questions.
Order sufficient NSP stock to cover an anticipated increase in demand.
Please advise us at info@penington.org.au or a dedicated DHHS AOD email inbox aod.enquiries@dhhs.vic.gov.au at your earliest convenience if you anticipate any NSP service disruption.
ASHM
Updates will be posted regularly to ASHM’s social media channels, via regular email communications and on our dedicated COVID-19 page on the ASHM website. This page includes a recording of the COVID-19 BBV and STI Sector Briefing held on Thursday, 19 March.
Training and events
We are assessing our upcoming courses and, where applicable, adapting them to webinar formats for online delivery.
We acknowledge that this does not replicate the face-to-face experience, but we are working to ensure a high quality, interactive learning experience. We also acknowledge the additional demands on health professionals’ time may impact on their ability to participate.
Where online delivery is not possible, courses may need to be postponed or cancelled. Participants who have already registered for upcoming courses have been notified about the status of the course.
ASHM also offers a range of interactive online learning modules that can be accessed at your convenience for free. See our online learning page for details on courses and to access.
For information about the status of all upcoming courses, visit our training page or contact education@ashm.org.au.
Conferences
Our 2020 conference planning is under active discussion and consultation with our sector partners, and we are investigating alternative timings and formats as those plans emerge. We will communicate changes to the status of our conferences as information becomes available.
Please direct any enquires related to ASHM’s conferences to conference@ashm.org.au.
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