National HIV/AIDS Strategy 2005-2008: Implementation Plan

2. Improving the health of people living with hiv/aids

Page last updated: 07 November 2006

Priority Action Area:

  • Updating of the “Models of Care for HIV Management in Adults" including allied health support and a specific focus on the psychosocial and physical wellbeing of PLWHA.

Responsibility:

Lead: ASHM Clinical Subcommittee.
Partners: HASTI and MACASHH; Department of Health and Ageing; AFAO; NAPWA.

By When:

December 2005.

Approach to Achieve Outcomes:

  • Provision of recommendations by Models of Care Panel on how models of care can be progressed.
  • Provision of and regular updating of commentary on the USA DHHS Guidelines for the Use of Antiretroviral Agents in HIV-1 Infected Adults and Adolescents.
  • Regular consideration of Models of Care, Guidelines and Standards, via an annual consensus conference adjacent to the ASHM Conference.

Outcome:

  • Models of Care developed to reflect current requirements of HIV positive adults in Australia and complexity of HIV clinical management.
  • Adoption of recommendations for progressing models of care standards and resources, including the Australian Commentary on the USA Guidelines.

Measures of Achievement:

  • Report provided to MACASHH and HASTI for consideration by December 2005.

Priority Action Areas:

  • The MACASHH to continue to play a central role in monitoring and advocating for best practice standards of care for PLWHA in prisons.
  • Establish a collaboration of State and Territory Governments to develop and implement HIV/AIDS education and prevention in custodial settings and to encourage sharing models of care between jurisdictions.
  • Consider the possibility of a national summit of all involved parties and stakeholders to discuss approaches to ensuring quality treatment and care in correctional facilities.

Responsibility:

Lead: MACASHH; Australian Government Departments; IGCAHRD; State and Territory Governments.
Partners: Other State and Territory Government Departments, including Corrective Services Departments; NACCHO/ACCHOs and affiliates; ASHM; AFAO; NAPWA; AIVL.

By When:

Convene summit during life of the Strategy.
Establish collaboration during the first year of the Strategy.

Approach to Achieve Outcomes:

  • To establish a mechanism to engage with Corrective Service Departments; and the Corrective Services Administrators Conference/the Australasian Council of Prison Health Services. This should involve liaising with IGCAHRD in order to develop a working relationship and promote appropriate ownership.
  • Examine the systemic and clinical impediments to obtaining best practice standards of care in custodial settings, including young people in detention, and consider processes required for the removal of these impediments.
  • Examine the issues of payment for medications.
  • IGCAHRD to discuss the establishment and support of a collaboration of State and Territory Governments regarding HIV education and prevention in custodial settings.
  • Arrange a summit of relevant stakeholders.

Outcomes:

  • Collaborative mechanism/s established and strengthened.
  • Summit convened.
  • HIV/AIDS in custodial settings included as regular agenda items for MACASHH and its Subcommittees.
  • An increase in the number of jurisdictions having considered education and prevention programs for custodial settings.
  • Models of Care shared between jurisdictions.
  • Clinical outcomes for PLWHA in custodial settings are improved.

Measures of Achievement:

  • Summit convened within expected timeframe, outcomes or recommendations circulated to partners for comment.
  • Standards of care for people with HIV in custodial settings considered by MACASHH during the life of the Strategy.

Priority Action Areas:

  • Ensuring that there is an appropriate level of dialogue and consultation between the MACASHH, the TGA and the PBAC in regard to the approval and listing of advantageous new technologies.
  • Ensuring that important new diagnostic and management tools can be incorporated into routine clinical care, with appropriate national clinical management guidelines for their use.

Responsibility:

Lead: MACASHH and HASTI; Department of Health and Ageing
Partners: TGA; National Research Centres in HIV/AIDS, Hepatitis C and STIs; IGCAHRD; State and Territory Governments; ASHM; NAPWA; AFAO; PBAC; MSAC.

By When:

As required

Approach to Achieve Outcomes:

  • MACASHH and HASTI to liaise with TGA, PBAC and MSAC where necessary, as well as the Pharmaceutical Benefits Branch of DoHA.
  • Establish a mechanism for consultation between partners and the Department of Health and Ageing on the introduction of new diagnostic and management tools for routine clinical care.
  • Expert evaluation, including the cost effectiveness of new diagnostic and management tools; timely introduction of these tools; and development of relevant guidelines for their use.
  • Consultation between HIV/AIDS Section and the Pharmaceutical Benefits Branch of DoHA, and TGA in relation to release of diagnostic and management tools.

Outcomes:

  • Consultation between MACASHH and HASTI, the Pharmaceutical Benefits Branch, TGA and/or PBAC and MSAC where necessary.
  • Guidelines developed to support approval of new diagnostic tools and treatments.

Measures of Achievement:

  • Record maintained of all consultations between MACASHH and HASTI and TGA, PBAC and MSAC.
  • Guidelines developed for all new diagnostic tools and treatments as they are approved.

Priority Action Areas:

  • Strengthening current training programs and continuing medical education in HIV/AIDS for general practitioners, recognising the differing needs of general practitioners with low and high caseloads.
  • Ensuring that HIV practitioners delivering complex care are appropriately supported.

Responsibility:

Lead: Department of Health and Ageing; ASHM.
Partners: State and Territory Government Departments; relevant medical colleges and divisions; medical education institutions; MACASHH.

By When:

Progressively

Approach to Achieve Outcomes:

  • Ensure these actions are linked with other workforce development actions in this and other implementation plans.
  • Facilitate and support use of the EPC items by S100 prescribing GPs and evaluate their effectiveness in improving the health of PLWHA.
  • Establish a mechanism to ensure sexual health content and skill development are included across the undergraduate medical curricula.
  • Develop models to increase coordination between specialist tertiary care centres and S100 prescribing GPs.
  • Ensure appropriate support is available to allow S100 prescribing GPs with low caseloads to maintain their skills in HIV management.
  • Promote teamwork i.e. support quality and safety in HIV management, especially so that S100 prescribing GPs can be involved in care planning/case conferencing.

Outcomes:

  • An increase in the number of GPs with S100 prescribing rights (per capita) accessing EPC arrangements.
  • Integrated coordinated care, improved effectiveness and improved quality of care.
  • An assessment of which EPC items are most useful/relevant to HIV patient care, and in what ways.
  • Increasing care planning and use of the EPC items by S100 prescribing GPs with low caseloads, to ensure best practice and multi- disciplinary care, and improved health outcomes for HIV positive patients with complex care needs.
  • Improved clinical outcomes for people living with HIV/AIDS.

Measures of Achievement:

  • Number of S100 prescribing GPs using EPC items and/or other models of shared care.
  • Effectiveness of EPC items for care of people with HIV/AIDS assessed.
  • Feedback from S100 prescribing GPs and specialist physicians and HIV positive patients.