The WA AIDS Council and Next Step Alcohol and Drug Service, East Perth have worked together for a number of years, assisting each other with workforce development in their respective areas of specialty. From July 2017, Next Step will begin delivering an outreach service at the M Clinic. The service is designed to be an open-door to gay, bisexual and other homosexually active men, to access peer-based, non-judgemental, friendly and tailored services. This includes general information, education, referral and support with any difficulties they may be experiencing with their substance use.
The idea to co-locate sexual health and alcohol and other drug (AOD) services is not a new one – in fact, 56 Dean Street has modelled how this integration of services can achieve phenomenal results, when provided with sound peer support. M Clinic Manager, Justin Manuel, says, “A lot of our clients just don’t feel comfortable taking that step into an external service, especially if they’ve had poor experiences with traditional AOD services in the past, or know someone who has. The co-location within M Clinic allows clients to remain in a comfortable setting to begin accessing information and support.”
The services commence on Tuesday 4th July, and will initially run fortnightly from 1:00 to 4:00 pm. Clients are free to drop-in between those times, or alternatively, can make an appointment by contacting M Clinic.
by Simon Yam, Manager, Organisational Development
Towards the end of April, we were able to send five of our staff to attend the National Gay Men’s Health Promotion Conference in Sydney. The group that went covered a diverse range of our activities, from counselling to the M Clinic, to media and our Needle Syringe Exchange Program. Of course, linking these activities is the number of gay men that are our interface through our entire organisation.
Before they left, we asked that they consider four important questions and provide feedback to all of us about ways in which our work can be both relevant and meaningful in terms of the lived experience of gay and bisexual men. The questions were;
1. How should AIDS councils be adapting to the new prevention landscape as it affects gay men?
2. How are we (WA) gearing up for new service models in key areas like HIV testing and PrEP compared to other jurisdictions?
3. How realistic are the 2020 targets and in what ways are they oriented towards gay men in Australia?
4. There are concerns that wide scale adoption of PrEP will lead to significant rises in other STIs amongst gay and other homosexually active men. What are some alternative responses to this? What kind of language should we be adopting?
Naturally, the responses were quite varied as you would expect, with so many different perspectives among the participants. Nonetheless, a number of significant themes certainly emerged that were consistently reported.
Not only has it become even more important to be fully inclusive of all the diversity we work with, it has also become harder. In the past, programs may have been designed for a primary priority population and subsequently adapted, but this is no longer effective. Building programs from the ground up that have a degree of relevance to wide audiences and then supplementing them with additional resources that are audience-specific seems to be the way forward.
An AIDS Council is fundamentally a community-based organisation that was born from a community facing disaster, and from the beginning was deeply embedded and connected to the community from whence it sprung. As time has gone by and as AIDS Councils have become dependant on delivering services contracted by governments, the level of embeddedness in community has somewhat dissipated. And yet, at this stage in the epidemic where new bio-medical technologies are arriving that make ending HIV a real possibility, being driven by community need is vital. There needs to be a rethink about how prevention organisations can again become more embedded, and new ways found to communicate. Whilst social media provides opportunities from one perspective, another view is that the entire communication landscape has become more convoluted and difficult to navigate.
It was no surprise that PrEP had a dominant place in the conference, given that it presents both opportunities and challenges. It is also clear that around the country there are a number of different approaches based on population size, government attitude and community mobilisation. Indeed, it was said that there has been a level of activism around access to PrEP that we have not seen for two decades. Conversations about PrEP will play out in the community and not in the doctors’ surgeries or sexual health clinics. Those who control the prescribing pen cannot control the real-time decisions being made in and amongst the communities of homosexually active men. It is therefore essential that any PrEP program, regardless of whether there are demonstration projects, is built at a grassroots level.
The 2020 Targets
There is a general consensus that achieving a virtual elimination of HIV transmission amongst gay and bisexual men is a realistic proposition, whilst there is also a consensus that this is unlikely to actually happen. There is actually no definition of what a “virtual elimination” is, so there remains doubt around the question. The two areas of new understanding - PrEP and the impact of treatment as prevention (TasP) - are the ‘game changers’, but present difficulties. There seems to be a general view that increasing uptake of PrEP and an increase in numbers with an undetectable viral load will be accompanied by a decrease in condom use and an increase in other STIs. This will not only further accentuate a need for expanded testing programs, but also points to a need for new testing models such as ‘pop-up’ testing sites and outreach services. And there was a note of caution too. Linking rising STI rates to increased use of PrEP will lead to further dissemination of ‘sex stigma’ in the community, and this will be counter-productive in terms of boosting and maintaining community connectedness.
Last month the WA AIDS Council hosted two screenings of the controversial film 'Chemsex' at the Backlot Cinema, West Perth. “Chemsex” is used in the United Kingdom to describe intentional sex under the influence of psychoactive drugs, mostly among men who have sex with men.
The first screening was for invited guests who work in this field, followed by a panel discussion. The second screening was for members of the wider LGBTI+ community. Both screenings were very well attended, with representatives from the Mental Health Commission, Hepatitis WA and Royal Perth Hospital in attendance.
This was the first screening of the film in Perth, following similar screenings of the film with panel discussions that have occurred in Melbourne, Brisbane and Sydney.
Panellists for the evening included Garry Kuchel (Registered Nurse, M Clinic), Justin Dorigo (Clinical Nurse Specialist, DAWN) and Dr. Kevin O’Connor (HIV Neurologist, Fiona Stanley Hospital). The panel were unanimous in their view that this is a very complex issue facing the gay community and that what they saw in the documentary is mirrored here in Perth and causing a range of serious problems for individuals.
The ‘integrated service and treatment’ approach, which was illustrated in the film by the 56 Dean St Clinic in London, is considered to be the world’s best for those needing support with methamphetamine use. With funding a similar model could potentially be replicated here in Australia.
The website touchbase.org and ‘Turning Tina’ from The Institute of Many (TIM) are excellent resources for those that would like further information or support.
The WA AIDS Council would like to thank each of the panellists for their contributions on the evening, Ian from Backlot Cinema and our guests that attended the event.
The M Clinic team is very excited to announce that Rapid HIV Testing is now available for clients.
Between 2014 and 2015, the M Clinic took part in a Rapid HIV Test trial through the Kirby Institute. The trial focussed on the Trinity Uni-Gold Rapid Test Kit, of which the team expressed their satisfaction with the Rapid HIV finger-prick test.
After some extensive planning and collaboration with partner organisations, the Rapid HIV finger-prick test is back.
M Clinic Coordinator Justin Manuel states, “One great thing about Rapid HIV testing is the very short time it takes to get an initial result; 10 minutes. Receiving an initial HIV result during an appointment can save a lot of time worrying while waiting for a result; the standard blood tests results can take up to a week.”
It is well known that a Rapid HIV test can miss early HIV infections that a Standard HIV test would detect. It is therefore important to note that M Clinic clients wishing to take a Rapid HIV test will still be required to have blood taken for Standard HIV testing.
Rapid HIV testing at M Clinic will cost $20 per test. For those who prefer the Standard HIV test, this service is available at no cost.
The M Clinic is specifically for men who have sex with men.
For more information on testing or to book online, go to mclinic.org.au or contact the M Clinic on 9227 0734.
Syphilis is a sexually transmitted infection (STI) that often has no symptoms. It can be passed on through oral sex, vaginal sex, anal sex (top or bottom), rimming, fingering and sharing sex toys. It can also be spread through intimate or skin-to-skin contact with someone who has syphilis.
There are a range of symptoms depending on the stage of syphilis infection and may range from sores, through to a rash and swollen glands. There may be no symptoms.
Condoms work well as a preventative measure from getting syphilis, however there is a chance you could still become infected. This is why it’s important to get tested regularly to ensure you’re clear.
The good news is that syphilis infections are completely curable with antibiotics.
In Western Australia the number of cases of syphilis among men who have sex with men (MSM) in the 2015/16 financial year have more than doubled* in comparison to the previous financial year.
Syphilis testing is via a blood test and swabs may be taken if you have sores. For those that are HIV positive, it’s recommended to get tested for syphilis every 3 months along with regular HIV blood tests.
Where to Get Tested
You can go to your GP and get a syphilis test as part of your routine STI testing or go to a sexual health clinic such as M Clinic (Specifically for MSM), South Terrace Clinic or Royal Perth Hospital Sexual Health Clinic.
*Source: Communicable Disease Control Directorate
• Total WA Syphilis notifications increased 142% from the 2014-15 Financial Year (107) to the 2015-16 Financial Year (259), and 171% higher than the 5 year mean (95.6)
• MSM metro notifications increased 152% from the 2014-15 Financial Year (65) to the 2015-16 Financial Year (164).
Thank you to everyone who came along to PrEP: Who Gives a ****?
The conversation flowed freely and Nic Holas was brilliant as the facilitator.
It is an exciting time for treatment but there is much work to be done to provide access to PrEP for those who need it.
If you would like to contribute, or find out more, visit the PrEPaccessNOW Facebook page.
M Clinic is Perth’s only sexual health clinic that caters exclusively to men who have sex with men. M Clinic is an appointment only clinic that provides free, confidential, non-judgemental STI testing & treatment.
M Clinic works on a peer-based model, combining integrated health promotion with clinical service provision, with the aim of reducing acquisition of Human Immunodeficiency Virus (HIV) and other sexually transmissible infections (STI’s) at a population health level.
The clinic provides a full range of STI and HIV testing and also provides vaccination for hepatitis A and B and human papillomavirus (HPV), the main cause of genital warts.
It also gives guys a chance to engage with other health and related services that are on offer to them in Perth by carrying out appropriate referrals.
To read more and make a booking, visit the M Clinic website here.