ENHANCING PROGRAM DELIVERY session

11.00am - 11.10am FIFO Sexual Health Project: Challenges, Insights, and Opportunities

Maddison Whittle (Sexual Health Quarters)

Background/aims: The FIFO Sexual Health Project was a two-year project delivered from 2021 to 2023, seeking to improve the sexual health of FIFO (fly-in fly-out) workers in WA. This project was funded to support the National STI Strategy 2018 – 2022, which identifies mobile workers as a priority population to target. There is a paucity of research available, but this population faces reduced access to STI testing and STI prevention methods, and typically work in geographical locations where STI rates are higher. The project activities were delivered collaboratively with a mining company, codesigning interventions to be relevant to the unique demographic characteristics. Method: The project consisted of workforce development to health and safety staff (including mental health staff), community education and outreach, a statewide health promotion campaign, condom distribution, a confidential helpline and policy & procedure support. Results: The delivered activities increased the knowledge, confidence and comfort of professionals supporting the well being of FIFO workers, and improved the referral pathways to STI testing. FIFO workers demonstrated increased understanding of sexual health and STIs, a greater understanding of where to go for help, and an uptake in accessing safer sex methods. Conclusions: This project was innovative and the first of its kind in Australia. We hope that the improved access to a priority population who have previously been missed in health promotion initiatives will lend itself to future opportunities to improve the sexual health of FIFO workers. We expect that our insights can be used to support the sexual health of mobile workers and Australians.

​

11.10am - 11.20am “Step Forward: Fight Stigma.” Shifting social perceptions of HIV.

Marcus Shaw (WAAC)

Background/aims: Despite medical progress in HIV treatment, social stigma persists, causing discrimination against people living with HIV (PLHIV). Combating stigma requires empathy, however, brief interventions make this challenging. To address this, a campaign was developed, which aimed to: (1) increase knowledge of the physical and social impact and experience of living with HIV; (2) increase awareness of current HIV landscape and individual health outcomes, (3) increase visibility and normalisation of HIV within mainstream and social media; and (4) shift perceptions of HIV and PLHIV. Methods: The "Step Forward: Fight Stigma" campaign utilised a narrative video format, where people living with a chronic health condition and PLHIV participated in a spectrum/continuum activity. By using real people, the interviews were completely unscripted, and the responses and reactions were authentic, leading to a deeply meaningful and richer piece of work. The campaign was shaped by feedback from PLHIV to ensure appropriateness and to amplify their voices. Results: The campaign was widely distributed in the Perth metropolitan area and WA through social media, Spotify, billboards, venues, posters, and large format screens. Evaluation results showed that a majority of participants reported a better understanding of HIV, increased intention to combat HIV-related stigma and discrimination, and changes in perception towards HIV. Additionally, the campaign was shared and received support from the National Association of People with HIV Australia, Health Equity Matters, and the Australian Medical Association WA. Future actions: To address HIV related stigma and discrimination, ongoing and more targeted efforts are critical. Given the success of the campaign among the general population, future adaptations will target specific populations to address social perceptions of HIV. Conclusions: This campaign effectively normalised living with HIV by comparing it to living with other chronic health conditions, a connection not previously explored in WA. This approach effectively highlighted the disparity in social treatment faced by PLHIV and contributed to social change among the general population.

​

11.20am - 11.30am W3 Project – lessons on sustained meaningful community involvement from a 10-year community/research partnership

Graham Brown (Australian Research Centre in Sex, Health and Society [ARCSHS]), Peta Gava (Peer Based Harm Reduction WA [PBHRWA]), Paul Dessauer (PBHRWA), Petrina Hilton (ARCSHS)

Background: The meaningful involvement of communities is a central principle of the Australian HIV and Hepatitis C responses, and this includes within research. However, community involvement in research is often conceptualised as consultation and reporting back, rather than a genuine collaboration in the priority setting, design, and conduct of research, and maintaining relationships over the long term. Beginning in 2014, the W3 Project collaborated with peer and community-led organisations to explore the system-level role these organisations play in the HIV and hepatitis C response. The study required peer staff and researchers to undertake the simultaneous role of drivers, participants, and analysts in the research. Methods: To identify the successes, challenges and learnings in relation to sustaining long-term and meaningful participation of peer organisations in research, we drew together the insights and experiences of peer staff and researchers across the 10 years of the study. Results: The W3 Project experienced both successes and significant challenges in maintaining the research collaboration as we navigated the introduction of systems thinking, the competing pressures on peer organisations and their communities, research funding challenges, and the ongoing impact of epidemics (HIV, hepatitis C and COVID-19). The W3 Project provided insights into the nuances of community-engaged research practice and the ongoing benefits, barriers, and enablers to the meaningful participation of communities and their peer organizations. This required looking beyond research methods to system level factors such as flexibility in research resources and management; sustained two-way trust, benefits and commitment;  and the visible valuing of peer participation and leadership to counter system-level stigma. Future actions/conclusions: Recognizing peer organizations as active participants and drivers within community and policy systems can help clarify their role in research. Achieving meaningful collaboration with peer organisations requires looking beyond good practice methods to the system-level factors with attention to the system-level benefits, barriers, and enablers.

​

11.30am - 11.40am A partnership between WAAC and Curtin to strengthen evaluation capacity

Rochelle Tobin (SiREN), Máiréad Grant (WAAC) 

Background/aims: There is a need to strengthen evaluation capacity within non-government organisations to promote evidence informed decision making and improve the public health response to STIs and BBVs. In 2021, WAAC and Curtin established a five-year partnership to build evaluation capacity within WAAC to support continuous improvement and sustainability and support WAAC to deliver evidence-informed services and programs. Methods: To evaluate the partnership's impact, two surveys were developed using a validated tool developed by Schwarzman et al. (2019) to assess organisational evaluation capacity and a tool developed to assess evaluation capacity building partnerships functioning and impact (Tobin et al. under review). Evaluation capacity was assessed across five domains. The survey was administered at baseline (n = 17) and then one year post (n = 19). Results: In relation to the functioning of the partnership, staff reported that the support provided by Curtin was relevant and reliable and that they worked well with Curtin to problem-solve and overcome difficulties. Significant improvements were seen in three domains of evaluation capacity, including individual skills for evaluation tasks, tools for evaluation and evaluation systems and structures. Evaluation attitudes and beliefs were high at baseline and no significant improvement was seen in this domain. There was no significant improvement in leadership for evaluation. Staff were asked what the most valuable aspect of the partnership was, and the three main areas reported were increased evaluation skills and confidence, enhanced evaluation culture and improved evaluation processes. Future actions: The findings from these surveys were used to develop strategies to further strengthen the partnership, including staff training and greater support for staff to use evaluation findings to support evidence-informed decision-making. Conclusions: Partnerships between universities and non-government can effectively increase organisational evaluation capacity within a relatively short time frame. 

​

11.40am - 11.50am Adapting a gay men’s survey to become more gender and sexuality inclusive: a mixed methods study

Anthony K.J. Smith (Centre for Social Research in Health [CSRH]), Christy E. Newman (CSRH), Timothy R. Broady (CSRH), James MacGibbon (CSRH), Curtis Chan (Kirby Institute), Benjamin Bavinton (Kirby Institute), Martin Holt (CSRH)

Background/aims: Since 1996, the Gay Community Periodic Surveys (GCPS) have formed a key part of Australia’s behavioural surveillance system for HIV, sexual health, and drug use. Following critical feedback from bi+ and trans communities, the GCPS was rebranded in 2024 as the GBQ+ Community Periodic Survey, with questionnaire redesign to better reflect gender and sexuality diversity amongst previous and future anticipated respondents. Methods: Given the complexities involved in adapting this questionnaire, we designed a mixed method research study to support and capture this process. Throughout 2023, we consulted multiple times with the national GCPS advisory group. We undertook cognitive interviewing (n=30) with gay, bi+, and queer men (cis and trans) and non-binary people on a redesigned version of the questionnaire in August-October 2023, to assess acceptability and comprehension. In January 2024, rapid field interviews (n=39) were undertaken with participants completing the new questionnaire during Melbourne GCPS recruitment. Results: The main elements of the questionnaire redesign were the adoption of more gender-neutral language, a shift from an exclusive focus on anal sex, an increase in questions about sex with female partners, and new questions about non-binary partners. Cognitive interviewing prompted refinements, including better recognition of non-monogamous sex and relationships. Participants were either largely positive or did not notice questionnaire changes, suggesting high acceptability. However, some trans men and non-binary participants indicated that while more inclusive, the questionnaire retained a focus on an overly cisgender and binary conceptualisation of men. Future actions

The GCPS team will report on outcomes of the new questionnaire indicators later in 2024. Collected data will require careful assessment, particularly when comparing to past indicators. Conclusions: As a questionnaire originally designed with a mono-gender and HIV/sexual health focus, the GCPS may not serve the needs of all communities. This process could be adapted to other repeated, longitudinal, and/or paper-based questionnaires to improve inclusivity.

​

11.50am - 12.00pm Co-locating a Hep C clinic with our NSP

Ali Lori (HepatitisWA), Jess McNabb (HepatitisWA)

Background/aims: This abstract explores HepatitisWA's innovative model of care, focusing on the Deen Clinic's strategic integration with the Needle and Syringe Program (NSP) to address the challenges of Hepatitis C (HCV) treatment accessibility. Established in 2016, the model aims to reach priority populations, including people living with HCV, people who inject drugs (PWID), and Aboriginal people.  The Deen Clinic, co-located within the NSP building, provides a seamless pathway for clients to access testing and treatment for HCV. In 2022, the clinic expanded its reach, aspiring to become a primary health care hub for viral hepatitis. Description of model of care: This comprehensive model embraces a patient-centred approach, offering a supportive environment and immediate referrals for testing and treatment. The intervention involves NSP staff offering brief interventions, with direct referrals to the Deen Clinic. The clinic staff conduct patient-centred intakes, inclusive of BBV and STI screenings and vaccinations. A General Practitioner provides HCV treatment and primary healthcare services, ensuring holistic care beyond the immediate focus on blood-borne viruses. Effectiveness: Data from August 2016 to the present indicates the model's effectiveness, with 1056 direct referrals resulting in 347 initiated treatments. Notably, 237 patients achieved successful HCV treatment, and 160 demonstrated a serological viral response 4- or 12-weeks post-treatment. Conclusion and next steps: In conclusion, the co-location of the HCV treatment clinic and NSP service proves to be a strategic and impactful approach, overcoming barriers to treatment. The model's flexibility, non-judgmental nature, and targeted focus on priority groups underscore a commitment to a non-mainstream approach. The initiative's success is further highlighted by proactive measures to build partnerships with homeless services, implementing Point-of-Care Testing (POCT) clinics for vulnerable populations. Sustaining and expanding these partnerships, along with a continued patient-centred and flexible approach, will be crucial for the clinic’s ongoing success and provide a positive example for future healthcare endeavours in similar contexts.

​

12.00pm - 12.10pm Virtual Elimination with Integrity: The Peer-Led Path to Zero

Rhys Ross (WAAC) 

Background: WAAC’s Peer Program is a unique program that supports people living with HIV (PLHIV). The program takes a person-centred approach to support clients to navigate their diagnosis and attain better quality of life. This approach aligns with principles of empowerment and community engagement, which is essential to achieve virtual elimination of HIV. Methods: The Peer Program currently supports long terms clients, and new clients. Often, these clients have experienced stigma for such a long time, it has become a part of them internally and externally, and acts as a barrier to seeking support and treatment adherence. PLHIV have complex needs, and support looks different for each client. For example, clients may be at risk, have history of, or are currently experiencing homelessness, family violence, sexual abuse and relationship issues. The program supports clients by responding to these complexities in a non-judgemental way. Overtime, Peer Workers build trust with PLHIV and bring a shared understanding of lived experience that builds authentic connections and mitigates power imbalances to support clients. Results: A case study of a client will be presented. As a result of the program, clients have seen positive outcomes since starting the program, such as better treatment adherence and linkage to healthcare services. Quality of life beyond the medical perspective is also critical. Additionally, better living conditions, pathways to employment, and improved sense of self have resulted in some clients as a result of the program. Future Actions: It is essential that peer approaches to supporting PLHIV should be continued. The integration of lived experience into workforce development is also needed, to educate those working with PLHIV. This will also help PLHIV have their voices heard in support programs, making them more accessible. Peer Workers should be seen as equal partners in multi-disciplinary teams. Conclusions: Achieving zero transmission by 2030 requires integrity and approaches that work with clients, instead of from a top-down perspective. Peer Workers are integral to supporting PLHIV and can help bridge the gap between clients and care.

​

12.10pm - 12.30pm Q&A session