26-29 September 2018 — Dili, Timor-Leste
In collaboration with Marie Stopes Timor-Leste, ASHM's International Program conducted a 4-day clinical workforce training for experienced clinical providers (doctors, midwives, nurses) in Dili, Timor-Leste. The workshop aimed to improve the quality of HIV & Sexual Health clinical services (testing, treatment and clinical management) by strengthening the knowledge and skills of Marie Stopes staff to train and mentor its own clinical workforce.
HIV & Sexual Health Specialist, Associate Professor Catherine O’Connor (pictured above with training participants), facilitated the training using an ASHM International multi-modal training package, including evaluation and participant assessments, that had been adapted to country and organisational context. A series of web-facilitated discussions, and a preparation day in Dili prior to the training, enabled Catherine to meet with local staff and ensured training program alignment with skills and experience of participants. Content focused on:
- Voluntary Confidential Counseling and Testing (VCCT) for HIV and syphilis updates
- STI Syndromic Management Updates
- Sexual and reproductive health (SRH) counselling and services, including family planning, for people living with HIV
- an overview of transgender health
- the art and practice of clinical mentoring
ASHM has grounded experience of the challenges and gaps in clinical workforce capacity in Timor-Leste, through management of the Integrated Biological-Behavioral Surveillance Surveys Among Female Sex Workers and Men Who Have Sex with Men in Timor-Leste, 2016-2017 which primarily aims to track the HIV epidemic, monitor sexual risk behaviours, and to measure access to intervention programs in responding to HIV.
Background on Timor-Leste
Formal reporting of HIV data from Timor-Leste is limited, however the national general population HIV prevalence is consistently reported below 1%  (anecdotally, around 0.06% at end of 2016), with prevalence among key populations also reported as less than concentrated epidemic levels (<5%) .
Over 90 newly diagnosed cases of HIV in 2016  resulted in a cumulative national total of 642 People Living with HIV (PLHIV) - 60% aged 25-44yrs, 28% aged 15-24yrs, 8% over 45yrs and 4% under 14 years of age. By the end of 2016, there had been 80 registered deaths from HIV in Timor-Leste, since the first diagnosed case in 2003 . Surveillance and data reporting within the country continues to provide challenges in providing a tailored programmatic and clinical response to HIV in Timor-Leste.
High reported prevalence of sexually transmitted infections, along with anecdotal evidence of concentrated regions of HIV, determines the need for effective prevention, testing, treatment and management, to prevent escalating transmission and to ensure the health and productivity of individuals living with HIV, their families, and the broader community.
HIV and STIs, along with co-morbid presentations including tuberculosis and Hepatitis B, present significant health, social and economic challenges in Timor-Leste.
There is limited opportunity for the clinical workforce to access professional development and clinical upskilling programs that enable reflective practice, support the introduction of new clinical guidelines, guide advanced practice and promote evidenced-based innovative approaches to HIV and STI prevention, testing, treatment and management.
Find out more about the ASHM International Program
ASHM’s international partnerships and projects are designed to:
- Support sustainable capacity development through long-term engagement in training and mentoring that builds individual partnerships, as well as provides access to the broader ASHM Regional Network
- Strengthen the capacity of health care workers and organisations to actively participate in developing and maintaining effective and efficient systems for prevention, testing, treatment and management of HIV, viral hepatitis and sexual health
- Inform an evidence base (social, behavioural, economic and epidemiological) for effective and efficient responses to HIV, viral hepatitis and sexual health
- Develop the skills, expertise and confidence of key and priority populations, communities and peer-based organisations to actively engage and meaningfully participate in national and regional responses
- Create an enabling environment for partners to collaborate across the health care, research and community sectors to contribute to effective HIV, viral hepatitis and sexual health responses
- Align with national and regional guidelines and programs. This is achieved by working with key government departments, programs, associations, and community stakeholders within project context.