Challenges, knowledge and inspirations

A report back on the Australasian Sexual Health and HIV&AIDS Conference 2019. 

I work across the in-patient, (midwifery) setting, in the outpatient arm of our health service providing breastfeeding support, sexual health, women's health, and refugee health services. We collaborate regularly with the Aboriginal Health Service. I bear witness to the traumatising effects of colonisation on First Nation Peoples within our region. I see this as the number one priority, and few months ago I was elected to the Swan Hill Rural City Council  

My 'bio' almost speaks to the challenges of providing sexual health care in the regions. Taking on many roles, filling gaps, but also understanding the impacts of limited services, difficulty retaining medical staff, and the tyranny of distance. 

However, thinking of positives we are one health service, therefore the connection and referral between emergency acute and community services is quick and easy. We build rapport, trust and know who to refer and to connect to.  

It is the third day in at the Australasian Sexual Health and HIV&AIDS conference, and the useful and relevant presentations of research and broader overviews continues. The symposiums have been wonderful, theme and issue based, with opportunities to discuss and share experiences.  

On Tuesday, "Access, Equity and Integration: Meeting the Reproductive Health Needs of People across Australia and New Zealand" was a meaningful place to begin, exploring the barriers from systemic to personal, and everything in-between, from coercion and intimate partner violence, and successful programs, such as the integrated models discussed by Sharon Cameron from Edinburgh. 

Later in the afternoon it was so interesting to hear about results of Australian surveys of health and relationships, and adolescent sexual health. There were positives, but also confirmation that as a nation the provision of relationships and sex education is of varying quality, quantity, and, most significantly, failing to be consistently relevant and valuable to youth. However, I wouldn't like to be too negative, one quote stuck in my mind, "I wouldn't know anything if it wasn't for the subject", so considering deficits, we must also consider the importance and essential work and achievements of educators.  

The last session from Nicole Lima, was of great interest to a rural-based community health nurse dealing with "tests of cure" and chlamydia screening. It was fantastically engaging, exploring a more specific and accurate diagnostic test for chlamydia, the molecular variety. It can distinguish between the viable and dead chlamydia molecules, reducing the false positive rate. Is it the explanation for the uncurable, or unresponsive cases?  

During the symposium, "Culture is strength: First Nations People and Culturally Secure Sexual Health work in Australia", the sharing of tactics and challenges of tackling sexual health, the most dominant health issue for youth in remote First Nations communities, provided enlightening listening. One of the disabling factors that stood out was the alarming turnover, and short length of stay, of remote nurses. It was somewhat encouraging to hear that the response to the Syphilis outbreak is becoming more coordinated and resourced. The fact that it took so long to get any response is a National Scandal. Praise to the programs, both clinical, and media/communication being delivered to bring it under control. After listening to the lecture, (not, "bring under control", "eliminate" I thank-you, James Ward, Head of Infectious Diseases Research Team, “Indigenising Interventions to impact STI inequality among First Nations People's of Australia”.  

Gilda Tachedjian's was absolutely fascinating! Her research is exploring the impact of vaginal microbiota, and potentially protective quality of lactobacilli against HIV virus would seem to be incredibly impactful! Useful, also to hear about improved accuracy of diagnostic testing for Bacterial Vaginosis through, again molecular methods!  

Author bio: Nicole works as a Community Health Nurse in Health Promotion at Swan Hill District Health. Her roles encompass sexual and reproductive health; community health; refugee Health; and women's health. There is a strong health promotion component focus to all aspects of this work, but particularly the Sexual and Reproductive Health aspect. She has developed and delivered community education programs in a variety of settings, particularly utilising established social networks and groups, such as multicultural mother’s groups, and refugee men's groups to provide sexual health information.