COVID-19 and the effective treatment and prevention of MDR-TB and HIV
For many people across the globe, the COVID-19 pandemic has impacted the treatment and care for areadly life threatening infectious diseases. The pandemic has created new challanges for people with multi-drug resistant TB, its effective treatment and the work of clinicians. People with HIV have to navigate HIV treatment and care when health services are increasingly stretched and remote. Treating and preventing TB and HIV - each with their own, at times, overlapping implications for drug resistance, treatment monitoring, and individual wellbeing - are deeply intersected by the COVID-19 pandemic crisis in ways we do not hear much about in the public sphere. To help us understand these implications with an interdisciplinary lens, our presenters, Justin Denolm, Lisa Fitzgerald and Allyson Mutch, will draw on their extensive expertise in clinical care and research, policy-making, social science research and community advocacy.
3pm to 4:30 pm, 7 September 2022, by zoom
Abstracts + Bios
COVID-19 and multi-drug resistant TB
Justin Denholm
In addition to widespread and well-recognised disruption to healthcare services globally, the COVID-19 pandemic has had a disproportionate impact on TB services and progress towards TB elimination efforts. These impacts have arisen for a variety of reasons, including direct competition for healthcare resources, logistic and infrastructure disruption and workforce displacement. The impact of the co-pandemic has not been equally felt globally, with a high degree of contextualisation of factors determining what challenges have been faced, and the degree to which usual services have been maintained. Professor Denholm will discuss impacts in Australian and global TB services, as well as other programmatic developments relevant to antimicrobial resistance occurring contemporaneously. In particular, the COVID-19 pandemic has been co-emergent with the establishment and increasing us of pathogen whole genome sequencing. This tool has become increasingly routinely used by TB programs in settings including Victoria, and continued development of structures for optimal integration into clinical and public health practice has progressed despite, or perhaps even assisted by, COVID-19. This talk will also consider emerging approaches to whole genome sequencing for public health action, and the rapid change in multidrug resistant TB treatment protocols which have accompanied it.
Bio: Professor Justin Denholm (BMed, MBioethics, MPH+TM, PhD, FRACP) is an infectious diseases physician based at the Royal Melbourne Hospital, and the Medical Director of the Victorian Tuberculosis Program. His work includes clinical and public health management of TB and other infectious diseases, as well as research into a variety of aspects of TB relating to ethics, epidemiology, clinical medicine and public health. Justin has a particular interest in public health strategies towards TB elimination, and he especially loves making a practical difference through collaborative research that brings together a wide range of skills and disciplines. During 2020-2022, he has been engaged in range of COVID-19 related work, including responsive evaluation and adaptation of TB services, both within Australia and internationally.
'COVID on top of everything else, it was a struggle’: Living positive through the COVID-19 pandemic
Lisa Fitzgerald and Allyson Mutch
For many people living with HIV (PLHIV), particularly the first generation of PLHIV in Australia, the experience of living through a pandemic is not new. This presentation examines how PLHIV navigated the first wave of the COVID-19 pandemic by drawing on interviews from Living Positive in Queensland (LPQ), a qualitative longitudinal study. Our interviewees articulated confidence, knowledge, and skills gained from living through the HIV epidemic and were early adopters of public health measures. They trusted the health system would adapt and many responded to innovative new approaches such as telehealth. However, for some telehealth meant a loss of human connection, struggles with technological literacy, poor access to computers or smart phones, and unaffordable internet/phone charges. COVID-19 was layered onto existing issues and intensified social disconnection in the most socially marginalised participants, (who were older, in care, had cognitive decline and/or complex social and mental health issues). COVID magnified the strengths and vulnerabilities of many PLHIV, highlighting benefits and limitations of living in a time of enforced social isolation, and challenges associated with shifting to online interactions. Robust and equitable social and mental health support are essential to maintain continuity of care. We support the call for a ‘social vaccine’ that tackles the root causes of inequalities, by building equitable policies and services so PLHIV can live with COVID-19 with dignity, recognition and respect as citizens, and important contributors to the positive community and broader society.
Bios: Lisa Fitzgerald is an Associate Professor in the School of Public Health, University of Queensland with research interests in the health and wellbeing of people experiencing marginalisation and the social determinants of (sexual) health. She is engaged in social research projects related to HIV, sexual health, young people, LGBTIQ+ health, and sex worker health.
Allyson Mutch is an Associate Professor in Health Systems in the School of Public Health, University of Queensland and a Senior Fellow in the Higher Education Academy. Her research uses qualitative methods to investigate the social determinants of health and the health and wellbeing of people who are socially excluded and experiencing disadvantage. Allyson's research is firmly embedded in community, with strong links to community organizations’ that ensure their needs are represented.