A new Kirby Institute research report published in Lancet on October 18, calls for more promotion of HIV prevention medication PrEP in culturally diverse communities. Launched in March 2016, the EPIC-NSW research study funded by NSW Health, reports that despite unprecedented success in reducing new HIV infections, the level of reduction remains less so in people from diverse communities.

PrEP stands for Pre-Exposure Prophylaxis and is a way of protecting yourself from getting HIV by taking a tablet once a day every day.

"The speed of the decline we’ve seen in new HIV infections in gay and bisexual men is a world first," according to Professor Andrew Grulich from the Kirby Institute who led the study.

"These numbers are the lowest on record since HIV surveillance began in 1985. Our research tells us these reductions are a result of PrEP, implemented on a background of high and increasing HIV testing and treatment rates."

"However, we did not see the same reductions across the board.

"Reductions were lower in non-English speaking immigrants with a smaller 21% decline among those born in Asia.

"We need to improve education and promote access to PrEP, particularly amongst culturally and linguistically diverse men who have sex with men, and those outside the gay neighbourhoods of Sydney."
NSW was the first state in Australia to trial PrEP on a large scale.The EPIC-NSW trial enrolled 9,714 HIV negative people at high risk of HIV and provided them with PrEP.

The study ceased enrolling on the 30 April 2018, following PrEP being made available in Australia through the subsidised Pharmaceutical Benefits Scheme (PBS).

"Now that PrEP has been listed on the PBS, and is available across Australia, we need to focus our attention on ensuring equitable access for all people at risk of HIV," said Professor Grulich.
Visit our website here for PrEP information in different languages.
Live free of hepatitis C, the campaign to promote the new hepatitis C cure among culturally diverse communities, is gaining momentum, according to the MHAHS.

Launched in July to coincide with World Hepatitis Day, the campaign aims to raise awareness of hepatitis C testing and treatment and has attracted significant interest among Arabic-speaking, Chinese-speaking and Vietnamese communities.

The campaign encompasses distribution of multilingual posters, wallet cards, videos, and targeted media campaigns.  

The campaign has gained support from Michael Ninburg, President of World Hepatitis Alliance, at the 11th Viral Hepatitis Conference in Adelaide recently who said the campaign "was a step in the right direction".

“Working together with diverse communities is vital to eliminating viral hepatitis. That includes working with communities that remain unware of viral hepatitis. It is vital to get the word out about the risks associated with viral hepatitis so people can get tested and access treatment for hepatitis B or cure for hepatitis C,” Mr Ninburg said.

MHAHS manager, Barbara Luisi,  said only a few weeks in, Live free of hepatitis C campaign is already exceeding our expectations.

“We have worked in partnership with diverse community organisations, health care service providers, ethnic media outlets and community leaders to deliver culturally appropriate activities – and the results speak for themselves.”
The campaign has distributed thousands of hepatitis C print resources, reached more than 46 thousand people online and generated considerable ethnic media coverage, suggesting growing community support.

"The promotions have not only increased people’s awareness of hepatitis C testing and treatment, but have also drawn people to the MHAHS website where they can access other viral hepatitis information,”Ms Luisi said.
11th Viral Hepatitis Conference update:

The MHAHS presented a highly successful paper and 2 posters at the Adelaide conference. Check out two video posters from the conference showcasing how our allies work with people from culturally diverse communities:

•  Anup Pereira, Hepatitis ACT  

We Belong”- A Peer Based Review On Extension, Inclusion And Appropriateness Of Health Care In The Multicultural Communities, and

•    Zhihong Gu, Ethnic Communities Council of Queensland

Short And Simple Messages Are Not Enough – Developing A Resource For People Living With Chronic Hepatitis B From Non-English Speaking Backgrounds.
The MHAHS, will deliver an important paper titled Do broad population health promotion campaigns reach CALD communities? along with two posters at the 2018 Viral Hepatitis Conference in Adelaide beginning 13th of August.
Aimed at improving health communication practices at the population health level, the paper comes after recent statewide campaigns in which the MHAHS successfully worked with diverse communities.
The paper offers useful insights into what needs to be done to make our campaigns more inclusive, according to MHAHS Health Promotion Officer, Natali Smud, the paper's presenter.
“The top-down approach to reach diverse communities has not met with the intended success it aimed for. For a more sustainable engagement and success, our plans need to be owned by everyone, including people from diverse cultural backgrounds. A hierarchical approach will not serve our purpose. As health care service providers, we need to find a different way to engage if we are to meet important goals such as eliminate viral hepatitis transmission by 2030,” said Dr Smud.
MHAHS learnings from previous campaigns
We learnt that imposing pre-developed messages meant for the broader community - even while adapting them to fit CALD communities - diminishes the messages’ impact. We need to comprehend One size does not fit all. To improve upon it, this year, we consulted and involved the communities in an early stage of the process. The mainstream Live Hep C free campaign focused on sharing injecting equipment as the main mode of hepatitis C transmission. Our campaign Live free of Hepatitis C re-developed and tailored the messages for each community.   
The MHAHS will also present two posters titled Mobilisation Of CALD Communities Around Sensitive Issues and Hep B: Could it be me? An inclusive communications strategy promoting hepatitis B testing in diverse communities at the same conference.
Follow the MHAHS Facebook page to keep upto date with the 11th Viral Hepatitis Conference.
Working in partnership with communities affected by viral hepatitis is key to eliminating viral hepatitis, according to this year’s World Hepatitis Day campaign. The Finding the missing millions campaign on July 28, emphasise collaboration as integral to increasing awareness of viral hepatitis testing and treatment to eliminate the virus by 2030.

Viral hepatitis isn’t just an issue for one community but for many others, according Barbara Luisi, manager of the Multicultural HIV and Hepatitis Service (MHAHS).

“Joining hands with affected communities makes sense for it is both respectful as well as necessary. Only the affected communities know how to tap into their own networks and find the missing millions unaware of viral hepatitis. Unless we engage communities to help spread the word about the importance of testing for hepatitis C and the new treatments that cure hepatitis C, lives will continue to be lost,” said Ms Luisi.
According to the World Hepatitis Alliance, globally an estimated 325 million people are living with viral hepatitis with about 290 million unaware of their status, including people from the culturally diverse communities.

(Dr Chant acknowledging the role of community collaboration at the 2018 World Hepatitis Day launch in Sydney)

More than a quarter of all Australians living with hepatitis C have been successfully treated and cured since 2016. Despite this, many people from diverse cultural backgrounds still remain unaware of new, effective treatments, according to Senior Staff Specialist at the AW Morrow Gastro and Liver Centre, Royal Prince Alfred Hospital, Associate Professor Simone Strasser.

“People born in countries of high hepatitis C prevalence may have acquired hepatitis C through unsterile medical or traditional practices in their country of birth. Often they acquired hepatitis C at a young age and are not aware of their hepatitis status until later in life, resulting in higher risk of serious liver disease and/or cancer.

“We need to get the message out that testing for hepatitis C is just a simple blood test. If you think you could possibly have it, get a blood test. If you’ve got it, you can have 8 to 12 weeks of tablets and get cured. So, it is a really, really important message.”
The MHAHS has recently launched the Live free of hepatitis C multilingual campaign aimed at supporting World Hepatitis Day and to raise awareness of hepatitis C testing and the availability of a cure among Arabic-, Chinese- and Vietnamese-speaking communities living in NSW. Visit our World Hepatitis Day campaign page for more details.