Day 1 :
Keynote Forum
Dr Shimu Khamlichi
Royal Free Hospital, Pond Street, London
Keynote: Psychological and Practical Management of Neurocognitive Impairments in People living with HIV
Biography:
Dr Shimu Khamlichi is a Clinical Psychologist registered with the Health and Care Professionals Council (HCPC) in the UK. She has a Doctorate in Clinical Psychology from The University of East London (2013), BSc in Psychology from the University of Manchester (2007) and has been trained in a variety of therapy models including Cognitive Behavioural Therapy, Systemic Therapy, Mindfulness Based Therapies, Acceptance Commitment Therapy, and Compassion Focused Therapy. Dr Khamlichi has been working with the National Health Service in the UK for over 10 years. Currently, she works at the Royal Free Hospital in London, providing psychological therapy to people living with HIV. She provides psychological assessment for problems associated with the HIV conditon and offers specialist interventions to increase treatment adherence, reduce risk-taking behaviour and prevent HIV transmission. The psychological therapy is aimed at acceptance of, and adaptation to, living with HIV.
Abstract:
With recent decline in HIV associated severe neurocognitive impairments in the era of combined ARTs, the focus has now moved to ‘Mild Cognitive Disorder’ (MND) defined by mild to moderate impairment in at least two cognitive domains (e.g., processing speed, memory (short/longterm), executive function, language). MND is not progressive and a significant proportion of individuals improve neurocognitively if given the right interventions (psychological therapy, compensatory strategies and neurocognitive rehabilitation). With the aging HIV population, we are likely to see an increase in MND. Additionally, HIV positive individuals experience significantly higher rates of mental health problems than general population. Unmanaged mental health problems can decrease adherence to ART and increase substance abuse - both have effects on cognitive function. Managing mental health problems and cognitive impairments in patients increases ARV adherence rates and has a positive impact on health outcomes. As there are no firstline medical treatment to manage neurocognitive impairments, it is imperitive that patients receive appropriate psychological and neuropsychological treatments. At the Royal Free Hospital in London, we offer a Neurocognitive Screening Service for patients with HIV reporting mild to moderate cognitive difficulties. The recommendations following a screen includes a) retesting in a year to chart cognitive performance over time, 2) referral to neurology for neuro-rehabilitation if significant deficits are identified, c) treatment of drug and alcohol misuse d) medication review if ARVs are thought to be contributing and e) offering psychological intervention to treat mood problems and/or symptom management that may be contributing to the presentation of MND. The talk I am interested in presenting at the conference is on the psychological and practical management of neurocognitive impairments in the HIV population. I recently presented this talk in the BHIVA Autum Conference in 2018 and received a great deal of positive comments and feedback from the medical professionals that attended.
- AIDS stigma and discrimination, Viral, Bacterial, Fungal & Protozoan STDs, HIV Drug Discovery and Research.
Location: WEBINAR
Session Introduction
Edgar D. Bagasol Jr
University of the Philippines Los Baños (UPLB), Philippines
Title: Kuwentong Positibo: Unfolding Identities and Human Potentials of Selected People Living with HIV (PLHIV) Through Their Counter Narratives.
Biography:
Edgar D. Bagasol Jr. is a Cum Laude graduate of Bachelor of Science in Development Communication in the University of the Philippines Los Baños. He is an active advocate for HIV/AIDS education and prevention, indigenous people’s rights, environmentalism, and ending poverty. He is also an alumnus member of the UP Alliance of Development Communication Students and UP Roadperson’s Organization for Responsible Tourism and Recreation in the Philippines.
Abstract:
My fear of acquiring HIV as part of the risky population and my concern for the affected and infected sectors prompted my interest to pursue this narrative research. Current epidemiological data show that HIV/AIDS in the Philippines is already an epidemic and a public health concern that demands urgent action. In 2017 alone, 968 new HIV-positive individuals were reported, making this the highest number of reported cases since 1984 (Department of Health, 2016). After reviewing existing literature on people living with HIV (PLHIV) in the country, I found out that much can be explored about their experiences. Moreover, labels and identities that were usually ascribed to them have a totalizing effect that centers on HIV/AIDS and stigmatizing typologies that have continued to misrepresent them. This study argued that these misrepresentations are products of dominant narratives that continuously shape their realities and identities, and by countering them, PLHIV may better represent their identities. Thus, this research explored how queer identities are constructed from their counter narratives. This stems from the belief that empowerment and identity are inevitably inseparable concepts (Drury, Evripidou & Zomeren, 2015), and that the fight against oppressive structures begins with the collective consciousness of the oppressed of their distinct experience of marginalization (Turner & Maschi, 2014). Hence, to remain true to its goal of "unfolding human potentials" (Quebral, 1971), Development Communication must also interrogate the power relationship between identity and marginalization. Six PLHIV, aged 22-35, were selected using intensity sampling to participate in the pakikipagkuwentuhan (Narrative interviewing). Through narrative analysis, this study: 1) narrated their individual stories of living with HIV; 2) analyzed the dominant and counter narratives from their stories; and 3) unfolded queer identities from their counter narratives. Some principles of narrative inquiry and the foundations of Queer Theory were adopted as theoretical lenses in analyzing their stories. Four general themes of dominant narratives were elicited from their stories of living with HIV. These include: 1) Hindi normal at tinatago (not normal and hidden); 2) Sakit ng bakla at makakati kaya mga walang silbi at mamamatay na (disease of gays and the promiscuous, and, by extension, the worthless and dying people); 3) Bawal sayo (you’re not allowed); and 4) Iresponsable (irresponsible). These narratives have continued to misrepresent their realities and suppress their identities. In response, their counter narratives were elicited and analyzed individually to recognize the uniqueness of their narratives and their counteractions. A closer look at their counter narratives revealed themes that talk about: 1) normal self; 2) PLHIV’s different stories and needs; 3) fair treatment to PLHIV; 4) responsibility; 5) HIV as everyone’s disease; and 6) breaking misconceptions about mental health. Subsequently, their narratives unfolded their queer identities as empowered individuals, responsible, optimistic, and emphatic leaders and most especially, normal people. Findings revealed that the interplay of dominant and counter narratives in their stories is dynamic and does not follow a one-to-one correspondence. Hence, this dynamic interplay can be used in understanding narratives inside a story and in constructing queer identities. Also, this study found that PLHIV are not passive “oppressed” individuals, but actually have the agency to fight for their rights and represent themselves through their own stories. This study provides insights that could improve HIV/AIDS initiatives in the field of DevCom, and implications on DevCom practice that draw parallelisms between the recognition of (queer) identities and the giving of voice to the voiceless. Further studies maybe conducted involving PLHIV from other specific sectors and employing narrative inquiry as both an approach and methodology in research. Likewise, the concepts of listening and participation may also be better explored in DevCom practice.
Arthur Mandisodza
University of Zimbabwe College of Health Sciences, Avondale, Harare. Zimbabwe.
Title: The Role of von Willebrand in HIV and its Reduction with Antiretroviral treatment in Zimbabwe
Biography:
Professor Arthur Mandisodza completed his BSc in Medical Technology from the University of Charleston, West Virginia in 1981 and MSc in Haematology and Clinical Chemistry from the Ohio State University in 1985. He is Associated Professor of Haematology/Blood Transfusion Science at the College of Health Sciences, University of Zimbabwe. Professor Arthur Mandisodza has published more than 45 articles in peer reviewed journals, and 15 of these were related to HIV/AIDS.
Abstract:
High levels of vWF have been associated with HIV infection and noted to decrease with ARV therapy. The monitoring of ARV treatment requires the measurement of many parameters and the vWF could be one of them. The main objective of this study was to compare the levels of vWF amongst normal subjects (regular blood donors), HIVAIDS patients on ARV treatment and HIV/AIDS patients not on ARV treatment to determine the prognostic and diagnostic significance of the plasma vWF. A cross sectional study was carried out at National Blood transfusion Services (NBTS) and CIMAS Medical Laboratories, Harare on 50 regular blood donors and 80 HIV patients in 2005. The mean vWF levels for normal subjects, on treatment and not on treatment were 0.9, 2.1, 2.8 U/ml respectively. There was a statistically significant difference between normal subjects (regular donors) and those not on treatment (P=0.0001). There was also a statistically significant difference in vWF concentrations between those on ARV treatment and those with HIV but not on treatment (P=0.0014). There was no statistically significant difference between those who were on treatment and normal (regular donors) subjects (P=0.58). There was an association between HIV infection without treatment and high levels of vWF (X2 test, P=0.031). Although the vWF levels in normal subjects varied with age, the values were within normal reference range (figure 1). Measurement of vWF levels may help in monitoring the treatment of HIV/AIDS.
Wudinesh Belete Belihu
Ethiopian public health institute Addis Ababa, Ethiopia
Title: Planning HIV case surveillance: a data quality assessment of paper and electronic medical records – Addis Ababa, Ethiopia, Wudinesh B Belihu
Biography:
Wudinesh Belete Belihu has her expertise research in HIV, STI and other related diseases such as HIV/AIDS bio-behavioral survey among most at risk populations (female sex workers, long distance drivers, injectable drug users and other surveys) and surveillances such as sexually transmitted infections sentinel surveillance, PMTCT based sentinel HIV surveillance, HIV case based surveillance and other surveillances.
Abstract:
Background: With an estimated 613,823 HIV-positive Ethiopians who have ever enrolled in HIV care, there is a need to better understand how well health services diagnose, link, and retain HIV-positive people in care. Utilization of existing health service data may be an effective way to monitor patient clinical outcomes and target resources at the population level. HIV Case Surveillance use these service data to generate information on patient clinical outcome. Hence, assessment of health service data was conducted to explore its utility for HIV case surveillance. Methods: Using convenience sampling, 24 HIV treatment facilities in Addis Ababa, Ethiopia, was selected to participate. In facilities with an electronic medical record (EMR), we reviewed HIV patients’ paper health records from patients attending the facility during October 1 – December 31, 2014and extracted Electronic health data from facilities’ EMR. In facilities with no EMR, paper records from patients attending the facility during January 1 – December 31, 2014 were reviewed. A standard assessment tool quantified data completeness and validity as quality indicators. Data were analyzed using SAS 9.4 and Microsoft Excel. Results: 1,500 paper health records were reviewed from 21(87.5%) health facilities with an EMR and 3(12.5%) with no EMR. Of 53 paper-based variables assessed, 16(30.2%) variables, including patient cell phone number, sex, and age were high quality (>90% completeness and validity), 24(45.3%) variables, including patient first name and address were medium-high quality (51-89%), 10(18.9%) variables, including patient last name and year of HIV diagnosis were medium-low quality (26-50%), and 3(5.7%) variables were low quality (<25%). A total of 52,817 electronic records were available from 21 health facilities’ EMR. Of 82 electronic variables assessed, 15(18.3%) variables, including patient age, sex, and address were high quality, 26(31.7%) variables were medium-high quality, 12(14.6%) variables were medium-low quality, and 29(35.4%) variables, including patient date of birth were low quality. Quality of paper and electronic data varied by health facility and service unit. Conclusions: Existing paper and electronic patient health data in Ethiopia could allow for HIV case surveillance. Opportunities exist to improve data quality, particularly patient demographic data that could facilitate identification of unique patients across health records.
Christopher Fairbank
Lake Highlands Schertz, Texas
Title: Mindset Rewiring for Speedy Results and How to Use My Unique Formula to Discover Your Personal Power
Biography:
Christopher Fairbank is a renowned ballet dancer and police officer turned motivational speaker. Christopher speaks at many schools, businesses, conferences, and hospitals around the country with the goal of creating a positive change in ourselves. Christopher regularly speaks with those who are sick and battling cancer, HIV, STD’S and other infectious diseases. He helps motivate them and helps them find the positive in their situation. Through his talks, many patients have seen great results and have even seen improvements in their health. Christopher has experience as a professional motivational speaker, mentor, public information officer, and retired professional ballet dancer and teacher, having danced and taught professionally for over eighteen years. He serves youth and adults alike, helping them realize their potential and understand that they can become successful in life no matter their circumstances. Audiences describe his life experiences and stories as unique, motivating, funny, and captivating.
Abstract:
Mindset Rewiring for Speedy Results How do you think, and why do you think like that? During this session, we will go over and determine what our mindset should be or what we want it to be. We will also discuss how our mindset can be changed through our thought process, our personal “self- talk”, our language, and our personal goals and how we can apply it by jumping out of our comfort zone. Attendees will also learn “How to Use My Unique Formula to Discover Your Personal Power.” These 6 steps are essential for each of us to better understand our own uniqueness. I will personally help each listener learn how to use my unique formula to discover their personal power and grow their selfesteem by following and applying my 6 steps.