Page 163 - HA Convention 2015

Parallel Sessions

PS2.1 Controlling AIDS 10:45 Theatre 2

Epidemiology and Control of HIV/AIDS in Hong Kong Tuesday, 19 May
Wong KH
Centre for Health Protection, Department of Health, The Government of the Hong Kong Special Administrative Region

30 years after the report of the first AIDS case in Hong Kong, HIV/AIDS remains a major public health challenge. Contrary to
the belief of many people, the local HIV epidemic is still on a rising trend and not yet under control. The cumulative number of
reported infections was close to 7,000 as of the end of 2014, with a record high of 651 newly reported cases in last year. Men
who have sex with men (MSM) bear the brunt, as if the scenario of early epidemics. HIV prevalence of MSM community was
5.9% according to a survey in 2014, which was much higher than any other populations.

Combination prevention has been advocated by international authorities in response to the soaring HIV epidemics. Risk
behaviour modification, time and again safer sex with consistent condom use are effective; but rarely practice at a desirable
scale to achieve the effect. Addressing the needs of most-at-risk populations, notably MSM, injecting drug users and
female sex workers, are key to engaging and assisting them to prevent HIV. In recent years, biomedical measures have been
brought to the limelight, in research or field settings. Treatment as prevention with sustaining full suppression of viral load of
the infected people reduces their risk of onward transmission while pre-exposure prophylaxis for the uninfected but at-risk
people aims to lower the chance of HIV acquisition.

Hong Kong adopts a public health oriented comprehensive approach to tackle HIV. The local AIDS programme comprises
clinical, prevention, health promotion, surveillance, policy and research components. Healthcare professionals not
specialising in HIV can participate in and contribute to the response in many areas, including promotion of early HIV testing,
reporting of HIV/AIDS, intercurrent management and care of HIV patients, referral of infected individuals for lifelong HIV care,
supporting education and promoting acceptance of people living with HIV.

PS2.2 Controlling AIDS 10:45 Theatre 2

Impact of the Changing HIV/AIDS Landscape on Treatment Programmes HOSPITAL AUTHORITY CONVENTION 2015
Lee MP
Department of Medicine, Queen Elizabeth Hospital, Hong Kong

Highly active antiretroviral therapy (HAART), also known as “cocktail therapy”, has revolutionised HIV/AIDS care. HAART is
able to achieve potent and sustained viral control. HIV/AIDS has transformed from an inevitably fatal condition to a chronic
manageable disease. People with HIV who diagnosed early can have a near-normal life expectancy. They can now stay
healthy with much improved quality of life.

However, HIV treatment programmes are facing new challenges. Current treatment cannot cure the disease and lifelong
therapy is required. Drug adherence support for patient is one of the most important measures to prevent drug resistance.
Non-communicable diseases including cardiovascular diseases, cancers, chronic kidney and liver diseases have emerged as
an important cause of morbidity and mortality in people living with HIV. HIV infection, antiretroviral therapy and host factors
all contribute to the increased prevalence of non-communicable diseases. Besides, treatment for HIV/AIDS remains costly
and complex disease nature requires multi-disciplinary care approach.

In order to sustain quality HIV service, HIV treatment programmes should be scale-up to meet the increasing service demand
in terms of sustained access to antiretroviral treatment, enhanced laboratory support and strengthened manpower of the
treatment team. Holistic HIV care training should not be limited to designated centres but institution-wide instead. Treatment
programmes should continue their effort to improve efficiency and capacity utilisation. New services are necessary to meet
the evolving needs of the patients such as prevention and screening of non-communicable diseases, sexual and reproductive
health counselling, linking mental health and substance abuse service, vocational training and life restructuring programme,
etc.

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