Victorian HIV Treatment Options

Location: Melbourne, VIC

Duration: 3 months

Proposed start date: ASAP

Keywords: Literature review, situational analysis, population health

Please note: Due to funding requirements students must have Australian Citizenship or Permanent Residency to apply. Applicants not meeting this requirement will be ineligible for the project.

Project Background

There are approximately 8000 people living with HIV (PLHIV) in Victoria at 31 December 2017.

The Victorian Government has released the Victorian HIV Strategy 2017-2020 with clear and bold targets across prevention, testing, treatment and stigma. The targets include:

  • Increase to 95 per cent the proportion of people living with HIV who are accessing appropriate treatment and care
  • Increase to 95 per cent the proportion of people living with HIV achieving undetectable viral load.

Historically, the Melbourne Sexual Health Centre (MSHC, now run by Alfred Health) has provided HIV medication at no cost to patients, as agreed by government. This is a historical anomaly dating back to the 1990s when the then government promised that PLHIV facing hardship would not have to meet the cost of co-payment for HIV medications.

This anomaly has created an inequitable landscape between diseases and between health services in Victoria. The co-payment costs for other infectious diseases and other chronic conditions are not covered by the Victorian Government. The co-payment costs at other hospitals and health services that supply s100 medications for HIV, hepatitis C and other sexual health medications are also not covered by the Victorian Government.

Approximately 1500 PLHIV access free anti-retroviral treatment (ART) at MSHC while the remaining 6500 PLHIV (those who are on treatments) access other health services in Victoria pay co-payment costs for HIV medications.

Research to be Conducted

This research projects aims to develop an options paper on HIV treatment access and uptake in Victoria. The research paper would compare current jurisdictional arrangements and develop options for different sustainable co-payment arrangements in Victoria for HIV ART in the context of the treatment targets outlined in the Victorian HIV strategy.

Substantial individual health, public health and HIV prevention benefit is realised from the provision of ART to people living with PLHIV. People with complex HIV treatment needs can necessitate multiple ART items. Those with co-morbidities are also likely to experience financial barriers to accessing medications. People who are Medicare ineligible and living with HIV are at greater risk of interrupted treatment regimes.

This research paper would explore options that include: a standardised system where the state supplements Commonwealth PBS rebates; a transitional and sliding scale model of access; and creation of a compassionate access scheme for Medicare ineligibles and those facing financial hardship.

Skills Required

We are looking for a PhD student with the following skills:

Essential

  • Situational analysis
  • Population health

Desirable

  • Knowledge of HIV in a population health context
  • Lived experience of HIV, or a willingness to work with people living with HIV in the development of the options paper
  • Knowledge of State and Commonwealth health systems
  • Understanding of the unique needs and concerns of the priority populations named in the Victorian HIV Strategy 2017-2020

Expected Outcomes

The PhD student will produce a research paper that outlines sustainable policy and programmatic reform options for bringing ART payment arrangements into line with co-payment costs at other Victorian hospitals and health services that supply s100 medications for HIV. This paper would clearly outline the benefits and risks of each option in the context of the targets in the Victorian HIV strategy 2017-2020.

The research would also address the development of an associated hardship or compassionate access scheme to ensure that those PLHIV who cannot afford to pay the costs of a co-payment or are ineligible to access the commonwealth rebate are able to access ART at no cost. The paper should also discuss the policy justification for providing free or subsidised access to ART.

Additional Details

The intern will receive $3,000 per month of the internship, usually in the form of stipend payments.

It is expected that the intern will primarily undertake this research project during regular business hours, spending at least 80% of their time on-site with the industry partner.  The intern will be expected to maintain contact with their academic mentor throughout the internship either through face-to-face or phone meetings as appropriate.

The intern and their academic mentor will have the opportunity to negotiate the project’s scope, milestones and timeline during the project planning stage.

To participate in the APR.Intern program, all applicants must satisfy the following criteria:

  • Be a PhD student currently enrolled at an Australian university
  • PhD candidature must be confirmed
  • Applicants must have the written approval of their Principal Supervisor to undertake the internship. This approval must be submitted at the time of application.
  • Internships are also subject to any requirements stipulated by the student’s and the academic mentor’s university
Applications Close

 24 June 2018

Reference

INT – 0443