Human immunodeficiency virus (HIV) drug resistance occurs when HIV treatment is interrupted which limits effectiveness of available medications. This affects outcomes for people living with HIV. Sophisticated testing to determine which drugs to use to treat a particular HIV case in order to avoid drug resistance is part of routine care in Australia but is not feasible in Papua New Guinea.
At the end of the Accelerating the UPtake of HIV Drug Resistance surveillance initiatives in Papua New Guinea project (ACT-UP PNG), we will have improved laboratory testing and better trained health workers who are able to manage patients with HIV drug resistance in Mt Hagen and Port Moresby and reduce the spread of HIV drug resistance
ACT-UP PNG will work across three broad thematic areas: finance and policy, laboratory capacity and point-of-care testing.
Finance and Policy
ACT-UP PNG will conduct a health economics assessment to analyse the cost-effectiveness of surveillance approaches and then facilitate workshops with Government of PNG partners to help mobilise new domestic funding. ACT-UP PNG will work with PNG Government partners to identify the current capacities and needs in HIV testing and surveillance and develop policies and a regulatory framework that considers HIV drug resistance. The information from laboratory and point-of-care testing will also target resource allocation to outbreak areas.
This project will build laboratory capacity to test for markers of treatment success. Laboratory capacity to support HIV drug resistance surveillance and clinical care will be increased by a mixture of trainings at St Vincent’s Hospital, Sydney and a ‘train the trainer’ approach to ensure laboratory staff are able to use an innovate platform for HIV drug resistance in PNG.
ACT-UP PNG will introduce a rapid test-kit method to test for drug resistance at pilot sites in Mt Hagen and Port Moresby. Targeted health workers will help develop patient consultation guides and be trained in counselling skills that encourage adherence to treatment. Standard operating procedures for health workers to engage with patients that are lost to follow-up will also be developed- a key means of preventing drug resistant HIV from developing.
Some of ACTUP-PNG’s activities have been held remotely and others have been rescheduled for later in the project cycle. ACTUP-PNG has not shifted its focus from HIV drug resistance to COVID-19.