Research to help clients with HIV maintain their treatment
In the 80’s and 90’s, HIV were three of the scariest letters that a person could hear… thankfully, these days… that’s no longer the case.
With advances in medication efficacy and tolerability, HIV can be easily managed medically. Successful treatment requires clients to continue therapy and engage in regular care and monitoring. Clinical Psychology PhD Candidate and recipient of a Health Education and Training (HETI) Mental Health Research Award, Shiraze Bulsara’s research focuses on identifying people with HIV and other conditions that may be at risk of discontinuing treatment.
Vast medical advances over the past two decades means that people living with HIV (PLHIV) are now able to effectively manage this chronic illness and the majority of clients can manage their medical treatment. However, Shiraze Bulsara, Senior Clinical Psychologist and PhD candidate, recognises that clinicians are noticing the high prevalence of people presenting with psychosocial multi-morbidities (co-occurring clinical presentations which can interact and increase the burden of illness), which can create a barrier between the client and their treatment.
It is well understood that to effectively manage the virus long term, clients must remain adherent to medication and continue to have regular medical reviews. However, for some people, the presence of psychosocial multi-morbidities can impact their capacity to effectively manage HIV. Ms Bulsara’s research explores the need to recognise and address these multi-morbidities, to best assist PLHIV to adhere to their medical treatment and schedule of visits. Calls are made for regular reviews and monitoring conducted by specialists, informed by a holistic view of the client’s healthcare and wellbeing. Ms Bulsara’s research focusses on the importance of continued treatment at this phase and with the ultimate aim to combine the clinician’s wealth of experience and expertise, whilst also holding the client’s perspective.
The research is made up of a qualitative review, exploring the clinician and client perspectives of HIV and the barriers that get in the way of effective treatment. It also focuses on how to accurately and effectively identify these factors as early as possible, to facilitate early intervention. Ms Bulsara outlined that part of this research has seen the development of a brief screening tool which incorporates the key variables that impact these clients, as determined through clinical work and existing literature. The key purpose of the research series is to promote a proactive, rather than reactive, approach to assisting these vulnerable clients. ‘We don't want to wait for the wheels to fall off for people before we intervene and we do something.’
We don't want to wait for the wheels to fall off for people before we intervene and we do something.
Ms Bulsara highlights that in Australia, the number of people with HIV that are considered ‘retained in care’ is high. However, Ms Bulsara argues that the way retention is defined in Australia and the US requires review to bring the guidelines in line with global World Health Organization (WHO) standards. The concern is that current definitions of retention in Australia and the US are overly broad and do not account for the role of complex psychosocial multi-morbidities.
Her study aims to review the widely held definition of retention in Australia. Ms Bulsara emphasises that this research will ensure that people are not being missed; those who, on paper, look like they’re doing really well, but in practice, may not be. The HETI Mental Health Research Award will fund Shiraze’s salary for 12 months, allowing her to focus on completing her research.
Learn more about Clinical Psychology at UTS.