KIRBY

Professor David Cooper and Mr Michael KirbyThe Kirby Institute

The Kirby Institute for infection and immunity in society was formed on the 25th anniversary of the establishment of the National Centre in HIV Epidemiology and Clinical Research (NCHECR). Named for former High Court Judge Michael Kirby AC, the Kirby Institute now fulfils a much broader role than was first imagined in 1986 when the three National Centres in HIV research were formed in response to the then-emerging and little understood HIV pandemic. NCHECR collaborated extensively in the international effort that ensured that HIV became one of the most intensively studied diseases in the history of medical science. Over time, the skills, techniques and expertise developed in the study of HIV were applied to a range of other infectious diseases, notably viral hepatitis and sexually transmissible infections and the affected populations. The new name of the Kirby Institute takes in this broader scope and, reflecting Michael Kirby’s lifelong interest in health and human rights. It also reflects the diverse and often disadvantaged communities that are the focus of the Institute’s research.

The Kirby Institute is affiliated with the Faculty of Medicine at the University of New South Wales, and receives funding through the Australian Government Department of Health and Ageing. The NCHECR’s original roles were limited to the co-ordination of national surveillance programs, clinical research and clinical trials. The Kirby Institute’s research program has increasingly taken on a regional focus, with major collaborative programs in Thailand, Cambodia, and Papua New Guinea. Other functions of the Kirby Institute include the training of health professionals, and input into the development and implementation of health policy and programs.

The Kirby Institute carries out its functions by working with an extensive range of collaborators, including the other national HIV research centres, State and Territory Health Departments, public and private clinical services, national and international organisations, and the corporate sector including the pharmaceutical industry. The Director is supported in the overall management of the Kirby Institute by the Executive Committee as well as the managers of Finance and Administration. Executive Committee members are the Heads of Kirby’s eleven programs and groups, as well as the managers of Finance and Administration.

 

Public health research programs within the Kirby Institute

The Kirby Institute is comprised of public health (including epidemiology and prevention research), clinical research, and laboratory research programs. The public health research programs are:

1. HIV Epidemiology and Prevention Program

2. Viral Hepatitis Epidemiology and Prevention Program

3. Sexual Health Program

4. Aboriginal and Torres Strait Islander Health Program

5. Public Health Interventions Research Group

6. The Surveillance and Evaluation Program for Public Health

7. Justice Health Research Program

 

1. HIV Epidemiology and Prevention Program (Head: Professor Andrew Grulich)

The HIV Epidemiology and Prevention Program (HEPP) conducts research into the transmission and prevention of HIV and sexually transmissible infections (STIs), and on the natural history of HIV. Our work is multidisciplinary and collaborative. We work in partnership with communities most affected by HIV, particularly the gay community and those people living with HIV. We work across the spectrum of biomedical, behavioural and structural prevention, because effective HIV prevention acknowledges the complexities of everyday life for at-risk communities. Our work includes behavioural risk surveillance, studies of risk behaviour, and studies of use of biomedical preventive interventions. Researchers in HEPP conduct a range of work on the intersection of infection, immunity and cancer to inform our knowledge of how we might prevent cancer in people with HIV. A particular focus is the prevention of anal cancer in gay men.

 

2. Viral Hepatitis Epidemiology and Prevention Program (Head: Professor Lisa Maher)

The Viral Hepatitis Epidemiology and Prevention Program strives to conduct multidisciplinary public health research that is ethical, innovative and makes a difference. We are proud of, and committed to, working in partnership with affected communities in Australia and internationally to achieve our goals. Key aims of the program are to:

  • Initiate and undertake epidemiological, social and behavioural research examining viral hepatitis and public health issues associated with drug use and risk behaviour;
  • Design and implement trials of behavioural and biomedical prevention interventions designed to prevent viral hepatitis and other infectious diseases in vulnerable populations;
  • Conduct and support surveillance activities including monitoring trends in blood-borne virus incidence, prevalence and risk behaviour among people who inject drugs;
  • Translate research outcomes into evidence-based public health practice; and
  • Build capacity for research, surveillance and harm reduction within Australia and the region through the provision of training and technical assistance.

 

3. Sexual Health Program (Head: Professor Basil Donovan)

The Sexual Health Program leads and participates in research into the epidemiology, surveillance, microbiology, clinical management, and prevention of sexually transmissible infections (STIs); including – but not limited to - chlamydia, syphilis, gonorrhoea, human papillomavirus infection, herpes simplex virus infection, and HIV infection. Our program is also involved in research into the behaviour and sexual health of priority populations for STI control such as youth, gay men, sex workers, Aboriginal people, prisoners, and travellers.

The Sexual Health Program works closely with several other Programs within the Kirby Institute. The Program also enjoys collaborating with a national network of 25 specialist sexual health services; research laboratories in Sydney, Melbourne, Brisbane and PNG; the School of Population Health at the University of Melbourne; the Burnet Institute in Melbourne; and the Menzies School of Health Research in Darwin. Methodologies used in the Program’s research range from descriptive epidemiology with novel analytical techniques, molecular epidemiology, enhanced surveillance strategies, data linkage studies, social and behavioural research, test evaluations, detecting antimicrobial resistance, evaluating and improving health care delivery, legal and policy research, anthropology, and biomedical prevention.

 

4. Aboriginal and Torres Strait Islander Health Program (Currently vacant)

The Aboriginal and Torres Strait Islander Health Program was established in 2007. The Program works collaboratively to close the gap in health between Aboriginal and Torres Strait Islander and non-Indigenous people, with a key focus upon sexually transmitted and blood borne viral infections.

The overall objective of the Program is to enhance the capacity of Aboriginal and Torres Strait Islander communities to responding to these infections. conducting rigorous, ethical, timely and culturally appropriate research. The program has four primary domains of activity that together aim to increase the health and well-being of Aboriginal and Torres Strait Islander people and communities.

1. Research: To conduct research in partnership with Aboriginal and Torres Strait Islander communities that is rigorous, ethical, timely and culturally appropriate.  

2. Surveillance: To support existing surveillance activities and identify innovative methods of surveillance that will benefit Aboriginal and Torres Strait Islander communities.

3. Capacity Building: To work with health services and the health workforce to enhance their capacity in service delivery; research..

4. Information dissemination on Aboriginal and Torres Strait Islander health initiatives including surveillance and research

The Program works closely with the National Aboriginal Community Controlled Health Organisation, its State and Territory based Affiliate organisations and Aboriginal Community Controlled Health Services to make a difference to the health of communities.

 

5. Public Health Interventions Research Group (Head: Professor John Kaldor)

The Public Health Interventions Research Group undertakes a diverse range of projects that focus on the evaluation of strategies to prevent infectious disease. We collaborate extensively within the Kirby Institute and externally, and emphasise research that benefits the health of disadvantaged populations in Australia and the Asia-Pacific Region, with a strong capacity-building component. Much of our work also has a strong capacity building component. The group is involved in projects related to the control of HIV, sexually transmitted infections, viral hepatitis, tuberculosis, scabies and trachoma. Countries of activity include Australia, Papua Guinea, Indonesia, Cambodia and Fiji.

 

6. The Surveillance and Evaluation Program for Public Health (Head: A/Professor David Wilson)

The Surveillance and Evaluation Program for Public Health (SEPPH) monitors the pattern of transmission of HIV, viral hepatitis, and specific sexually transmissible infections in Australia, assesses past and expected epidemic trends, and evaluates the epidemiological impact and cost-effectiveness of public health intervention strategies and programs. SEPPH also evaluates HIV epidemics and develops research capacity in Southeast Asia and the Pacific. Surveillance activities are conducted in collaboration with the Australian Commonwealth Government Department of Health and Ageing, State and Territory health authorities and collaborating networks. Analyses and interpretation of recent trends in new diagnoses of HIV, viral hepatitis and STIs, and estimates of prevalence and incidence in key population subgroups are published in our Annual Surveillance Report. Public release datasets on new HIV and AIDS diagnoses are also available for download. SEPPH, of the National Centre in HIV Epidemiology and Clinical Research, is a collaborating unit of the Australian Institute of Health and Welfare. SEPPH carries out extensive mathematical modelling research in order to evaluate public health programs, understand drivers of epidemic trends, project future epidemic trajectories, and assess the potential impact of public health strategies. This research is focused on HIV, viral hepatitis, and sexually transmissible infections in Australian populations and on HIV/AIDS in the Southeast Asia and Pacific region. This evaluation is often extended to health economic analyses of different programs or interventions. SEPPH is also involved in building research capacity in the areas of epidemiology, biostatistics, mathematical modelling, and other biomedical research associated with HIV/AIDS in Southeast Asia and the Pacific.

 

7. Justice Health Research Program (Head: Professor Tony Butler)

The Justice Health Program is the most recently established research program in the Kirby Institute. Offender populations are one of the most stigmatised and socially excluded groups in the community and are characterised by extreme social and psychological disadvantage. Those exposed to the criminal justice system are typically poorly educated, unemployed, socially isolated, and financially dependent. Epidemiological surveys of prisoners consistently find high level of physical ill health, psychiatric illness, high rates of blood borne and sexually transmitted infections, and substance misuse. Indigenous Australians are disproportionately over represented in the criminal justice system and form an important part of the work of the Justice Health program. The work of the Justice Health research program is multifaceted covering blood-borne virus and STIs surveillance in prison in the form of the National Prison Entrants' Bloodborne Virus and Risk Behaviour Survey, an investigation into why prisoners have low rates of hepatitis C treatment, tobacco use among prisoners, an intervention to treat impulsivity in repeat violent offenders, and the development of national health indicators for prisoners. An NHMRC capacity building grant in the Indigenous offender health area is helping to develop a cohort of Aboriginal researchers in this area.

 

RECENT PUBLIC HEALTH FUNDING SUCCESS AT THE KIRBY INSTITUTE

John Kaldor, David Wilson, James Ward and Bette Liu won a tender with the Department of Health and Ageing to undertake national trachoma surveillance to 2013.

Andrew Vallely, John Kaldor, Angela Kelly, Peter Siba (PNG IMR), Lisa Fitzgerald (UQ), Maxine Whittaker (UQ) were recently awarded a grant from the PNG National AIDS Council Secretariat (2010 - 2013; AUD 259,150) to undertake a qualitative longitudinal study to investigate constructions of masculinity, sexuality and agency among male youth in Papua New Guinea.

Andrew Vallely was awarded an NHMRC Training Fellowship in 2010 to support his research in HIV/STI prevention and sexual health in Melanesia.

Andrew Vallely, Claire Ryan (PNG IMR/Burnet Institute), John Kaldor, Peter Siba (PNG IMR) and collaborators in Papua New Guinea were awarded funding in 2011 through the PNG IMR Internal Competitive Research Award Scheme (2011-2012; AUD 60,000) to investigate human papillomavirus (HPV) infection among women attending sexual health clinics inGoroka and Port Moresby, Papua New Guinea.

Claire Ryan (PNG IMR/Burnet Institute), Andrew Vallely, John Kaldor, Peter Siba (PNG IMR) and collaborators in Papua New Guinea received funding from the PNG Partnerships in Health Program in 2011 (2011-2012; AUD 293,988) to investigate the epidemiology of HIV and STIs, including human papillomavirus (HPV), among pregnant women attending antenatal clinics at four sites in Papua New Guinea.

Claire Ryan (PNG IMR/Burnet Institute) Andrew Vallely, John Kaldor, Peter Siba (PNG IMR) and collaborators in Papua New Guinea received funding in 2010 from the PNG National AIDS Council Secretariat (NACS; 2011 – 2012; AUD 41,250) to investigate the relationship between HIV-1 and HSV-2 in the Highlands of Papua New Guinea.

The Aboriginal and Torres Strait Islander Health Program recently received funding to evaluate two major projects funded under the National Partnership Agreement Indigenous Health, namely a sexual and reproductive health program and a hepatitis C program. The program will be rolled out in communities across NSW 2011-2014.

Lisa Fitzgerald (UQ), Andrea Whittaker (UQ), Andrew Vallely and collaborators in Queensland received ARC funding (LP110200318; 2011 – 2014; AUD 191,059) for a qualitative longitudinal study of aging, place and social isolation to be conducted among people living positive in Queensland.

Andrew Grulich and collaborators were awarded a NHMRC project grant for $1,350,000 for the years 2011-2015 for a project entitled “Viral load, HIV treatment, and HIV transmission in serodiscordant male homosexual couples”.

Rebecca Guy, Larissa Lewis, Handan Wand, John Kaldor, Basil Donovan, and collaborators have received a grant from the NSW Health Department (2011-2012) for the eTEST project – an initiative to increase HIV/STI testing in gay men attending GP clinics in NSW.

Rebecca Guy, James Ward, David Whiley (UQ), Basil Donovan, David Wilson, Davis Regan, and Handan Wand received NHMRC Project funding (2011-2013) for a randomized trial of rapid point-of-care tests for chlamydia and gonorrhoea in remote Aboriginal communities.

Rebecca Guy, Donovan B, John Kaldor, Matthew Law, and David Regan, with collaborators from the University of Melbourne and the University of Bern received NHMRC Project funding (2011-2013) for a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of chlamydia testing in general practice (ACCEPt).

Lisa Maher and collaborators from the British Columbia Centre for Excellence in HIV/AIDS received a NIH grant (2012-2017) to examine HIV risk environments among female sex workers and drug users in Vancouver using a longitudinal ethno-spatial approach.

Lisa Maher, John Kaldor and collaborators from the University of California San Francisco received a NIH grant (2012-2016) to conduct a cluster randomised trial of individual and structural-level interventions for female sex workers in Cambodia.

Lisa Maher and collaborators received a grant from NIH (2011-2015) for InC3 – an international collaboration of prospective studies of HIV and hepatitis in people who inject drugs.

Lisa Maher and Jenny Iversen received a grant from the NSW Health Department (2012-2013) to conduct a census of clients attending Needle and Syringe Programs in NSW.