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Evidence Update: December 2022| December 20, 2022 |
PUBLICATIONS FROM THE SIREN TEAM AND MEMBERS
Making your Materials Work: A Quick Guide to Developing Culturally Appropriate and Effective HIV Resource Content. Collaboration for Evidence, Research and Impact in Public Health. This guide is for those working with migrants and people from culturally and linguistically diverse backgrounds in Australia to prevent and manage human immunodeficiency virus (HIV). The Guide contains information, practical tools and quick links to assist practitioners in planning, implementing and evaluating culturally appropriate HIV information, education and communication resources.
Parents and their support for school-based relationships and sexuality education: Western Australia snapshot report. Collaboration for Evidence, Research and Impact in Public Health. This report summarises the WA findings of a study exploring attitudes towards relationships and sexuality education (RSE) in schools among a national sample of parents (or other adults) with caring responsibilities for school-aged children. The methods (including survey instrument and sample), findings, and recommendations for involving parents and adults with caring responsibilities in school-based RSE are presented.
Australia’s progress towards hepatitis C elimination: annual report 2022. Burnet Institute. This is the fourth national report on progress toward hepatitis C (HCV) elimination in Australia. This report brings together national data, including new data on HCV indicators among priority populations.
Dangerous inequalities: World AIDS Day report 2022. UNAIDS. This report, released to commemorate World AIDS Day 2022, unpacks the impact that inequalities faced by key populations, gender inequalities and inequalities between children and adults have had on the AIDS response.
HIV, viral hepatitis and sexually transmissible infections in Australia: Annual surveillance report 2022. Kirby Institute. The report provides a comprehensive analysis of HIV, viral hepatitis, and sexually transmissible infections in Australia. Incidence and prevalence by demographic and risk groups, patterns of treatment, and behavioural risk factors are presented.
HIV Futures 10. Australian Research Centre in Sex, Health and Society. HIV Futures 10 is a study of quality of life (QoL) among people living with HIV (PLHIV) in Australia. This report summarises data to inform progress against the QoL indicator outlined by the National HIV Strategy 2018–2022, and provides insight into how QoL among PLHIV can be supported at a service level.
Bacterial STIs: The DoxyPEP Trial. BMJ talk medicine. This episode interviews principal investigators of the DoxyPEP trial, a clinical trial in the United States involving the provision of doxycycline post-exposure prophylaxis (PEP) to reduce syphilis, chlamydia and gonorrhoea infections.
HIV and drug research use. WELL WELL WELL. In this episode, Dr. Thomas Norman from the Australian Research Centre in Sex, Health and Society discusses recent research on HIV and injecting drug use, and HIV Futures 10.
HIV unmuted. International AIDS Society. This podcast series interviews global HIV change makers who have shaped the HIV response and discusses what needs to be done to end the AIDS epidemic.
Syphilis update. The Good GP. In this episode, Dr. Grace Phua from Metropolitan Communicable Disease Control provides an update on syphilis and discusses the symptoms and presentations, congenital syphilis, testing, and treatment.
AIDS and Behavior
A Scoping Review of Peer Navigation Programs for People Living with HIV: Form, Function and Effects. Krulic et al. This scoping review explored research focused on peer navigation programs for people living with HIV.. The peer programs identified involved health systems navigation and social support. The evidence provides a strong theoretical base for peer engagement to enhance the effectiveness of health systems navigation and social support as well as evidence for the ability of peer navigation to strengthen the HIV continuum of care. However, further research is recommended to capture the role HIV peer navigators play in preventing disease and promoting quality of life, mental health, and disease self-management in diverse settings and populations. In addition, future research on peer programs should evaluate the role of peer navigators, their activities, the quality of peer engagement, and employee and community support structures.
Archives of Sexual Behavior
Explicit Relationship Agreements and HIV Pre-exposure Prophylaxis Use by Gay and Bisexual Men in Relationships. MacGibbon et al. This study aimed to identify specific education and health promotion needs of gay and bisexual men (GBM) in relationships who are considering or already using pre-exposure prophylaxis (PrEP), from data collected from a national online survey completed by non-HIV-positive GBM. Analysis suggests PrEP users in relationships had similar sexual practices to PrEP users not in relationships. GBM in relationships who have casual sex and who meet PrEP suitability criteria may be good candidates for PrEP. Explicit relationship agreements remain important for HIV prevention, and they support PrEP use among GBM in relationships.
BMC Public Health
“It was protected, except, it wasn’t [with] a condom": a mixed-methods study of BBVs/STIs protective practices among International University Students in Sydney, Australia. Okeke. This study explored protective practices against BBVs and STIs among Sydney-based East Asian and sub-Saharan African international students, using data collected from an anonymous online survey and qualitative interviews. The quantitative findings showed consistent or occasional condom use as commonly self-reported BBVs/STIs prevention strategies. However, the qualitative results revealed this group may be more motivated by contraception over BBVs/STIs prevention in their condom use practices which may have implications for BBVs/STIs risks. Tailored sexual health interventions for international students are recommended, including strategies promoting dual protection for both contraception and BBVs/STIs.
Time-series analysis of presentations to four syringe dispensing machines and a needle and syringe programme during COVID-19 lockdowns in Melbourne, Australia. O'Keefe et al. This study explored changes to harm reduction usage during periods of COVID-19 lockdowns in Melbourne, Australia in 2020. Data were collected from usage of four syringe-dispensing machines (SDMs) and a needle and syringe program (NSP). An estimated 85,851 SDM presentations and 29,051 NSP presentations occurred. Usage across both the SDMs and the NSP declined during the COVID-19 lockdowns, suggesting barriers to access. Further research is needed to explore potential changes in preference for needle/syringe acquisition sites and associated barriers.
Participant perceptions on the acceptability and feasibility of a telemedicine-based HIV PrEP and buprenorphine/naloxone program embedded within syringe services programs: a qualitative descriptive evaluation. Corneli et al. This study summarises the evaluation of PARTNER UP, a telemedicine-based pilot project aiming to provide PWID with access to both oral PrEP for HIV prevention and medication for opioid use disorder through two syringe services programs (SSPs) in North Carolina, USA. Interviews were conducted with participants to assess perceptions of usefulness and ease of use, and intent to continue to use the program components. The evaluation found the project to be acceptable and feasible. Future studies should continue to explore the benefits of embedding both PrEP and medication for opioid use disorder into SSPs with larger numbers of participants.
Health and Social Care in the Community
Optimising community health services in Australia for populations affected by stigmatised infections: What do service users want? Horwitz et al. This study explored the experiences in accessing and receiving health services, including what characteristics promoted better health, safety and well-being for people with BBVs or STIs. Interviews were conducted with people who inject drugs, gay men and other men who have sex with men, sex workers, people in custodial settings, culturally and linguistically diverse people, Indigenous Australians, and young people in one Australian urban community setting. Stigma was found to persist in the provision of healthcare services. Previous experiences of discrimination or fear of mistreatment may result in a reluctance to continue to access services. On-going staff training, education and specialised services, and strong collaboration between health services are recommended to ensure healthcare environments are welcoming and inclusive.
Effectiveness of interventions aimed at reducing HIV acquisition and transmission among gay and bisexual men who have sex with men (GBMSM) in high income settings: A systematic review. Sewell et al. This study aimed to review research evaluating the effectiveness of HIV prevention interventions for gay and bisexual men who have sex with men (GBMSM) in high-income countries. There was some evidence that one-to-one counselling, group interventions and online (individual) interventions could be effective for reducing HIV transmission risk behaviours such as condomless anal intercourse. PrEP was the only intervention that was consistently effective at reducing HIV incidence. Targeted and culturally tailored behavioural interventions for sub-populations of GBMSM vulnerable to HIV infection and other STIs are recommended, particularly for GBMSM who cannot access or decline to use PrEP.
Chlamydia home sampling in the real world: a cross-sectional analysis. Foster et al. This study aimed to describe chlamydia home sampling at a Sexual Health Centre in Sydney, using data collected from cases of heterosexual males and non-sex-working females who tested positive for chlamydia. Just under half of the participants returned the home-sampling kit. Of these, 13.0% were positive for chlamydia. The home sampling process for chlamydia reinfection screening in heterosexual men and non-sex-working women was found to have a much lower uptake than seen in a previous trial with high attrition rates at each stage.
Migrant and refugee youth perspectives on sexual and reproductive health and rights in Australia: a systematic review. Napier-Raman et al. This study utilised a systematic review to examine the understandings and perspectives of migrant and refugee youth (MRY) on sexual and reproductive health (SRH) and rights. The review found socioecological factors shaped MRY perspectives at individual, interpersonal, institutional and societal levels. It is recommended that health practices should be situated in MRY’s structural, emotional, cultural, and social conditions. These are important findings to guide service delivery to optimise MRY’s SRH and outcomes, not just in Australia but more widely in the region and other multicultural populations.
Patient-centred approaches to providing care at HIV diagnosis: perspectives from healthcare and peer-support workers. Wells et al. In this study, interviews were conducted with sexual health clinicians and HIV support workers to understand how they approached HIV diagnosis delivery and care immediately thereafter. Centering patients was an important aspect of how participants delivered HIV diagnoses. This approach ensured clinicians were best able to consider patient readiness to initiate treatment and referrals to social support services. Given HIV diagnoses are increasingly occurring in generalist health services, the findings offer an important opportunity to learn from the experiences of specialist sexual health clinicians and HIV support workers.
Men of refugee and migrant backgrounds in Australia: a scoping review of sexual and reproductive health research. Mengesha et al. This review aimed to synthesise the available evidence on refugee and migrant men’s sexual and reproductive (SRH) needs, understandings and experiences of accessing services after resettlement in Australia. The World Health Organization framework for operationalising sexual health and its relationship with reproductive health was used to map the studies. Thematic analysis identified several factors that influenced refugee and migrant men’s SRH, including a lack of access to SRH information, language barriers and stigma. SRH literature on refugee and migrant men focuses on STIs, meaning other areas of SRH are poorly understood. Further research is recommended to better understand migrant men’s SRH needs.
Telehealth for sexual and reproductive health issues: a qualitative study of experiences of accessing care during COVID-19. Bittleston et al. This study investigated barriers and facilitators to patient use of telehealth to explore acceptability for the provision of ongoing SRH telehealth services. Data were analysed from two online surveys conducted in 2020. Respondents had a wide range of experiences. Telehealth improved access to services for some participants, and it was appropriate for some, but not all SRH issues. Difficulties connecting with clinicians on both an interpersonal and technical level was a key barrier to a satisfactory patient experience. Telehealth can offer a viable alternative to face-to-face care, providing patients can overcome key connection and communication barriers.
Sexuality Research and Social Policy
Stigma Regarding HIV and Sexual Identity as Barriers to Accessing HIV Testing and Prevention Services Among Gay and Bisexual Migrants in Australia. Philpot et al. Interviews with gay and bisexual migrants in Australia were conducted to identify how HIV and sexual identity stigmas were barriers to accessing HIV testing and prevention. Stigma was found to be deeply embedded into social, cultural, and institutional settings in participants’ countries of origin, resulting in poor HIV literacy, reluctance to access HIV-related services, including HIV testing, and fears of being identified as gay/bisexual publicly. Underpinned by internalised stigma, these fears and poor outcomes often persisted after moving to Australia. To address multifaceted HIV testing and prevention barriers policies, there is a need for systems and interventions that increase health literacy about HIV testing, prevention, and treatment; build trust and confidence when navigating Australian health services; and reduce the impacts of HIV and sexual identity stigmas in migrants’ countries of origin on their experiences in Australia.
Sexually Transmitted Diseases
Factors associated with willingness to use daily antibiotics as STI prophylaxis among HIV-PrEP-experienced gay and bisexual men in Australia. Tyson et al. This study explored willingness to use STI-PrEP among HIV-PrEP-experienced gay and bisexual men (GBM) in Australia, using data from an observational online cohort study. Over half of the participants were willing to use daily STI-PrEP, suggesting STI-PrEP is likely to be appealing to many HIV-PrEP-experienced GBM, especially those who engage in activities associated with higher risk of STI transmission. However, they are less likely to be willing to use STI-PrEP unless it aligns with their HIV-PrEP dosing regimen, suggesting research into the safety and efficacy of alternative STI prophylaxis dosing options is needed.
Sexually Transmitted Infections
Improved rapid diagnostic tests to detect syphilis and yaws: a systematic review and meta-analysis. Zhang et al. This systematic review explored literature about rapid diagnostic tests (RDT) used to detect active infections of syphilis or yaws. Current RDTs for syphilis and yaws were found to have slightly lower sensitivity but very high specificity, compared to laboratory-based testing. If distributed widely with appropriate training, these tests can potentially decrease the incidence of both adult and congenital syphilis and contribute to the global eradication of yaws.