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Evidence Update Issue 15, 2019| May 14, 2019 |
Publications from the SiREN Team & Members
What Works? Prevention and Control of Sexually Transmitted Infections and Blood-Borne Viruses in Migrants from Sub-Saharan Africa, Northeast Asia and Southeast Asia Living in High-Income Countries: A Systematic Review. This review identified three levels of interventions; individual, community and structural. Most studies addressed factors at an individual level. The review identified a critical need for more comprehensive interventions that consider both individual and broader socioeconomic and sociocultural factors.
A snapshot of male sex worker health and wellbeing in Western Australia. This study surveyed and interviewed male sex workers from Western Australia. The majority of respondents reported that sex work enhanced their wellbeing, with negative effects being largely due to stigma and discrimination, and the uncertainty related to not having a steady income. The study highlights the need for peer outreach and support, interventions to improve the broader health of male sex workers and decriminalisation of sex work in Western Australia.
Strategies used by gay male HIV serodiscordant couples to reduce the risk of HIV transmission from anal intercourse in three countries. This study followed male serodiscordant couples in Australia, Brazil and Thailand. The study found couples used condoms, PrEP or perceived undetectable VL for prevention in the majority of anal intercourse acts. Differences in couples and variation between countries may reflect differences in access to HIV treatment, education, knowledge and attitudes, impacting upon the implications for HIV prevention in each setting.
Why I can’t, won’t or don’t test for HIV: Insights from Australian migrants born in Sub-Saharan Africa, Southeast Asia and Northeast Asia. This study explored individuals barriers to HIV testing and the acceptability of new testing methods (rapid HIV testing and HIV self-testing kits) by conducting focus groups with people from sub-Saharan Africa (SSA), Southeast Asia (SEA) and Northeast Asia (NEA). Barriers to HIV testing included: cost and eligibility of health services, low visibility of HIV in Australia, HIV-related stigma, and missed opportunities by general practitioners (GPs) for early diagnosis of HIV and linkage into care. Participants had low levels of knowledge on where to test for HIV and the different methods available. The study calls for interventions, aimed at individual, community, and policy level, to address low levels of HIV testing among SSA and SEA/NEA migrants in Australia.
HIV Point of Care Testing (PoCT) at Late‑Night Sex on Premises Venues (SOPV) for Gay and Bisexual Men and Other Men Who Have Sex with Men (GBMSM): A Mixed Methods Analysis. This study trialled a PoCT area within one SOPV during late night group sex theme parties, with participants filling out a survey and an optional in-depth interview at a later date. This study established ‘proof of concept’ for a novel approach to HIV and STI testing. The findings support further PoCT endeavours within MSM communities to target harder to reach communities to reduce the rate of new transmissions of HIV.
People on the move: implications for meeting Australia’s 95:95:95 targets by 2022. This essay explores the impact of mobility on meeting Australia's targets for HIV. It stresses the need for greater political will and cross-border collaboration to ensure equitable access to HIV prevention, testing and treatment for mobile populations.
Most UK clinic staff now tell people about U=U, but not always in the same way. This report discusses the inconsistent delivery of information by healthcare workers to patients when discussing U=U. Patients' responses to current delivery included relief, confusion, distress, the misinterpretation of information, and the development of inaccurate beliefs. Clinicians call for more materials (e.g. leaflets) to show patients clear messages about U=U and encourage a public health information campaign.
Alcohol and other drug treatment services in Australia 2017-2018: key findings. This report presents key findings for 2017-2018 about publicly funded AOD treatment service agencies, the people they treat, and the treatment provided.
AFAO - In conversation: The Hon Dr Neal Blewett AC and the Hon Dr Peter Baume AC. This is an interview with the Hon Dr Neal Blewett AC (Australian Health Minister, 1983-1990) and the Hon Dr Peter Baume AC (Senior Shadow Cabinet Minister 1983 – 1991) on the bipartisanship that defined Australia’s early response to the HIV epidemic.
AFAO – In conversation: Professor Sharon Lewin AO from the Doherty Institute. This is an interview with Professor Sharon Lewin AO, Director of The Peter Doherty Institute for Infection and Immunity, explaining the details of the London Patient, how he was ‘cured’ and what this means for the future of HIV cure research.
S04 SpeakEasy with Emma Rafferty: Talking treatment, talking journeys. In this episode of SpeakEasy, Annie and Carla chat to Emma Rafferty who is a Systemic Advocacy Lead at the Association of Participating Service Users (APSU) in Victoria. Emma introduces a new podcast series “Straight to the Source” and discusses how the show is working to empower people who use alcohol and other drug services, increase the impact of people's voices and create sustainable change at the system level.
‘When asking for help is the hardest thing’ – Straight From The Source Ep.7. Straight from the Source looks at a range of different issues relevant to those impacted by drug and alcohol use from varying perspectives and talks through real and honest stories, straight from the source. This episode explores Brendan’s story and reflects on the importance of having a voice.
What proportion of female sex workers practise anal intercourse and how frequently? A systematic review and meta-analysis. This review found receptive anal intercourse (AI) among female sex workers (FSW) is generally common globally. Neither AI prevalence nor frequency varied substantially by any participant or study characteristics. AI is inconsistently protected with condoms and practiced sufficiently frequently to contribute substantially to HIV acquisition in this risk group. Interventions to address barriers to condom use are needed.
Self-disclosure of HIV status among youth living with HIV: A global systematic review. This review investigated the antecedent goals, disclosure patterns, and long-term outcomes of youth self-disclosure. The results indicated a lack of intervention studies around HIV self-disclosure, lack of quality studies and knowledge gaps around disclosure among youth. The review suggests a need for peer mentors and/or other paraprofessionals to be involved in the disclosure process and to be aware of the complexities and dynamic processes of disclosure.
Culture, Health & Sexuality (Volume 21, Issue 3)
How do older people discuss their own sexuality? A systematic review of qualitative research studies. This systematic review captured older people’s attitudes and concerns about sex and sexuality in later life. Three main themes were identified: (a) social legitimacy for sexuality in later life; (b) health, not age, is what truly impacts sexuality, and (c) the hegemony of penetrative sex. Review findings suggest that later life sexuality should be addressed within social policy, sex education and ageing policies.
Harm Reduction (Volume 16, Issue 16)
"Maybe if I stop the drugs, then maybe they'd care?" - hospital care experiences of people who use drugs. Using semi-structured interviews, this study investigated the experience of acute care for people who use drugs. Drug use was experienced as a barrier at all stages of hospital care. Interventions to decrease stigma and improve consistency and the approach to pain management are necessary. Findings call for integrated care, where multiple services are provided in the same facility.
International Journal of Drug Policy (Volume 66 & 67)
Learning from the past, looking to the future – Is there a place for injectable opioid treatment among Australia’s responses to opioid misuse? This commentary explored the current need and the options to implement a supervised injectable opioid treatment (SIOT), in Australia. The commentary calls for the drug and alcohol sector, policy makers responsible for opioid assisted therapy funding, and consumers to be involved in further discussions regarding the acceptability and feasibility of this treatment modality.
The unintended consequences of emphasising blood-borne virus research on, and services for, people who inject image and performance enhancing drugs: A commentary based on enhanced bodybuilder perspectives. This commentary discusses ways research and harm reduction efforts could tackle the issue of BBV without exacerbating existing divides between people who inject image and performance enhancing drugs (IPEDs) and the health and academic communities. This commentary suggests shifting harm reduction and research from BBVs, to infection in general, whilst also including injection risks.
Quantitative evaluation of an integrated nurse model of care providing hepatitis C treatment to people attending homeless services in Melbourne, Australia. This study evaluated the outcomes of a service providing HCV treatment to people attending homeless services. Most clients commenced treatment and the majority were successfully cured using a dedicated nursing service. This suggests a nurse-led model of care for HCV testing and treatment can be effective in engaging clients of homeless services. Implementation of point of care testing and same day treatment prescription is likely to be of critical importance among these people.
Sex Education (Volume 19, Issue 3)
Sex educators’ attitudes and intentions towards using sexually explicit material: an application of the theory of planned behaviour. Using an online survey, this study investigated factors predicting the intention to use sexually explicit material among sex educators. This study found the strongest predictors were practical obstacles, followed by descriptive norms. Sex educators who had viewed and discussed sexually explicit material during their professional training had a higher intention to use sexually explicit material than those who had not. These findings may be important elements to consider in the future training of sex educators and when organising sex education classes.
Framing gender identity and sexual orientation: media influence on young men who have sex with men’s health. Focus groups were used to investigate young MSM's perceptions of the media (how it frames gender identity and sexual orientation) and the implications of these messages on sexual health. Participants felt that the media only worsened HIV-related stigma and discrimination. Findings illustrate the important role that media can play in educating about gender identity and sexual orientation and the implications this framing has for HIV prevention.
Australian students’ experiences of sexuality education at school. This paper presents findings related to sexuality education from the Fifth National Survey of Secondary Students and Sexual Health. Students’ overall knowledge of HIV, STI and HIV was low which shows a distinct lack of awareness in these areas and may be a reflection of students’ inadequate sexuality education. A tailored approach is required to address the diverse needs of young people’s sexual health knowledge.
Sexual Health (Volume 16, Issue 2)
New digital media interventions for sexual health promotion among young people: a systematic review. The aim of this study was to assess the effectiveness of sexual health interventions delivered via new digital media to young people (aged 13–24 years). The findings reveal a large diversity in intervention designs, settings, populations and evaluation strategies of new digital media in this age group. This review highlights the broad potential for digital media to enhance health promotion and service delivery towards better sexual health.
Rapid HIV testing increases testing frequency among gay and bisexual men: a controlled before-after study. The effect of the availability of rapid HIV testing on testing frequency among gay and bisexual men (GBM) was evaluated. This study found that following the introduction of rapid HIV testing for routine testing at clinics accompanied by social marketing, HIV testing frequency among GBM who had at least one rapid test was higher than among GBM who only had conventional serology. The study suggests integrating rapid HIV testing into clinics to support more frequent HIV testing among GBM.
Sexually Transmitted Infections (Volume 95, Issue 3)
Choose to test: self-selected testing for sexually transmitted infections within an online service. This study aimed to describe the outcomes of user-led choice of test through collecting data from a free, online sexual health service. The study found user-led decision-making on test choice results in cost saving by reducing the number of blood test kits for HIV and syphilis taken, but the cost implications of possible missed HIV diagnoses due to reduced testing is unknown. Further development of a decision-making process to further address technical knowledge and public health knowledge is recommended.