REPORTS

Summary Report of Key Learnings from a Scoping Study of HIV Testing in Australia. Australian Federation of AIDS Organisations (AFAO). AFAO undertook a scoping study of Human Immunodeficiency Virus (HIV) testing in Australia to better understand the reasons why people test for HIV too infrequently, or not at all and to identify strategies and resources to support HIV testing among different sub-populations at risk of HIV.

What Works and Why (W3) Project Impact Analysis. La Trobe University. The W3 Project aims to build a deeper understanding of the way peer-based programs operate and how they create value in a dynamic, complex HIV and hepatitis C community and policy system. This report discusses the W3 Framework, and presents a series of case studies that explore the way organisations are using the framework to strengthen their work and their contributions to the BBV response in Australia.

Spotlight: HIV-Related Discrimination Against Women and Girls. UNAIDS. For Zero Discrimination Day, March 1, UNAIDS released a report highlighting areas where change is urgently needed for HIV reduction in women and girls worldwide. Key global data on HIV incidence in women and girls is also presented.

Missing Connections: Service user experiences of people living with hepatitis C exiting custodial settings. Australian Injecting & Illicit Drug Users League (AVIL). This report highlights areas that continue to present as barriers and challenges of access to care for hepatitis C in custodial settings. Recommendations on how improvements can be made to improve health outcomes in this setting are presented.

Hidden Harms: Methamphetamine use and routes of transmission of blood-borne viruses and sexually transmissible infections. Australian Injecting & Illicit Drug Users League (AVIL) The report highlights the various potential routes of blood-borne virus transmission associated with meth use and the current policy and legislative barriers that have adverse impacts on known harm reduction measures. Best practice guidelines are presented, which could be implemented to improve the public health outcomes associated with meth use.

A Hidden Population: Supporting healthy ageing for people who inject drugs and/or receive pharmacotherapies. Australian Injecting & Illicit Drug Users League. This report provides a comprehensive needs analysis for supporting healthy ageing amongst older people who inject drugs, older people on pharmacotherapies and older people living with hepatitis C or hepatitis C-related complications. Recommendations for systematic changes are presented. 

PODCASTS

What needs to be done about Hepatitis C. Hear from Hepatitis Victoria CEO Melanie Eagle, as she discusses Hepatitis C 'miracle cures' and the possible reasons why thousands of Australian's aren't using them. This podcast is from the ABC's Nightlife national radio program. 

JOURNAL ARTICLES 

AIDS and Behavior (Volume 24, Issue 3)
Increases in HIV Incidence Following Receptive Anal Intercourse Among Women: A Systematic Review and Meta‑analysis. The study explored associations between receptive anal intercourse (RAI) and incident human immunodeficiency virus (HIV) among women worldwide, though a systematic review of relevant journal articles. The review found that a gap in health promotion of condom use and oral PrEP exists, there is a need for better counselling on HIV transmission for women, and suggested that RAI should no longer be neglected as a key risk factor. 

Barriers to Accessing Sexual Health Services for Transgender and Male Sex Workers: A Systematic Qualitative Meta-summary. A review of 22 papers was conducted to explore the reasons for the higher prevalence of HIV and sexually transmitted infections (STIs) in transgender and male sex workers (TMSW). Stigma was identified as a barrier as were confidentiality concerns, sexual health literacy, fatalism, and structural barriers. This review highlights the need for integrated sexual healthcare services, with appropriately trained staff, that respect the dignity of all clients.

What Proportion of Female Sex Workers Practise Anal Intercourse and How Frequently? A Systematic Review and Meta‑analysis. From an analysis of 131 studies, anal intercourse among female sex workers was found to be generally common, inconsistently protected with condoms and engaged in frequently. This has contribute substantially to HIV acquisition in this risk group. Interventions to address barriers to condom use are recommended. 

Correlates of Transactional Sex Among a Rural Population of People Who Inject Drugs. This study explored transactional sex among people who inject drugs (PWID) in rural populations. By analysing data from a survey of rural PWID in West Virginia, it was found that a minority reported engaging in transactional sex work in the past 6 months, and were exposed to multiple vulnerabilities that increase their HIV risk. Thus, there is need for increased access to harm reduction services and other health and human services for this population group. 

How Male Sex Workers and Their Clients Shifted from Reluctance About HIV Pre-exposure Prophylaxis to Advocating for Its Use: A Longitudinal Mixed Methods Study. This study analysed perspectives on HIV pre-exposure prophylaxis (PrEP) in male sex workers and clients, in an effort to understand how this community viewed PrEP. Data was collected from an online forum used by gay and bisexual-identified male sex workers and the clients of male sex workers. It was found that male sex workers and their clients utilised many different strategies to explain and explore PrEP, and that their initial views of hesitancy had changed to advocacy over a number of years. 

Culture, Health & Sexuality (Volume 21, Issue 12)
PrEP indicators, social capital and social group memberships among gay, bisexual and other men who have sex with men. The influence of social groups on HIV prevention was explored among gay, bisexual and men who have sex with men (MSM) in this study. Data was collected from a survey administered to cisgender men who reported ever having sex with men, and whose HIV status was negative. Men who reported community group participation were more likely to be aware of PrEP compared to those who did not. Social group membership is suggested to be a potential social indicator for addressing HIV prevention among men.

Australian Journal of General Practice (Volume 49, Issue 1/2)
'Think Hep B' in Primary Care. The researchers of this study developed a survey and found that insufficient knowledge on Hepatitis B (HBV) was a barrier to HBV testing by General Practitioners in Victoria, Australia. An educational fact sheet was created to help General Practitioners identify priority populations at risk of HBV, which received positive feedback. These findings will help to identify and increase HBV testing among priority populations. 

International Journal of Drug Policy (Volume 76)
Frequency of injecting among people who inject drugs: A systematic review and meta-analysis.The study aimed to explore injecting frequency among PWID and harms associated with once daily or more injecting. The systematic review found that PWID daily or more had a higher prevalence of HIV and hepatitis C antibody, non-fatal overdose, and receptive needle sharing. The World Health Organisation recently recommended a needle–syringe distribution target of 300 needles per PWID per year, which the findings suggests is unlikely to be sufficient for the majority of PWID injecting daily or more who are out of drug treatment. 

A cost-effectiveness analysis of primary versus hospital-based specialist care for direct acting antiviral hepatitis C treatment. A randomised controlled study comparing the uptake of direct-acting antiviral (DAA) treatment in primary care settings with hospital-based care settings amongst PWID was conducted. Compared to hospital-based care, providing hepatitis C (HCV) services for PWID in primary care can improve treatment uptake and approximately halve the average cost of treatment. To improve treatment uptake and cure, countries should consider primary care as the main model for HCV treatment scale-up.

Journal of Adolescent Health (Volume 66, Issue 3)
Social Support Networks Among Young Men and Transgender Women of Color Receiving HIV Pre-Exposure Prophylaxis. The role of social support networks was explored in HIV-negative young men and transgender women who have sex with men, who take prescribed oral PrEP. Results from questionnaires and analysis found that a PrEP support figure was valuable to participants, and that future intervention should consider the role of integrated social network and family-based approaches.

Perspectives and Recommendations From Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Youth of Color Regarding Engagement in Biomedical HIV Prevention. Data from focus groups was analysed to understand the perspectives and preferences of Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Youth of Colour who were prescribed PrEP. The study found that youth of colour represent a disproportionately high percentage of incident HIV cases, and that engagement with and understandings of their specific needs and preferences should be explored in future research and intervention development. 

Sexual Health (Volume 17, Issue 1)
‘I make sure my doctor doesn’t know that I use meth’: perceived barriers to pre-exposure prophylaxis (PrEP) uptake among community peer educators in Seattle (WA, USA). The study aimed to identify key barriers to PrEP use in cisgender men and transgender people who have sex with men that use methamphetamine. Focus groups facilitated by peer educators were conducted as part of a harm reduction intervention. Stigma relating identity, sexual behaviour and methamphetamine use was identified as a key barrier to PrEP use. The research suggests that PrEP delivery interventions must incorporate stigma reduction methods. 

Use of pre-exposure prophylaxis increases the odds of condomless anal sex among young men who have sex with men (MSM) of colour. Research was conducted to determine whether PrEP users would be more likely to report condomless anal sex than those not taking PrEP, in a Black and Latino young men who have sex with men (YMSM) population group in Los Angeles, USA. The study found PrEP users to be more likely to report condomless anal sex than those not on PrEP.  The development and testing of evidence-based condom promotion counselling programs that can be implemented as part of a PrEP-based prevention system should be a national priority. 

Sexually Transmitted Infections (Volume 96, Issue 2)
Chemsex-related drug use and its association with health outcomes in men who have sex with men: a cross-sectional analysis of Antidote clinic service data. The study aimed to investigate chemsex-related drug use  and HIV related issues among MSM in the United Kingdom. Findings show that  MSM presenting for chemsex-related drug use are a heterogeneous high-risk population with unmet health needs. There is a need for standardised chemsex surveillance and for improved intersectorial working between sexual health and drug treatment services. Future research should investigate typological differences between MSM presenting for chemsex-related drug use.

Potential HIV transmission risk among spouses: marriage intention and expected extramarital male-to-male sex among single men who have sex with men in Hunan, China. A web-based, cross sectional survey was used to explore the potential HIV transmission risk among MSM living with HIV and their female spouses in China. It was found that extramarital homosexual behaviours were common in nearly half of Chinese MSM participants who intended to marry women. Interventions are recommended to reduce the potential transmission risk between MSM living with HIV and their female spouse.

Population-level diagnosis and care cascade for chlamydia in Australia. A diagnosis and care cascade for Chlamydia was developed to highlight gaps and to inform efforts to improve current control programmes in Australia. By analysing surveillance data and previous research, it was found that the greatest gaps in the Australian Chlamydia Cascade for young people were in the diagnosis and re-testing steps, with both especially low among men. Treatment rates were also lower than recommended by guidelines. The cascade highlights the need for enhanced strategies to improve treatment and re-testing coverage. 

Healthcare providers and community perspectives on expedited partner therapy (EPT) for use with gay, bisexual and other men who have sex with men. In this study, health care providers and gay, bisexual and other men who have sex with men (GBMSM) in Michigan, USA were interviewed to identify opinions, barriers and facilitators for expedited partner therapy (EPT). The study concluded that acceptability of EPT use for both chlamydia and gonorrhoea was high among providers and GBMSM community members, however there were a number of barriers to facilitation. This study demonstrates the potential acceptability of EPT with GBMSM among both providers and community members in the USA.