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Evidence Update Issue 5, 2017
| October 18, 2017 |
This month, in addition to our regular journals that we search for articles, we came across an editorial that discusses the barriers to hepatitis C elimination and how to prioritise access for all affected people. The authors advocate a number of strategies to ensure the effective delivery of hepatitis C treatments in order to achieve WHO targets of an 80% reduction in new infections and a 50% reduction in hepatitis C prevalence by 2030. Read more here.
REPORTS
National Drug Strategy Household Survey 2016: detailed findings. Australian Institute of Health and Welfare (AIHW). The AIHW have published the findings of the National Drug Strategy Household Survey 2016.
HIV Futures 8: Women Living with HIV in Australia. R. Thorpe, J. Power, G. Brown, A. Lyons, G.W. Dowsett & J. Lucke. The Australian Research Centre in Sex, Health and Society at La Trobe University have released the latest report from a series of cross-sectional surveys that aim to provide information about factors that support physical and emotional wellbeing among people living with HIV. The latest release focuses on the experiences of women living with HIV.
Viral Hepatitis kills more than HIV, malaria or tuberculosis, study finds. Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine News. This article summarises some of the key findings of the Lancet’s Global Burden of Disease study in relation to Viral Hepatitis.
Annual Report of Trends in Behaviour 2017: Viral Hepatitis in Australia. J. Bryant, J. Rance, L. Lafferty, C. Treloar. The Annual Report of Trends in Behaviour presents data from a selection of the behavioural and social research conducted by the Centre for Social Research in Health. The report focuses in particular on studies assessing trends over time or addressing emerging issues.
Drug injection trends among participants in the Australian Needle and Syringe Program Survey, 2012-2016. S. Memedovic, J. Iversen & L. Maher. This bulletin from the National Drug and Alcohol Research centre summarises recent drug injection trends among The Australian Needle and Syringe Program Survey participants over the five-year period 2012 to 2016.
HIV Prevention 2020 Road Map: Accelerating HIV prevention to reduce new infections by 75%. UNAIDS. The Prevention 2020 Road Map provides the basis for a country-led movement to scale up HIV prevention programmes as part of Fast-Tracking a comprehensive response to meet global and national targets and commitments to end AIDS as a public health threat by 2030.
Confronting discrimination: Overcoming HIV-related stigma and discrimination in healthcare settings and beyond. UNAIDS. This report compiles the latest body of evidence on how stigma and discrimination create barriers across the HIV prevention, testing and treatment cascades and reduce the impact of the AIDS response. The report also brings together best practices on confronting stigma and discrimination, providing a valuable resource for programme managers, policy-makers, health-care providers and communities.
JOURNAL ARTICLES
Journals include: AIDS and Behavior; Journal of Medical Internet Research; Sexually Transmitted Infections; Harm Reduction; Sex Education; Journal of Viral Hepatitis; and Culture, Health and Sexuality. We have selected a maximum of five articles from each journal that have relevance to sexual health, STIs and BBVs in the Australian context. To view more articles from each journal, please visit the journal homepage.
AIDS and Behaviour (Volume 21, Issues 9 & 10)
Main topics |
Title and first author |
Summary |
HIV, behavioural intervention |
What they did: A pilot study assessed feasibility, acceptability, and preliminary efficacy of a brief acceptance based behavior therapy (ABBT), relative to treatment-as-usual (TAU) in new-to-care HIV patients. What they found: ABBT had significant positive effects on retention, as well as putative mechanisms of action compared to TAU. Policy and practice implications: Further testing of ABBT is warranted. |
|
PWID, NSP |
What they did: Conducted a study of syringe borrowing and syringe lending within a prospective cohort of street-involved youth in Canada. What they found: 28% participants reported syringe borrowing and 26% reported syringe lending. Having difficulty finding clean needles and homelessness were significantly associated with syringe borrowing. Policy and practice implications: Further examination of how needle distribution efforts might be improved to better meet the needs of young people is warranted. |
|
HIV, prevention, evidence-based approach |
When Science and Values Collide: Recalling the Lessons of Evidence-Based HIV Prevention R.O. Valdiserri |
What they did: Editorial discussing evidence-based approaches to HIV prevention. What they found: Empowered communities (such as MSM and PWID) can generate changes that will support their members in achieving and sustaining better health. Policy and practice implications: What we do as a society in response to health and social problems must be informed by the best available information. |
GBM, HIV, serosorting |
What they did: Investigated the association between serosorting and HIV infection among HIV-negative MSM. What they found: Compared to no condomless discordant anal sex, serosorting was associated with increased HIV risk. Compared to condomless discordant anal sex, serosorting was associated with reduced HIV risk. Policy and practice implications: Understanding the potential risk and benefit of serosorting continues to be important, particularly within the context of other prevention strategies. |
|
HIV, migrant health |
Interventions for Increasing HIV Testing Uptake in Migrants: A Systematic Review of Evidence E. Aung |
What they did: Reviewed and evaluated interventions that aimed to increase HIV testing uptake in migrant populations. What they found: Three types of interventions were identified; exposure to HIV prevention messages, HIV education programs, and direct offer of testing. All interventions were based on individual models of behaviour change targeting migrants or general practitioners. Policy and practice implications: Primary health care integration and interventions that address broader health system and structural factors that contribute to late HIV-diagnosis in migrant populations are needed. |
Journal of Medical Internet Research (Volume 19, Issue 9)
Main topics |
Title and first author |
Summary |
Digital intervention, HIV |
Video Game Intervention for Sexual Risk Reduction in Minority Adolescents: Randomized Controlled Trial L.E. Fiellen
|
What they did: Developed and trialled an interactive video game as an intervention to improve sexual health outcomes in minority adolescents. What they found: The interactive video game intervention group improved sexual health attitudes and knowledge in minority adolescents for at least 12 months compared to controls. Policy and practice implications: Interactive video games as digital health interventions offer the unique opportunity to increase the accessibility and reach of theory-driven and tested interventions. |
Technology, education, evidence-informed decision making |
What they did: Evaluation of the Understanding Research Evidence web-based video series, explaining odds ratios, confidence intervals, clinical significance, and forest plots. What they found: Overall, the results of the evaluation showed that watching the videos resulted in an increase in knowledge, and participants had an overall positive experience with the videos. Policy and practice implications: With increased competence professionals are empowered to contribute to decisions that can improve health outcomes of communities. |
|
Technology, professional development |
What they did: Analysed how public health professionals used Twitter to enhance their formal and informal professional development within the context of public health. What they found: The most popular reasons for using twitter was to expand networking opportunities and for professional development. Qualitative data showed other reasons for use of Twitter were: geography; continuing education; professional gain; and communication. Policy and practice implications: Use of Twitter allows public health professionals to overcome a series of barriers and enhances opportunities for growth. |
|
HIV, PrEP, technology |
A.J. Siegler |
What they did: This project sought to create a national database of PrEP-providing clinics to allow patients access to a unified, vetted source of PrEP providers in an easily accessible database. What they found: Within 6 months, preplocator.org and hosting websites had received over 35,000 unique views and 300 clinic additions, and five websites had initiated hosting of the widget. Policy and practice implications: Geolocated directories can assist patients in accessing care and have the potential to increase demand for and access to newer, more efficacious medical interventions. |
Sexually Transmitted Infections (Volume 93, Issue 5 & 6)
Main topics |
Title and first author |
Summary |
HIV, MSM, STI, PrEP |
What they did: A retrospective study of bacterial STI incidence and HIV seroconversion. What they found: Diagnosis of early syphilis carries a high risk of consequent HIV seroconversion. Policy and practice implications: Those with early syphilis should receive prioritised prevention measures such as PrEP and regular STI screening. |
|
GBM, HIV, PrEP |
What they did: Assessed willingness of Australian GBM to use PrEP, support for others using it and willingness to have sex with partners using it. What they found: Interest in and support for using PrEP are concentrated among men who engage in higher risk practices and who know more about living with HIV. Policy and practice implications: The results were consistent with the targeting of PrEP in Australia. The results support the targeted rollout of PrEP in Australia to GBM at higher risk of HIV. |
|
STI, testing |
Impact of deploying multiple point-of-care tests with a ‘sample first’ approach on a sexual health clinical care pathway. A service evaluation E.M. Harding-Esch |
What they did: A evaluation of the clinical service value of STI point-of-care test (POCT) use in a ‘sample first’ clinical pathway for chlamydia and gonorrhoea. What they found: A ‘sample first’ clinical pathway was acceptable to patients and feasible in a busy sexual health clinic, but chlamydia and gonorrhoea processing time was too long to enable POCT use. Policy and practice implications: There is need for further development to improve test processing times to enable POCT for chlamydia and gonorrhoea. |
HIV, MSM |
Challenges and emerging opportunities for the HIV prevention, treatment and care cascade in men who have sex with men in Asia Pacific F. van Griensven |
What they did: A review of currently available biomedical HIV prevention strategies, national HIV prevention policies and guidelines from selected countries in Asia Pacific. What they found: No evidence for efficacy of antiretroviral treatment for prevention in protecting MSM from HIV infection was found. Policy and practice implications: PrEP will be instrumental in achieving HIV epidemic control in this group. |
Harm Reduction (Published online in September)
Main topics |
Title and first author |
Summary |
HCV, opioid substitution, peer education |
Perceived benefits of the hepatitis C peer educators: a qualitative investigation A.W. Batchelder |
What they did: Qualitative analysis to explore HCV patients and peer educator’s perceptions of a HCV peer education program within an established methadone maintenance program. What they found: Participants unanimously described the program as beneficial to HCV treatment, HCV treatment success and perceived stigma. Peer educators described personal benefits. Policy and practice implications: HCV peer educators can enhance HCV treatment initiation and engagement within opioid substitution programs. |
Sex Education (Volume 17, Issue 6)
Main topics |
Title and first author |
Summary |
Young adults, sex education |
What they did: Qualitative evaluation of young adult’s reactions to sex-positive or sex-negative messages. What they found: Sex-positive messages that focus on the benefits of certain behaviours tend to resonate better with young adults. Policy and practice implications: More can be done to understand how the wording of health messages influences individual decisions and behaviours. Findings such as those documented here may help create stronger forms of health communication. |
|
GBM, sex education |
What they did: Conducted semi-structured interviews about sex education experiences of GBM in socially conservative rural USA and ways to compensate for lack of information. What they found: Participants noted a lack of meaningful sexual education with a primary focus on abstinence. They compensated by accessing pornography and information on the internet. Policy and practice implications: The results highlight the importance of public health professionals using the internet and peer educators to deliver inclusive and informative sexual health information. |
|
Sex education |
Empowerment through sex education? Rethinking paradoxical policies M. Naezer |
What they did: An evaluation of Dutch sexual education policies. What they found: Dutch sex educational policies inhibit rather than encourage young people’s empowerment by allowing only a limited number of sexual knowledge building practices. Policy and practice implications: To facilitate young people’s empowerment, policies should aim to create space for young people to develop their own themes and priorities. |
Journal of Viral Hepatitis (Volume 24, Issue 9)
Main topics |
Title and first author |
Summary |
HCV, PWID, prisons |
What they did: Investigated trends in HCV incidence and associated factors among a cohort of prisoners with a history of injecting drug use (IDU) in NSW. What they found: A stable trend in HCV incidence was observed. IDU frequency and needle sharing were independently associated with time to HCV seroconversion. Policy and practice implications: Findings highlight the need for improved HCV prevention strategies in prison, including needle/syringe programmes and HCV treatment. |
|
HCV, DAA |
Augmentation of hepatitis C virus-specific immunity and sustained virologic response S. Shrivastava |
What they did: This study analysed changes in HCV-specific immunological responses associated with viral clearance with combination directly acting antiviral (DAA) therapy. What they found: Suppression of HCV was associated with a decline in T-cell exhaustion markers along with augmented of HCV-specific T-cell IFN-gamma responses post-treatment. Policy and practice implications: These findings demonstrate a novel effect of DAA in inducing host immune responses to aid HCV clearance and achieve sustained virological response. |
HBV, liver transplant |
What they did: Retrospective analyses of overall trends in liver transplantation (LT) waitlist registrations, waitlist survival and likelihood of receiving LT among chronic HBV patients in the United States. What they found: The total number of HBV patients listed for LT was stable, waitlist mortality significantly improved, probability of receiving LT was higher, and proportion of HBV patients with HCC continued to rise. Policy and practice implications: The decrease in waitlist mortality and lower likelihood of LT among HBV patients may reflect the effectiveness of antiviral therapies in delaying disease progression in the current era. |
Culture, Health & Sexuality (Volume 19, Issue 10 & 11)
Main topics |
Title and first author |
Summary |
HIV, PrEP, gay men |
Science, technology, power and sex: PrEP and HIV-positive gay men in Paris J. Brisson |
What they did: Explored what PrEP represents for HIV-positive gay men living in Paris, based upon data collected through interviews and ethnographic research. What they found: Participants held opinions and understandings specifically as it related to their own sexuality. Findings from this study make it clear that there is no one response to the use of PrEP. Policy and practice implications: To fully appreciate people’s attitudes toward PrEP, we must understand how lines are blurred between the sexuality of the individual, HIV prevention technologies and science. |
Female sexuality, sexual identity |
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What they did: Qualitative and quantitative data were gathered using an online survey of lesbian, bisexual, queer and pansexual women from across the USA. What they found: Bisexual and pansexual participants were significantly less likely to disclose identity than lesbian participants. There were no significant differences related to age or ethnicity. Policy and practice implications: Findings from this study have the potential to inform ethical medical practices and improve healthcare quality among sexual minority women. |
Autism, sexuality, gender |
Intersectional harassment and deviant embodiment among Autistic adults: (dis)ability, gender and sexuality J. Penwell Barnett |
What they did: Conducted in-depth interviews of adults on the autism spectrum in the USA. What they found: Gender, sexuality and (dis)ability in the construction of deviant embodiments are targets for harassment. Policy and practice implications: It is critical for scholars and activists to account for the role of gender and heterosexist harassment in ableist oppression and disability harassment in (hetero)sexist oppression. |
HIV, GBM |
What they did: Conducted life history interviews with GBM to identify modes of syndemic experience and risk practice. What they found: Modes whereby syndemic conditions are navigated and expressed were identified. Factors included episodes of depression or anxiety, migration, adverse childhood events, substance abuse. Risk practices fell into three high-risk modes: active and frequent engagement in condomless sex; unassertive deferment to a partner's initiation of condomless sex; and episodic risk combined with a risk reduction strategy. Policy and practice implications: Different modes of syndemic experience and risk management may have implications for identification of the effective HIV prevention tools that work best for different sets of men. |
Acronyms
ABBT Acceptance Based Behavior Therapy (ABBT)
AIDS Acquired Immune Deficiency Syndrome
AIHW Australian Institute of Health and Welfare
BBV Blood Borne Virus
DAA Direct Acting Antiviral
GBM Gay and Bisexual Men
HBV Hepatitis B
HCC Hepatocellular carcinoma
HCV Hepatitis C
HIV Human Immunodeficiency Virus
IDU Injecting Drug Use
LT Liver Transplant
MSM Men who have Sex with Men
NSP Needle and Syringe Program
PrEP Pre-Exposure Prophylaxis
PWID People Who Inject Drugs
POCT Point-Of-Care Test
STI Sexually Transmitted Infection
TAU Treatment-As-Usual