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Evidence Update Issue 8, 2018| April 18, 2018 |
PUBLICATIONS FROM THE SiREN TEAM AND MEMBERS
Twenty years of capacity building and partnership: A case study of a health promotion scholarship program. Published by members of the SiREN Management Team in the Health Promotion Journal of Australia, this article provides a case study of the Australian Health Promotion Association (WA Branch) scholarships program and its contribution to capacity building within the health promotion workforce.
Check It Out. AIDS Action Council. This podcast covers a wide range of topics, from injecting drug use in prisons to policy and conference updates. Episodes are available on SoundCloud.
Hepatitis Victoria. The latest episode of Hepatitis Victoria's podcasts is presented by Dr Bruce Bolam, the Victorian Government's Chief Preventative Health Officer. Dr Bolam addresses the barriers created by stigma around hepatitis, the consequential health impacts, and the importance of confronting stigma in all forms. The episode can be accessed via SoundCloud.
Speak Easy. Centre for Social Research in Health, UNSW. The latest episode of Speak Easy sees a discussion of the tabling of Victoria's drug law reform report and recommendations. The episode is accessible via the Centre's website.
Sydney Sexual Health Centre. This podcast covers a wide range of topics related to sexual health. The most recent episode, celebrating Youth Week, addresses issues of consent and making sex education available to young people. All episodes are available on SoundCloud.
REPORTS AND OTHER ARTICLES
Is Truvada (PrEP) the game-changer that will end new HIV transmissions in Australia? The Conversation published this article by Edwina Wright from the Burnet Institute on pre-exposure prophylaxis (PrEP) as it is introduced to the Pharmaceutical Benefits Scheme this month.
Needle and Syringe Programs in Australia: Peer-led Best Practice. Australian Injecting & Illicit Drug Users League. This report outlines recommendations for peer-led best practice NSP service delivery in Australia. The report and a summary version of the recommendations can be found here.
Impact of alcohol and illicit drug use on the burden of disease and injury in Australia: Australian Burden of Disease Study 2011. Australian Institute of Health and Welfare. This report quantifies the health impact that alcohol and illicit drug use place on Australia, including as risk factors for other diseases and injuries. The report is available on the Institute's website.
Women and Girls and HIV. UNAIDS. The report outlines current statistics regarding the transmission and effects of HIV on women and girls and details necessary actions for the future. The report can be accessed via the UNAIDS website.
Journals in this edition include: AIDS and Behavior, Culture, Health & Sexuality, Harm Reduction, Health Promotion Journal of Australia, Journal of Medical Internet Research, Journal of Youth Studies, Sex Education, and Sexual Health.
Only articles relevant to sexual health, STIs and BBVs in the Australia context have been summarised.
AIDS and Behavior (vol. 22, issues 3-4)
The impact of substance abuse on adherence to antiretroviral therapy among HIV-infected women in the United States. Authors assessed antiretroviral adherence rates of women who also reported substance use. It was found that substance use was significantly associated with sub-optimal ART adherence. Authors recommend additional or targeted interventions for women who take ART and use substances.
A global estimate of the acceptability of pre-exposure prophylaxis for HIV among men who have sex with men: A systematic review and meta-analysis. A world-wide literature review has assessed the acceptability of PrEP and the associated population characteristics. The study found that PrEP is more likely to be accepted by populations which are younger, better educated, or are already aware of PrEP. Barriers to acceptance include perceived stigma, affordability, side-effects, and adherence. As PrEP becomes more readily available, programs and interventions should work to address these barriers.
Will gay and bisexual men taking oral pre-exposure prophylaxis (PrEP) switch to a long-acting injectable PrEP should it become available? Researchers surveyed gay or bisexual cisgender adult males with a current PrEP prescriptions to assess participants' familiarity with and preference for long-acting injectable PrEP (LAI-PrEP). Results found that nearly half of participants had no knowledge of LAI-PrEP and that many expressed interest in switching to LAI-PrEP should it become available. Concerns raised included the longevity of protection provided by LAI-PrEP and the potential side effects. Findings from clinical trials will likely influence whether oral PrEP users consider LAI-PrEP.
The role of emotional avoidance, the patient–provider relationship, and other social support in ART adherence for HIV+ individuals. This study has assessed the relationships between emotional avoidance, the patient-provider relationship, and other sources of social support, and the impact these relationships have on ART adherence. Results indicate that emotional avoidance behaviours negatively impact ART adherence. As such, targeting these behaviours as part of pre-existing ART adherence programs may results in may results in more positive outcomes.
Behavioral changes following uptake of HIV pre-exposure prophylaxis among men who have sex with men in a clinical setting. Researchers have monitored the sexual behaviours of MSM at the time of PrEP initiation, and at three and six months post-initiation. While there was no statistically significant change in total number of partners, there was a significant increase in number of condomless anal sex partners at six months post-initiation. This suggests that PrEP programs should address the potential for reduced condom use and provide appropriate counselling regarding PrEP adherence and regular STI screening.
Culture, Health & Sexuality (vol. 20, issues 2-4)
Barriers to primary and emergency health care for trans adults. This study engaged with trans people aged over 18 years living in Nova Scotia, Canada to explore barriers trans adults encounter when pursuing primary and emergency health care. Findings revealed that trans adults are often burdened by an expectation that they will take on a more active role in their care than cisgender patients, including educating their health care providers.
Performance, power and condom use: reconceptualised masculinities amongst Western male sex tourists to Thailand. By examining online discussion board posts and conducting face-to-face interviews, the authors sought to examine the ways in which understandings and performances of masculinities may inform the sexual risk-taking behaviours of Western male sex tourists. Findings indicated that unprotected sex served as a mark of being a 'real' man, authenticating both romantic and broader masculine success. Participants expressed a distrust of official health promotion messages, and valuing of the own experiences and the opinion of their peers. Consequently, the authors suggest using peer education methods to change these socially embedded behaviours.
Syndemics of stigma, minority-stress, maladaptive coping, risk environments, and littoral spaces among men who have sex with men using chemsex. Data collected from telephone interviews with men attending sexual health clinics for post-exposure prophylaxis following chemsex determined psycho-social contexts influencing their engagement in chemsex. Participants recounted experiences of marginalisation, loneliness, personal affirmation, and liberation which contributed to their engagement in chemsex. The authors conclude that personalised interventions may appeal to target populations if they recognise and articulate the psychosocial effects of marginalisation and the 'escape' chemsex provides.
Harm Reduction (vol. 15)
Scoping out the literature on mobile needle and syringe programs - review of service delivery and client characteristics, operation, utilization, referrals, and impact. Authors conducted a scoping review of existing literature to synthesise evidence related to NSP operations. The review found that NSPs have scope to provide a range of other services, often attract 'hard to reach' clientele, and are able to adapt to changes more readily than fixed-location services. The authors conclude that more work is needed to create clearer assessment metrics for NSP services.
Health Promotion Journal of Australia (vol. 28, issue 3)
Features of successful sexual health promotion programs for young people: Findings from a review of systematic reviews. This study collated and reviewed systematic reviews published between 2005 - 2015 which reported on programs targeting young people and sexual and reproductive health. Results found that effective interventions were longer-term, multi-setting or multi-component, included parental involvement, culturally/gender/age appropriate, and included skills-building. This study provides guidance for optimising the design of sexual and reproductive health interventions for young people.
Journal of Medical Internet Research (vol. 20, issues 2-3)
Web-based activity within a sexual health economy: Observational study. This article describes the introduction of a web-based STI screening service to an under-served area of London. The addition of online services was associated with increase in total testing. This indicates that web-based services may benefit areas which are under serviced or have limited resources.
Journal of Youth Studies (vol. 21, issues 1-4)
'All in all it is just a judgement call': Issues surrounding sexual consent in young people's heterosexual encounters. Drawing on data from workshops and survey responses from over 500 young people in the UK, this study examines young people's understanding of sexual consent. Findings demonstrate that the majority of heterosexual young people understood the complexity of sexual consent as a embodied process. The authors conclude that these findings can be used to inform communication strategies for education surrounding sexual assault and consent.
Sex Education (vol. 18, issues 1-2)
Mixed messages: Inconsistent sexual scripts in Australian teenage magazines and implications for sexual health practices. This study examines common sexual and reproductive health messages found in two Australian magazines targeted at teenage girls. Results demonstrated that the two dominant messages in these magazines are at odds; 'romantic messaging' emphasises the benefits of sexual acts within a romantic relationship, while 'protective messaging' stresses the dangers inherent in any sexual encounter. This study highlights the varied messages young women receive about sex from the media. Reconciling these competing messages needs to be considered in the promotion of consistent condom use among youth.
Spring fever: Process evaluation of a sex and relationships education programme for primary school pupils. Evaluation of Spring Fever has demonstrated teacher, pupil, and parental satisfaction with the program, as well as high delivery fidelity. The article provides evaluation procedures which will be of benefit to those considering implementing or evaluating a sex and relationships education program.
'The trouble with normal': (re)imagining sexuality education with young people. This participatory action research project worked with young people to assess what content young people found to be relevant and necessary in their sexuality education. Results indicated that reposititioning young people as architects of their own learning reframes key debates about the appropriateness, nature, and relevance of sexuality education.
AIDS Acquired Immune Deficiency Syndrome
ART Antiretroviral Therapy
BBV Blood Borne Virus
DAA Direct Acting Antiviral
GBM Gay and Bisexual Men
GSN Geosocial Networking
GP General Practitioner
HBV Hepatitis B
HCV Hepatitis C
HIV Human Immunodeficiency Virus
IDU Injecting Drug Use
MSM Men who have Sex with Men
NSP Needle and Syringe Program
PrEP Pre-Exposure Prophylaxis
PWID People Who Inject Drugs
PLWH People Living With HIV/AIDS
STI Sexually Transmitted Infection