HIV diagnoses in migrant populations in Australia: a changing epidemiology

PLoS ONE ,14(2): e0212268. https://doi.org/10.1371/journal.pone.0212268

Abstract

Introduction

We conducted a detailed analysis of trends in new HIV diagnoses in Australia by country of birth, to understand any changes in epidemiology, relationship to migration patterns and implications for public health programs.

Methods

Poisson regression analyses were performed, comparing the age-standardised HIV diagnosis rates per 100,000 estimated resident population between 2006–2010 and 2011–2015 by region of birth, with stratification by exposure (male-to-male sex, heterosexual sex–males and females). Correlation between the number of permanent and long-term arrivals was also explored using linear regression models.

Results

Between 2006 and 2015, there were 6,741 new HIV diagnoses attributed to male-to-male sex and 2,093 attributed to heterosexual sex, with the proportion of diagnoses attributed to male-to-male sex who were Australian-born decreasing from 72.5% to 66.5%. Compared with 2006–2010, the average annual HIV diagnosis rate per 100,000 in 2011–15 attributed to male-to-male sex was significantly higher in men born in South-East Asia (summary rate ratio (SRR) = 1.37, p = 0.001), North-East Asia (SRR = 2.18, p<0.001) and the Americas (SRR = 1.37, p = 0.025), but significantly lower as a result of heterosexual sex in men born in South-East Asia (SRR = 0.49, p = 0.002), Southern and Central Asia (SRR = 0.50, p = 0.014) and Sub-Saharan Africa (SRR = 0.39, p<0.001) and women born in South-East Asia (SRR = 0.61, p = 0.002) and Sub-Saharan Africa (SRR = 0.61, p<0.001). Positive associations were observed between the number of permanent and long-term arrivals and HIV diagnoses particularly in relation to diagnoses associated with male-to-male sex in men from North Africa and the Middle East, North Asia, Southern and Central Asia and the Americas.

Conclusion

The epidemiology of HIV in Australia is changing, with an increase in HIV diagnosis rates attributed to male-to-male sex amongst men born in Asia and the Americas. Tailored strategies must be developed to increase access to, and uptake of, prevention, testing and treatment in this group.

 

One in four people say those in same-sex relationships ‘should be charged as criminals’

The Guardian, 1st November 2017

More than one in four people across the world think people engaging in same-sex relationships should be charged as criminals, according to a new survey of 77 countries and territories.

However, there were major divisions in attitudes towards the criminalisation of those engaging in same-sex relationships when broken down across regions, the 2017 Ilga-Riwi global attitudes survey to sexual and gender minorities found.

Managing Chronic Hepatitis B – Advice for GPs (SHINE SA video)

SHINE SA, July 2017

Today, July 28th, is World Hepatitis Day.

There are no ‘healthy carriers’ of hepatitis B!

SA Health & SHINE SA are promoting a 6-minute video providing advice for general practitioners in diagnosing, managing and contact tracing patients with chronic hepatitis B (CHB), to assist in preventing serious liver disease.

It is now known that people who were previously considered to have ‘unresolved hepatitis B virus carrier state’ in fact have CHB. CHB requires lifelong recall and monitoring for disease progression, even when asymptomatic. It is estimated that South Australia has 14,400 people with CHB, 6,600 (46%) who are undiagnosed.  Current clinical guidelines recommend that patients with CHB should be monitored at least annually by their GP for disease progression and suitability for anti-viral treatment.

This video provides clinical advice from the Royal Adelaide Hospital, Viral Hepatitis Centre Co-Directors Dr Edmund Tse (Head of Hepatology) and Dr David Shaw (Head of Infectious Diseases), Margery Milner (Viral Hepatitis CPC) and Dr Sam Elliott, a GP and Hepatitis B s100 Community Prescriber.

NSW introduces Dried Blood Spot test for HIV

NSW Health, December 1, 2016

A new HIV testing service has launched in NSW, allowing people to mail off a sample of their blood and receive their results by phone, SMS or email. There’s no need to visit a doctor, clinic or pathology centre. 

DBS HIV testing is for people living in New South Wales, who are over 16 years old. The test is for gay and other men who have sex with men, people from Africa or Asia and people who have current or previous sexual partners from Africa or Asia.

For other groups of people, conventional laboratory HIV testing may be more suitable.

 

Contraceptive rates in poorest countries leap by 30 million users in four years

Guardian, Tuesday 1 November 2016

The number of women in the world’s poorest countries using modern forms of contraception has jumped by more than 30 million in the past four years, according to a report that found the most significant progress had been made in sub-Saharan Africa.

At the halfway point of the Family Planning 2020 (FP2020) initiative, launched in 2012, around 12 million more women and girls were using contraceptives in east, south and west Africa.

FGM: number of victims found to be 70 million higher than thought

The Guardian, 5 February 2015

The huge global scale of female genital mutilation has been revealed in disturbing new statistics, which show at least 200 million girls and women alive today have undergone ritual cutting, half of them living in just three countries.

Read more here