Women and Sexual and Reproductive Health Position Paper: Second Edition, 2019

Australian Women’s Health Network Inc., 2019

The Australian Women’s Health Network first published its Women and Sexual and Reproductive Health Position Paper in 2012. Since then significant work has been undertaken across Australia in this area and a number of its recommendations have been implemented. This has resulted in a robust on going public conversation and a greater understanding of women’s sexual and reproductive ill health, its impact, what drives it and how best to prevent it. These gains have only been possible through continuing evidence-informed advocacy, research and practice development.

In light of the new knowledge and experience available, and changes to the political, organisational and social landscape in 2019, the Australian Women’s Health Network has updated its Women and Sexual and Reproductive Health paper to produce
this Second Edition.

This paper advocates for a rights-based approach to ensuring all women can access comprehensive sexual and reproductive health care appropriate to their needs,
regardless of their location, age, sexuality, financial status and religious and cultural background. It explores seven key areas through which good sexual and reproductive
health for Australian women can be achieved.

These are:

1. promoting positive and respectful attitudes to sex and sexuality

2. developing women’s health literacy

3. increasing reproductive choice

4. facilitating women’s health throughout pregnancy and birth

5. expanding prevention and treatment of reproductive cancers and menstrual issues

6. improving prevention and treatment of sexually transmitted infections (STIs)

7. equipping the health workforce to better respond to women’s health needs.

STIs in remote Australia

ABC Health Report, Monday 18 March 2019 5:45 PM

Leading Aboriginal researcher Associate Professor James Ward* is calling for action in remote Australia to deal with a preventable epidemic of sexually transmissible infections — including syphilis — in a population that’s no more sexually active than non-Indigenous people of the same age.  

He joined Dr Norman Swan’s Health Report on ABC RN.

Later this month James will present to the National Rural Health Conference about addressing sexually transmitted infections in remote Australia.

*James Ward is Associate Professor, Flinders University; & Head of Infectious Diseases Research, Aboriginal Health, South Australian Health and Medical Research Institute. 

 

 

HIV and Trans Women: A Literature Review

Transgend Health. 2018; 3(1): 239–250

Abstract:

Trans women are a key, yet under-researched, population in the HIV epidemic. However, there remains a paucity of data on the health and wellbeing of trans women at risk of, or living with, HIV in the United Kingdom.

This article provides a narrative review of key empirical research into HIV among trans women. In an effort to explore individual and social factors in relation to HIV in this population, we outline key tenets of identity process theory from social psychology and the concept of structural violence from medical anthropology.

We focus on published studies around the following themes: (1) epidemiological data, (2) syndemic factors (3) barriers to social support, (4) HIV and gender transitioning, and (5) access to and engagement with health care.

We identify lacunae and thus call for United Kingdom-based research in the following areas: (1) the prevalence and incidence of HIV in trans women, (2) the impact of syndemic factors on HIV risk and acquisition in trans women, (3) the nature of social support for coping with syndemic factors, (4) the interface of gender transitioning and HIV, and (5) barriers to accessing HIV prevention and care services.

There is great scope (and urgency) for research into HIV among trans women, especially in the United Kingdom, to reduce incidence in this group, to enhance engagement in HIV care across the care continuum, and to improve the health and wellbeing of those living with HIV. A tentative model for HIV prevention and care is presented in this article.

National abortion data vital to safe, accessible services

MJA InSight+, Issue 10 / 18 March 2019

EXPERTS are in the dark about the extent to which abortion is contributing to Australia’s historically low teenage birth rate, prompting renewed calls for the collection of national abortion data.

In a Perspective published by the MJA, Professor Susan Sawyer, Chair of Adolescent Health at the University of Melbourne, and Dr Jennifer Marino, research fellow at the University of Melbourne, have called for the collection of abortion data in all states and territories, with national integration and analysis. They further called for publicly funded abortion clinics in all states and territories, with a feasible plan for access for people living in remote areas.

Drug and alcohol report uncovers burden in regional Australia

ABC Central West, 15/03/2019

A report from the Australian Institute of Health and Welfare (AIHW) has revealed alarming statistics about drug and alcohol use in regional Australia, and the difficulties faced by those seeking treatment.

The report found a 41 per cent increase in drug-induced deaths in regional and remote areas in the decade to 2017, compared to a 16 per cent spike in major cities.

Researchers said this could be attributed to opioid overdoses.

The report found there was a higher rate of people seeking drug and alcohol treatment in regional and remote communities in 2016–17, but they were likely to travel one hour or more to receive treatment.

It also said people in country areas were more likely to smoke, drink heavily, use drugs, and avoid exercise.

“No‐one’s driving this bus” – qualitative analysis of PrEP health promotion for Aboriginal gay and bisexual men

“No‐one’s driving this bus” – qualitative analysis of PrEP health promotion for Aboriginal and Torres Strait Islander gay and bisexual men

Aust NZ J Public Health,  2019; 43:18-23; doi: 10.1111/1753-6405.12852
Objective: HIV prevention tools such as pre‐exposure prophylaxis require equitable access and uptake to protect all at‐risk populations. This project assessed the perceived barriers to accessible HIV prevention for Aboriginal and Torres Strait Islander gay and bisexual men (GBM) and evaluated the presence of health promotion for pre‐exposure prophylaxis (PrEP) for this population from the perspective of service providers.

Methods: Eighteen semi‐structured interviews with healthcare providers, researchers and AIDS Council employees were qualitatively analysed for themes and concepts related to PrEP‐specific health promotion.

Results: Respondents noted AIDS Councils and affiliated sexual health clinics had been instrumental in promoting PrEP to at‐risk GBM. However, many Aboriginal gay and bisexual men who are not well connected with these communities and services may not have been exposed to this health promotion and therefore have not accessed PrEP effectively.

Conclusions: Aboriginal community and gay community controlled health organisations need to collaborate to ensure they deliver effective and tailored health promotion to Aboriginal communities.

Implications for public health: The rising HIV notification rates in Aboriginal Australians is an example of the health gap experienced by First Nation people. Effective HIV prevention is required to ensure this gap does not widen further, and that Australia meets its goal of preventing all new HIV infections. However, these efforts will be hampered by ineffective health promotion of HIV prevention tools, such as PrEP, for Aboriginal Australians.