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.

 

Advertising (in)equality: the impacts of sexist advertising on women’s health and wellbeing

Women’s Health Victoria, Issues Paper No. 14, December 2018

 

The aim of this issues paper is to provide an overview of significant literature

currently published on the nature of gender portrayals in advertising, and the

impacts of these representations on women’s health and wellbeing, gender

inequality and attitudes and behaviours that support violence against women.

 

This issues paper found that the continued use of gender stereotypes

and increasing reliance on images that sexualise and objectify women in

advertisements undermines efforts to promote gender equality in Australia.

Gender-stereotyped portrayals limit the aspirations, expectations, interests and

participation of women and men in our society. These portrayals are associated

with a range of negative health and wellbeing outcomes and are highly

problematic for the prevention of family violence and other forms of violence

against women.

 

The studies cited in this paper demonstrate that there is a clear business

case for change. Brands, businesses and creative agencies can benefit from

portraying both women and men proportionately, respectfully and realistically.

 

It’s hard to think about, but frail older women in nursing homes get sexually abused too

The Conversation, November 22, 2018 6.02am AEDT

We don’t often think of older women being victims of sexual assault, but such assaults occur in many settings and circumstances, including in nursing homes. Our research, published this week in the journal Legal Medicine, analysed 28 forensic medical examinations of female nursing home residents who had allegedly been victims of sexual assault in Victoria over a 15-year period.

The majority of the alleged victims had some form of cognitive or physical impairment. All 14 perpetrators who were reported were male, half of whom were staff and half other residents.

 

 

Exploring psychosocial predictors of STI testing in University students

BMC Public Health, 2018 18:664, Published: 29 May 2018

https://doi.org/10.1186/s12889-018-5587-2

Abstract:

Background

To explore university students’ Sexually Transmitted Infection (STI) testing knowledge, psychosocial and demographic predictors of past STI testing behaviour, intentions to have an STI test, and high risk sexual behaviour, to inform interventions promoting STI testing in this population.

Methods

A cross-sectional, quantitative online survey was conducted in March 2016, recruiting university students from North East Scotland via an all-student email. The anonymous questionnaire assessed student demographics (e.g. sex, ethnicity, age), STI testing behaviours, sexual risk behaviours, knowledge and five psychological constructs thought to be predictive of STI testing from theory and past research: attitudes, perceived susceptibility to STIs, social norms, social fear and self-efficacy.

Results

The sample contained 1294 sexually active students (response rate 10%) aged 18–63, mean age = 23.61 (SD 6.39), 888 (69%) were female. Amongst participants, knowledge of STIs and testing was relatively high, and students held generally favourable attitudes. 52% reported ever having an STI test, 13% intended to have one in the next month; 16% reported unprotected sex with more than one ‘casual’ partner in the last six months. Being female, older, a postgraduate, longer UK residence, STI knowledge, perceived susceptibility, subjective norms, attitudes and self-efficacy all positively predicted past STI testing behaviour (p < 0.01). Perceived susceptibility to STIs and social norms positively predicted intentions to have an STI test in the next month (p  < 0.05); perceived susceptibility also predicted past high-risk sexual behaviour (p < 0.01).

Conclusions

Several psychosocial predictors of past STI testing, of high-risk sexual behaviour and future STI intentions were identified. Health promotion STI testing interventions could focus on male students and target knowledge, attitude change, and increasing perceived susceptibility to STIs, social norms and self-efficacy towards STI-testing.

Sexual & Reproductive Health Resource Kit for Aboriginal young people

Aboriginal Health & Medical Research Council of New South Wales, 2018

The AH&MRC has developed a new vibrant Sexual and Reproductive Health Resource Kit for workers to use with Aboriginal young people named “DOIN ‘IT’ RIGHT!”.

DOIN IT RIGHT! provides workers who work with young Aboriginal people (including non-sexual health and non-Aboriginal workers) with step by step instructions on delivering sexual and reproductive health activities appropriately.

Although the statistics are sobering, ongoing education and health promotion will assist young Aboriginal people to make informed choices about their sexual and reproductive health. Given the decreasing age of first sexual experience, high rates of STIs and teen pregnancy, it is important that age and culturally appropriate information and education is provided to young people from an early age.

Contents:

Introduction
Introduction to Sexual and Reproductive Health ……………………………….. 6
Sexual and Reproductive Health in an Aboriginal Context …………………. 7
Aboriginal Cultural Considerations and the Worker’s Role in Sexual
and Reproductive Health Education …………………………………………………. 9
Working with Aboriginal Young People …………………………………………….. 11
Disclosure ……………………………………………………………………………………….. 13
Organisational Philosophy, Policies and Procedures ………………………… 14
How to Generate Conversations ……………………………………………………….. 15
How to use this Kit …………………………………………………………………………… 19
Welcome to Country and Acknowledgment of Country………………………. 21
Group Agreement …………………………………………………………………………….. 23
Opportunity for Anonymous Questions to be Asked Safely………………… 24

1 Looking After Me
Section Introduction ………………………………………………………………………… 27
Changes When Growing Up
Changing Bodies …………………………………………………………………….. 28
Knowing Your Reproductive System and How It All Works ………. 33

2 My Sexuality and How I Feel About Myself

Section Introduction………………………………………………………………………….. 47
Sexuality and me
Sexuality and Sexual Diversity. Step Forward, Step Back ………….. 48
Myths and Stereotypes about Sexuality ……………………………………. 63
Sexuality and Popular Culture ………………………………………………….. 67
Self Esteem
Self Esteem. I Like Me! …………………………………………………………….. 69

3 Sex, Pregnancy and Keeping Safe
Section Introduction …………………………………………………………………………. 76
Sexual Health – What’s Safe and What’s Not
Healthy Vs Unhealthy ………………………………………………………………. 77
High Risk, Low Risk, No Risk …………………………………………………… 87
Sexually Transmissible Infection Information Sheets ………………… 97
Safer Sex STI & Pregnancy Prevention
Contraception and Safer Sex. Methods and Myths ……………………. 113
Using a Condom – DOIN ‘IT’ RIGHT! …………………………………………. 118
Contraception and Safer Sex Information Sheets ……………………… 125

4 Coming to a Decision
Section Introduction …………………………………………………………………………. 142
Sexual and Other Important Decisions
What’s Most Important …………………………………………………………….. 143
Values and Decisions ………………………………………………………………. 152
Decision Tree and Me ………………………………………………………………. 155
I Can Say No!……………………………………………………………………………. 159
What’s Drugs Got To Do With It?
Are You Thinking What I’m Thinking? ………………………………………. 168
Sex, Drugs and Your Choices ………………………………………………….. 175

5 Evaluation
Section Introduction …………………………………………………………………………. 180
What is evaluation …………………………………………………………………… 181
Types of program evaluation …………………………………………………… 182
Planning your evaluation …………………………………………………………. 183
Data collection methods ………………………………………………………….. 185
Documenting activities ……………………………………………………………. 189
Participant feedback ………………………………………………………………… 191
Further evaluation resources …………………………………………………… 192

6 Additional Resources and Information Pages
Section Introduction ………………………………………………………………………… 194
Glossary of Terms ……………………………………………………………………………. 195
Resources and Organisation Contact Details ……………………………………. 202
Broad Sexual and Reproductive Health Information and
Resources……………………………………………………………………………….. 204
Information and Resources for Parents and Carers…………………… 208
Puberty Information and Resources …………………………………………. 209
Contraceptives Information and Resources ……………………………… 211
Pregnancy and Parenting Information and Resources……………….. 213
Sexually Transmissible Infections Information and Resources…… 215
Sexting Information and Resources…………………………………………… 219
Domestic Violence and Sexual Assault Information and
Resources……………………………………………………………………………….. 220
Alcohol and Other Drugs Information and Resources ……………….. 221
Lesbian, Gay, Bisexual, Transgender, Intersex, Queer (LGBTIQ)
and Same Sex Couples Information and Resources…………………… 224
Blood Borne Viruses: HIV and Hepatitis Information and
Resources……………………………………………………………………………….. 226
Social Emotional Wellbeing Health Information and Resources…. 229
Legal Information and Resources………………………………………………. 231
References ………………………………………………………………………………………. 233

 

Intercourse, age of initiation and contraception among adolescents in Ireland

BMC Public Health 2018 18:362 https://doi.org/10.1186/s12889-018-5217-z

Abstract

Background

The need to tackle sexual health problems and promote positive sexual health has been acknowledged in Irish health policy. Young people’s sexual behaviour however remains under-researched with limited national data available.

Methods

This study presents the first nationally representative and internationally comparable data on young people’s sexual health behaviours in Ireland. Self-complete questionnaire data were collected from 4494 schoolchildren aged 15–18 years as part of a broader examination of health behaviour and their context. The prevalence of sexual initiation, very early sexual initiation (< 14 years) and non-condom use at last intercourse are reported and used as outcomes in separate multilevel logistic regression models examining associations between sociodemographic characteristics, lifestyle characteristics and young people’s sexual behaviours.

Results

Overall, 25.7% of boys and 21.2% of girls were sexually initiated. Older age was consistently predictive of initiation for both boys and girls, as were alcohol, tobacco and cannabis involvement, living in poorer neighbourhoods and having good communication with friends. Involvement in music and drama was protective. Very early sexual initiation (< 14 years) was reported by 22.8% of sexually initiated boys and 13.4% of sexually initiated girls, and was consistently associated with rural living, cannabis involvement and bullying others for both. Boys’ very early initiation was predicted by alcohol involvement, receiving unhealthy food from parents and taking medication for psychological symptoms, whereas better communication with friends and more experience of negative health symptoms were protective. Girls’ very early initiation was predicted by being bullied and belonging to a non-Traveller community, whereas taking medication for physical symptoms and attending regular health checks was protective. Condom use was reported by 80% of sexually initiated students at last intercourse. Boys’ condom use was associated with older age, higher family affluence, bullying others, more frequent physical activity and health protective behaviours. For girls, condom use was predicted by belonging to a non-Traveller community, healthy food consumption, higher quality of life and being bullied, whereas taking medication for physical and psychological symptoms was associated with non-condom use.

Conclusions

These nationally representative research findings highlight the importance of focusing on young people as a distinct population subgroup with unique influences on their healthsexual health requiring targeted interventions and policy.