“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.

Special issue of Drugs and Alcohol Today: ChemSex – Apps, drugs and the right to pleasure

Emerald Publishing Limited, 2019

This special edition of Drugs and Alcohol Today, entitled “Chemsex – Apps, drugs and the right to pleasure”, acknowledges an aspect of drug taking that is often ignored in the discourse on the “scourge” of drug abuse – that drugs enhance pleasure.

Amidst the pleasure brought on by “chems”, there has been pain. Drug overdoses and deaths fuelled by a prohibition that supports an illicit market of unlabelled, often adulterated drugs and fear that calling an ambulance will implicate you in a crime

Chemsex is a unique phenomenon, requiring unique public health responses. The melding of smart phone apps, spatial data and real time “personal adverts requires a significant re-think and re-design when developing public health responses”.

This issue publishes work from experts that help gay communities to mobilise their own responses. It takes the onus off public health policy to respond, and respectfully recognises the agency and resilience within gay communities, to formulate culturally and contextually competent community responses to chemsex.

Free access to this special issue until March 31st

 

 

 

Update on multi-drug resistant shigella

SHINE SA, 7/3/2019

The shigella outbreak is continuing in South Australia. This is to advise clinicians to be on alert for a potential increase in shigella cases, and to highlight updated recommendations on treatment as released by the Communicable Disease Control Branch (CDCB).

The outbreak is predominantly in men who have sex with men (MSM) and there is a potential for further increase in numbers related to a larger outbreak in Victoria and NSW. We encourage you to be alert for clients who have recently traveled interstate.The CDCB is now recommending that patients with confirmed multi-drug resistant (MDR) shigella (or at risk of MDR shigella while awaiting sensitivities) be treated with five days of Ceftrixaone 1g IV, rather than 1 day (as recommended in the Public Health Alert issued in December 2018).

Landmark study to track gay and bisexual men’s attitudes on body image

ABC News Breakfast, 15/2/2019

Steroid use is on the rise as young men fuelled by social media lead a dangerous pursuit of muscle-bound perfection, researchers warn.  Now, for the first time, a global study run from Australia will look specifically at how gay and bisexual men are impacted and whether this could be leading to fatal outcomes.

Starting today, 3.5 million men on the Grindr app in Australia, Canada, the UK and the US will be invited to start the Gay Bodies Worldwide survey.

The Ban on ‘Amyl’

Australia’s Therapeutic Goods Administration (TGA) recently postponed its decision on whether or not to change the law around alkyl nitrites (the active ingredient in ‘amyl’ or ‘poppers’). Currently, the TGA is conducting public consultations into the proposed amendments that could see amyl recategorised as a ‘prohibited substance’.

The legal consequence of this decision could see amyl fall into the same category as prohibited drugs like heroin, methamphetamine and cocaine, with serious penalties for their possession, use or supply. This issue has raised concerns within our communities where amyl is used during sex.

Submissions to the TGA

The deadline for written submissions to the TGA closed on 15 January 2019; however, a number of organisations expressed their concerns including:

Earlier this month, the Nitrites Action Group (comprised of community health advocates, researchers, and clinicians) released guidelines around community submissions to the TGA.

 

HIV diagnoses hit seven year low: Australia’s annual HIV figures released

Kirby Institute, UNSW, Monday, 24 September 2018

Australia has recorded its lowest level of HIV diagnoses in seven years, according to a new report from the Kirby Institute at UNSW Sydney.

The report, released at the Australasian HIV&AIDS Conference in Sydney, found that there were 963 new HIV diagnoses in 2017, the lowest number since 2010.

Researchers are attributing the promising results to more people getting tested for HIV, more people living with HIV starting treatment which reduces the risk of HIV transmission to effectively zero, and an increased use of pre-exposure prophylaxis (or PrEP, an HIV prevention pill).

However, it is not all good news. According to the report, a quarter of new HIV diagnoses in 2017 were among heterosexuals, with a 10% increase in diagnoses over the past five years.

Among Aboriginal and Torres Strait Islander populations, HIV diagnoses have been increasing over the past five years, with rates almost two times higher than the Australian-born non-Indigenous population in 2017.