It’s time to lift the restrictions on medical abortion in Australia – Professor Caroline de Costa

The Conversation, April 1, 2019 6.13am AEDT

Over the past thirteen years, many Australian women have used the drug mifepristone (RU486) to bring about a medical abortion.

Rather than undergoing a surgical abortion in a clinic or hospital operating theatre, a medical abortion is induced by taking drugs prescribed by a doctor.

But while mifepristone has been available in Australia since 2006, only some women, in some parts of the country, are able to access it. Professor Caroline de Costa argues in the Medical Journal of Australia that this needs to change.

Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER)

Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study

The Lancet, Published Online May 2, 2019

Background

The level of evidence for HIV transmission risk through condomless sex in serodifferent gay couples with the HIV-positive partner taking virally suppressive antiretroviral therapy (ART) is limited compared with the evidence available for transmission risk in heterosexual couples. The aim of the second phase of the PARTNER study (PARTNER2) was to provide precise estimates of transmission risk in gay serodifferent partnerships.
Findings
Between Sept 15, 2010, and July 31, 2017, 972 gay couples were enrolled, of which 782 provided 1593 eligible couple-years of follow-up with a median follow-up of 2·0 years (IQR 1·1–3·5). At baseline, median age for HIV-positive partners was 40 years (IQR 33–46) and couples reported condomless sex for a median of 1·0 years (IQR 0·4–2·9). During eligible couple-years of follow-up, couples reported condomless anal sex a total of 76 088 times. 288 (37%) of 777 HIV-negative men reported condomless sex with other partners. 15 new HIV infections occurred during eligible couple-years of follow-up, but none were phylogenetically linked within-couple transmissions, resulting in an HIV transmission rate of zero (upper 95% CI 0·23 per 100 couple-years of follow-up).

Interpretation

Our results provide a similar level of evidence on viral suppression and HIV transmission risk for gay men to that previously generated for heterosexual couples and suggest that the risk of HIV transmission in gay couples through condomless sex when HIV viral load is suppressed is effectively zero. Our findings support the message of the U=U (undetectable equals untransmittable) campaign, and the benefits of early testing and treatment for HIV.

 

Actions to support Lesbian, Gay, Bisexual, Trans and Gender Diverse, and Intersex elders

Australian Department of Health, February 2019

We know that LGBTI older people and elders are likely to have experienced violence, stigma and discrimination throughout their lives. As a result, they may be reluctant to disclose their identities or histories to aged care services and therefore remain isolated or invisible within both the aged care sector and the broader community. Combined with general stigmatisation and invisibility of LGBTI needs at large, this results in a lack of awareness of the unique needs of LGBTI elders and older people, including a lack of targeted services to support them. In addition, the fear of mistreatment or rejection from aged care providers can lead to LGBTI elders and older people delaying seeking care until their health deteriorates or a crisis occurs.

Many LGBTI elders and older people have lived through a time where identities were pathologised or criminalised, aversion therapies were encouraged, and non-consensual surgeries were routinely performed. As a result, many LGBTI older people have learned to conceal their sexual orientation, gender identity or intersex status in order to be safe, particularly when interacting with the health or social services sector. The fear and mistrust of these services in the past have led LGBTI elders and older people to be reluctant to utilise mainstream services, including aged care. Reliving past discrimination when encountering new forms of discrimination in the aged care
environment can lead to feelings of anxiety and/or depression.

The Action Plan is a resource that will assist aged care service providers to better understand how they can advocate for and support LGBTI elders and older people. By providing culturally safe and inclusive services, providers will build confidence amongst LGBTI elders and older people and their carers, families of choice (who may or may not include biological family) and allies that aged care services are available for them and they will be given the support and care they need as they age.

The Consumer Guide captures the voice of LGBTI peoples expressed through those consultations. It is intended both to help LGBTI peoples express their needs when speaking with aged care providers and as a resource to support people working in aged care to understand the perspectives of LGBTI peoples.

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.

 

Understanding U=U for women living with HIV

ICASO, September 2018

Since its announcement, Undetectable equals Untransmittable (U=U) has
become a call to action to assert that when someone living with HIV has an
undetectable viral load they cannot transmit HIV. Additionally, the U=U message
is evolving to challenge notions of HIV infectivity, vulnerability and stigma.

The science behind the U=U message provides the evidence that we can reduce the anxiety related to the sexual transmission of the HIV virus with confidence.

To contribute to getting this message out, ICASO produced a Community Brief on U=U. This community brief explains why it is so important to understand what ‘U=U’ means for women. The brief documents the experiences and needs of individual women living with HIV from all over the world. Important questions still remain that need to be answered to make the U=U message relevant, understandable and more meaningful to women in their diversity.

  • Download the community brief in English here

S.A. sex workers more confident for law reform second time round

InDaily, Wednesday May 30, 2018

The Sex Industry Network will rally outside parliament on Friday for International Sex Workers Day after Greens MLC Tammy Franks earlier this month introduced new legislation to legalise sex work in state.

The Legislative Council passed a similar bill in July last year however it failed to pass the lower house before the March election.