80% of new HIV cases transmitted by undiagnosed or untreated people

Healio, March 18, 2019

In 2016, more than 80% of new HIV infections in the United States were transmitted by individuals who either did not know they were infected with HIV or had been diagnosed but were not receiving care, according to data released on the first day of the National HIV Prevention Conference in Atlanta.

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.

Cultural and linguistic diversity of people living with chronic hepatitis B

Cultural and linguistic diversity of people living with chronic hepatitis B in 2011–2016: changing migration, shifting epidemiology
Aust NZ J Public Health. 2018; 42:441-3; doi: 10.1111/1753-6405.12826
Abstract
Objective: To estimate the cultural and linguistic diversity in Australians currently living with chronic hepatitis B (CHB), the majority of whom were born overseas, and to identify trends in this diversity over time.
Methods: Estimates were generated by combining Australian census country of birth
information with seroprevalence data generated from antenatal serology linked with
surveillance notifications. The number of people living with CHB was assessed according to country of birth using the 2011 and 2016 censuses.
Results: The total number of Australian residents living with CHB increased by 20% between 2011 and 2016, substantially outpacing population growth. The most common country of birth continued to be China, with the number of Chinese-born Australians living with CHB increasing by 60% in the 5-year period. Decreased numbers were observed for people born in European countries.
Conclusions: The epidemiology of chronic hepatitis B in Australia has shifted over time due to changing migration patterns, with increases in many countries in the Asia-Pacific, African and Middle Eastern regions. 
Implications for public health: Interventions to improve the health of people living with CHB are imperative, and these up-to-date estimates identify priority groups and communities, which are constantly changing.

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.

 

New report about Aboriginal and Torres Strait Islander women’s experience of violence

Australian Bureau of Statistics, 19 February 2019

The extent of family and domestic violence experienced by Aboriginal and Torres Strait Islander women has been revealed in a new Australian Bureau of Statistics (ABS) report using previously unpublished data from the 2014-15 National Aboriginal and Torres Strait Islander Social Survey. 

ABS Director of the Centre of Excellence for Aboriginal and Torres Strait Islander Statistics, Debbie Goodwin said “Of those women who had experienced violence, more than two-thirds (72 per cent) identified an intimate partner or family member as a perpetrator in their most recent experience. This was twice the rate reported by Aboriginal and Torres Strait Islander men (35 per cent).