Intersex people and COVID-19

Intersex Human Rights Australia, 12 April 2020

COVID-19 can infect any individual, irrespective of age or health but its impact exacerbates existing inequalities. All populations that suffer health inequalities are disproportionately affected, and people with intersex variations are no exception.

Current health is determined to some extent by biological factors.

Position Statement on LARC access during the COVID-19 pandemic

SHINE SA, April 7, 2020

SHINE SA, along with Family Planning VictoriaFamily Planning NTFamily Planning TasmaniaSexual Health and Family Planning ACTSexual Health Quarters, and True Relationships & Reproductive Health have co-signed a Position Statement on LARC access during the COVID-19 pandemic.

Extended use of and ongoing access to LARCs during the COVID-19 pandemic

Provision of contraception is essential during the COVID-19 pandemic to prevent unintended pregnancies. This is particularly important for individuals most at risk, including young people due to their high levels of fertility, people with serious health conditions, and for those who are post-abortion. Long Acting Reversible Contraceptive methods (LARCs) are more effective than shorter acting methods and increased community access and uptake is associated with lower abortion rates.

Ongoing access to LARC insertion is essential during the pandemic

Contraception is essential health care and all efforts should be made to continue the insertion of LARCs during the pandemic. To reduce the risk of infection with COVID-19, this may require different approaches to insertion such as a wearing mask during insertion of contraceptive implant or using an inserter-only approach for IUD insertion (with an assistant outside the room for emergencies).

Summary of recommendations during the pandemic

  • All efforts should be made to continue access to insertion of LARCs during the pandemic, particularly for younger people, people with serious health conditions, and post-abortion
  • The etonogestrel implant (Implanon NXT) can be extended off-label for use up to 4 years
  • The 52mg LNG IUD (Mirena) can be extended off-label for use up to 6 years
  • The 19.5mg LNG IUD (Kyleena) cannot be extended beyond 5 years
  • Standard sized T shaped banded copper IUDs can be extended off-label for use up to 12 years
  • 5-year copper IUDs (Load 375 and Copper T short) can be extended off-label for use up to 6 years
  • Additional use of condoms and/or a contraceptive pill should be discussed with users for whom the risk of an unintended pregnancy is unacceptable during extended use.

 

Disability Support Toolkit for frontline workers – violence and abuse

1800RESPECT, March 2020

The Disability Support Toolkit has resources for front line workers supporting people with disability who have been impacted by violence and abuse.

People with disability are 1.8 times more likely to experience violence and abuse, including more varied forms of abuse. (Source: AIHW Report 2019.) They are also less likely, and take longer to reach out for support.

This Toolkit includes:

  • Research paper on best practice to implement the disability toolkit
  • Videos to share with clients on how to contact the 1800RESPECT service and how the service works
  • Easy English booklets that can be downloaded or ordered free from 1800RESPECT.

This Toolkit can be used in conjunction with information provided on our website on Inclusive Practice: Supporting people with disability.

‘Putting it into practice’ Guidelines

The ‘Putting it into Practice’ guidelines are a resource to support access and inclusion. The guidelines provide information on:

  • General principles
  • Engaging women with disabilities, including language
  • Using specialist resources

 

  • Download the guidelines in Word or PDF.

Scope Videos

This set of 3 videos were co-developed by Scope and 1800RESPECT. They are designed to be viewed by people with disability, and include information on how to contact 1800RESPECT, and how the service works.

  • Watch the videos here

Easy English booklets

The Easy English booklets have been developed as part of the Disability Pathways Project and with Women with Disabilities Australia. They are evidence based, user group tested and easy to use.

Sunny app

Sunny is 1800RESPECT’s app for women with disability who have experienced violence and abuse. Sunny has been co-designed with women with disability to make sure it provides the very best support for the people who use it. Learn more about Sunny. Sunny is free to download and is free to use on your phone.

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High-risk behaviors and their association with awareness of HIV status among participants of a prevention intervention

High-risk behaviors and their association with awareness of HIV status among participants of a large-scale prevention intervention in Athens, Greece.

Pavlopoulou, I.D., Dikalioti, S.K., Gountas, I. et al.

BMC Public Health 20, 105 (2020). https://doi.org/10.1186/s12889-020-8178-y

Abstract

Background

Aristotle was a seek-test-treat intervention during an outbreak of human immunodeficiency virus (HIV) infection among people who inject drugs (PWID) in Athens, Greece that started in 2011. The aims of this analysis were: (1) to study changes of drug injection-related and sexual behaviors over the course of Aristotle; and (2) to compare the likelihood of risky behaviors among PWID who were aware and unaware of their HIV status.

Methods

Aristotle (2012–2013) involved five successive respondent-driven sampling rounds of approximately 1400 PWID each; eligible PWID could participate in multiple rounds. Participants were interviewed using a questionnaire, were tested for HIV, and were classified as HIV-positive aware of their status (AHS), HIV-positive unaware of their status (UHS), and HIV-negative. Piecewise linear generalized estimating equation models were used to regress repeatedly measured binary outcomes (high-risk behaviors) against covariates.

Results

Aristotle recruited 3320 PWID (84.5% males, median age 34.2 years). Overall, 7110 interviews and blood samples were collected. The proportion of HIV-positive first-time participants who were aware of their HIV infection increased from 21.8% in round A to 36.4% in the last round. The odds of dividing drugs at least half of the time in the past 12 months with a syringe someone else had already used fell from round A to B by 90% [Odds Ratio (OR) (95% Confidence Interval-CI): 0.10 (0.04, 0.23)] among AHS and by 63% among UHS [OR (95% CI): 0.37 (0.19, 0.72)]. This drop was significantly larger (p = 0.02) among AHS. There were also decreases in frequency of injection and in receptive syringe sharing in the past 12 months but they were not significantly different between AHS (66 and 47%, respectively) and UHS (63 and 33%, respectively). Condom use increased only among male AHS from round B to the last round [OR (95% CI): 1.24 (1.01, 1.52)].

Conclusions

The prevalence of risky behaviors related to drug injection decreased in the context of Aristotle. Knowledge of HIV infection was associated with safer drug injection-related behaviors among PWID. This highlights the need for comprehensive interventions that scale-up HIV testing and help PWID become aware of their HIV status.

Striving towards the elimination of HCV infection among PWID

International Journal of Drug Policy, Volume 72,Pages 1-198 (October 2019)

Nearly 200 pages of open access articles from projects and research around the world.

While this special issue highlights some successful efforts towards HCV elimination among people who inject drugs, it also highlights the relative lack of attention to settings in which resources enabling elimination are scarce, and where elimination hopes and potentials are less clear, such as in many low and middle income countries. Strengthening capacity in areas of the world where resources are more limited will be a critical step towards ensuring equity for all so that global HCV elimination among PWID can be achieved.

  • Browse articles here
  • You can also download the full issue as PDF by creating an account and signing in at the above link

Emergency contraception awareness in an at‐risk population

Hope, D. L., Hattingh, L. and King, M. A. (2019) J Pharm Pract Res. doi:10.1002/jppr.1554

Background

Consumer awareness of emergency contraception is generally poor. School leavers (schoolies) engage in risky behaviours, including casual sex and alcohol and drug consumption.

Aim

The aim of this study was to explore the awareness of an at‐risk population of schoolies regarding the use and availability of emergency contraception.

Methods

An electronic survey was self‐administered by participants using Wi‐Fi‐connected iPads at the Schoolies Wristband Distribution Centre, Surfers Paradise, on the first day of Queensland Schoolies Week, November 2017. Outcomes measured were awareness of the availability of emergency contraception from a pharmacy, maximum time for effective use following unprotected intercourse and whether emergency contraception is harmful to the health of the user.

Results

Schoolies completed 498 valid surveys. Most (83.5%) were aged 17 years and 50.8% were aware that emergency contraception is available from community pharmacies with prescription and 36.7% were aware that it is available without prescription; 18.5% were aware of the 72‐ or 120‐h effectiveness window and 38.0% agreed that it is not harmful. All questions were associated with considerable uncertainty. Females were 1.8‐ to 3.2‐fold more likely than males to provide an appropriate response to any emergency contraception statement.

Conclusion

Schoolies’ awareness of emergency contraception availability, effectiveness window and safety was low. At‐risk schoolies may not access emergency contraception when indicated due to fear of harm, uncertainty about its effectiveness window or a lack of knowledge about timely non‐prescription access from community pharmacies. Targeted education may improve current knowledge gaps. The misnomer ‘morning‐after pill’ should be abandoned for the clinically appropriate term ‘emergency contraception.