How pregnancy can be made more difficult by maternity care’s notions of ‘normal’

The Conversation, October 8, 2019 10.04pm AEDT

Maternity records in the UK have spaces only for the expectant mother and the baby’s father. This inflexibility can cause difficulties for the pregnant person, their partner, and their unborn baby if they do not fit into these boxes.

Over the last decade there has been a significant increase in the number of people conceiving outside of the traditional model of a heterosexual couple, so this affects an increasing number of parents.

Research shows that problems occur when heteronormativity – the perception that heterosexuality is the normal, default, or preferred sexual orientation – is communicated either overtly or subtly in the way healthcare staff treat patients, the way leaflets are worded, or the assumptions made in the way administration systems are designed.

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.

 

Report: 6th National Survey of Australian Secondary Students and Sexual Health

Australian Research Centre in Sex, Health and Society (ARCSHS), 2019

The Secondary Students and Adolescent Sexual Health survey is a national study exploring the sexual health and well-being of Australian adolescents. The anonymous survey asks questions about knowledge, behaviour and educational experiences related to sexual health and well-being.

The Commonwealth Department of Health funded study has been conducted approximately every 5 years since 1992. This is the 6th time the survey has been conducted in Australia. Results play a vital role in safeguarding the nation’s health by informing the national strategies to prevent HIV, sexually transmissible infections and blood-borne viruses as well as providing valuable information to improve service provision and education across multiple sectors.

A community perspective: On Human Papillomavirus (HPV)-related cancer among women and, trans and gender diverse people

Positive Life NSW & Femfatales, April 2019

Authors: Liz Sutherland, Lance Feeney, Katya Samodurov

Human papillomavirus (HPV) is a common virus which can be passed through skin to skin contact during sexual activity. Evidence to date shows that women living with HIV are 3 to 6 times more likely to develop cervical cancer than the general female population. They are also at greater risk of developing anal, vaginal, oropharyngeal and vulvar cancers.

There are other groups who may have a higher but preventable risk because they are often left out of the conversation about HPV and related cancers. Trans men are less likely to be up-todate with Pap tests to screen for cervical cancer. Furthermore, several studies have highlighted that trans and gender diverse people, and lesbian and bisexual cis-gendered women are often disregarded as not being at risk.

Positive Life and Femfatales developed a cross-sectional study to:

• Assess awareness and knowledge of HPV infection and risk for 4 HPV-related cancers (cervical, vaginal, vulvar, and anal) among women and, trans and gender diverse people in Australia;

• Assess the knowledge gaps to inform the development and implementation of population-specific educational resources to increase community and healthcare professional awareness of HPV and related cancers;

• Assist with the prevention of morbidity and mortality by increasing screening, early detection and treatment of HPV-related cancers, and;

• Assess rates of HPV vaccination in women and, trans and gender diverse people

KEY FINDINGS:

1. The results from this survey highlighted a lack of awareness of risk, prevention,
symptoms, and early detection of HPV-related vaginal, vulvar, and anal cancers.

2. Approximately 28% of HIV-positive respondents were unaware that a vaccination
against HPV exists and 71% of HIV-positive respondents had not been vaccinated
against HPV.

3. Over half (60%) of HIV-positive respondents believe their risk of anal cancer was either‘about the same’, ‘lower’, or ‘much lower’ than the general female population’s risk.

4. While all HIV-positive respondents had screened for cervical cancer at some point in
their lives, 91.7% had never had an anal examination for anal cancer.

5. Among HIV-positive and HIV-negative but immunocompromised respondents who had undergone staging or treatment for either cervical, vaginal, or vulvar cancer, none had ever screened for anal cancer.

6. Of the HIV-positive respondents who do not receive screening reminder notifications, none were aware of the new 3 yearly National Cervical Screening Guidelines and changes.

7. Qualitative responses indicated that respondents generally preferred having clinician-initiated conversations with female doctors or nurses who were non-judgemental, non-dismissive, clear, and made them feel comfortable.

8. In an open-ended short-answer question, more than 25% of qualitative respondents felt that more awareness and normalising talking about HPV in the public realm would help increase their chance of detecting HPV-related cancer early.

Secondary students’ sexual health survey results

La Trobe University, 11th June 2019

The sixth National Survey of Australian Secondary Students and Sexual Health, conducted in 2018 and released today, found 47 per cent of Year 10-12 students taking the survey had engaged in sexual intercourse.  Of sexually active respondents, 76 per cent had sex at home; 65 per cent with a boyfriend or girlfriend; 62 percent often or always used a condom; and 86 per cent with somebody about the same age.

Lead researcher at La Trobe University’s Australian Research Centre in Sex, Health and Society Dr Christopher Fisher said the survey asked 6327 Year 10-12 students in Government, Catholic and Independent schools from each state and territory, about their sexual behaviour and knowledge of sexually transmitted infections.

“Overall, young Australians have good knowledge of sexual health, are behaving responsibly and are actively seeking out trusted, reliable sources of information,” Dr Fisher said.

Factors associated with testing for HIV in people aged ≥50 years

BMC Public Health 2018 18:1204

https://doi.org/10.1186/s12889-018-6118-x

Published: 26 October 2018

Factors associated with testing for HIV in people aged ≥50 years: a qualitative study

Abstract

Background

Despite a decline in the number of new HIV infections in the UK overall, the number and proportion of new HIV diagnoses in people aged ≥50 years continues to increase. People aged ≥50 years are disproportionately affected by late diagnosis, which is associated with poorer health outcomes, increased treatment complexity and increased healthcare costs. Late HIV diagnosis also has significant public health implications in terms of onward HIV transmission. It is not fully understood what factors affect the decision of an older person to test for HIV. The aim of this study was to identify factors associated with testing for HIV in people aged ≥50 years who tested late for HIV.

Methods

We interviewed 20 people aged ≥50 years diagnosed late with HIV to identify factors associated with HIV testing. Interviews were audio recorded, transcribed verbatim and thematically analysed.

Results

Seven themes associated with HIV testing in people aged ≥50 years were identified: experience of early HIV/AIDS campaigns, HIV knowledge, presence of symptoms and symptom attribution, risk and risk perception, generational approaches to health and sexual health, stigma, and type of testing and testing venue.

Conclusion

Some factors associated with testing identified in this study were unique to older individuals. People aged ≥50 years often do not perceive themselves to be at risk of HIV. Further, stigma and a lack of knowledge of how to access HIV testing suggest a need for health promotion and suggest current sexual health services may need to adapt to better meet their needs.