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.

Surgeon Who Was Denied Disability Insurance for Taking PrEP Tells His Story

Earlier this year, urology resident Dr. Philip Cheng appeared on the front page of the New York Times. Here was the headline: He Took a Drug to Prevent AIDS. Then He Couldn’t Get Disability Insurance.

The piece understandably drew widespread attention, with sharp disapproval of the denial from ID specialists and public health officials. We couldn’t understand why someone adopting the recommended strategy for HIV prevention was being penalized.

In this Open Forum Infectious Diseases podcast, he tells us some more about himself and the events surrounding his decision.

Barriers to HIV testing for people born in Southeast Asia & sub-Saharan Africa

Curtin University,  2017

Over the past decade Australia has seen an increase in HIV notifications among people born in sub-Saharan Africa (SSA) and South East Asia (SEA).

People born in these regions have the highest rates of HIV diagnosis by region of birth and are overrepresented in late or advanced presentations of HIV infection.

Previous research indicates that migrants from SSA and SEA attend health services in Australia regularly, but only 50% have ever tested for HIV.

This report provides a brief overview of the preliminary results from the Barriers to HIV
testing project – a qualitative research project using focus groups and in-depth interviews to explore the barriers and enablers to HIV testing among priority communities born in SSA and SEA, to better understand the factors influencing late
diagnosis.

Recognise and Respond to Disclosures of Rape and Sexual Assault -1 Day Training

Women’s and Children’s Health Network, June 2018

This training is designed for workers in all areas of human services and health
care. The focus will be on providing knowledge, skills and attributes necessary to
provide appropriate trauma informed response to adults who have been raped
or sexually assaulted.

This involves an understanding of the context in which rape and sexual assault occurs; the ability to assess client needs and match them to services available; and supporting the rights of clients through the implementation of practices which promote client self-determination.

Prerequisites:  None
When: 9:30am – 4:30pm TUESDAY 4th SEPTEMBER, 2018
Where: Yarrow Place, Level 2, 55 King William Road, North Adelaide
Cost: $150.00 + GST per day (WCHN Staff discount $50 + GST per day). Invoice will be sent to the person responsible for the payment

Morning tea and lunch provided

RSVP: Please email marianne.law@sa.gov.au to register. Seating is strictly limited.

Parking: Yarrow Place has no on-site parking available, there is parking at the Women’s & Children’s Hospital or Wilson’s car park on Kermode Street otherwise there is 2 hour street parking around the North Adelaide area.

This training is presented by Yarrow Place staff

Download flyer: 18.9.4 R R YP Training 4th Sept