Cervical cancer self-tests helping to break down barriers and increase screening rates

ABC Health & Wellbeing, Posted Friday 8th March 2019 at 14:54

In Australia, 80 per cent of cervical cancers are found in women who are overdue for screening or have never been screened.

“We know there’s an equity issue in our cervical screening program,” said Dr Saville, executive director of the VCS Foundation, a cervical screening not-for-profit.

“Women from lower socio-economic settings, Aboriginal and Torres Strait Islander women, and women from culturally and linguistically diverse backgrounds do not screen as often … and are more likely to get cancer.”

In a bid to overcome these barriers, a self-testing process was introduced to Australia’s National Cervical Screening Program in 2017.

Australia will never be HIV-free if access to prevention requires a medicare card

The Conversation, January 23, 2019 12.21pm AEDT

by Nicholas Medland, Sexual health physician and senior researcher, UNSW

Australia aims to “virtually eliminate” HIV transmission by 2022, according to the health minister’s new national HIV strategy. This ambitious goal has been made possible by biomedical HIV prevention, a new and highly effective way of preventing HIV using medications.

But new inequalities are emerging between those who can and can’t access these medications because of their Medicare eligibility. These inequalities may undermine the success of HIV elimination in Australia and threaten Australia’s international reputation as a safe place to study, work and live.

Read more of Australia will never be HIV-free if access to prevention requires a medicare card

 

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.

HIV diagnoses hit seven year low: Australia’s annual HIV figures released

Kirby Institute, UNSW, Monday, 24 September 2018

Australia has recorded its lowest level of HIV diagnoses in seven years, according to a new report from the Kirby Institute at UNSW Sydney.

The report, released at the Australasian HIV&AIDS Conference in Sydney, found that there were 963 new HIV diagnoses in 2017, the lowest number since 2010.

Researchers are attributing the promising results to more people getting tested for HIV, more people living with HIV starting treatment which reduces the risk of HIV transmission to effectively zero, and an increased use of pre-exposure prophylaxis (or PrEP, an HIV prevention pill).

However, it is not all good news. According to the report, a quarter of new HIV diagnoses in 2017 were among heterosexuals, with a 10% increase in diagnoses over the past five years.

Among Aboriginal and Torres Strait Islander populations, HIV diagnoses have been increasing over the past five years, with rates almost two times higher than the Australian-born non-Indigenous population in 2017.

HIV incidence in Indigenous and non-Indigenous populations in Australia

The Lancet HIV: August 07, 2018

DOI: https://doi.org/10.1016/S2352-3018(18)30135-8

Ward, J ;McManus, H; McGregor, S;  et al.

Methods

Using the National HIV Registry at The Kirby Institute at UNSW, Sydney, NSW, Australia, we collated and analysed annual HIV notification data for 1996–2015. Patients who were not born in Australia were excluded. We calculated the rates of HIV diagnoses with annual trends in notification rates for Indigenous versus non-Indigenous Australians by demographic characteristics, exposure categories, and stage of HIV at diagnosis. For missing data, assumptions were made and verified through sensitivity analyses. Annual rate ratio (RR) and 4 year summary rate ratio (SRR) trends were calculated to determine patterns of HIV diagnosis in the two populations.

Findings

Between Jan 1, 1996, and Dec 31, 2015, 11 492 people born in Australia were reported with a diagnosis of HIV, of whom 461 (4%) were recorded as Indigenous Australians and we classified the remaining 11 031 (96%) as non-Indigenous Australians. For exposure to HIV, among Indigenous Australians a higher proportion of diagnoses occurred among women, and through injecting drug use and heterosexual sex than among non-Indigenous Australians (p<0·0001). Among Indigenous Australians, we found a significantly higher SRR of HIV diagnoses among men in the period 2012–15 than in previous periods (SRR 1·53, 95% CI 1·28–1·83; p<0·0001), and significantly higher diagnosis among Indigenous women (4·92, 4·02–6·02; p<0·0001) for the entire study period than among non-Indigenous women. Concurrently, a decrease in HIV diagnoses of 1% per annum (RR 0·99, 95% CI 0·98–0·99; p<0·0001) across the study period was seen among non-Indigenous people. Indigenous Australians were more likely to be diagnosed at an advanced stage of HIV infection than non-Indigenous Australians (20·8% vs 15·1%; p=0·0088).

Interpretation

Greater efforts should be made to include Indigenous people in prevention strategies, particularly newer biomedical interventions, such as scale up of pre-exposure prophylaxis and treatment as prevention initiatives in Australia. More involvement of Indigenous Australians in these approaches is also required to prevent widening of the gap in HIV diagnosis rates between non-Indigenous and Indigenous Australians.

 

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.