Could It Be HIV? Video for GPs

Thorne Harbour Health, November 2017

‘Could it be HIV?’ features of the story of Abby Landy, whose story is all-too-common for the many individuals who are given a late HIV diagnosis.

Produced with the support of ViiV healthcare, this video encourages clinicians and doctors to ‘consider HIV’. This clip also features Professor Jenny Hoy from Alfred Health.

“This video is vital. We shouldn’t be missing opportunities to diagnose HIV. With a late diagnoses, there is already substantial damage to the immune system. Diagnosing HIV in a timely manner is paramount — for the benefit of the individual as well as the benefit of the broader community’s health and wellbeing.” – Jenny Hoy

  •  Watch embedded video below:

Prostitution and sex work: nature and prevalence in England and Wales (report)

University of Bristol, commissioned by the Home Office and the Office of the South Wales Police and Crime Commissioner, October 2019

The University of Bristol was commissioned by the Home Office and the Office of the South Wales Police and Crime Commissioner to look in to the current ‘nature’ and ‘prevalence’ of prostitution in England and Wales, involving adults aged 18 or over. The research was carried out between May 2018 and June 2019.  We were not asked to report on policy or law.  Drawing on the literature and initial findings, we used the following definition:

Prostitution and/or sex work constitutes the provision of sexual or erotic acts or sexual intimacy in exchange for payment or other benefit or need.

Following a systematic search of the existing national and international evidence base, including a review of previous prevalence studies, we sought views, data and personal experiences through a 6-month public online survey, yielding almost 1200 often detailed responses with over 500 from those currently or formerly involved in selling sexual services.  We also worked through NGOs and support services to identify individuals unlikely to respond to online surveys. We completed follow up in-depth email interviews with 42 individuals.  We invited 155 organisations, collectives and individuals to consult on our draft finding at four regional meetings in early 2019.

Given methodological and ethical constraints, we recognise two groups whose voices are under-represented or absent within this report: (1) Migrant sex workers; (2) British and non-British individuals who are/were forcibly coerced, who are/were trafficked, who are/were sexually exploited and/or who are traumatised in relation to their experience.

In terms of ‘prevalence’, currently in England and Wales there is no source of data which allows for the production of representative population estimates for this group.  Stigma, the private and hidden nature of the sex industry, complex engagement patterns and definitions of activities mean that estimating prevalence is challenging.  Producing an accurate estimate would require studies to follow the guidance and recommendations on data collection jointly produced by the UNAIDS and World Health Organisation (WHO) (2010) and/or to use statistically representative samples.  Focused and small-scale prevalence studies are also more likely to be accurate.  The report provides guidance on such work.

In terms of ‘nature’, overall, we found that the way that sex is sold in England and Wales today is both complex and diverse.  It is common for individuals to move between settings and services, for safety or to maintain income, and to engage full-time, part-time (sometimes alongside other paid work or study), intermittently or casually.  Looking across our data, we identified and structured our commentary around the following:

Cross-cutting themes

Identifying sex work, identifying as a sex worker

·         Social identities, inequalities and routes in

·         Patterns of engagement and moving between settings/services

·         Advertising, payment and third parties

·         Risk, harm and managing safety

·         Buyers and buying

 Settings and services

·         Bar-based sex work and hostess bars

·         BDSM, kink and fetish

·         Brothels, parlours, saunas

·         Erotic and exotic dance

·         Erotic massage

·         Escort: independent

·         Escort: agency

·         Pornography, glamour, erotica

·         Sex parties

·         Street and outdoor sex work

·         Sugar arrangements

·         Telephone, text-based, TV-based, live voyeurism

·         Therapeutic services

·         Webcamming

Individuals selling sex in England and Wales today are varied in terms of demographics and motivation. At the same time, there are recurrent patterns of experience or identity that mark some individuals’ entry into the sex industry and/or the type of setting, service or the conditions in which they work.

We found that a substantial proportion of individuals (mainly women and trans women) are selling sex to get by financially, given different constraints in their lives around caring responsibilities, physical and mental health, lack of access to social security benefits and support services, workplace discrimination, or other reasons.  Their situation is compounded by stigma and managing safety, and many find that the longer they sell sex, the harder it can be to leave completely.  This moves beyond individual ‘choosing or ‘not choosing’ and recognises the structural economic and social context in which choices are narrowed: or in the case of those coerced in to selling sex, choices removed.

Domestic & Family Violence: Strangulation Awareness Training

Women’s Safety Services SA, October 2019

Domestic and Family Violence: Strangulation Awareness is a specialised course in understanding and responding to this key high risk factor. The latest research will be presented as well as a practice framework for responding to disclosures.

  • Tuesday 31st October 2019
  • 1:00 pm – 4:00 pm
  • Location advised on registration (Mile End area)
  • Cost: $90**

**limited half price tickets available for full time students – contact kellyb@womenssafetyservices.com.au for details of how to access these tickets

LEARNING OUTCOMES:

  • Understand the signs and symptoms of strangulation
  • Understand the physiological consequences of strangulation
  • Identify factors that indicate risk of serious harm or death in D&FV
  • Respond to disclosures of strangulation from risk and safety response model

For further information about this course, please contact the Learning and Education Coordinator: kellyb@womenssafetyservices.com.au

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.

 

Trans health and the risks of inappropriate curiosity

BMJ, September 9, 2019

Care providers need to be aware of the damage of inappropriate curiosity when working with people who are transgender, say Adam Shepherd, Benjamin Hanckel, and Andy Guise.

Encountering inappropriate curiosity is a common experience among people who identify as LGBT. This kind of behaviour shouldn’t happen in a healthcare facility, yet recent reports from Stonewall and the government’s Equalities Office confirm that this is a problem in healthcare and that it particularly affects people who are transgender.

What do we mean when we say that a healthcare provider is showing “inappropriate curiosity?” Researchers provided insight into what this is in a study where they describe trans participants being asked intrusive questions about their personal lives and being subjected to invasive physical examinations. Participants felt that these were irrelevant to why they had sought out medical care, and that their only purpose was to satisfy the personal interest of the healthcare practitioner. Imagine, for example, going to your GP for a chronic cough and being asked what genitals you have, or going for a foot X-ray and the radiographer making comments about your breasts.

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.