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.

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.

HIV & the Law: updated content from ASHM

Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, 2019

The NEW Guide to Australian HIV Laws and Policies for Healthcare Professionals includes two new sections on Mandatory Testing for HIV and My Health Record.

This resource aims to provide health care workers with information on legal and ethical responsibilities under various laws and regulations related to human immunodeficiency virus (HIV). It does not contain legal advice. Those seeking advice on individual cases should contact their health department, solicitor or their medical defence organisation as appropriate.

In the interests of brevity, laws have been summarised and re-written specifically as they relate to HIV. In many instances key legislation is more broadly targeted at a range of infectious diseases (with definitions varying by state).

All efforts have been made to ensure the content is current at time of publication.

No single ‘gay gene’, reveals the largest-ever study of the genetics of same-sex sexual behaviour

ABC news, 30/08/2019

Scientists have again debunked the idea of a single “gay gene”, in the largest study to date of the genetics of same-sex sexual behaviour.

Rather, their findings paint a diverse and complex picture of human sexuality, and the genetic factors that influence it.

Nearly half a million people took part in the study, mostly from the United Kingdom and the United States, which was published in the journal Science today.

Lastest Gay Community Periodic Survey for Adelaide released

Centre for Social Research in Health, UNSW, June 2019

Gay Community Periodic Survey: Adelaide 2018

Authors: Broady, T., Mao, L., Bavinton, B., Jeffries, D., Bartlett, S., Calabretto, H., Narciso, L., Prestage, G., & Holt.

The Adelaide Gay Community Periodic Survey is a cross-sectional survey of gay and homosexually active men recruited at a range of gay community sites in Adelaide, and online throughout South Australia. The major aim of the survey is to provide data on sexual, drug use, and testing practices related to the transmission of HIV and other sexually transmissible infections (STIs) among gay men. The most recent survey, the twelfth in South Australia, was conducted in November and December 2018 to coincide with the Adelaide Feast Festival.

Key points

– The proportion of men who reported ever having been tested for HIV increased from 83% in 2011 to 87% in 2018.

– The percentage of non-HIV-positive men who reported testing for HIV in the 12 months prior to the survey remained stable (and was reported by 71% in 2018), although the percentage reporting three or more HIV tests in the previous year increased (from 11% in 2014 to 22% in 2018).

– The use of HIV treatment by HIV-positive men has remained stable over time (and was reported by 93% of HIV-positive men in 2018). The percentage of men on antiretroviral treatment who reported an undetectable viral load also remained stable (reported by 94% in 2018).

Mobile phone apps remained the most common way that men met male sex partners, reported by 44% in 2018.

– The proportion of men with regular male partners reporting condomless anal intercourse with those partners (CAIR) increased from 55% in 2011 to 65% in 2018.

– The proportion of men with casual male partners reporting condomless anal intercourse with those partners (CAIC) increased from 38% in 2011 to 51% in 2018.

– Most of the recent increase in CAIC appears to be attributable to the growing proportion of HIV-negative men using pre-exposure prophylaxis (PrEP).

STI testing among HIV-negative men has remained stable over time, with 74% reporting any STI test in the year prior to the 2018 survey. The proportion of HIV-positive men reporting any STI test in the previous year decreased from 91% in 2011 to 72% in 2018.

Use of PrEP increased between 2014 and 2018 from 1% to 16% of non-HIV-positive men.