Aboriginal and Torres Strait Islander health survey shows mixed outcomes

Australian Bureau of Statistics, 11/12/2019

A new report shows mixed health outcomes for Aboriginal and Torres Strait Islander people with a reduction in smoking and improvements in how people feel about their health, but an increased proportion of people with chronic conditions causing significant health problems.

The 2018-19 National Aboriginal and Torres Strait Islander Health Survey released today by the Australian Bureau of Statistics (ABS) examines long-term health conditions, risk factors, and social and emotional well-being indicators. The survey included Aboriginal and Torres Strait Islander people from all states and territories and included people in both non-remote and remote areas.

Contents include:

Smoking and HIV: what are the risks and what harm reduction strategies do we have at our disposal?

AIDS Res Ther. 2018 Dec 12;15(1):26. doi: 10.1186/s12981-018-0213-z.

Abstract

The World Health Organization estimates that smoking poses one of the greatest global health risks in the general population. Rates of current smoking among people living with HIV (PLHIV) are 2-3 times that of the general population, which contributes to the higher incidence of non-AIDS-related morbidity and mortality in PLHIV.

Given the benefit of smoking cessation, strategies to assist individuals who smoke to quit should be a primary focus in modern HIV care.

Tobacco harm reduction focuses on reducing health risk without necessarily requiring abstinence. However, there remains uncertainty about the safety, policy and familiarity of specific approaches, particularly the use of vaporised nicotine products. Evidence suggests that vaporised nicotine products may help smokers stop smoking and are not associated with any serious side-effects. However, there is the need for further safety and efficacy data surrounding interventions to assist quitting in the general population, as well as in PLHIV specifically.

In addition, official support for vaping as a harm reduction strategy varies by jurisdiction and this determines whether medical practitioners can prescribe vaporised products and whether patients can access vaporised nicotine products. When caring for PLHIV who smoke, healthcare workers should follow general guidelines to assist with smoking cessation.

These include: asking the patient about their smoking status; assessing the patient’s readiness to quit and their nicotine dependence; advising the patient to stop smoking; assisting the patient in their attempt to stop smoking through referral, counselling, pharmacotherapy, self-help resources and/or health education; and arranging follow-up with the patient to evaluate their progress.

Media release from SHINE SA: Teen Pregnancy

SHINE SA, Issued: 25 May 2018

Following the release of the Australian Institute of Health and Wellbeing’s Report, that includes the latest figures on teen birth-rates, SHINE SA believes that a decrease in the teen birth-rate as indicated in the report, is a positive outcome from the study.

“A decrease may reflect better sexual health information for young people including education in schools, and better access to sexual health services”, said Dr Amy Moten, Coordinator, Medical Education at SHINE SA.

“Increased access to Long Acting reversible Contraception for young people, as promoted by Family Planning Alliance Australia, is also a significant factor in reducing teen pregnancy rates”, Dr Moten said.

Low socio-economic status can be a marker of poor health outcomes overall. This increases with remoteness from metropolitan areas and Indigenous status. This has been shown in previous studies and also is supported by national data regarding cervical screening that shows that low socio-economic and Indigenous status reduces the rate of screening compared to people from a higher socioeconomic areas.

Social determinants of health are linked to social and economic factors that influence health. Young people from a lower socioeconomic area are likely to have poorer health literacy, lower levels of education and poorer access to health services including contraception. These have all been shown to be linked to an increased birth rate over all ages. Barriers to access health and contraceptive services such as cost and availability of these services increase with distance from metropolitan areas.

“Generally, teen mums often face increased stigma about being a parent and should be supported in their decision to continue parenting”, Dr Moten said.

“At SHINE SA, we provide pregnancy testing, counselling and advice. When a young person is pregnant they can discuss their options and be referred to appropriate services. For a young person continuing to parent we would refer them to the Metropolitan Youth Health Service for example, which has a Young Parenting program”, Dr Moten said.

SHINE SA believes that young mums should be supported to continue their education as completing secondary school after pregnancy has been shown to improve long term outcomes in both mother and child.

Dr Amy Moten, Coordinator Medical Education, SHINE SA
Issued: 25 May 2018

 

Poorer outcomes for babies born to teen mums – often linked to low socioeconomic status

Australian Institute of Health and Welfare,  02 May 2018

Babies of teenage mothers often experience poorer health outcomes than babies born to women just a few years older, according to the Australian Institute of Health and Welfare’s (AIHW) first report on this subject.

The report, Teenage mothers in Australia 2015, shows that about 8,200 teenage mothers gave birth to 8,300 babies (3% of all babies) in 2015, down from 11,800 teenage mothers giving birth a decade earlier. Almost three-quarters of teenage mothers were aged 18 or 19.

One in 4 (24%) of all teenage mothers were Aboriginal and/or Torres Strait Islander. Indigenous teenage mothers had higher levels of antenatal risk factors and poorer baby outcomes than non-Indigenous teenage mothers in terms of pre-term birth
and low birthweight.

 

Smoking causes one in five cancers in people with HIV in North America

aidsmap/nam, 22 January 2018

A fifth of all cancers in people receiving HIV care in North America between 2000 and 2015 was due to smoking, according to US research published this month in advance online by the journal AIDS.

“In the United States, the prevalence of smoking among HIV-infected people is substantially higher than in the general population, and most HIV-infected individuals either currently smoke or have previously smoked,” comment the authors. “Our findings indicated that a substantial fraction of cancer diagnoses among HIV-infected individuals potentially would not have occurred if they had never smoked.”

Thanks to improvements in HIV treatment and care, most people with HIV now have a normal or near-normal life expectancy. As these people age, non-AIDS-related cancers are an important cause of death.

Smoking Highly Dangerous for HIV-Positive Patients

Specialty Pharmacy Times,  Tuesday, October 17, 2017

Patients with HIV who smoke may have an increased risk of lung cancer mortality compared with the risk of dying from HIV, according to a new study published by JAMA Internal Medicine. 

These findings suggest that healthcare providers should strongly advocate for smoking cessation and cancer screening for patients with HIV.

The abstract concludes with: Those PLWH who adhere to ART but smoke are substantially more likely to die from lung cancer than from AIDS-related causes.