The Aboriginal Gender Study

Aboriginal Health Council of South Australia, 2019

Partnering with the University of Adelaide and the South Australian Health and Medical Research Institute, the Aboriginal Gender Study aimed to explore, from a strengths-based perspective, the diversity of contemporary perspectives of gender, gender roles and gender equity in South Australian Aboriginal communities.

The project addressed three overall questions comprising:

1. What is the current evidence about gender roles and gender equity in the Australian
literature and Australian policy documents regarding Aboriginal and Torres Strait
Islander people?

2. What is the current understanding of gender roles and relationships in Aboriginal and Torres Strait Islander communities?

3. What might gender equity/fairness look like for Aboriginal and Torres Strait Islander young people, adults, families and communities?

For findings and recommendations, please see report:

 

A systematic review of Indigenous narratives of culturally safe healthcare communication

The power of talk and power in talk: a systematic review of Indigenous narratives of culturally safe healthcare communication

Australian Journal of Primary Health
doi: 10.1071/PY17082
Volume: 24 Issue: 2

Abstract

The study aimed to explore Indigenous narrative accounts of healthcare access within qualitative research papers, to better understand Indigenous views on culturally safe healthcare and health communication represented in that literature.
A systematic literature review of peer-reviewed academic qualitative studies identified 65 papers containing Indigenous respondents’ views on accessing healthcare.
Analysis included all Indigenous voice (primary quotations) and author findings describing healthcare access across these studies.
Healthcare communication, or ‘talk’, emerged as a key theme. Indigenous clients valued talk within healthcare interactions; it was essential to their experience of care, having the power to foster relationships of trust, strengthen engagement and produce positive outcomes.
By mediating the power differentials between health professionals and Indigenous clients, talk could either reinforce powerlessness, through judgmental down-talk, medical jargon or withholding of talk, or empower patients with good talk, delivered on the client’s level.
Good talk is a critical ingredient to improving Indigenous accessibility and engagement with healthcare services, having the ability to minimise the power differentials between Indigenous clients and the healthcare system.

Study suggests drug criminalization undermining global HIV/AIDS efforts

Medical News Today, May 2017

The criminalization of drugs is a leading factor in the world’s HIV epidemic and a potential barrier to eradicating HIV/AIDS, say researchers who’ve undertaken a sweeping review of research on laws and policies prohibiting drug use. Assistant professor Kora DeBeck of SFU’s School of Public Policy, who is a research scientist with the BC Centre for Excellence in HIV/AIDS, is co-lead of the study, published in The Lancet.

 

The quality and effectiveness of interventions that target multiple risk factors among young people

Australian and New Zealand Journal of Public Health, 2016, doi:10.1111/1753-6405.12573

Abstract

Objective: To identify evaluations of interventions that target multiple risk factors in high-risk young people, describe their characteristics, critique their methodological quality and summarise their effectiveness.

Methods: A search of the literature published between 2009 and 2014 identified 13 evaluations of interventions that targeted multiple risk factors, compared to 95 evaluations that targeted single risk factors. The methodological adequacy of the 13 evaluation studies was analysed using the Quality Assessment Tool for Quantitative Studies and information regarding characteristics and intervention effectiveness was extracted and summarised.

Results: There were very few outcome evaluation studies of interventions that targeted multiple risk factors, relative to single risk factors, among high-risk young people. Of the identified studies, half were methodologically weak. Interventions delivered in community settings targeted a greater number of risk factors, while those delivered in a school or health setting reported a higher proportion of statistically significant outcomes. No economic analyses were conducted.

Conclusions and Implications for Public Health: More methodologically rigorous evaluations of interventions targeting multiple risk factors among high-risk young people are required, especially for those delivered in community settings. Four key areas for improvement are: i) more precisely defining the risk factors experienced by high-risk young people; ii) achieving greater consistency across interventions; iii) standardising outcome measures; and iv) conducting economic analyses.

Full text (open access) here 

Impact of Opioid Substitution Therapy on Antiretroviral Therapy Outcomes

Clin Infect Dis. 2016 Jun 25. pii: ciw416. [Epub ahead of print]

Impact of Opioid Substitution Therapy on Antiretroviral Therapy Outcomes: A Systematic Review and Meta-Analysis

BACKGROUND:

Human immunodeficiency virus (HIV)-infected people who inject drugs (PWID) frequently encounter barriers accessing and remaining on antiretroviral therapy (ART). Some studies have suggested that opioid substitution therapy (OST) could facilitate PWID’s engagement with HIV services. We conducted a systematic review and meta-analysis to evaluate the impact of concurrent OST use on ART-related outcomes among HIV-infected PWID.

METHODS:

We searched Medline, PsycInfo, Embase, Global Health, Cochrane, Web of Science, and Social Policy and Practice databases for studies between 1996 to November 2014 documenting the impact of OST, compared to no OST, on ART outcomes. Outcomes considered were coverage and recruitment onto ART, adherence, viral suppression, attrition from ART, and mortality. Meta-analyses were conducted using random-effects modeling, and heterogeneity assessed using Cochran Q test and I2 statistic.

RESULTS:

We identified 4685 articles, and 32 studies conducted in North America, Europe, Indonesia, and China were included. OST was associated with a 69% increase in recruitment onto ART (hazard ratio [HR], 1.69; 95% confidence interval [CI], 1.32-2.15), a 54% increase in ART coverage (odds ratio [OR], 1.54; 95% CI, 1.17-2.03), a 2-fold increase in adherence (OR, 2.14; 95% CI, 1.41-3.26), and a 23% decrease in the odds of attrition (OR, 0.77; 95% CI, .63-.95). OST was associated with a 45% increase in odds of viral suppression (OR, 1.45; 95% CI, 1.21-1.73), but there was limited evidence from 6 studies for OST decreasing mortality for PWID on ART (HR, 0.91; 95% CI, .65-1.25).

CONCLUSIONS:

These findings support the use of OST, and its integration with HIV services, to improve the HIV treatment and care continuum among HIV-infected PWID.

Access full text (free access) here

Evidence Lacking on Pelvic Exams in Asymptomatic Women

American Academy of Family Physicians, July 06, 2016 03:30 pm

In 2010, physicians performed more than 60 million pelvic examinations in the United States. And although this is a common element of physical exams, it remains unclear whether performing screening pelvic examinations in asymptomatic women significantly affects disease morbidity or mortality.

On June 28, the U.S. Preventive Services Task Force (USPSTF) tackled this issue by posting a draft recommendation statement and draft evidence review on screening asymptomatic, nonpregnant adult women for gynecologic conditions using pelvic examination.

Read more here