HIV diagnoses in migrant populations in Australia: a changing epidemiology

PLoS ONE ,14(2): e0212268. https://doi.org/10.1371/journal.pone.0212268

Abstract

Introduction

We conducted a detailed analysis of trends in new HIV diagnoses in Australia by country of birth, to understand any changes in epidemiology, relationship to migration patterns and implications for public health programs.

Methods

Poisson regression analyses were performed, comparing the age-standardised HIV diagnosis rates per 100,000 estimated resident population between 2006–2010 and 2011–2015 by region of birth, with stratification by exposure (male-to-male sex, heterosexual sex–males and females). Correlation between the number of permanent and long-term arrivals was also explored using linear regression models.

Results

Between 2006 and 2015, there were 6,741 new HIV diagnoses attributed to male-to-male sex and 2,093 attributed to heterosexual sex, with the proportion of diagnoses attributed to male-to-male sex who were Australian-born decreasing from 72.5% to 66.5%. Compared with 2006–2010, the average annual HIV diagnosis rate per 100,000 in 2011–15 attributed to male-to-male sex was significantly higher in men born in South-East Asia (summary rate ratio (SRR) = 1.37, p = 0.001), North-East Asia (SRR = 2.18, p<0.001) and the Americas (SRR = 1.37, p = 0.025), but significantly lower as a result of heterosexual sex in men born in South-East Asia (SRR = 0.49, p = 0.002), Southern and Central Asia (SRR = 0.50, p = 0.014) and Sub-Saharan Africa (SRR = 0.39, p<0.001) and women born in South-East Asia (SRR = 0.61, p = 0.002) and Sub-Saharan Africa (SRR = 0.61, p<0.001). Positive associations were observed between the number of permanent and long-term arrivals and HIV diagnoses particularly in relation to diagnoses associated with male-to-male sex in men from North Africa and the Middle East, North Asia, Southern and Central Asia and the Americas.

Conclusion

The epidemiology of HIV in Australia is changing, with an increase in HIV diagnosis rates attributed to male-to-male sex amongst men born in Asia and the Americas. Tailored strategies must be developed to increase access to, and uptake of, prevention, testing and treatment in this group.

 

New sexual health videos for international students

WA Department of Health, 2018

The WA Department of Health has launched its 2018 “Be Safe. Stay Well” sexual health campaign for international students. The four short videos, available on the Healthy WA website were developed in consultation with international students and aim to give students from across the world a good understanding of sexual health topics and the health care system in WA.

Video – Health service costs

Read the video transcript – Health service costs

Video – Discussing sexually transmitted infections

Read the video transcript – Discussing sexually transmitted infections

Video – Sex and the law

Read the video transcript – Sex and the law

Video – Importance of safe sex

Read the video transcript – Importance of safe sex

Sex education gap haunts Australia’s international students

SBS News, March 2nd, 2018

High numbers of international students with unwanted pregnancies is prompting questions about whether more could be done to better prepare those with little sexual health knowledge for life in Australia.

Marie Stopes Australia, a national provider of sexual and reproductive health services, estimated 4000 international students seek abortions across the country each year.

 

Temporary migration and family violence: an analysis of victimisation, support and vulnerability

Monash University / InTouch Multicultural Centre Against Family Violence, 2017

Family violence does not discriminate. However, it is known that for various subsets of the population, both the experience of family violence and the support and response options do vary, in some cases significantly. The Victorian Royal Commission into Family Violence (VRCFV) acknowledged the importance of recognising these points of differentiation among key groups.

This report presents the results of the first comprehensive study of a subset of the immigrant and refugee community: temporary migrants. This group is comprised of those who are in Australia on temporary visas, which include partner-related visas, as well as working, student, visitor and other temporary visas.

Temporary migration status matters in the context of family violence because, in addition to the acknowledged levers of financial, emotional, technological, physical and sexual abuse that occur across situations of family violence, uncertainty of migration status creates additional leverage for violence and control.

This report draws on detailed cases of 300 women who sought the support service of InTouch Multicultural Centre Against Family Violence over 2015–16. The findings lay the ground for a range of potential interventions and improved responses for this group of women, on the basis of significant data that details the specific impact of migration status on the experience of family violence and access to support.

In summary, this report urges recognition of the following:

  • Temporary migration status impacts women regardless of whether or not they are eligible to apply for the family violence provision
  • On the one hand, migration status is prioritised over and above the experience of family violence. The response and support made available is dependent on migration status first and foremost, rather than risk and need in relation to experiencing family violence. This is most evident in relation to the limits on access to financial and housing support for women with temporary migration status.
  • On the other, migration status is often not factored into assessment of risk. The failure to recognise, understand and assess risk pertaining to migration status results in limited recognition of violence, abuse and coercion in all their forms, and their impact.
  • As a nation we are only just coming to grips with the complexity of family violence, the interventions required to better understand and manage risk, what is required to prevent family violence and what we need to do to ensure a comprehensive, impactful and efficient response. It is critical that we respond to family violence first and foremost, in its various manifestations across Australia, and that we recognise and support all victims equally, regardless of migration status or any other point of difference.

Access full report (PDF): Temporary Migration and Family Violence: An analysis of victimisation, vulnerability and support