Disparities in characteristics in accessing public Australian sexual health services between Medicare‐eligible and Medicare‐ineligible MSM

Disparities in characteristics in accessing public Australian sexual health services between Medicare‐eligible and Medicare‐ineligible men who have sex with men

Australian and New Zealand Journal of Public Health

Anysha M. Walia, Christopher K. Fairley, Catriona S. Bradshaw, Marcus Y. Chen, Eric P.F. Chow

First published: 31 August 2020
https://doi.org/10.1111/1753-6405.13029
Abstract:

Objectives: Accessible health services are a key element of effective human immunodeficiency virus (HIV) and sexually transmitted infection (STI) control. This study aimed to examine whether there were any differences in accessing sexual health services between Medicare‐eligible and Medicare‐ineligible men who have sex with men (MSM) in Melbourne, Australia.

Methods: We conducted a retrospective, cross‐sectional study of MSM attending Melbourne Sexual Health Centre between 2016 and 2019. Demographic characteristics, sexual practices, HIV testing practices and STI diagnoses were compared between Medicare‐eligible and Medicare‐ineligible MSM.

Results: We included 5,085 Medicare‐eligible and 2,786 Medicare‐ineligible MSM. Condomless anal sex in the past 12 months was more common in Medicare‐eligible compared to Medicare‐ineligible MSM (74.4% vs. 64.9%; p<0.001) although the number of partners did not differ between groups. There was no difference in prior HIV testing practices between Medicare‐eligible and Medicare‐ineligible MSM (76.1% vs. 77.7%; p=0.122). Medicare‐ineligible MSM were more likely to have anorectal chlamydia compared to Medicare‐eligible MSM (10.6% vs. 8.5%; p=0.004).

Conclusions: Medicare‐ineligible MSM have less condomless sex but a higher rate of anorectal chlamydia, suggesting they might have limited access to STI testing or may be less willing to disclose high‐risk behaviour.

Implications for public health: Scaling up access to HIV and STI testings for Medicare‐ineligible MSM is essential.

Sexual and reproductive health a COVID-19 priority (Statement)

Burnet Institute, 28 May, 2020

Burnet Institute is a member of a consortium of Australian-based non-governmental organisations (NGOs) and academic institutes concerned about the detrimental effects of the COVID-19 pandemic on the sexual and reproductive health and rights of women and girls globally.

The International Sexual and Reproductive Health and Rights Consortium, which includes Save the Children, Family Planning NSW, CARE Australia, The Nossal Institute for Global Health, and Médecins Sans Frontières Australia, is calling on the Australian Government to prioritise the needs of women and girls in its response to COVID-19.

Collectively, the consortium works across 160 countries to champion universal access to sexual and reproductive health and rights.

It’s concerned that women and girls across the globe are struggling to access critical sexual and reproductive health care, citing evidence that COVID-19 lockdowns are likely to cause millions of unplanned pregnancies.

In the Pacific, travel to rural and remote areas have been curtailed, and physical distancing requirements have forced the cancellation of most group training on sexual and reproductive rights.

A recent UNFPA report determined that a six-month lockdown could mean 47 million women and girls globally cannot access contraception, and seven million will become pregnant.

The consortium has issued a joint statement setting out priorities to ensure Australia’s global response to COVID-19 meets the critical needs of all women and girls, including:

  • Recognise and respond to the gendered impacts of the pandemic, and the increased risk to women and girls from gender-based violence and other harmful practices
  • Improve the supply of contraceptives and menstrual health products which are being impacted by the strain and disruption on global supply chains
  • Increase flexibility in delivering sexual and reproductive health services during lockdown using innovative health delivery models such as task-sharing, tele-health and pharmacy distribution
  • Support sexual and reproductive health workers and clinics to continue delivering services sagely with access to personal protective equipment as well as training on how to refer, test or diagnose COVID-19.

 

HIV and viral hepatitis disclosure [in South Australia] – factsheet

SA Health, updated 2019

Deciding to disclose your HIV or viral hepatitis (hepatitis B or hepatitis C) status is a personal choice. There are few situations where you are legally required to disclose your HIV or viral hepatitis status, however, there may be times when it’s in your best interests to disclose your status even if you are not legally required to do so.

 

Update on multi-drug resistant shigella

SHINE SA, 7/3/2019

The shigella outbreak is continuing in South Australia. This is to advise clinicians to be on alert for a potential increase in shigella cases, and to highlight updated recommendations on treatment as released by the Communicable Disease Control Branch (CDCB).

The outbreak is predominantly in men who have sex with men (MSM) and there is a potential for further increase in numbers related to a larger outbreak in Victoria and NSW. We encourage you to be alert for clients who have recently traveled interstate.The CDCB is now recommending that patients with confirmed multi-drug resistant (MDR) shigella (or at risk of MDR shigella while awaiting sensitivities) be treated with five days of Ceftrixaone 1g IV, rather than 1 day (as recommended in the Public Health Alert issued in December 2018).

Gonorrhoea: Drug Resistance in Australia

Australian Federation of AIDS Organisations (AFAO), 26 June 2018

There has long been concern globally about the potential emergence of drug resistant STIs. In response, the World Health Organisation released new treatment guidelines for three common STIs – chlamydia, gonorrhoea and syphilis – in 2016.

At present, strains resistant to first line treatment of syphilis and chlamydia are not common and not a concern in Australia. There is, however, a growing level of concern about gonorrhoea. This paper therefore focuses on the likelihood and implications of the emergence of drug resistant cases of gonorrhoea in Australia. It also highlights treatment options in Australia and current and emerging strategies for preventing drug resistant gonorrhoea.

Download paper: AFAO Brief – Gonorrhoea – Drug Resistance in Australia – 26 June 2018

‘People are scared’: the fight against a deadly virus no one has heard of

Guardian Australia, Tue 24 Apr 2018 

An Aboriginal woman – we’ll call her B – is sitting in a dry creek bed outside her community and telling the world “this is a very bad disease. But we have to talk in a way not to shame people. Not telling them straight out. Telling them gently and quietly.”

B is talking about a sickness that has killed her family member and is a potential tragedy facing Aboriginal communities in central Australia, who have the world’s highest rates of a fatal, human immune virus for which there is no current cure, no treatment and no coordinated public health response.

Human T-lymphotropic virus type 1 (HTLV-1) is transmitted through sexual contact, blood transfusion and from mother to child by breastfeeding. It can cause a rapidly fatal form of leukaemia. Some people die within weeks of diagnosis. HTLV-1 also causes inflammation of the spinal cord leading to paralysis, severe lung disease known as bronchiectasis and other inflammatory disease.

In five communities around Alice Springs, more than 45% of adults tested have the virus, a rate thousands of times higher than for non-Indigenous Australians.