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.

Australian Burden of Disease Study: Illicit Drug Use, Intimate Partner Violence, Unsafe Sex

 Australian Institute of Health and Welfare, Last updated: 

Burden of disease is a measure of the years of healthy life lost from living with, or dying from disease and injury. A portion of this burden is preventable, being due to modifiable risk factors. This report provides information on the deaths and burden of disease due to risk factors included in the Australian Burden of Disease Study 2015. 

New analyses of the key drivers of change over time in the burden of disease due to selected risk factors have recently been added to these data visualisations (August 2020).

The following excerpts may be of interest:

Or you can see all the data here

 

 

Clinical Characteristics and Results of Semen Tests Among Men With Coronavirus Disease

Li D, Jin M, Bao P, Zhao W, Zhang S. Clinical Characteristics and Results of Semen Tests Among Men With Coronavirus Disease 2019. JAMA Network Open. 2020;3(5):e208292. doi:10.1001/jamanetworkopen.2020.8292

Research Letter

Infectious Diseases

May 7, 2020

Discussion

In this cohort study, we found that SARS-CoV-2 can be present in the semen of patients with COVID-19, and SARS-CoV-2 may still be detected in the semen of recovering patients. Owing to the imperfect blood-testes/deferens/epididymis barriers, SARS-CoV-2 might be seeded to the male reproductive tract, especially in the presence of systemic local inflammation. Even if the virus cannot replicate in the male reproductive system, it may persist, possibly resulting from the privileged immunity of testes. So far, researchers have found 27 viruses associated with viremia in human semen. But the presence of viruses in semen may be more common than currently understood, and traditional non–sexually transmitted viruses should not be assumed to be totally absent in genital secretions.5,6 Studies on viral detection and semen persistence are beneficial to clinical practice and public health, especially concerning viruses that could cause high mortality or morbidity, such as SARS-CoV-2.

This study is limited by the small sample size and the short subsequent follow-up. Therefore, further studies are required with respect to the detailed information about virus shedding, survival time, and concentration in semen.

If it could be proved that SARS-CoV-2 can be transmitted sexually in future studies, sexual transmission might be a critical part of the prevention of transmission, especially considering the fact that SARS-CoV-2 was detected in the semen of recovering patients.

Multiple factors explain why middle-aged heterosexuals with new sexual partners don’t use condoms

nam/aidsmap

New strategies and approaches are needed to address the sexual health needs of middle-aged heterosexuals starting new relationships, research published in Sexually Transmitted Infections suggests.

The UK study involved men and women aged between 40 and 59 years with, or considering, new sexual partners after the break-up of a long-term relationship. In-depth interviews showed that beliefs about sexual risk were frequently based on past rather than current circumstances and that individuals often felt that existing sexual health services were geared towards the needs of younger people.

“I’m never having sex with anybody ever again”: what helps PLHIV get over these feelings

nam/aidsmap, 27 January 2020

For people living with HIV, sexual adjustment after diagnosis is affected by fears of transmitting the virus and of possible rejection by sexual partners, new qualitative research shows. Healthy sexual adjustment over time is facilitated by partner acceptance; peer, community and professional support; and up-to-date knowledge of HIV transmission, including U=U.

Barriers to healthy sexual adjustment include the persistence of undue fears of transmission and rejection long after diagnosis, which may result in avoiding sex or pairing it with drugs and alcohol. Based on these findings, Dr Ben Huntingdon and colleagues at the University of Sydney propose a new model of sexual adjustment to HIV, published in the BMC Infectious Diseases journal.

Thirty participants (19 male, 11 female) out of 45 PLWH who agreed to be contacted completed the interview and questionnaire as part of the study.

Let’s Celebrate Safer Sex this National Condom Day (SHINE SA Media Release)

SHINE SA, 11 February 2020

Forget Valentine’s Day, there’s a new romantic day occupying February 14: National Condom Day! With only 36% of young South Australians always using a condom during casual sex, it’s no surprise that STI rates are on the rise. Like an elusive Valentine’s partner, many STIs are hidden. Around 70% of people with chlamydia have no symptoms, going unnoticed while being transmitted to others.

So what could be more romantic than preventing the unintended consequences of unprotected sex? Show some romance by taking advantage of how easy it is to get your hands on a condom. Condoms are widely available, don’t require a prescription and can even be found for free at SHINE SA clinics. SHINE SA encourages all young people to take steps to engage in safer sex. This means always having a condom handy, making time for that discussion with your partner/s, ensuring you have informed and enthusiastic consent and getting regular sexual health checks either through a GP or at a SHINE SA clinic.

Natasha Miliotis SHINE SA’s Chief Executive said:

“National Condom Day is a great reminder to take control of our own sexual health. Through the use of condoms and regular testing, STIs are preventable.”

For more information on the sexual health of young people in South Australia see: www.sahmri.org/aboriginal-health-equity-theme/news-270/

Want to learn more about safer sex? To mark National Condom Day SHINE SA have released the Safer Sex – Use a Condom campaign. The campaign highlights the importance of condoms and the concepts of safety, pleasure and respect for a safer sex life. View the campaign here: www.shinesa.org.au/safersex

For further information and media enquiries see media release for contacts: