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.

Sex and gender: modifiers of health, disease, and medicine

The Lancet, Volume 396, Issue 10250, 22–28 August 2020, Pages 565-582
Mauvais-Jarvis, F., et al

Clinicians can encounter sex and gender disparities in diagnostic and therapeutic responses. These disparities are noted in epidemiology, pathophysiology, clinical manifestations, disease progression, and response to treatment. This Review discusses the fundamental influences of sex and gender as modifiers of the major causes of death and morbidity. We articulate how the genetic, epigenetic, and hormonal influences of biological sex influence physiology and disease, and how the social constructs of gender affect the behaviour of the community, clinicians, and patients in the health-care system and interact with pathobiology. We aim to guide clinicians and researchers to consider sex and gender in their approach to diagnosis, prevention, and treatment of diseases as a necessary and fundamental step towards precision medicine, which will benefit men’s and women’s health.

 

How sexual assault survivors can feel in control during cervical screenings

ABC Life By Kellie Scott / 12th August 2020
Kate* avoids cervical screenings.The 34-year-old from Sydney is a survivor of sexual assault and finds the physical examination re-traumatising.

Kate’s experience is not unique.

One in five Australian women has experienced sexual violence since the age of 15. And research shows those who have experienced sexual abuse, either as adults or children, are less likely to attend regular cervical screening.

Impact of COVID-19 on Migrant and Refugee Women and Children Experiencing DFV

Women’s Safety NSW, Published: July 31, 2020

Whilst research on the prevalence of violence against migrant and refugee women is limited, what is known is that cultural, language and systemic barriers serve to reduce access to safety and support for this group of women, and they are at higher risk of domestic homicide. (AIC 2020)

This also corresponds with lower rates of reporting amongst migrant and refugee women experiencing domestic and family violence, as distrust for authorities, limited knowledge of rights and services and concerns about both material and cultural ramifications can serve as insurmountable barriers to accessing the supports needed. (AIFS 2018)

What has not yet been investigated is the specific impact of COVID-19 on migrant and refugee women experiencing domestic and family violence. This report from Women’s Safety NSW offers the experiences and professional observations of multicultural domestic and family violence specialists supporting hundreds of these very women at this critical time. What they’ve reported is that migrant and refugee women who are experiencing domestic and family violence are at higher risk than they have ever been before and that urgent action is needed if we are going to save lives.

Accessing pharmacotherapy (opioid replacement therapy) during COVID-19

Alcohol and Drug Foundation (Australia), April 27th 2020

There are now new challenges for people who access opioid replacement therapy (ORT) due to the COVID-19 (coronavirus) pandemic. Many may be experiencing anxiety and fear due to COVID-19 and trying to reduce and mitigate these feelings is vital.

In most cases, people who are on ORT are required to visit their health clinic or pharmacy on a daily basis. This can be more difficult for people right now, due to restrictions on movement and the social distancing regulations imposed to curtail COVID-19.

 

Marie Stopes Australia seeks signatories to open letter re changes to telehealth

July 2020
 
There are changes to Telehealth from Monday, July 20th which mean that clients who have not attended a service within the last 12 months – that is, new clients or clients who have not used a service in the last 12 months – will no longer be eligible for a Telehealth appointment.
 
Marie Stopes Australia has written an open letter about the impact of this change access to sexual and reproductive health services. If you are interested in endorsing the letter, you can add your name as a private individual or an organisation.