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.

Flux Study COVID-19 Diary Recruitment and Report

Kirby Institute, UNSW, July 2020

Social distancing restrictions due to COVID-19 may affect how gay and bisexual men are arranging their sex lives and taking care of their health. And this will likely also affect trends in HIV infection and STIs over coming months, or even years. Monitoring the impact of COVID-19, before, during, and after the pandemic, is essential to understanding and responding to trends in HIV infection, mental health, and STIs.

​This study investigating the lived experiences of COVID-19 among gay and bisexual men including isolation, support, mental health and resilience, income loss, and access to health services. We will address how gay and bisexual men experience, engage with, and emerge from, COVID-19.

What does participation in this research require? 

If you decide to take part in this study, we will ask you to do the following:

  1. Your first questionnaire: This questionnaire collects information about you and your previous experiences.

  2. Weekly diary: After completing the your first survey, you will be asked to complete a 5-minute diary each Sunday.

What’s in it for you? 

We value our participants! To show our appreciation, for every survey you complete, you’ll automatically go in a raffle to win prizes in the form of gift cards to the value of $200.

Links

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.

High-risk behaviors and their association with awareness of HIV status among participants of a prevention intervention

High-risk behaviors and their association with awareness of HIV status among participants of a large-scale prevention intervention in Athens, Greece.

Pavlopoulou, I.D., Dikalioti, S.K., Gountas, I. et al.

BMC Public Health 20, 105 (2020). https://doi.org/10.1186/s12889-020-8178-y

Abstract

Background

Aristotle was a seek-test-treat intervention during an outbreak of human immunodeficiency virus (HIV) infection among people who inject drugs (PWID) in Athens, Greece that started in 2011. The aims of this analysis were: (1) to study changes of drug injection-related and sexual behaviors over the course of Aristotle; and (2) to compare the likelihood of risky behaviors among PWID who were aware and unaware of their HIV status.

Methods

Aristotle (2012–2013) involved five successive respondent-driven sampling rounds of approximately 1400 PWID each; eligible PWID could participate in multiple rounds. Participants were interviewed using a questionnaire, were tested for HIV, and were classified as HIV-positive aware of their status (AHS), HIV-positive unaware of their status (UHS), and HIV-negative. Piecewise linear generalized estimating equation models were used to regress repeatedly measured binary outcomes (high-risk behaviors) against covariates.

Results

Aristotle recruited 3320 PWID (84.5% males, median age 34.2 years). Overall, 7110 interviews and blood samples were collected. The proportion of HIV-positive first-time participants who were aware of their HIV infection increased from 21.8% in round A to 36.4% in the last round. The odds of dividing drugs at least half of the time in the past 12 months with a syringe someone else had already used fell from round A to B by 90% [Odds Ratio (OR) (95% Confidence Interval-CI): 0.10 (0.04, 0.23)] among AHS and by 63% among UHS [OR (95% CI): 0.37 (0.19, 0.72)]. This drop was significantly larger (p = 0.02) among AHS. There were also decreases in frequency of injection and in receptive syringe sharing in the past 12 months but they were not significantly different between AHS (66 and 47%, respectively) and UHS (63 and 33%, respectively). Condom use increased only among male AHS from round B to the last round [OR (95% CI): 1.24 (1.01, 1.52)].

Conclusions

The prevalence of risky behaviors related to drug injection decreased in the context of Aristotle. Knowledge of HIV infection was associated with safer drug injection-related behaviors among PWID. This highlights the need for comprehensive interventions that scale-up HIV testing and help PWID become aware of their HIV status.

Sexual minority women face barriers to health care

The Conversation, October 23, 2019 9.25pm AEDT

Stigma and discrimination are common experiences that people who identify as LGBT or sexual minority face when accessing health services. One report found that one in seven LGBT people in the UK avoided seeking healthcare for fear of discrimination from staff. As many as one in four also experienced negative remarks against LGBT people from healthcare staff.