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.

 

Hormones are not the key to younger women’s sexual function

Monash University, 22 July 2020

A Monash University study into the causes of sexual dysfunction in young women has found social factors play just as important a role as hormone levels, and hormone therapy should not be prescribed as the only treatment.

The study uncovered that while hormones, including androgens like testosterone, play a role, the things that matter more are whether a woman has children (parity), being partnered or taking psychoactive medication for depression or other mental health issues.

Community Forum: Sex Work Decriminalisation (free online event)

Thorne Harbour Health, July 2020

A review into the decriminalisation of sex work in Victoria is currently underway. Join us to learn about sex work decriminalisation from an expert panel including representatives of the Scarlet Alliance, Sex Industry Network, Vixen Collective, SWOP NT and Respect QLD.

The event will feature presentations on the current regulatory framework in different Australian jurisdictions and the lived experiences of sex workers under the criminalised model, followed by a panel discussion covering issues such as licensing, mandatory STI testing, and recent reform efforts.

Forum date & time: Wed, 29 July 2020 at 5:30 PM – 7:00 PM ACST

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. 
 

Stigma towards people who inject drugs and sex workers prevalent, according to new Australian study

Centre for Social Research in Health, UNSW, July 2020

Priority groups at risk of blood borne viruses and sexually transmissible infections are still likely to experience negative behaviour from the general public and in healthcare settings according to a recent report from the Stigma Indicators Monitoring Project.

86% of the general public sampled self-reported that they would behave negatively towards people who inject drugs to some extent, as did 56% of healthcare workers and 55% of healthcare students. Additionally, 64% of the general public, and 36% and 31% of healthcare workers and students respectively, self-reported likely negative behaviour (to some extent) towards sex workers.