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.

The Experience of International Students Before and During COVID-19: Housing, work, study, and wellbeing

 University of Technology Sydney, Australian Research Council study (DP190101073),

International students’ experience of renting accommodation in Australia is a crucial but overlooked determinant of their wellbeing, which has been brought into stark relief by the impacts of the COVID-19 pandemic.

This report is based on two surveys of international students in the private rental sector (PRS). The first survey was conducted in the second half of 2019, before the outbreak of the COVID-19 pandemic, and the second survey in June and the first week of July 2020, during the pandemic.

The findings of the first survey show that a substantial proportion of international students were already in a precarious situation before the pandemic.

The second survey reveals the various impacts of the pandemic on international students in the private rental sector and the extent to which their circumstances have deteriorated.

The report also draws on data from the initial stage of the qualitative component of the study – semi-structured in-depth interviews with international students conducted between April and July 2020. Quotes from some of the 26 semi-structured interviews conducted thus far, are presented alongside the survey data evidence that follows.

Although the focus is on the experiences of private renting, the report has taken a broader sociological approach to student housing problems and, as such, it offers wider insights into the wellbeing, employment, and income situations of international students at a crucial turning point for the Australian higher education sector

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.

Women on temporary visas experiencing family violence face additional complex barriers to seeking help

inTouch Multicultural Centre Against Family Violence, March 11th, 2020

CEO of inTouch, Ms Michal Morris, today released a position paper on women on temporary visas who are experiencing family violence. The paper urges the government to implement eight recommendations in order to improve supports and services for these vulnerable women.

‘I believe that all women who experience family violence in Australia should have access to the full suite of support services and be safe. Visa status should not be a factor, nor should living in destitution. Today, the government is issuing more temporary visas than ever before. Because of this we are only going to see more women in need and more gaps in services’, said Ms Morris.

A simple way to promote HPV vaccination among Asian American women: Storytelling

The Conversation, March 4, 2020 10.58pm AEDT

Why do so many Asian Americans and Pacific Islander women know so little about HPV? We set out to answer this question by interviewing  ethnic groups and conducting surveys.

Our findings suggest their knowledge and attitudes toward HPV prevention are closely tied to health beliefs and cultural or language barriers. What’s more, we discovered preventive health care is not a top priority for immigrant populations. In general, they seek treatment only when already sick. Our studies also suggest many of them are skeptical about participating in research.

We discovered in our study that narrative storytelling – that is, mothers and their children sharing their experiences and having conversations about HPV vaccination – can increase HPV vaccination rates.

From that, we’ve developed what we call a storytelling intervention for young Korean American women using a “peer-paired” approach. Because the storytellers are about the same age as the participants, a meaningful conversation is more likely to occur. The women are less shy about sharing their personal experiences, feelings and fears.

Discrimination: a health hazard for people from refugee and asylum-seeking backgrounds resettled in Australia

Ziersch, A., Due, C. & Walsh, M. Discrimination: a health hazard for people from refugee and asylum-seeking backgrounds resettled in Australia. BMC Public Health 20108 (2020). https://doi.org/10.1186/s12889-019-8068-3

Abstract

Background

Research has shown that discrimination is harmful to health, but there is relatively little known about discrimination experienced by people from refugee and asylum-seeking backgrounds in resettlement countries and associated health effects. This qualitative-focused mixed methods paper reports on discrimination experienced by refugees and asylum seekers, responses to discrimination, and impacts on health.

Methods

As part of a broader study of housing, social inclusion and health, surveys were completed by 423 adult refugees and asylum seekers living in South Australia who had been in Australia for up to 7 years. The survey included questions on discrimination based on skin colour, ethnicity and religion, as well as questions on hope, trust, belonging, sense of control and health (including the SF-8). Semi-structured interviews were conducted with 65 survey participants, purposively sampled by visa status, continent and gender, further exploring experiences of discrimination. These and survey open-ended responses were analysed thematically.

Results

Twenty-two percent of survey participants reported experiences of discrimination since arriving in Australia (14% in the last year), and 90% of these felt that discrimination had harmed their health. Key settings of discrimination were public transport, within the neighbourhood, and in relation to employment. Those who reported discrimination had significantly worse mental health (p < .000) but not physical health. Discrimination was also associated with less sense of belonging (p = .001), lower levels of trust (p = .038), reduced sense of control (p = .012) and less hope (p = .006). Incidents described in interviews and the open-ended survey responses included incivility, physical assault, and denial of services, experienced across intersecting characteristics of race/ethnicity, religion, gender and visa status. Responses to discrimination spanned affective, cognitive and behavioural dimensions, ranging across types of experience, participant characteristics and context, with most individuals reporting multiple response types. While some of the responses were reported by participants as protective of health, participants’ reflections indicated significant negative impacts on mental health in particular.

Conclusion

Discrimination featured in the resettlement experiences of a significant number of refugees and asylum seekers, with participants reporting clear negative impacts on mental health. Addressing discrimination is a key resettlement and health issue requiring urgent action.