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.

There are fears coronavirus is stopping Australia’s migrant women from accessing abortions

SBS News, 26th April 2020

Vulnerable pregnant women could lose access to abortion throughout Australia because of increased financial hardship caused by the coronavirus pandemic, reproductive health providers have warned. 

A combination of widespread job losses, differing abortion laws around the country, and patchy access to Medicare, could mean more women need financial assistance to terminate unwanted pregnancies or will face carrying their pregnancies to term.

Some providers even fear a return to people attempting unsafe abortions if women cannot afford legal terminations.

Information about TRUVADA and ATRIPLA delisting

Australian Federation of AIDS Organisations (AFAO), March 30th 2020

From 1 April 2020 Truvada for HIV treatment and for pre-exposure prophylaxis (PrEP) will no longer be available through the Pharmaceutical Benefits Scheme (PBS).

There are alternatives to Truvada for PrEP in Australia.

Community members eligible for PrEP can access generic versions of Truvada supplied by Apotex, Mylan and Lupin Generic Health. The drugs manufactured by these three suppliers contain the same active ingredients as Truvada.

In addition, from October 2020 Atripla will be delisted. A generic equivalent of Atripla has been approved by the PBS for community members who wish to continue using Atripla.

We encourage you to talk to your prescribing doctor if you want more information about these changes.

For more information, visit the following websites:

Medicare ineligible PLHIV in Australia

NAPWHA, May 2019

This NAPWHA report is an analysis drawing together several years’ worth of data from the main pharmaceutical industry suppliers of compassionate access antiretroviral (ARV) therapy in Australia and combines this with, for the first time, data from the State and Territory jurisdictions to produce the most accurate estimate to-date of the number of Medicare ineligible PLHIV in Australia. It comes with recommendations for systemic improvements.

Australia will never be HIV-free if access to prevention requires a medicare card

The Conversation, January 23, 2019 12.21pm AEDT

by Nicholas Medland, Sexual health physician and senior researcher, UNSW

Australia aims to “virtually eliminate” HIV transmission by 2022, according to the health minister’s new national HIV strategy. This ambitious goal has been made possible by biomedical HIV prevention, a new and highly effective way of preventing HIV using medications.

But new inequalities are emerging between those who can and can’t access these medications because of their Medicare eligibility. These inequalities may undermine the success of HIV elimination in Australia and threaten Australia’s international reputation as a safe place to study, work and live.

Read more of Australia will never be HIV-free if access to prevention requires a medicare card

 

Barriers to HIV testing for people born in Southeast Asia & sub-Saharan Africa

Curtin University,  2017

Over the past decade Australia has seen an increase in HIV notifications among people born in sub-Saharan Africa (SSA) and South East Asia (SEA).

People born in these regions have the highest rates of HIV diagnosis by region of birth and are overrepresented in late or advanced presentations of HIV infection.

Previous research indicates that migrants from SSA and SEA attend health services in Australia regularly, but only 50% have ever tested for HIV.

This report provides a brief overview of the preliminary results from the Barriers to HIV
testing project – a qualitative research project using focus groups and in-depth interviews to explore the barriers and enablers to HIV testing among priority communities born in SSA and SEA, to better understand the factors influencing late
diagnosis.