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

Asian, Gay & COVID-19 (Free online event)

 Gay Asian Proud & Thorne Harbour Health, July 2020

A live online chat with James & Amirul – sharing their lived experience as same-sex attracted guys with Asian backgrounds.

Date And Time:

Thu, 6 August 2020, 5:30 PM – 7:00 PM ACST

Living Room Sharing Session:

Join Gay Asian Proud (GAP) coordinators James and Amirul in this casual, friendly and insightful conversation about being gay, Asian, moving away from home and living in the midst of COVID-19 restrictions.

Listen to them share their experiences about living in Australia, overcoming challenges as a migrant and international student, maintaining emotional and mental well-being during the COVID-19 lockdown.

This session welcomes all of the LGBTIQ+ community and their allies. Attendees will be able to ask questions during the online chat which James & Amirul will endeavour to answer in a live Q & A after the session.

Meet the guys:

Amirul (or Rul for short) is a proud GAY-sian guy, born and raised in Sunny Singapore and has been living in Melbourne, Australia for almost 8 years. He first arrived in Australia back in 2012 as an international student and calls Melbourne home for now. Originally starting out as a member, he is now one of the volunteer facilitators for the social support group, Gay Asian Proud,

James is a migrant from Singapore and a former international student who has been living in Australia for more than 10 years. He is a Thorne Harbour Health peer education facilitator, and a Community Reference Group member at the Victorian Pride Centre. He writes “The Well-Fed Nomad”, a Facebook food blog about his cooking and eating experiences around the world. His passion for arts and culture has brought him to Asia and Europe to participate in cross-cultural leadership and international collaboration programs.

A comparative, retrospective analysis of HIV testing among gay, bisexual and other MSM in Melbourne

Australian and New Zealand Journal of Public Health
First published: 29 May 2019
https://doi.org/10.1111/1753-6405.12903

Abstract

Objective: PRONTO!, a peer‐led rapid HIV‐testing service in Melbourne, Australia, opened to improve HIV testing among gay and bisexual men (GBM). We compared client characteristics and return testing among GBM testing at PRONTO! with GBM testing at Melbourne Sexual Health Centre (MSHC).

Methods: All GBM attending PRONTO! and MSHC for HIV testing between August 2013 and April 2016 were included. We describe the number of tests, percentage of clients who returned during follow‐up, the mean number of tests and median time between tests at the two services.

Results: At PRONTO!, 33% of 3,102 GBM and at MSHC 50% of 9,836 GBM returned for a further HIV test at least once. The mean number of tests per client was 1.7 and 2.5 at PRONTO! and MSHC (p<0.01), respectively. A majority of clients at both services reported behaviours that would recommend up to quarterly testing, however, the median time between tests was 20.0 and 17.0 weeks at PRONTO! and MSHC (p<0.01), respectively.

Conclusions: A greater proportion of clients returned and returned frequently at MSHC compared to PRONTO!, however, at both services HIV testing frequency was suboptimal.

Implications for public health: Novel HIV testing services should provide convenient and comprehensive sexual health services.

Community-level changes in condom use and uptake of HIV PrEP by gay and bisexual men in Melbourne and Sydney

Lancet HIV (2018). Published online 06 June 2018. doi: 10.1016/S2352-301830072-9.

Abstract:

Background

Pre-exposure prophylaxis (PrEP) has been rapidly rolled out in large, publicly funded implementation projects in Victoria and New South Wales, Australia. Using behavioural surveillance of gay and bisexual men, we analysed the uptake and effect of PrEP, particularly on condom use by gay and bisexual men not using PrEP.

Methods

We collected data from the Melbourne and Sydney Gay Community Periodic Surveys (GCPS), cross-sectional surveys of adult gay and bisexual men in Melbourne, VIC, and Sydney, NSW. Recruitment occurred at gay venues or events and online. Eligible participants were 18 years or older (face-to-face recruitment) or 16 years or older (online recruitment), identified as male (including transgender participants who identified as male); and having had sex with a man in the past 5 years or identified as gay or bisexual, or both. Using multivariate logistic regression, we assessed trends in condom use, condomless anal intercourse with casual partners (CAIC), and PrEP use by gay and bisexual men, controlling for sample variation over time.

Findings

Between Jan 1, 2013, and March 31, 2017, 27 011 participants completed questionnaires in the Melbourne (n=13 051) and Sydney (n=13 960) GCPS. 16 827 reported sex with casual male partners in the 6 months before survey and were included in these analyses. In 2013, 26 (1%) of 2692 men reported CAIC and were HIV-negative and using PrEP, compared with 167 (5%) of 3660 men in 2016 and 652 (16%) of 4018 men in 2017 (p<0·0001). Consistent condom use was reported by 1360 (46%) of 2692 men in 2013, 1523 (42%) of 3660 men in 2016, and 1229 (31%) of 4018 men in 2017 (p<0·0001). In 2013, 800 (30%) of 2692 men who were HIV-negative or untested and not on PrEP reported CAIC, compared with 1118 (31%) of 3660 men in 2016, and 1166 (29%) of 4018 in 2017 (non-significant trend).

Interpretation

A rapid increase in PrEP use by gay and bisexual men in Melbourne and Sydney was accompanied by an equally rapid decrease in consistent condom use. Other jurisdictions should consider the potential for community-level increases in CAIC when modelling the introduction of PrEP and in monitoring its effect.