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

Free workshop series on Sexuality and Intellectual Disability

South Australian Council on Intellectual Disability, July 2020

Sexuality and Relationships is an essential area of learning for people with an intellectual disability. Adults with intellectual disability say they want to learn together in their own right. Parents and carers can make a big difference in small ways by improving their own knowledge and using supportive approaches.

These interactive workshops will be presented in both the northern and southern suburbs of Adelaide. All workshops are free of charge.

Handouts and resources will be provided during the workshops.

Workshops for parents of people with intellectual disability: Each region will have a set of four 1-day education workshops for parents. The introductory workshop Sexuality and Disability is offered three times. It is recommended that you try to attend one of these sessions before attending others. You can enrol in one or more of the workshops. The Puberty and Adolescence Workshop will be held at the Special Education Resource Unit of the Department of Education in Henley Beach (SERU). This is so that parents of school-age children can become familiar with the range of resources available to them and their children for use at home and at school.
Other sessions will be held in a variety of venues. Parents will have first priority and support workers may also attend if numbers allow.

There will also be a series of four workshops for adults with intellectual disability.

Please see flyer for more information.

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.

Emergency contraception awareness in an at‐risk population

Hope, D. L., Hattingh, L. and King, M. A. (2019) J Pharm Pract Res. doi:10.1002/jppr.1554

Background

Consumer awareness of emergency contraception is generally poor. School leavers (schoolies) engage in risky behaviours, including casual sex and alcohol and drug consumption.

Aim

The aim of this study was to explore the awareness of an at‐risk population of schoolies regarding the use and availability of emergency contraception.

Methods

An electronic survey was self‐administered by participants using Wi‐Fi‐connected iPads at the Schoolies Wristband Distribution Centre, Surfers Paradise, on the first day of Queensland Schoolies Week, November 2017. Outcomes measured were awareness of the availability of emergency contraception from a pharmacy, maximum time for effective use following unprotected intercourse and whether emergency contraception is harmful to the health of the user.

Results

Schoolies completed 498 valid surveys. Most (83.5%) were aged 17 years and 50.8% were aware that emergency contraception is available from community pharmacies with prescription and 36.7% were aware that it is available without prescription; 18.5% were aware of the 72‐ or 120‐h effectiveness window and 38.0% agreed that it is not harmful. All questions were associated with considerable uncertainty. Females were 1.8‐ to 3.2‐fold more likely than males to provide an appropriate response to any emergency contraception statement.

Conclusion

Schoolies’ awareness of emergency contraception availability, effectiveness window and safety was low. At‐risk schoolies may not access emergency contraception when indicated due to fear of harm, uncertainty about its effectiveness window or a lack of knowledge about timely non‐prescription access from community pharmacies. Targeted education may improve current knowledge gaps. The misnomer ‘morning‐after pill’ should be abandoned for the clinically appropriate term ‘emergency contraception.

 

Report: 6th National Survey of Australian Secondary Students and Sexual Health

Australian Research Centre in Sex, Health and Society (ARCSHS), 2019

The Secondary Students and Adolescent Sexual Health survey is a national study exploring the sexual health and well-being of Australian adolescents. The anonymous survey asks questions about knowledge, behaviour and educational experiences related to sexual health and well-being.

The Commonwealth Department of Health funded study has been conducted approximately every 5 years since 1992. This is the 6th time the survey has been conducted in Australia. Results play a vital role in safeguarding the nation’s health by informing the national strategies to prevent HIV, sexually transmissible infections and blood-borne viruses as well as providing valuable information to improve service provision and education across multiple sectors.