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Holton S, Papanikolaou V, Hammarberg K, Rowe H, Kirkman M, Jordan L, McNamee K, Bayly C, McBain J, Sinnott V, Fisher J. Fertility management experiences of women with polycystic ovary syndrome in Australia. EUR J CONTRACEP REPR 2018; 23:282-287. [DOI: 10.1080/13625187.2018.1483020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Sara Holton
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
| | | | - Karin Hammarberg
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
| | - Heather Rowe
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
| | - Maggie Kirkman
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
| | - Lynne Jordan
- Family Planning Victoria, Box Hill, VIC, Australia
| | - Kathy McNamee
- Family Planning Victoria, Box Hill, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Chris Bayly
- The Royal Women’s Hospital, Parkville, VIC, Australia
| | - John McBain
- Melbourne IVF, East Melbourne, VIC, Australia
| | - Vikki Sinnott
- Victorian Government Department of Health, Melbourne, VIC, Australia
| | - Jane Fisher
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
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Bryant RA, Gibbs L, Gallagher HC, Pattison P, Lusher D, MacDougall C, Harms L, Block K, Sinnott V, Ireton G, Richardson J, Forbes D. Longitudinal study of changing psychological outcomes following the Victorian Black Saturday bushfires. Aust N Z J Psychiatry 2018; 52:542-551. [PMID: 28605987 DOI: 10.1177/0004867417714337] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To map the changing prevalence and predictors of psychological outcomes in affected communities 5 years following the Black Saturday bushfires in Victoria. METHOD Follow-up assessment of longitudinal cohort study in high, medium and non-affected communities in Victoria, Australia. Participants included 1017 respondents (Wave 1) interviewed via telephone and web-based survey between December 2011 and January 2013, and 735 (76.1%) eligible participants were retested between July and November 2014 (Wave 2). The survey included measures of fire-related and subsequent stressful events, probable posttraumatic stress disorder, major depressive episode, alcohol use and severe distress. RESULTS There were reduced rates of fire-related posttraumatic stress disorder (8.7% vs 12.1%), general posttraumatic stress disorder (14.7% vs 18.2%), major depressive episode (9.0% vs 10.9%) and serious mental illness (5.4% vs 7.8%). Rates of resilience increased over time (81.8% vs 77.1%), and problem alcohol use remained high across Wave 1 (22.1%) and Wave 2 (21.4%). The most robust predictor of later development of fire-related posttraumatic stress disorder (odds ratio: 2.11; 95% confidence interval: [1.22, 3.65]), general posttraumatic stress disorder (odds ratio: 3.15; 95% confidence interval: [1.98, 5.02]), major depressive episode (odds ratio: 2.86; 95% confidence interval: [1.74, 4.70]), serious mental illness (odds ratio: 2.67; 95% confidence interval: [0.57, 1.72]) or diminished resilience (odds ratio: 2.01; 95% confidence interval: [1.32, 3.05]) was extent of recent life stressors. CONCLUSION Although rates of mental health problems diminished over time, they remained higher than national levels. Findings suggest that policy-makers need to recognize that the mental health consequences of disasters can persist for many years after the event and need to allocate resources towards those who are most at risk as a result of substantive losses and ongoing life stressors.
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Affiliation(s)
- Richard A Bryant
- 1 School of Psychology, University of New South Wales, Sydney, NSW, Australia.,2 Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Lisa Gibbs
- 3 The Jack Brockhoff Child Health & Wellbeing Program, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Hugh Colin Gallagher
- 4 Centre for Transformative Innovation, Swinburne University of Technology, Melbourne, VIC, Australia
| | | | - Dean Lusher
- 4 Centre for Transformative Innovation, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Colin MacDougall
- 6 Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, SA, Australia
| | - Louise Harms
- 7 Department of Social Work, The University of Melbourne, Melbourne, VIC, Australia
| | - Karen Block
- 3 The Jack Brockhoff Child Health & Wellbeing Program, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Greg Ireton
- 3 The Jack Brockhoff Child Health & Wellbeing Program, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - John Richardson
- 9 Emergency Services, Australian Red Cross, Melbourne, VIC, Australia
| | - David Forbes
- 2 Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
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Rowe H, Holton S, Kirkman M, Bayly C, Jordan L, McNamee K, McBain J, Sinnott V, Fisher J. Abortion: findings from women and men participating in the Understanding Fertility Management in contemporary Australia national survey. Sex Health 2017. [PMID: 28637579 DOI: 10.1071/sh17004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background There are few reliable Australian abortion data. The aim was to investigate prevalence, sexual experiences and socioeconomic characteristics of women and men who report having had or being a partner in an abortion. METHODS A cross-sectional survey of women and men aged 18-50 years randomly selected from the Australian Electoral Roll was used. Weighted multivariable analyses were conducted. RESULTS Data from 2235 returned (of 15480) mailed surveys were analysed. One in six women and one in 10 men had experienced or been a partner in an abortion. In adjusted analyses, for women, experience of sexual coercion [adjusted odds ratio (AOR) 2.18, 95% confidence interval (CI) 1.46, 3.24] was associated with significantly increased odds of abortion, and socioeconomic advantage (AOR=0.57; 95% CI 0.39, 0.84), being comfortable negotiating contraceptive use (AOR 0.26; 95% CI 0.09, 0.73) and importance of religion in fertility choices (AOR=0.55; 95% CI 0.35, 0.87) were associated with significantly reduced odds. For men, sexual coercion (AOR=3.05; 95% CI 1.51, 6.18) and metropolitan residence (AOR=1.70; 95% CI 1.06, 2.75) significantly increased the odds of reporting being a partner in an abortion. CONCLUSIONS The findings contribute to scarce information about abortion in Australia. The high prevalence of abortion suggests that effective contraceptive counselling and accessible contraception services are not sufficient, and that there is a continuing need for universal pregnancy advice and abortion services. The association between sexual coercion and abortion warrants further investigation.
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Affiliation(s)
- Heather Rowe
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553St Kilda Road, Melbourne, Vic. 3004, Australia
| | - Sara Holton
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553St Kilda Road, Melbourne, Vic. 3004, Australia
| | - Maggie Kirkman
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553St Kilda Road, Melbourne, Vic. 3004, Australia
| | - Christine Bayly
- The Royal Women's Hospital, 20 Flemington Road, Parkville, Vic. 3052, Australia
| | - Lynne Jordan
- Family Planning Victoria, 901 Whitehorse Road, Box Hill, Vic. 3128, Australia
| | - Kathleen McNamee
- Family Planning Victoria, 901 Whitehorse Road, Box Hill, Vic. 3128, Australia
| | - John McBain
- Melbourne IVF, 344 Victoria Parade, East Melbourne, Vic. 3002, Australia
| | - Vikki Sinnott
- Victorian Government Department of Health and Human Services, 50 Lonsdale Street, Melbourne, Vic. 3000, Australia
| | - Jane Fisher
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553St Kilda Road, Melbourne, Vic. 3004, Australia
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Ellawela Y, Nilaweera I, Holton S, Rowe H, Kirkman M, Jordan L, McNamee K, Bayly C, McBain J, Sinnott V, Fisher J. Contraceptive use and contraceptive health care needs among Sri Lankan migrants living in Australia: Findings from the understanding fertility management in contemporary Australia survey. Sexual & Reproductive Healthcare 2017; 12:70-75. [DOI: 10.1016/j.srhc.2017.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 02/19/2017] [Accepted: 03/08/2017] [Indexed: 11/30/2022]
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Freilich K, Holton S, Rowe H, Kirkman M, Jordan L, McNamee K, Bayly C, McBain J, Sinnott V, Fisher J. Sociodemographic characteristics associated with the use of effective and less effective contraceptive methods: findings from the Understanding Fertility Management in Contemporary Australia survey. EUR J CONTRACEP REPR 2017; 22:212-221. [PMID: 28492087 DOI: 10.1080/13625187.2017.1304534] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Unintended pregnancy and abortion may, in part, result from suboptimal use of effective contraception. This study aimed to identify sociodemographic factors associated with the use of effective and less effective methods among women and men of reproductive age living in Australia. METHODS In a cross-sectional national survey, 1544 women and men aged 18-51 were identified as being at risk of pregnancy. Chi-square and logistic regression analyses were used to assess the sociodemographic factors related to contraceptive use. RESULTS Most respondents (n = 1307, 84.7%) reported using a method of contraception. Use of any contraceptive was associated with being born in Australia (Odds Ratio [OR] 1.89; 95% Confidence Interval [CI]1.186, 3.01; p = .008), having English as a first language (OR 1.81; 95% CI: 1.07, 3.04; p = .026), having private health insurance (OR 2.25; 95% CI 1.66, 3.04; p < .001), and not considering religion important to fertility choices (OR 0.43; 95%CI 0.31, 0.60; p < .001). A third used effective contraceptive methods (n = 534, 34.6%; permanent methods: 23.1%, and long-acting reversible contraception (LARC): 11.4%). Permanent methods were more likely to be used in rural areas (OR 0.62; 95%CI 0.46, 0.84; p = .002). Use of the least effective, short-term methods was reported by nearly half (condoms: 25.6%, withdrawal: 12.5%, and fertility-awareness-based methods: 2.8%). Those who relied on withdrawal were more likely to live in a metropolitan area (OR 2.85; 95% CI 1.95, 4.18; p < .001), and not have private health insurance (OR 0.52; 95% CI 0.38, 0.71; p < .001). CONCLUSIONS Targeted promotion of the broad range of available contraceptives may raise awareness and uptake of more effective methods and improve reproductive autonomy in certain population groups.
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Affiliation(s)
- Karen Freilich
- a Jean Hailes Research Unit , Monash University , Melbourne , Australia
| | - Sara Holton
- a Jean Hailes Research Unit , Monash University , Melbourne , Australia
| | - Heather Rowe
- a Jean Hailes Research Unit , Monash University , Melbourne , Australia
| | - Maggie Kirkman
- a Jean Hailes Research Unit , Monash University , Melbourne , Australia
| | - Lynne Jordan
- b Family Planning Victoria , Melbourne , Australia
| | | | | | | | - Vikki Sinnott
- e Victorian Government Department of Health and Human Services , Melbourne , Australia
| | - Jane Fisher
- a Jean Hailes Research Unit , Monash University , Melbourne , Australia
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Bryant RA, Gallagher HC, Gibbs L, Pattison P, MacDougall C, Harms L, Block K, Baker E, Sinnott V, Ireton G, Richardson J, Forbes D, Lusher D. Mental Health and Social Networks After Disaster. Am J Psychiatry 2017; 174:277-285. [PMID: 27838935 DOI: 10.1176/appi.ajp.2016.15111403] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Although disasters are a major cause of mental health problems and typically affect large numbers of people and communities, little is known about how social structures affect mental health after a disaster. The authors assessed the extent to which mental health outcomes after disaster are associated with social network structures. METHOD In a community-based cohort study of survivors of a major bushfire disaster, participants (N=558) were assessed for probable posttraumatic stress disorder (PTSD) and probable depression. Social networks were assessed by asking participants to nominate people with whom they felt personally close. These nominations were used to construct a social network map that showed each participant's ties to other participants they nominated and also to other participants who nominated them. This map was then analyzed for prevailing patterns of mental health outcomes. RESULTS Depression risk was higher for participants who reported fewer social connections, were connected to other depressed people, or were connected to people who had left their community. PTSD risk was higher if fewer people reported being connected with the participant, if those who felt close to the participant had higher levels of property loss, or if the participant was linked to others who were themselves not interconnected. Interestingly, being connected to other people who in turn were reciprocally close to each other was associated with a lower risk of PTSD. CONCLUSIONS These findings provide the first evidence of disorder-specific patterns in relation to one's social connections after disaster. Depression appears to co-occur in linked individuals, whereas PTSD risk is increased with social fragmentation. These patterns underscore the need to adopt a sociocentric perspective of postdisaster mental health in order to better understand the potential for societal interventions in the wake of disaster.
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Affiliation(s)
- Richard A Bryant
- From the School of Psychology, University of New South Wales, Sydney; the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne; the Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; the Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney; the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide; the Department of Social Work, University of Melbourne, Melbourne; the Victorian Department of Health and Human Services, Melbourne; the Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne; Emergency Services, Australian Red Cross, Melbourne; Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne; and the Centre for Transformative Innovation, Swinburne University of Technology, Melbourne
| | - H Colin Gallagher
- From the School of Psychology, University of New South Wales, Sydney; the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne; the Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; the Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney; the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide; the Department of Social Work, University of Melbourne, Melbourne; the Victorian Department of Health and Human Services, Melbourne; the Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne; Emergency Services, Australian Red Cross, Melbourne; Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne; and the Centre for Transformative Innovation, Swinburne University of Technology, Melbourne
| | - Lisa Gibbs
- From the School of Psychology, University of New South Wales, Sydney; the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne; the Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; the Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney; the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide; the Department of Social Work, University of Melbourne, Melbourne; the Victorian Department of Health and Human Services, Melbourne; the Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne; Emergency Services, Australian Red Cross, Melbourne; Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne; and the Centre for Transformative Innovation, Swinburne University of Technology, Melbourne
| | - Philippa Pattison
- From the School of Psychology, University of New South Wales, Sydney; the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne; the Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; the Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney; the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide; the Department of Social Work, University of Melbourne, Melbourne; the Victorian Department of Health and Human Services, Melbourne; the Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne; Emergency Services, Australian Red Cross, Melbourne; Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne; and the Centre for Transformative Innovation, Swinburne University of Technology, Melbourne
| | - Colin MacDougall
- From the School of Psychology, University of New South Wales, Sydney; the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne; the Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; the Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney; the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide; the Department of Social Work, University of Melbourne, Melbourne; the Victorian Department of Health and Human Services, Melbourne; the Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne; Emergency Services, Australian Red Cross, Melbourne; Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne; and the Centre for Transformative Innovation, Swinburne University of Technology, Melbourne
| | - Louise Harms
- From the School of Psychology, University of New South Wales, Sydney; the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne; the Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; the Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney; the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide; the Department of Social Work, University of Melbourne, Melbourne; the Victorian Department of Health and Human Services, Melbourne; the Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne; Emergency Services, Australian Red Cross, Melbourne; Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne; and the Centre for Transformative Innovation, Swinburne University of Technology, Melbourne
| | - Karen Block
- From the School of Psychology, University of New South Wales, Sydney; the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne; the Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; the Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney; the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide; the Department of Social Work, University of Melbourne, Melbourne; the Victorian Department of Health and Human Services, Melbourne; the Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne; Emergency Services, Australian Red Cross, Melbourne; Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne; and the Centre for Transformative Innovation, Swinburne University of Technology, Melbourne
| | - Elyse Baker
- From the School of Psychology, University of New South Wales, Sydney; the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne; the Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; the Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney; the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide; the Department of Social Work, University of Melbourne, Melbourne; the Victorian Department of Health and Human Services, Melbourne; the Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne; Emergency Services, Australian Red Cross, Melbourne; Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne; and the Centre for Transformative Innovation, Swinburne University of Technology, Melbourne
| | - Vikki Sinnott
- From the School of Psychology, University of New South Wales, Sydney; the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne; the Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; the Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney; the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide; the Department of Social Work, University of Melbourne, Melbourne; the Victorian Department of Health and Human Services, Melbourne; the Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne; Emergency Services, Australian Red Cross, Melbourne; Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne; and the Centre for Transformative Innovation, Swinburne University of Technology, Melbourne
| | - Greg Ireton
- From the School of Psychology, University of New South Wales, Sydney; the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne; the Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; the Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney; the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide; the Department of Social Work, University of Melbourne, Melbourne; the Victorian Department of Health and Human Services, Melbourne; the Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne; Emergency Services, Australian Red Cross, Melbourne; Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne; and the Centre for Transformative Innovation, Swinburne University of Technology, Melbourne
| | - John Richardson
- From the School of Psychology, University of New South Wales, Sydney; the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne; the Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; the Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney; the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide; the Department of Social Work, University of Melbourne, Melbourne; the Victorian Department of Health and Human Services, Melbourne; the Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne; Emergency Services, Australian Red Cross, Melbourne; Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne; and the Centre for Transformative Innovation, Swinburne University of Technology, Melbourne
| | - David Forbes
- From the School of Psychology, University of New South Wales, Sydney; the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne; the Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; the Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney; the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide; the Department of Social Work, University of Melbourne, Melbourne; the Victorian Department of Health and Human Services, Melbourne; the Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne; Emergency Services, Australian Red Cross, Melbourne; Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne; and the Centre for Transformative Innovation, Swinburne University of Technology, Melbourne
| | - Dean Lusher
- From the School of Psychology, University of New South Wales, Sydney; the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne; the Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne; the Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney; the Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide; the Department of Social Work, University of Melbourne, Melbourne; the Victorian Department of Health and Human Services, Melbourne; the Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne; Emergency Services, Australian Red Cross, Melbourne; Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne; and the Centre for Transformative Innovation, Swinburne University of Technology, Melbourne
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Kirkman M, Stubber C, Rowe H, Holton S, Bayly C, Jordan L, McBain J, McNamee K, Sinnott V, Fisher J. Subjective meanings of 'unintended' pregnancy: interviews from understanding fertility management in contemporary Australia. Cult Health Sex 2017; 19:179-193. [PMID: 27684303 DOI: 10.1080/13691058.2016.1214287] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Unintended pregnancy can be difficult to identify and conceptualise. We aimed to understand how unintended pregnancies are constructed, explained and situated in a reproductive life. A total of 41 women and 7 men aged 20-50 years were interviewed in depth. Transcripts were analysed using iterative hermeneutic techniques informed by narrative theory. Of 34 participants who had been pregnant or had a partner in pregnancy, 12 women and 1 man described 23 'unintended' pregnancies, about half of which ended in abortion. Their accounts reveal that an unintended pregnancy is identified subjectively, that the same pregnancy may be identified by one partner in the pregnancy as unintended and by the other as intended, and that a researcher's supposedly objective assessment of an unintended pregnancy may be inconsistent with the assessment of the woman who experienced it. A pejorative discourse was evident, predominantly among participants who did not report having an unintended pregnancy: women use an 'unintended' pregnancy to entrap men. Accounts from five participants reporting an unintended pregnancy were selected for illustration. An appreciation of the role such a pregnancy might play in an individual life requires a nuanced understanding of the complexity of human experience and a resistance to simple binary categorisation.
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Affiliation(s)
- Maggie Kirkman
- a Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University , Melbourne , Australia
| | - Claire Stubber
- a Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University , Melbourne , Australia
| | - Heather Rowe
- a Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University , Melbourne , Australia
| | - Sara Holton
- a Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University , Melbourne , Australia
| | - Chris Bayly
- b Royal Women's Hospital , Melbourne , Australia
| | - Lynne Jordan
- c Family Planning Victoria , Melbourne , Australia
| | | | | | - Vikki Sinnott
- e Victorian Government Department of Health , Melbourne , Australia
| | - Jane Fisher
- a Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University , Melbourne , Australia
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Holton S, Rowe H, Kirkman M, Jordan L, McNamee K, Bayly C, McBain J, Sinnott V, Fisher J. Barriers to Managing Fertility: Findings From the Understanding Fertility Management in Contemporary Australia Facebook Discussion Group. Interact J Med Res 2016; 5:e7. [PMID: 26878865 PMCID: PMC4771929 DOI: 10.2196/ijmr.4492] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 08/09/2015] [Accepted: 11/02/2015] [Indexed: 11/15/2022] Open
Abstract
Background As part of research investigating the complexities of managing fertility in Australia, public opinions about how Australians manage their fertility were sought from women and men. Objective To identify public opinion about sexual and reproductive health in Australia. Methods To ensure access to a diverse group of people throughout Australia, an online group was advertised and convened on Facebook from October through December 2013. In a closed-group moderated discussion, participants responded to questions about how people in Australia attempt to manage three aspects of fertility: avoiding pregnancy, achieving pregnancy, and difficulties conceiving. Nonidentifiable demographic information was sought; no personal accounts of fertility management were requested. The discussion transcript was analyzed thematically. Results There were 61 female and 2 male Facebook users aged 18 to 50 years living in Australia participating in the study. Four main themes about fertility management were identified: access, geographical location, knowledge, and cost. Participants reported that young people and people from rural areas face barriers accessing contraception and fertility services. Limited knowledge about sex and reproduction and the cost of fertility services and contraception were also said to impede effective fertility management. Conclusions Reasons for inequalities in effective fertility management that are amenable to change were identified. Facebook is an effective method for gaining insights into public opinion about sexual and reproductive health.
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Affiliation(s)
- Sara Holton
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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Rowe H, Holton S, Kirkman M, Bayly C, Jordan L, McNamee K, McBain J, Sinnott V, Fisher J. Prevalence and distribution of unintended pregnancy: the Understanding Fertility Management in Australia National Survey. Aust N Z J Public Health 2015; 40:104-9. [DOI: 10.1111/1753-6405.12461] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 05/01/2015] [Accepted: 06/01/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Heather Rowe
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine; Monash University; Victoria
| | - Sara Holton
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine; Monash University; Victoria
| | - Maggie Kirkman
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine; Monash University; Victoria
| | | | | | - Kathleen McNamee
- Family Planning Victoria
- Department of Obstetrics and Gynaecology; Monash University; Victoria
| | | | | | - Jane Fisher
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine; Monash University; Victoria
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Forbes D, Alkemade N, Waters E, Gibbs L, Gallagher C, Pattison P, Lusher D, MacDougall C, Harms L, Block K, Snowdon E, Kellet C, Sinnott V, Ireton G, Richardson J, Bryant RA. The role of anger and ongoing stressors in mental health following a natural disaster. Aust N Z J Psychiatry 2015; 49:706-13. [PMID: 25586750 DOI: 10.1177/0004867414565478] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Research has established the mental health sequelae following disaster, with studies now focused on understanding factors that mediate these outcomes. This study focused on anger, alcohol, subsequent life stressors and traumatic events as mediators in the development of mental health disorders following the 2009 Black Saturday Bushfires, Australia's worst natural disaster in over 100 years. METHOD This study examined data from 1017 (M = 404, F = 613) adult residents across 25 communities differentially affected by the fires and participating in the Beyond Bushfires research study. Data included measures of fire exposure, posttraumatic stress disorder, depression, alcohol abuse, anger and subsequent major life stressors and traumatic events. Structural equation modeling assessed the influence of factors mediating the effects of fire exposure on mental health outcomes. RESULTS Three mediation models were tested. The final model recorded excellent fit and observed a direct relationship between disaster exposure and mental health outcomes (b = .192, p < .001) and mediating relationships via Anger (b = .102, p < .001) and Major Life Stressors (b = .128, p < .001). Each gender was compared with multiple group analyses and while the mediation relationships were still significant for both genders, the direct relationship between exposure and outcome was no longer significant for men (p = .069), but remained significant (b = .234, p < .001) for women. CONCLUSIONS Importantly, anger and major life stressors mediate the relationship between disaster exposure and development of mental health problems. The findings have significant implications for the assessment of anger post disaster, the provision of targeted anger-focused interventions and delivery of government and community assistance and support in addressing ongoing stressors in the post-disaster context to minimize subsequent mental health consequences.
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Affiliation(s)
- David Forbes
- Australian Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Carlton, Australia
| | - Nathan Alkemade
- Australian Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Carlton, Australia
| | - Elizabeth Waters
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Lisa Gibbs
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Colin Gallagher
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia
| | - Phillipa Pattison
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia
| | - Dean Lusher
- Centre for Transformative Innovation, Swinburne University of Technology, Hawthorn, Australia
| | - Colin MacDougall
- Southgate Institute for Health, Society and Equity, and School of Medicine, Flinders University, Adelaide, Australia
| | - Louise Harms
- Department of Social Work, University of Melbourne, Carlton, Australia
| | - Karen Block
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Elyse Snowdon
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Connie Kellet
- Department of Social Work, University of Melbourne, Carlton, Australia
| | - Vikki Sinnott
- Prevention and Population Health Branch, Department of Health, Melbourne, Australia
| | - Greg Ireton
- Health and Human Services Emergency Management, Department of Human Services, Melbourne, Australia
| | - John Richardson
- Emergency Services, Australian Red Cross, Carlton, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
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Holton S, Rowe H, Kirkman M, Jordan L, McNamee K, Bayly C, McBain J, Sinnott V, Fisher J. Long-acting reversible contraception: Findings from the Understanding Fertility Management in Contemporary Australia survey. EUR J CONTRACEP REPR 2015; 21:116-31. [PMID: 26043118 DOI: 10.3109/13625187.2015.1052394] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aim of this research was to investigate awareness, perceived reliability and consideration of use of long-acting reversible contraception (LARC) among Australians of reproductive age. METHODS A sample of 18- to 50-year-old women and men (N = 2235) was randomly recruited from the Australian electoral roll in 2013. Respondents completed a self-administered, anonymous questionnaire. Data were weighted to reduce non-response bias. Factors associated with perceived reliability and consideration of use of LARC were identified in multivariable analyses. RESULTS Most respondents had heard of implants (76.5%) and intrauterine contraception (63.7%). However, most did not think implants (56.3%) or IUDs (63.9%) were reliable and would not consider using implants (71.6%) or IUDs (77.5%). Those significantly more likely to perceive LARC as reliable were younger, did not regard religion as important in fertility choices, had private health insurance, had been pregnant and had had an abortion; and women who had a partner. Those more likely to consider using LARC were younger and did not regard religion as important in fertility choices; women who had private health insurance, lived in an area of socioeconomic advantage and had had an abortion; and men without a partner, born in Australia and comfortable talking to a health care provider about contraceptive matters. CONCLUSIONS Despite high awareness of LARC among Australian adults, its perceived reliability and willingness to use it remain low in certain groups. Targeted interventions that aim to increase knowledge of the benefits and reliability of LARC and allow informed use are recommended.
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Affiliation(s)
- Sara Holton
- a * Jean Hailes Research Unit, Monash University , Melbourne, Victoria , Australia
| | - Heather Rowe
- a * Jean Hailes Research Unit, Monash University , Melbourne, Victoria , Australia
| | - Maggie Kirkman
- a * Jean Hailes Research Unit, Monash University , Melbourne, Victoria , Australia
| | - Lynne Jordan
- b Family Planning Victoria , Melbourne, Victoria , Australia
| | - Kathy McNamee
- b Family Planning Victoria , Melbourne, Victoria , Australia
| | - Chris Bayly
- c The Royal Women's Hospital , Melbourne , Australia
| | - John McBain
- d Melbourne IVF, Melbourne , Victoria , Australia
| | - Vikki Sinnott
- e Victorian Government Department of Health , Melbourne, Victoria , Australia
| | - Jane Fisher
- a * Jean Hailes Research Unit, Monash University , Melbourne, Victoria , Australia
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Bryant RA, Waters E, Gibbs L, Gallagher HC, Pattison P, Lusher D, MacDougall C, Harms L, Block K, Snowdon E, Sinnott V, Ireton G, Richardson J, Forbes D. Psychological outcomes following the Victorian Black Saturday bushfires. Aust N Z J Psychiatry 2014; 48:634-43. [PMID: 24852323 DOI: 10.1177/0004867414534476] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We aimed to map the prevalence and predictors of psychological outcomes in affected communities 3-4 years after the Black Saturday bushfires in the state of Victoria, Australia. METHODS Baseline assessment of a longitudinal cohort study in high-, medium-, and low-affected communities in Victoria. Participants included 1017 residents of high-, medium-, and low-affected fire communities. Participants were surveyed by means of a telephone and web-based interview between December 2011 and January 2013. The survey included measures of fire-related post-traumatic stress disorder (PTSD) and general PTSD from other traumatic events, major depressive episode, alcohol use, and general psychological distress. RESULTS The majority of respondents in the high- (77.3%), medium- (81.3%), and low-affected (84.9%) communities reported no psychological distress on the K6 screening scale. More participants in the high-affected communities (15.6%) reported probable PTSD linked to the bushfires than medium- (7.2%) and low-affected (1.0%) communities (odds ratio (OR): 4.57, 95% confidence interval (CI): 2.61-8.00, p = 0.000). Similar patterns were observed for depression (12.9%, 8.8%, 6.3%, respectively) (OR: 1.83, 95% CI: 1.17-2.85, p = 0.008) and severe psychological distress (9.8%, 5.0%, 4.9%, respectively) (OR: 2.08, 95% CI: 1.23-3.55, p = 0.007). All communities reported elevated rates of heavy drinking (24.7%, 18.7%, 19.6%, respectively); however, these were higher in the high-affected communities (OR: 1.39, 95% CI: 1.01-1.89, p = 0.04). Severe psychological distress was predicted by fear for one's life in the bushfires, death of someone close to them in the bushfires, and subsequent stressors. One-third of those with severe psychological distress did not receive mental health assistance in the previous month. CONCLUSIONS Several years following the Black Saturday bushfires the majority of affected people demonstrated resilience without indications of psychological distress. A significant minority of people in the high-affected communities reported persistent PTSD, depression, and psychological distress, indicating the need for promotion of the use of health and complementary services, community-based initiatives, and family and other informal supports, to target these persistent problems.
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Affiliation(s)
- Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, Australia Emergency Services, Australian Red Cross, Melbourne, Australia
| | - Elizabeth Waters
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Lisa Gibbs
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - H Colin Gallagher
- School of Psychological Sciences, University of Melbourne, Australia
| | - Philippa Pattison
- School of Psychological Sciences, University of Melbourne, Australia
| | - Dean Lusher
- Swinburne Business School, Swinburne University of Technology, Melbourne, Australia
| | - Colin MacDougall
- Southgate Institute for Health, Society and Equity, Flinders University, Melbourne, Australia
| | - Louise Harms
- Department of Social Work, Department of Health (Victoria), Melbourne, Australia
| | - Karen Block
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Elyse Snowdon
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Vikki Sinnott
- Southgate Institute for Health, Society and Equity, Flinders University, Melbourne, Australia
| | - Greg Ireton
- Health and Human Services Emergency Management, Department of Human Services (Victoria), Melbourne, Australia
| | - John Richardson
- Emergency Services, Australian Red Cross, Melbourne, Australia
| | - David Forbes
- Australian Centre for Posttraumatic Mental Health, University of Melbourne, Australia
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Gibbs L, Waters E, Bryant RA, Pattison P, Lusher D, Harms L, Richardson J, MacDougall C, Block K, Snowdon E, Gallagher HC, Sinnott V, Ireton G, Forbes D. Beyond Bushfires: Community, Resilience and Recovery - a longitudinal mixed method study of the medium to long term impacts of bushfires on mental health and social connectedness. BMC Public Health 2013; 13:1036. [PMID: 24180339 PMCID: PMC3818325 DOI: 10.1186/1471-2458-13-1036] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 10/28/2013] [Indexed: 11/25/2022] Open
Abstract
Background Natural disasters represent an increasing threat both in terms of incidence and severity as a result of climate change. Although much is known about individual responses to disasters, much less is known about the social and contextual response and how this interacts with individual trajectories in terms of mental health, wellbeing and social connectedness. The 2009 bushfires in Victoria, Australia caused much loss of life, property destruction, and community disturbance. In order to progress future preparedness, response and recovery, it is crucial to measure and understand the impact of disasters at both individual and community levels. Methods/design This study aims to profile the range of mental health, wellbeing and social impacts of the Victorian 2009 bushfires over time using multiple methodologies and involving multiple community partners. A diversity of communities including bushfire affected and unaffected will be involved in the study and will include current and former residents (at the time of the Feb 2009 fires). Participants will be surveyed in 2012, 2014 and, funding permitting, in 2016 to map the predictors and outcomes of mental health, wellbeing and social functioning. Ongoing community visits, as well as interviews and focus group discussions in 2013 and 2014, will provide both contextual information and evidence of changing individual and community experiences in the medium to long term post disaster. The study will include adults, adolescents and children over the age of 5. Discussion Conducting the study over five years and focussing on the role of social networks will provide new insights into the interplay between individual and community factors and their influence on recovery from natural disaster over time. The study findings will thereby expand understanding of long term disaster recovery needs for individuals and communities.
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Affiliation(s)
- Lisa Gibbs
- Jack Brockhoff Child Health and Wellbeing Program, McCaughey VicHealth Centre for Community Wellbeing, University of Melbourne, Level 5, 207 Bouverie Street, Carlton, VIC 3053, Australia.
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Read TRH, Hocking J, Sinnott V, Hellard M. Risk factors for incident HIV infection in men having sex with men: a case-control study. Sex Health 2007; 4:35-9. [PMID: 17382036 DOI: 10.1071/sh06043] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2006] [Accepted: 01/24/2007] [Indexed: 11/23/2022]
Abstract
BACKGROUND HIV notifications affecting men having sex with men (MSM) in Victoria, Australia have been increasing. This study aimed to determine current risk factors for HIV infection in this population. METHODS Case-control study. Cases were MSM infected within the previous year (incident cases) as indicated by a previous negative test or seroconversion illness. Controls were MSM with a negative HIV test at the same clinic. From May 2001 to May 2003, cases and controls were interviewed about sexual behaviour, drug and alcohol use and mental health and sexually transmissible infections (STI) in the year before their HIV diagnosis. RESULTS Twenty-six cases and 52 controls were recruited. Risk factors in the year before diagnosis of incident HIV infection included: receptive unprotected anal intercourse (UAI) with ejaculation with casual partners (odds ratio [OR] and 95% confidence interval 57.2 [6.7, 489.4]); insertive UAI with ejaculation with >1 casual partners (OR 19.2 [2.2, 168.9]); having >14 casual partners at sex venues (OR 3.2 [1.1, 9.1]); and consuming >60 g alcohol at one sitting at least weekly (OR 3.6 [1.1, 11.4]). Cases were also more likely to have anal sex with >100 partners in their life and cases had more casual partners than controls in the year before the test. Cases were more likely to have consumed alcohol or amphetamines during a high-risk sexual episode in the year before the test. CONCLUSIONS UAI remains the most important behavioural risk for HIV in Australian MSM. Risk is increased by larger numbers of partners, partners met at sex venues and sex under the influence of alcohol.
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Affiliation(s)
- Tim R H Read
- Macfarlane Burnet Institute for Medical Research, Prahran, Victoria 3004, Australia.
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Gray A, Sinnott V. Anatomy of a partnership inside the Toronto Medical Labs. Hosp Q 1999; 1:42-5. [PMID: 10345290 DOI: 10.12927/hcq..16594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Evans BJ, Stanley RO, Coman GJ, Sinnott V. Measuring medical students' communication skills: Development and evaluation of an interview rating scale. Psychol Health 1992. [DOI: 10.1080/08870449208403185] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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