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Warzywoda S, Dyda A, Fitzgerald L, Mullens A, Debattista J, Durham J, Gu Z, Wenham K, Ariana A, Gilks CF, Bell SFE, Dean JA. A cross-sectional investigation of the factors associated with awareness of PEP and PrEP among Queensland university students. Aust N Z J Public Health 2024; 48:100136. [PMID: 38432178 DOI: 10.1016/j.anzjph.2024.100136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/11/2024] [Accepted: 02/08/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVE University creates unique social environments for many young people that can result in behaviour changes that can impact sexual health-related risks and facilitate transmission of HIV. Little is known about HIV knowledge, risk, and awareness of pre-exposure prophylaxis/post-exposure prophylaxis (PrEP/PEP) among Australian university students. METHODS A 2019 online survey distributed through Queensland universities, using active recruitment/snowball sampling. Descriptive and logistical regression analysis investigated HIV knowledge/risk and PrEP/PEP awareness. RESULTS Of the 4,291 responses, 60.4% were 20-29 years old, 57.0% identified as heterosexual, and 31.8% were born-overseas. Mean HIV knowledge score was 9.8/12. HIV risk scores were higher among men-who-have-sex-with-men (MSM) (mean=5.2/40) compared to all other sexual behaviours (mean=3.1/40). Logistic regression indicated PrEP and PEP awareness was associated with older age (p<0.05), being non-binary/gender-diverse (p<0.05), and MSM (p<0.05). Lower odds of PrEP awareness were associated with international student status (p<0.05). CONCLUSION This study highlights the need for future health promotion targeting younger Australians at risk of HIV to increase uptake of PrEP/PEP, particularly among overseas-born young people and those ineligible for appropriate health care in Australia. IMPLICATIONS FOR PUBLIC HEALTH Addressing these gaps will improve sexual health outcomes for young Australians at risk of HIV and work towards virtual elimination of HIV transmission in Australia.
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Affiliation(s)
- Sarah Warzywoda
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Amalie Dyda
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Lisa Fitzgerald
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Amy Mullens
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Australia
| | - Jo Durham
- School of Public Health and Social Work, Queensland University of Technology, Australia
| | - Zhihong Gu
- Ethnic Communities Council of Queensland, Australia
| | - Kathryn Wenham
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Australia
| | - Armin Ariana
- School of Medicine and Dentistry, Griffith University, Australia
| | - Charles F Gilks
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Sara F E Bell
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Judith A Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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Brömdal A, Sanders T, Stanners M, du Plessis C, Gildersleeve J, Mullens AB, Phillips TM, Debattista J, Daken K, Clark KA, Hughto JMW. Where do incarcerated trans women prefer to be housed and why? Adding nuanced understandings to a complex debate through the voices of formerly incarcerated trans women in Australia and the United States. Int J Transgend Health 2023; 25:167-186. [PMID: 38681496 PMCID: PMC11044725 DOI: 10.1080/26895269.2023.2280167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Background Incarcerated trans women experience significant victimization, mistreatment, barriers to gender-affirming care, and human rights violations, conferring high risk for trauma, psychological distress, self-harm, and suicide. Across the globe, most carceral settings are segregated by sex assigned at birth and governed by housing policies that restrict gender expression-elevating 'safety and security' above the housing preferences of incarcerated people. Aim/methods Drawing upon the lived experiences of 24 formerly incarcerated trans women in Australia and the United States and employing Elizabeth Freeman's notion of chrononormativity, Rae Rosenberg's concept of heteronormative time, and Kadji Amin's use of queer temporality, this paper explores trans women's carceral housing preferences and contextual experiences, including how housing preferences challenge governing chrononormative and reformist carceral housing systems. Findings Participants freely discussed their perspectives regarding housing options which through thematic analysis generated four options for housing: 1) men's carceral settings; 2) women's carceral settings; 3) trans- and gay-specific housing blocks; and 4) being housed in protective custody or other settings. There appeared to be a relationship between the number of times the person had been incarcerated, the duration of their incarceration, and where they preferred to be housed. Conclusions This analysis contributes to richer understandings regarding trans women's experiences while incarcerated. This paper also informs the complexities and nuances surrounding housing preferences from the perspectives of trans women themselves and considers possible opportunities to enhance human rights, health and wellbeing when engaging in transformative approaches to incarceration.
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Affiliation(s)
- Annette Brömdal
- School of Education, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Tait Sanders
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Melinda Stanners
- School of Education, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Carol du Plessis
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Jessica Gildersleeve
- School of Humanities and Communication, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Amy B. Mullens
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Tania M. Phillips
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital & Health Service, Brisbane, Queensland, Australia
| | - Kirstie Daken
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Kirsty A. Clark
- Department of Medicine, Health & Society, Institute for Public Policy Studies, Vanderbilt University, Nashville, Tennessee, USA
| | - Jaclyn M. W. Hughto
- Departments of Behavioral and Social Sciences and Epidemiology, Brown School of Public Health, Centre for Health Equity Research, Brown University, Providence, RI, USA
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Istiko SN, Remata S, Ndayizeye A, Moreno MEV, Kirunda V, Hollingdrake O, Osborne R, Hou JZ, Abell B, Mullens AB, Gu Z, Debattista J, Vujcich D, Lobo R, Parma G, Howard C, Durham J. Developing critical HIV health literacy: insights from interviews with priority migrant communities in Queensland, Australia. Cult Health Sex 2023:1-16. [PMID: 37950430 DOI: 10.1080/13691058.2023.2265960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/28/2023] [Indexed: 11/12/2023]
Abstract
In Australia, surveillance data establish that there are higher rates of late HIV diagnoses among heterosexual migrants from Sub-Saharan Africa and new HIV diagnoses among gay and bisexual men (GBM) from Southeast and Northeast Asia and Latin America. Together, these groups are identified as priority migrant communities in current efforts to eliminate HIV transmissions. HIV health literacy is recognised as a key means of improving access to services and health outcomes. This qualitative paper explores critical HIV health literacy among priority migrant communities in Queensland, Australia. To foreground community voices, peer researchers from priority migrant communities participated in the project design, data collection and analysis, with 20 interviews completed. The findings demonstrate how participants' engagement with HIV health information and services is highly relational and situated within the framework of sexual health and wellbeing. Participants strategically selected where to seek information and who they trusted to help them appraise this information. They further demonstrated reflective capacities in identifying the contextual barriers that inhibit the development of their HIV health literacy. The findings highlight the need for HIV health promotion strategies that embrace a sex positive approach, promote cultural change, and involve collaboration with general practitioners (GPs).
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Affiliation(s)
- Satrio Nindyo Istiko
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Simeon Remata
- Queensland Positive People, Brisbane, Queensland, Australia
- ACON, Sydney, New South Wales, Australia
| | - Aimable Ndayizeye
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Miguel Eduardo Valencia Moreno
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Vanessa Kirunda
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Olivia Hollingdrake
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Richard Osborne
- Department of Health and Medical Sciences, School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Jenny Zhengye Hou
- Faculty of Creative Industries, Education, and Social Justice, School of Communication/Digital Media Research Centre, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Bridget Abell
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Amy B Mullens
- Centre for Health Research, School of Psychology and Wellbeing, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Zhihong Gu
- Ethnic Communities Council of Queensland, Brisbane, Queensland, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Daniel Vujcich
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Roanna Lobo
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Gianna Parma
- True Relationships & Reproductive Health, Brisbane, Queensland, Australia
| | - Chris Howard
- Queensland Positive People, Brisbane, Queensland, Australia
| | - Jo Durham
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
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Daken K, Excell T, Clark KA, Hughto JMW, Sanders T, Debattista J, du Plessis C, Mullens AB, Phillips TM, Gildersleeve J, Brömdal A. Correctional staff knowledge, attitudes and behaviors toward incarcerated trans people: A scoping review of an emerging literature. Int J Transgend Health 2023; 25:149-166. [PMID: 38681490 PMCID: PMC11044747 DOI: 10.1080/26895269.2023.2265386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Background: Trans people are incarcerated at disproportionately high rates relative to cisgender people and are at increased risk of negative experiences while incarcerated, including poor mental health, violence, sexual abuse, dismissal of self-identity, including poor access to healthcare. Aims: This scoping review sought to identify what is known about the knowledge, attitudes, and behaviors of correctional staff toward incarcerated trans people within the adult and juvenile justice systems. Method: This scoping review was conducted in accordance with the five-stage iterative process developed by Arksey and O'Malley (2005), utilizing the PRISMA guidelines and checklist for scoping reviews and included an appraisal of included papers. A range of databases and grey literature was included. Literature was assessed against predetermined inclusion and exclusion criteria, with included studies written in English, online full text availability, and reported data relevant to the research question. Results: Seven studies were included with four using qualitative methodologies, one quantitative, and two studies employing a mixed methods approach. These studies provided insights into the systemic lack of knowledge and experience of correctional staff working with trans people, including staff reporting trans issues are not a carceral concern, and carceral settings not offering trans-affirming training to their staff. Within a reform-based approach these findings could be interpreted as passive ignorance and oversights stressing the importance of organizational policies and leadership needing to set standards for promoting the health and wellbeing of incarcerated trans persons. Conclusions: From a transformational lens, findings from this study highlight the urgent need to address the underlying structural, systemic, and organizational factors that impact upon the knowledge, attitudes, and behaviors staff have and hold in correctional, and other health and community settings to meaningfully and sustainably improve health, wellbeing, and gender-affirming treatment and care for trans communities, including make possible alternative methods of accountability for those who do harms.
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Affiliation(s)
- Kirstie Daken
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Tarra Excell
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Kirsty A. Clark
- Department of Medicine, Health & Society, Institute for Public Policy Studies, Vanderbilt University, Nashville, Tennessee, USA
| | - Jaclyn M. W. Hughto
- Departments of Behavioral and Social Sciences and Epidemiology, Brown School of Public Health, Centre for Health Equity Research, Brown University, Providence, Rhode Island, USA
| | - Tait Sanders
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital & Health Service, Brisbane, Queensland, Australia
| | - Carol du Plessis
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Amy B. Mullens
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Tania M. Phillips
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Jessica Gildersleeve
- School of Humanities and Communication, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Annette Brömdal
- School of Education, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
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5
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Engstrom T, Waller M, Mullens AB, Debattista J, Durham J, Gu Z, Wenham K, Daken K, Ariana A, Gilks CF, Bell SFE, Williams OD, Dingle K, Dean JA. STI and HIV testing: examining factors that influence uptake among domestic Australian-born, domestic overseas-born and international tertiary students studying in Australia. BMC Public Health 2023; 23:505. [PMID: 36922801 PMCID: PMC10018943 DOI: 10.1186/s12889-023-15418-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVES Sexual health knowledge among international students in Australia is lower than domestic students, however, little is known about what factors affect the uptake of STI testing, nor if there are differences for overseas-born domestic students. METHODS We included sexually active respondents from a survey of university students in Australia (N = 3,075). Multivariate regression and mediation analyses investigated associations of STI and HIV testing with STI and HIV knowledge respectively, sexual risk behaviour and demographics, including comparisons among: domestic Australian-born, domestic overseas-born, and international students. RESULTS STI and HIV knowledge was positively associated with STI and HIV testing respectively (STI OR = 1.13, 95% CI: 1.09, 1.16; HIV OR = 1.37, 95% CI: 1.27, 1.48). STI knowledge was significantly lower for international than domestic Australian-born students (10.8 vs. 12.2 out of 16), as was STI testing (32% vs. 38%); the difference in knowledge accounted for half the difference in STI testing rates between these two groups. International students from Southern Asia, and Eastern Asia reported the lowest STI testing rates. HIV testing was highest amongst international students from Africa and North America. Higher sexual risk behaviour, younger age, and identifying as gay or bisexual were positively associated with higher STI and HIV testing rates. CONCLUSIONS Our study supports greater investment and commitment by universities for the provision of sexual health education that can promote access to testing to improve the health of their students.
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Affiliation(s)
- Teyl Engstrom
- School of Public Health, Faculty of Medicine, The University of Queensland, Public Health Building, Herston, QLD, 4006, Australia.
| | - Michael Waller
- School of Public Health, Faculty of Medicine, The University of Queensland, Public Health Building, Herston, QLD, 4006, Australia
| | - Amy B Mullens
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Herston, Australia
| | - Jo Durham
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Zhihong Gu
- Ethnic Communities Council of Queensland, West End, Australia
| | - Kathryn Wenham
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Kirstie Daken
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Australia
| | - Armin Ariana
- School of Medicine and Dentistry, Griffith University, Nathan, Australia
| | - Charles F Gilks
- School of Public Health, Faculty of Medicine, The University of Queensland, Public Health Building, Herston, QLD, 4006, Australia
| | - Sara F E Bell
- School of Public Health, Faculty of Medicine, The University of Queensland, Public Health Building, Herston, QLD, 4006, Australia
| | - Owain D Williams
- School of Public Health, Faculty of Medicine, The University of Queensland, Public Health Building, Herston, QLD, 4006, Australia
| | - Kaeleen Dingle
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Judith A Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Public Health Building, Herston, QLD, 4006, Australia
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Brömdal A, Halliwell S, Sanders T, Clark KA, Gildersleeve J, Mullens AB, Phillips TM, Debattista J, du Plessis C, Daken K, Hughto JMW. Navigating intimate trans citizenship while incarcerated in Australia and the United States. Fem Psychol 2023; 33:42-64. [PMID: 37125407 PMCID: PMC10139736 DOI: 10.1177/09593535221102224] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Trans women incarcerated throughout the world have been described as "vulnerable populations" due to significant victimization, mistreatment, lack of gender-affirming care, and human rights violations, which confers greater risk of trauma, self-harm, and suicide compared with the general incarcerated population. Most incarceration settings around the world are segregated by the person's sex characteristics (i.e., male or female) and governed by strong cis and gender normative paradigms. This analysis seeks to better understand and appreciate how the "instructions" and the "authorities" that regulate trans women's corporeal representation, housing options and sense of self-determination implicate and affect their agency and actions in handling intimacies related to their personal life. Drawing upon lived incarcerated experiences of 24 trans women in Australia and the United States, and employing Ken Plummer's notion of intimate citizenship, this analysis explores how trans women navigate choices and ways "to do" gender, identities, bodies, emotions, desires and relationships while incarcerated in men's prisons and governed by cis and gender normative paradigms. This critical analysis contributes to understanding how incarcerated trans women through grit, resilience, and ingenuity still navigate ways to embody, express and enact their intimate citizenship in innovative and unique ways.
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Vickers ML, Choi YK, Eriksson L, Polyakova-Nelson Y, Jokovic Z, Parker SD, Moudgil V, Dean JA, Debattista J, Scott JG. Sexual and Reproductive Health in Adolescents and Young Adults With Psychotic Disorders: A Scoping Review. Schizophr Bull 2023; 49:108-135. [PMID: 36065153 PMCID: PMC9810019 DOI: 10.1093/schbul/sbac114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND HYPOTHESIS The sexual and reproductive health (SRH) of young people with psychosis has been largely overlooked. We hypothesised that there are key deficiencies in the existing literature on the SRH of adolescents and young adults with psychotic disorders. STUDY DESIGN We conducted a systematic scoping review using Pubmed, Web of Science, Embase, PsycINFO, and CINAHL. We included empirical studies and case reports focused on SRH issues in young people (aged 14-24 years) with psychotic disorders. A qualitative synthesis was completed. Joanna Briggs Institute Critical Appraisal Tools were utilized to assess study quality. STUDY RESULTS Seventeen empirical studies and 52 case reports met inclusion criteria. Most focused on sexual dysfunction which was identified as common among this cohort and associated with both psychotic disorders and antipsychotics. The study population was more likely to engage in sexual risk-taking behavior and was at higher risk of sexually transmissible infections than those without psychosis. SRH topics of clinical relevance in older patients with psychosis such as pregnancy, abortion, sexual violence, coercion, sexual identity, and gender were poorly addressed in this younger group. We found empirical studies generally lacked identification and controlling of confounders whilst case reports provided limited description of mental health and SRH outcomes following clinical intervention. CONCLUSION Research and clinical practice addressing sexual and reproductive health is needed for young people living with psychosis. To address research gaps future studies should focus on women's health, sexual violence, gender, and sexuality in young people with psychosis.
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Affiliation(s)
- Mark L Vickers
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Faculty of Health, Queensland University of Technology, Brisbane, Australia
- Metro North Mental Health Service, Herston, Brisbane, Australia
| | - Yoon Kwon Choi
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Metro North Mental Health Service, Herston, Brisbane, Australia
| | - Lars Eriksson
- Herston Health Sciences Library, University of Queensland, Brisbane, Australia
| | | | - Zorica Jokovic
- Metro North Mental Health Service, Herston, Brisbane, Australia
| | - Stephen D Parker
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Metro North Mental Health Service, Herston, Brisbane, Australia
| | - Vikas Moudgil
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Metro North Mental Health Service, Herston, Brisbane, Australia
| | - Judith A Dean
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Brisbane, Australia
| | - James G Scott
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Metro North Mental Health Service, Herston, Brisbane, Australia
- QIMR Berghofer, Medical Research Institute, Brisbane, Australia
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8
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Halliwell SD, du Plessis C, Hickey A, Gildersleeve J, Mullens AB, Sanders T, Clark KA, Hughto JMW, Debattista J, Phillips TM, Daken K, Brömdal A. A Critical Discourse Analysis of an Australian Incarcerated Trans Woman's Letters of Complaint and Self-Advocacy. Ethos 2022; 50:208-232. [PMID: 36337726 PMCID: PMC9632636 DOI: 10.1111/etho.12343] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This case study provides a critical discourse analysis of 121 letters of complaint and self-advocacy authored by Natasha Keating, a trans woman incarcerated in two Australian male correctional facilities from 2000 to 2007. During her incarceration, Natasha experienced victimization, misgendering, microaggression, and institutional discrimination. Despite this, Natasha embodied and "fought" against the injustices she experienced, whilst seeking to speak for other trans incarcerated persons also silenced and treated with indifference, contributing to changes in the carceral system. This original case study analyzes the discursive strategies Natasha employed to construct and reclaim an affirming self-identity through a deliberate campaign to effect social change and policy concessions within a system designed to curtail self-determination. Through her empathic and impassioned letter-writing approach, leveraging a military metaphor, this novel analysis showcases the significant implications her activism/agentism and determination had in naming and seeking to dismantle the systems of oppression trans incarcerated women experience.
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Affiliation(s)
| | - Carol du Plessis
- School of Psychology and Wellbeing at the University of Southern Queensland
| | - Andrew Hickey
- Communications in the School of Humanities and Communication and Chair of the Human Research Ethics Committee at the University of Southern Queensland
| | | | - Amy B Mullens
- School of Psychology and Wellbeing at the University of Southern Queensland
| | - Tait Sanders
- School of Psychology and Wellbeing at the University of Southern Queensland
| | - Kirsty A Clark
- Department of Medicine, Health, and Society and Program in Public Policy Studies
| | - Jaclyn M W Hughto
- Brown School of Public Health and faculty in the Center for Health Promotion and Health Equity at Brown University
| | | | - Tania M Phillips
- School of Psychology and Wellbeing at the University of Southern Queensland
| | - Kirstie Daken
- Centre for Health Research, Institute of Resilient Regions, University of Southern Queensland
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Swan J, Phillips TM, Sanders T, Mullens AB, Debattista J, Brömdal A. Mental health and quality of life outcomes of gender-affirming surgery: A systematic literature review. Journal of Gay & Lesbian Mental Health 2022. [DOI: 10.1080/19359705.2021.2016537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Jaime Swan
- School of Psychology and Counselling, Faculty of Health, Engineering and Sciences, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Tania M. Phillips
- School of Psychology and Counselling, Faculty of Health, Engineering and Sciences, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Tait Sanders
- School of Psychology and Counselling, Faculty of Health, Engineering and Sciences, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Amy B. Mullens
- School of Psychology and Counselling, Faculty of Health, Engineering and Sciences, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital & Health Service, Brisbane, Queensland, Australia
| | - Annette Brömdal
- School of Education, Faculty of Business, Education, Law and Arts, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
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10
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Bell SFE, Lemoire J, Debattista J, Redmond AM, Driver G, Durkin I, Coffey L, Warner M, Howard C, Williams OD, Gilks CF, Dean JA. Online HIV Self-Testing (HIVST) Dissemination by an Australian Community Peer HIV Organisation: A Scalable Way to Increase Access to Testing, Particularly for Suboptimal Testers. Int J Environ Res Public Health 2021; 18:ijerph182111252. [PMID: 34769771 PMCID: PMC8583017 DOI: 10.3390/ijerph182111252] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022]
Abstract
HIV self-testing (HIVST) introduces opportunities for screening in non-conventional settings, and addresses known testing barriers. This study involved the development and evaluation of a free online HIVST dissemination service hosted by a peer-led, community-based organisation with on-site, peer-facilitated HIV testing, and established referral and support programs for people newly diagnosed with HIV to determine whether this model was feasible and acceptable for engaging MSM, particularly among infrequent and naive HIV-testers, or those living in remote and rural areas. Between December 2016 and April 2018, 927 kits were ordered by 794 individuals, the majority of whom were men who have sex with men (MSM) (62%; 494), having condomless sex (50%; 392), or living outside a major city (38%; 305). Very few (5%; 39) sought the available pre-test peer contact, despite 45% (353) being naive HIV-testers. This study demonstrates that online HIVST dissemination is acceptable and feasible for engaging at-risk suboptimal testers, including those unwilling to test elsewhere (19%; 47/225). With half (50%; 403) unwilling to buy a kit, our study suggests that HIVST will need to be subsidized (cost-neutral to users) to enhance population coverage and access.
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Affiliation(s)
- Sara Fiona Elisabeth Bell
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia; (S.F.E.B.); (O.D.W.); (C.F.G.)
| | - Jime Lemoire
- Queensland Positive People, East Brisbane 4169, Australia; (J.L.); (A.M.R.); (G.D.); (I.D.); (L.C.); (M.W.); (C.H.)
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Windsor 4030, Australia;
| | - Andrew M. Redmond
- Queensland Positive People, East Brisbane 4169, Australia; (J.L.); (A.M.R.); (G.D.); (I.D.); (L.C.); (M.W.); (C.H.)
- Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Herston 4006, Australia
| | - Glen Driver
- Queensland Positive People, East Brisbane 4169, Australia; (J.L.); (A.M.R.); (G.D.); (I.D.); (L.C.); (M.W.); (C.H.)
| | - Izriel Durkin
- Queensland Positive People, East Brisbane 4169, Australia; (J.L.); (A.M.R.); (G.D.); (I.D.); (L.C.); (M.W.); (C.H.)
| | - Luke Coffey
- Queensland Positive People, East Brisbane 4169, Australia; (J.L.); (A.M.R.); (G.D.); (I.D.); (L.C.); (M.W.); (C.H.)
| | - Melissa Warner
- Queensland Positive People, East Brisbane 4169, Australia; (J.L.); (A.M.R.); (G.D.); (I.D.); (L.C.); (M.W.); (C.H.)
| | - Chris Howard
- Queensland Positive People, East Brisbane 4169, Australia; (J.L.); (A.M.R.); (G.D.); (I.D.); (L.C.); (M.W.); (C.H.)
| | - Owain David Williams
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia; (S.F.E.B.); (O.D.W.); (C.F.G.)
| | - Charles F. Gilks
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia; (S.F.E.B.); (O.D.W.); (C.F.G.)
| | - Judith Ann Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia; (S.F.E.B.); (O.D.W.); (C.F.G.)
- Correspondence: ; Tel.: +61-7-3346-4876 or +61-417768940
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11
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Abela M, Debattista J, Yamagata K, Felice T, Burg M, Sammut MA, Xuereb RG, Grech V, Monserrat L, Papadakis M. Yield from family screening in a national adolescent cardiac screening program. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Cascade family screening in patients with confirmed or suspected inherited cardiac disorders is now well established. This may refute or confirm a familial clinical diagnosis and is particularly relevant in young adolescent individuals as it may be too early to manifest a distinct phenotype.
Objectives
A large cohort of 2708 adolescents aged 14–16 years gave consent to participate in a national cardiac screening program (BEAT-IT). Individuals with suspected inherited cardiac disorders were extensively evaluated. Their relatives were also invited to undergo screening. This study reports the yield of this family cardiac screening program.
Methodology
Family members of probands with suspected or confirmed inherited cardiac conditions were offered cardiac screening. A standard clinical screening protocol for all first-degree family members included a resting 12-lead ECG and echocardiogram. Those with a channelopathy suspicion also underwent postural ECGs and exercise testing. Screening second-degree relatives was also performed in a cascade fashion when clinically indicated. Relatives with a normal baseline screen were offered surveillance if younger than 25 years or a proband clinical diagnosis. Those with an abnormal ECG and/or echocardiogram were referred for further evaluation.
Results
17 probands (63% females) were suspected of harbouring inherited heart disease. Another 2 were diagnosed with a clinical phenotype. The mean age was 15.3±0.58 years. All were Caucasian.
77 family members underwent cardiac screening, with a mean age of 42.5±16.43 at first evaluation. The majority were female (n=44, 57.1%). 12 (15.6%) had an abnormal ECG. 6 (7.8%) had an abnormal echocardiogram, with 2 (2.6%) consistent with cardiomyopathy. 8 (10.4%) were diagnosed with an inherited cardiac condition (n=2 HCM, n=1 DCM, n=5 LQTS). Another 7 (9.1%) are under surveillance because of a pathological ECG in the absence of a clinical phenotype.
The highest clinical yield was in the Long QT group (n=5, 55.6%). Family members (n=25) referred because of proband lateral TWI were the second most likely to require clinical follow-up because of a pathological ECG or a clinical diagnosis (n=7, 28.0%). Relatives referred because of isolated anterior TWI on the proband's ECG had the lowest diagnostic yield (n=17, 0%). After excluding families of probands with isolated anterior TWI (n=18), the overall clinical yield increased to 13.6%. Another 11.9% are under surveillance because of a pathological ECG.
Conclusion
The yield of family screening as part of a national cardiac screening program was 10.4%. This increases to 13.6% when excluding probands with anterior TWI, with 11.9% under surveillance because of a pathological ECG. To our knowledge, this is the first such study of its kind.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Beating Hearts MaltaResearch, Innovation and Development Trust (University of Malta)
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Affiliation(s)
- M Abela
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - J Debattista
- Mater Dei Hospital of Malta, Genetics laboratory, pathology department, Msida, Malta
| | - K Yamagata
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - T Felice
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - M Burg
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - M A Sammut
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - R G Xuereb
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - V Grech
- Mater Dei Hospital of Malta, Paediatrics, Msida, Malta
| | - L Monserrat
- University Hospital A Coruna, Cardiology département, Health in Code, A Coruna, Spain
| | - M Papadakis
- St George's University of London, Cardiovascular Clinical Academic Group, London, United Kingdom
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12
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Van Nguyen H, Lan Nguyen H, Thi Minh Dao A, Van Nguyen T, The Nguyen P, Mai Le P, Duy Vu K, Thi Ngoc Tran A, Kim Dao P, Thi Nguyen C, Debattista J. The COVID-19 pandemic in Australia: Public health responses, opportunities and challenges. Int J Health Plann Manage 2021; 37:5-13. [PMID: 34490663 PMCID: PMC8652799 DOI: 10.1002/hpm.3326] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/17/2021] [Accepted: 08/25/2021] [Indexed: 11/24/2022] Open
Abstract
In responding to the COVID‐19 pandemic, each country is presented with both opportunities and challenges, some unique and some shared with the global community. It is important to not only recognize, but to embrace them as drivers of the public to the current pandemic success. In this commentary, we discuss the opportunities and challenges that may affect ongoing public health programming in Australia within the current context of epidemiology. COVID‐19 within Australia has to date been effectively suppressed through the implementation of nationally coordinated, in which the state delivered public policy, guidelines and practice, and successful establishment of a comprehensive testing, contact tracing, patient isolation and contact quarantine regime combined with national and state social distancing, hygiene etiquette and movement restrictions. However, despite its success to date great challenges lay ahead for future public health policy with the threat of a second wave, or more likely, multiple smaller outbreaks across various population centres. Therefore, policies that aim to balance the twin socioeconomic and health impacts are crucial. The experience of Australia in managing its COVID‐19 response can provide a case study for other countries to reshape or adapt their policies and actions in the context of emerging global health crises.
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Affiliation(s)
- Huy Van Nguyen
- Health Innovation and Transformation Centre, Federation University, Ballarat, Victoria, Australia.,Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.,Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA.,Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Hoa Lan Nguyen
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - An Thi Minh Dao
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA.,Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.,School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Tien Van Nguyen
- Department of Health Organization and Management, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh City, Vietnam.,Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Phuong The Nguyen
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Phuong Mai Le
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Kien Duy Vu
- OnCare Medical Technology Company Limited, Hanoi, Vietnam
| | - Anh Thi Ngoc Tran
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
| | - Phuong Kim Dao
- Training Center and Scientific Management, National Institute of Occupational Health and Environment, Hanoi, Vietnam
| | - Cham Thi Nguyen
- Training Center and Scientific Management, National Institute of Occupational Health and Environment, Hanoi, Vietnam
| | - Joseph Debattista
- Metro North Hospital & Health Service, Queensland Health, Brisbane, Queensland, Australia
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13
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Engstrom T, Waller M, Mullens AB, Durham J, Debattista J, Wenham K, Bell SFE, Ariana A, Gu Z, Daken K, Dingle K, Gilks CF, Williams OD, Dean JA. STI and HIV knowledge and testing: a comparison of domestic Australian-born, domestic overseas-born and international university students in Australia. Sex Health 2021; 18:346-348. [PMID: 34412769 DOI: 10.1071/sh21055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/21/2021] [Indexed: 11/23/2022]
Abstract
University students usually consist of young people from culturally and linguistically diverse backgrounds, and a group recognised as being at increased risk of STI. This study found lower levels of STI knowledge and STI testing among international students and to a lesser extent, domestic overseas-born students, compared with domestic Australian-born students. International students exhibited lower risk sexual behaviour but were more likely to have had a HIV test than domestic students. This diversity in sexual health knowledge, sexual health services utilisation and sexual experience indicates the need for a variety of public health approaches to improve sexual health.
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Affiliation(s)
- Teyl Engstrom
- School of Public Health, Faculty of Medicine, The University of Queensland,Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia; and Corresponding author.
| | - Michael Waller
- School of Public Health, Faculty of Medicine, The University of Queensland,Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia
| | - Amy B Mullens
- School of Psychology and Counselling, Centre for Health Research, University of Southern Queensland, Ipswich Campus, 11 Salisbury Road, Ipswich, Qld 4305, Australia
| | - Jo Durham
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove Campus, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Bryden Street, Windsor, Qld 4030, Australia
| | - Kathryn Wenham
- School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Qld 4556, Australia
| | - Sara F E Bell
- School of Public Health, Faculty of Medicine, The University of Queensland,Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia
| | - Armin Ariana
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Parklands Drive, Southport, Qld 4222, Australia
| | - Zhihong Gu
- Ethnic Communities Council of Queensland, 253 Boundary Street, West End, Qld 4101, Australia
| | - Kirstie Daken
- School of Psychology and Counselling, Centre for Health Research, University of Southern Queensland, Ipswich Campus, 11 Salisbury Road, Ipswich, Qld 4305, Australia
| | - Kaeleen Dingle
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove Campus, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
| | - Charles F Gilks
- School of Public Health, Faculty of Medicine, The University of Queensland,Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia
| | - Owain D Williams
- School of Public Health, Faculty of Medicine, The University of Queensland,Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia
| | - Judith A Dean
- School of Public Health, Faculty of Medicine, The University of Queensland,Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia
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14
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Callan T, Debattista J, Berry B, Brown J, Woodcock S, Hocking JS, Huston WM. A retrospective cohort study examining STI testing and perinatal records demonstrates reproductive health burden of chlamydia and gonorrhea. Pathog Dis 2021; 78:5903269. [PMID: 32901793 DOI: 10.1093/femspd/ftaa052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/06/2020] [Indexed: 01/20/2023] Open
Abstract
Adverse reproductive health outcomes, such as pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility, have been associated with Chlamydia trachomatis and Neisseria gonorrhoea infections. These reproductive health outcomes could be complemented by measuring subsequent pregnancies to assess impact on fertility. The study design was a cohort study of women in Queensland (QLD), Australia, using data linkage methods to link chlamydia and/or gonorrhea testing records (including an unexposed group undergoing full blood count tests; 2000 and 2005) with the QLD Perinatal Registry (2000-2013). The cohort included 132 962 women, with 69 533 records of pregnancies. Women in the exposed group, with no prior pregnancy, had a reduced odds of a pregnancy during the follow up of the study (20-year-old (at 2005) aOR 0.91 95% CI 0.87-0.95, and 25-year-old aOR 0.71 95% CI 0.68-0.75). Women in the exposed group with a prior pregnancy had increased odds of pregnancy during the follow up of the study (20-year-old (at 2005) aOR 1.72 95% CI 1.59-1.86, and 25-year-old aOR 1.35 95% CI 1.26-1.45). Our data provides further evidence at a population level of the significant impact on reproductive outcomes associated with chlamydia and gonorrhea.
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Affiliation(s)
- Torrington Callan
- Faculty of Science, School of Mathematical and Physical Sciences, University of Technology Sydney, 15 Broadway, Ultimo, NSW 2007, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Queensland Health, Bryden Street, Windsor, 4030, Australia
| | - Brooke Berry
- Pathology Queensland, Health Support Queensland, Queensland Health, Herston Road, Herston, 4006, Australia
| | - James Brown
- Faculty of Science, School of Mathematical and Physical Sciences, University of Technology Sydney, 15 Broadway, Ultimo, NSW 2007, Australia
| | - Stephen Woodcock
- Faculty of Science, School of Mathematical and Physical Sciences, University of Technology Sydney, 15 Broadway, Ultimo, NSW 2007, Australia
| | - Jane S Hocking
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Level 3, 207 Bouverie St, Carlton, Victoria 3053, Australia
| | - Wilhelmina M Huston
- Faculty of Science, School of Life Sciences, University of Technology Sydney, Broadway, NSW 2007, Australia
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15
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Magro R, Grech Meli JA, Debattista J, Aquilina N, Gatt K, Borg A, Scerri C. AB0077 ASSOCIATION BETWEEN VITAMIN D RECEPTOR GENE POLYMORPHISMS AND SYSTEMIC LUPUS ERYTHEMATOSUS IN MALTESE PATIENTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Vitamin D deficiency is highly prevalent in patients with systemic lupus erythematosus (SLE). Vitamin D acts through the vitamin D receptor (VDR) that is present in most cells, and it can regulate the transcription of over 200 genes. The expression of vitamin D receptors by a variety of cells belonging to the innate and adaptive immune systems has created interest with regards to the role of vitamin D in the pathogenesis of SLE. Several polymorphisms of the VDR gene have been described, namely Bsml, Apal, Taql and Fokl. A number of VDR gene polymorphism genotypes have been associated with increased risk of SLE mostly in Asians and Africans.1Objectives:The aim of this study was to establish whether an association was present between VDR gene polymorphisms and SLE susceptibility in a cohort of SLE patients living in Malta. A further aim was to assess the relationship between these VDR gene polymorphisms and SLE disease characteristics.Methods:59 SLE patients living in Malta and attending Rheumatology clinic at Mater Dei Hospital were recruited for the study after providing informed consent. The patients were over the age of 18 years and fulfilled the SLICC classification criteria for SLE. The patients were interviewed and blood samples were taken. RNA extraction was performed from whole blood. QuantiGene Plex technology was used to measure the expression of 12 interferon (IFN) signature genes in the extracted RNA.93 cord blood samples obtained from individuals living in Malta were used as a control. DNA extraction was carried out from the blood samples obtained from the patients and controls. The VDR gene was screened and the regions containing the VDR polymorphisms were amplified for each patient. The amplified regions were then digested with their respective restriction enzymes in order to view the patient’s genotype via restriction fragment length polymorphism. Statistical analysis, including odds ratio (OR), was carried out to gauge the significance in the association of these polymorphisms with SLE.Results:94.9% of SLE patients were female and they had a mean age of 44.5 years. All the patients were of Caucasian ethnicity. 13.6% had vitamin D deficiency (serum 25-hydroxyvitamin D <20ng/ml) and 25.4% were vitamin D insufficient (serum 25-hydroxyvitamin D 20-29ng/ml). The results showed that when ApaI polymorphism was present as a homozygote for the variant allele there was a significant decrease in SLE prevalence (OR=0.39, CI 0.17-0.87, p=0.02). The results were also analysed by placing the polymorphs into haplotypes. The haplotype containing all wild-type alleles for the VDR gene and the haplotype containing all wild-type alleles with the variant allele for FokI had an increased prevalence of SLE (OR= 1.95, CI 1.12-3.38, p=0.01 and OR= 2.36, CI 1.13-4.91, p=0.02 respectively).The patients who were homozygous for the variant allele for BsmI had a significantly higher SLE disease activity index-2K (SLEDAI-2K) (mean 5.00) compared to those that were heterozygous (mean 2.66; p=0.010). No significant difference was noted in damage, IFN signature gene expression, organ manifestation and autoantibody profile between the different genotypes for the 4 VDR polymorphisms. SLE patients who were homozygous variant for the ApaI or TaqI polymorphisms had an increased prevalence of fibromyalgia (OR=7.50, CI 1.47-38.16, p=0.02 and OR=12.00, CI 1.80-80.05, p=0.02 respectively).Conclusion:The study showed that in the Maltese population the presence of the VDR gene polymorphism haplotype containing all wild-type alleles and the haplotype containing all wild-type alleles with the variant allele for FokI are associated with an increased risk of SLE. Moreover the homozygous variant genotype for BsmI was associated with a higher SLE disease activity. The homozygous variant genotype for ApaI and TaqI was associated with a higher risk of fibromyalgia in SLE patients.References:[1]Zhou TB, Jiang ZP, Lin ZJ, Su N. Association of vitamin D receptor gene polymorphism with the risk of systemic lupus erythematosus. J Recept Signal Transduct Res. 2015;35(1):8-14.Acknowledgements:The Faculty of Medicine and Surgery, University of Malta provided funding for this research.Disclosure of Interests:None declared
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16
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Nguyen HV, Debattista J, Pham MD, Dao ATM, Gilmour S, Nguyen HL, Nguyen TV, Le PM, Nguyen PT, Tran ATN, Vu KD, Dinh ST, Hoang MV. Vietnam’s Healthcare System Decentralization: how well does it respond to global health crises such as covid-19 pandemic? APJHM 2021. [DOI: 10.24083/apjhm.v16i1.619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This article discussed Vietnam’s ongoing efforts to decentralize the health system and its fitness to respond to global health crises as presented through the Covid-19 pandemic. We used a general review and expert’s perspective to explore the topic. We found that the healthcare system in Vietnam continued to decentralize from a pyramid to a wheel model. This system shifts away from a stratified technical hierarchy of higher- and lower-level health units (pyramid model) to a system in which quality healthcare is equally expected among all health units (wheel model). This decentralization has delivered more quality healthcare facilities, greater freedom for patients to choose services at any level, a more competitive environment among hospitals to improve quality, and reductions in excess capacity burden at higher levels. It has also enabled the transformation from a patient-based traditional healthcare model into a patient-centered care system. However, this decentralization takes time and requires long-term political, financial commitment, and a working partnership among key stakeholders. This perspective provides Vietnam’s experience of the decentralization of the healthcare system that may be considered as a useful example for other countries to strategically think of and to shape their future system within their own socio-political context.
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17
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Blondell SJ, Debattista J, Griffin MP, Durham J. 'I think they might just go to the doctor': qualitatively examining the (un)acceptability of newer HIV testing approaches among Vietnamese-born migrants in greater-Brisbane, Queensland, Australia. Sex Health 2021; 18:50-57. [PMID: 33573716 DOI: 10.1071/sh20064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/07/2020] [Indexed: 11/23/2022]
Abstract
Background In high-income countries (HICs), migrants often have higher rates of late diagnosis of HIV than the host population. Timely HIV testing has significant implications for HIV prevention and management. Newer HIV testing approaches, namely provider-initiated testing and counselling (PITC), HIV rapid testing (HIV RT) and HIV self-testing (HIV ST), aim to reach those populations most at risk and, particularly, those who have not previously tested for HIV. METHODS This study used semi-structured interviews to examine the (un)acceptability, barriers and facilitators to newer HIV testing approaches (i.e. PITC, HIV RT and HIV ST) among Vietnamese-born migrants (n = 10) in greater-Brisbane, Queensland, Australia. RESULTS Vietnamese-born migrants had mixed perspectives on the (un)acceptability of newer HIV testing approaches. PITC was largely viewed by participants as a facilitator to HIV testing for Vietnamese-born migrants. Likewise, HIV RT (undertaken by a doctor in a medical setting, as opposed to a trained community member in a community setting) was generally considered to facilitate HIV testing. HIV ST was largely not considered acceptable to Vietnamese-born migrants and they would prefer to go to a doctor for HIV testing. Several factors were identified that either facilitate or act as barriers to newer HIV testing approaches, including privacy; cost of (accessing) HIV testing; comfort and convenience; healthcare provider relationship; risk perception; symptoms; and technical and emotional support. CONCLUSIONS There is a need to understand migrants' HIV testing preferences if poorer HIV-related outcomes are to be overcome. The findings from this study show a preference for doctor-centred HIV testing, due to enhanced privacy, accuracy and support.
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Affiliation(s)
- Sarah J Blondell
- The University of Queensland, School of Public Health, Brisbane, Qld 4006 Australia; and Corresponding author.
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Brisbane, Qld 4029, Australia
| | - Mark P Griffin
- The University of Queensland, School of Public Health, Brisbane, Qld 4006 Australia; and Insight Research Services Associated, Brisbane, Qld 4109, Australia
| | - Jo Durham
- The University of Queensland, School of Public Health, Brisbane, Qld 4006 Australia; and Queensland University of Technology, School of Public Health and Social Work, Brisbane, Qld 4059, Australia
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18
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Dean JA, Bell SFE, Coffey L, Debattista J, Badman S, Redmond AM, Whiley DM, Lemoire J, Williams OD, Howard C, Gilks CF. Improved sensitivity from pooled urine, pharyngeal and rectal specimens when using a molecular assay for the detection of chlamydia and gonorrhoea near point of care. Sex Transm Infect 2020; 97:471-472. [PMID: 33188137 DOI: 10.1136/sextrans-2020-054835] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/25/2020] [Indexed: 11/03/2022] Open
Affiliation(s)
- Judith Ann Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Sara Fiona Elizabeth Bell
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Luke Coffey
- RAPID, Queensland Positive People, Brisbane, Queensland, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Windsor, Queensland, Australia
| | - Steven Badman
- The Kirby Insitute, University of New South Wales, Sydney, New South Wales, Australia
| | - Andrew M Redmond
- RAPID, Queensland Positive People, Brisbane, Queensland, Australia.,Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - David M Whiley
- Centre for Clinical Research, The University of Queensland, Herston, Queensland, Australia.,Pathology Queensland, Queensland Health, Herston, Queensland, Australia
| | - Jime Lemoire
- RAPID, Queensland Positive People, Brisbane, Queensland, Australia
| | - Owain David Williams
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Chris Howard
- RAPID, Queensland Positive People, Brisbane, Queensland, Australia
| | - Charles F Gilks
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
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Blondell SJ, Debattista J, Griffin MP, Durham J. Conceptualising, measuring, and addressing HIV-related stigma: Towards reducing disparities in HIV testing and HIV-related outcomes among migrants of HIV unknown or negative status in high-income countries. Health Promot J Austr 2020; 32:433-436. [PMID: 32619076 DOI: 10.1002/hpja.383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 06/29/2020] [Indexed: 11/07/2022] Open
Affiliation(s)
- Sarah J Blondell
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital & Health Service, Brisbane, QLD, Australia
| | - Mark P Griffin
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
- Insight Research Services Associated, Brisbane, QLD, Australia
| | - Jo Durham
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
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Wadham E, Green C, Debattista J, Somerset S, Sav A. New digital media interventions for sexual health promotion among young people: a systematic review. Sex Health 2020; 16:101-123. [PMID: 30819326 DOI: 10.1071/sh18127] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 11/22/2018] [Indexed: 11/23/2022]
Abstract
New digital media platforms (e.g. social networking sites, web pages and text messaging) have dramatically changed interpersonal communication and present novel opportunities for health interventions. Due to the high uptake and use of digital media among young people, advances in digital media provide potential new opportunities in delivering health interventions to this audience to reduce sexually transmissible infection (STI) risk. The aim of this study was to assess the effectiveness of sexual health interventions delivered via new digital media to young people (aged 13-24 years). A systematic search was conducted of seven databases for peer-reviewed literature published between January 2010 and April 2017 that evaluated a sexual health intervention delivered to young people (aged 13-24 years). Of 2017 papers reviewed, 25 met the inclusion criteria and were assessed. Sixteen studies used web-based platforms to deliver their intervention. A large proportion of studies (11/25) specifically focused on HIV prevention. Seven studies found a statistically significant effect of the intervention on knowledge levels regarding the prevention HIV and other STI, as well as general sexual health knowledge, but only one-fifth of interventions evaluating intentions to use condoms reported significant effects due to the intervention. Nine studies focused on individuals from an African American background. Although new media has the capacity to expand efficiencies and coverage, the technology itself does not guarantee success. It is essential that interventions using new digital media have high-quality, evidence-based content that engages with individual participants.
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Affiliation(s)
- Erin Wadham
- School of Allied Health, Australian Catholic University, Banyo, Qld 4014, Australia
| | - Clare Green
- School of Allied Health, Australian Catholic University, Banyo, Qld 4014, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Bryden Street, Windsor, Qld 4030, Australia
| | - Shawn Somerset
- School of Allied Health, Australian Catholic University, Banyo, Qld 4014, Australia; and Present address: Faculty of Health, University of Canberra, 11 Kirinari Street, Bruce, ACT 2617, Australia
| | - Adem Sav
- School of Allied Health, Australian Catholic University, Banyo, Qld 4014, Australia; and School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Qld 4059, Australia; and Corresponding author.
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Badman SG, Bell SFE, Dean JA, Lemoire J, Coffey L, Debattista J, Redmond AM, Williams OD, Gilks CF, Whiley DM. Reduced sensitivity from pooled urine, pharyngeal and rectal specimens when using a molecular assay for the detection of chlamydia and gonorrhoea near the point of care. Sex Health 2020; 17:15-21. [PMID: 31945307 DOI: 10.1071/sh19028] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 09/12/2019] [Indexed: 11/23/2022]
Abstract
Background The aim of this study was to compare the performance of pooled self-collected urogenital, pharyngeal and anorectal specimens to that of individual specimen results for the molecular detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) near the point of care (POC) for diagnostic sensitivity. METHODS Clients (mostly men who have sex with men) attending an urban community testing service and three sex-on-premises venues in Brisbane, Australia, were offered CT and NG testing by trained lay providers. Participants provided three self-collected specimens (urine, pharyngeal and rectal) for testing by GeneXpert (Cepheid, Sunnyvale, CA, USA). If any of the individual specimens from a participant were positive, all three specimens were pooled and retested. RESULTS Of the 388 participants who provided three individual anatomical specimens, 76 (19.6%) were found to be positive for CT and/or NG at one or more sites. The pooling approach failed to detect five CT rectal and four NG pharyngeal infections. The overall performance (sensitivity) of the pooling approach compared with individual specimen testing and Cohen's κ were 90.0% and 0.86 respectively for CT and 89.7% and 0.89 respectively for NG. CONCLUSIONS Reduced sensitivity was observed when using pooled specimens for the detection of CT and NG using GeneXpert near the POC, similar to results reported in laboratory-based CT and NG pooling studies. These data suggest specimen pooling is feasible near to the POC, potentially saving time and costs when screening at-risk populations for CT and NG. Our data also suggest a reduction in pooled urine could improve overall test sensitivity.
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Affiliation(s)
- Steven G Badman
- The Kirby Institute, Level 6, Wallace Wurth Building, High Street, UNSW Sydney, Randwick, NSW 2032, Australia; and Corresponding author.
| | - Sara F E Bell
- School of Public Health, The University of Queensland, 288 Herston Road, Herston, Qld 4006, Australia
| | - Judith A Dean
- School of Public Health, The University of Queensland, 288 Herston Road, Herston, Qld 4006, Australia
| | - Jime Lemoire
- RAPID, Queensland Positive People, 21 Manilla Street, East Brisbane, Qld 4169, Australia
| | - Luke Coffey
- RAPID, Queensland Positive People, 21 Manilla Street, East Brisbane, Qld 4169, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Bryden Street, Windsor, Qld 4030, Australia
| | - Andrew M Redmond
- RAPID, Queensland Positive People, 21 Manilla Street, East Brisbane, Qld 4169, Australia; and Infectious Diseases Services, Royal Brisbane and Women's Hospital, Herston, Qld 4029, Australia
| | - Owain D Williams
- School of Public Health, The University of Queensland, 288 Herston Road, Herston, Qld 4006, Australia
| | - Charles F Gilks
- School of Public Health, The University of Queensland, 288 Herston Road, Herston, Qld 4006, Australia
| | - David M Whiley
- Centre for Clinical Research, The University of Queensland, Building 71/918, Royal Brisbane and Women's Hospital Campus, Herston, Qld 4029, Australia; and Pathology Queensland, Level 4, Block 7, Royal Brisbane and Women's Hospital, Herston, Qld 4006, Australia
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Bell SFE, Coffey L, Debattista J, Badman SG, Redmond AM, Whiley DM, Lemoire J, Williams OD, Howard C, Gilks CF, Dean JA. Peer-delivered point-of-care testing for Chlamydia trachomatis and Neisseria gonorrhoeae within an urban community setting: a cross-sectional analysis. Sex Health 2020; 17:359-367. [PMID: 32731917 DOI: 10.1071/sh19233] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 06/11/2020] [Indexed: 11/23/2022]
Abstract
Background The advent of fully automated nucleic acid amplification test (NAAT) technology brings new public health opportunities to provide Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) point-of-care testing (POCT) in non-traditional settings. METHODS This pilot study evaluated the integration of the CT/NG Xpert diagnostic assay into an urban peer-led community setting providing HIV and syphilis POCT. A comprehensive protocol of testing, result notification, referral and follow up, managed by peer test facilitators, was undertaken. RESULTS Over 67 weeks, there were 4523 occasions of CT/NG testing using urine, oropharyngeal and anorectal samples with 25.7% (803) of the 3123 unique participants returning for repeat testing. The prevalence of CT and NG was 9.5% and 5.4% respectively. Where CT and or NG infection was detected, 98.4% (604/614) of participants were successfully notified of detected infection and referred for treatment. Evaluation Survey responses (11.4%, 516/4523) indicated a substantial proportion of respondents (27.1%, 140/516) 'would not have tested anywhere else'. Of note, 17.8% (92/516) of participants reported no previous CT/NG test and an additional 17.8% (92/516) reported testing more than 12 months ago. A total of 95.9% (495/516) of participants 'Strongly agreed' or 'Agreed' to being satisfied with the service. CONCLUSION The project successfully demonstrated an acceptable and feasible model for a peer-delivered community-led service to provide targeted molecular CT/NG POCT. This model offers capacity to move beyond the traditional pathology and STI testing services and establish community-led models that build trust and increase testing rates for key populations of epidemiological significance.
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Affiliation(s)
- Sara F E Bell
- School of Public Health, The University of Queensland, Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia
| | - Luke Coffey
- RAPID, Queensland Positive People, 21 Manilla Street, East Brisbane, Qld 4169, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Bryden Street, Windsor, Qld 4030, Australia
| | - Steven G Badman
- Kirby Institute, L6, Wallace Wurth Building, High Street, The University of New South Wales Sydney, Randwick, NSW 2032, Australia
| | - Andrew M Redmond
- RAPID, Queensland Positive People, 21 Manilla Street, East Brisbane, Qld 4169, Australia; and Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Butterfield St, Herston, Qld 4029, Australia
| | - David M Whiley
- Centre for Clinical Research, The University of Queensland, Building 71/918, Royal Brisbane and Women's Hospital Campus, Herston, Qld 4029, Australia; and Pathology Queensland, Block 7, Royal Brisbane and Women's Hospital, Herston, Qld 4029, Australia
| | - Jime Lemoire
- RAPID, Queensland Positive People, 21 Manilla Street, East Brisbane, Qld 4169, Australia
| | - Owain D Williams
- School of Public Health, The University of Queensland, Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia
| | - Chris Howard
- RAPID, Queensland Positive People, 21 Manilla Street, East Brisbane, Qld 4169, Australia
| | - Charles F Gilks
- School of Public Health, The University of Queensland, Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia
| | - Judith A Dean
- School of Public Health, The University of Queensland, Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia; and Corresponding author.
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23
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Brömdal A, Clark KA, Hughto JMW, Debattista J, Phillips TM, Mullens AB, Gow J, Daken K. Whole-incarceration-setting approaches to supporting and upholding the rights and health of incarcerated transgender people. INT J TRANSGENDERISM 2019; 20:341-350. [PMID: 32999621 PMCID: PMC6913601 DOI: 10.1080/15532739.2019.1651684] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Annette Brömdal
- School of Education, Faculty of Business, Education, Law and Arts, Centre for Health, Informatics and Economic Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Kirsty A Clark
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Jaclyn M W Hughto
- Departments of Behavioral and Social Sciences and Epidemiology, Brown School of Public Health, Center for Health Equity Research, Brown University, Providence, RI, USA
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital & Health Service, Brisbane, Queensland, Australia
| | - Tania M Phillips
- Centre for Health, Informatics and Economic Research, Institute for Resilient Regions, University of Southern Queensland, Queensland, Australia
| | - Amy B Mullens
- School of Psychology and Counselling, Faculty of Health, Engineering and Sciences, Centre for Health, Informatics and Economic Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Jeff Gow
- School of Commerce, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Queensland, Australia
- School of Accounting, Economics and Finance, University of KwaZulu-Natal, Durban, South Africa
| | - Kirstie Daken
- School of Psychology and Counselling, Faculty of Health, Engineering and Sciences, Centre for Health, Informatics and Economic Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
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Dean J, Mitchell M, Stewart D, Debattista J. Sexual health knowledge and behaviour of young Sudanese Queenslanders: a cross-sectional study. Sex Health 2019; 14:254-260. [PMID: 28104040 DOI: 10.1071/sh16171] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 11/18/2016] [Indexed: 11/23/2022]
Abstract
Background Forced migration is associated with sexual vulnerability. However, little is known about the sexual health literacy and needs of refugee-background youth post resettlement. METHODS Conducted in partnership with the Queensland Sudanese community, this study used a cross-sectional survey to explore the sexual health knowledge, attitudes and behaviours of a convenience sample of 16- to 24-year-old Sudanese-background youth in Australia (n=229). RESULTS Sexually transmissible infection (STI) and HIV knowledge scores were generally low, although they were found to significantly improve the longer participants had lived in Australia (P<0.001). Female participants reported significantly higher levels of both STI and HIV knowledge compared with the male cohort (P<0.001). The aggregated sexual risk behaviour score suggests generally low levels of risk-taking behaviour. However, of the 140 sexually active participants, 3.1% reported a STI diagnosis, 9.0% reported sex leading to a pregnancy and 33.1% reported they had experienced unwanted sex. Participants also reported engaging in behaviours such as anal sex (33%) and sharing injecting drug equipment. CONCLUSIONS Patterns of sexual behaviour among this predominately refugee-background group are not dissimilar to those of other young Australians. Nonetheless, the self-reported patterns of risk behaviour combined with the low and inaccurate levels of sexual health knowledge suggest this group of young people remain sexually vulnerable, particularly early within their resettlement experience. Culturally and contextually informed sexual health interventions are needed early within the resettlement experience.
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Affiliation(s)
- Judith Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia
| | - Marion Mitchell
- School of Nursing and Midwifery, Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Nathan Campus, 170 Kessels Road, Nathan, Qld 4111, Australia
| | - Donald Stewart
- School of Medicine, South Bank Campus, Griffith University, PO Box 3370, South Brisbane, Qld 4101, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Queensland Government, Bryden Street, Windsor, Qld 4030, Australia
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25
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O'Mullan C, Debattista J, Parkinson L. "I'm in control: I'm not stumbling in the dark anymore": Midlife women's experiences of successfully negotiating safer sex with new partners. J Women Aging 2018; 31:73-88. [PMID: 30160639 DOI: 10.1080/08952841.2018.1510243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 12/15/2022]
Abstract
The rates of STIs in women over 45 years have been steadily increasing in Australia and other Western countries. Traditionally sexual health and STI prevention and research has positioned young people as the priority population; to date, insufficient attention has been paid to the sexual health of women over 45 years. Using a strengths-based approach, the objective of this study was to explore the factors and mechanisms that enable Australian women aged 45 to 64 years to successfully negotiate safer sex practices in new relationships. Interpretative Phenomenological Analysis (IPA) was employed for an in-depth exploratory study of a sample of eight women. Three broad themes emerged: being informed, being prepared, and being empowered. These findings provide a valuable insight into how we can initiate change and support safer sex practices for this target group.
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Affiliation(s)
- Cathy O'Mullan
- a School of Health, Medical and Applied Science , Central Queensland University , Rockhampton , Australia
| | - Joseph Debattista
- b Metro North Public Health Unit , Queensland Health , Brisbane , Australia
| | - Lynne Parkinson
- a School of Health, Medical and Applied Science , Central Queensland University , Rockhampton , Australia
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26
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Bell SFE, Dean JA, Lemoire J, Debattista J, Driver G, Gilks CF, Redmond A, Williams OD. Integrated HIV self-testing (HIVST) service delivery in Queensland for policy and service development: study protocol. AIDS Care 2018; 31:207-215. [DOI: 10.1080/09540121.2018.1516859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
| | - Judith Ann Dean
- School of Public Health, The University of Queensland, Herston, Australia
| | - Jime Lemoire
- RAPID, Queensland Positive People, East Brisbane, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Windsor, Australia
| | - Glen Driver
- RAPID, Queensland Positive People, East Brisbane, Australia
| | - Charles F. Gilks
- School of Public Health, The University of Queensland, Herston, Australia
| | - Andrew Redmond
- RAPID, Queensland Positive People, East Brisbane, Australia
- Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Windsor, Australia
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Mullens AB, Kelly J, Debattista J, Phillips TM, Gu Z, Siggins F. Exploring HIV risks, testing and prevention among sub-Saharan African community members in Australia. Int J Equity Health 2018; 17:62. [PMID: 29784050 PMCID: PMC5963033 DOI: 10.1186/s12939-018-0772-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 05/03/2018] [Indexed: 12/20/2022] Open
Abstract
Background Significant health disparities persist regarding new and late Human Immunodeficiency Virus (HIV) diagnoses among sub-Saharan African (SSA) communities in Australia. Personal/cultural beliefs and practices influence HIV (risk, prevention, testing) within Australia and during visits to home countries. Method A community forum was conducted involving 23 male and female adult African community workers, members and leaders, and health workers; facilitated by cultural workers and an experienced clinician/researcher. The forum comprised small/large group discussions regarding HIV risk/prevention (responses transcribed verbatim; utilising thematic analysis). Results Stigma, denial, social norms, tradition and culture permeated perceptions/beliefs regarding HIV testing, prevention and transmission among African Australians, particularly regarding return travel to home countries. Conclusions International travel as a risk factor for HIV acquisition requires further examination, as does the role of the doctor in HIV testing and Pre-exposure Prophylaxis (PrEP). Further assessment of PrEP as an appropriate/feasible intervention is needed, with careful attention regarding negative community perceptions and potential impacts.
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Affiliation(s)
- Amy B Mullens
- School of Psychology and Counselling, Institute for Resilient Regions, University of Southern Queensland, Ipswich Campus, 11 Salisbury Road, Ipswich, Qld 4305, Australia.
| | - Jennifer Kelly
- School of Health and Wellbeing, University of Southern Queensland, Ipswich Campus, 11 Salisbury Road, Ipswich, Qld 4305, Australia
| | - Joseph Debattista
- Queensland Health, Metro North Public Health Unit, Bryden Street, Windsor, Qld 4030, Australia
| | - Tania M Phillips
- School of Psychology and Counselling, Institute for Resilient Regions, University of Southern Queensland, Ipswich Campus, 11 Salisbury Road, Ipswich, Qld 4305, Australia
| | - Zhihong Gu
- Ethnic Communities Council of Queensland, PO Box 5916, West End, Qld 4101, Australia
| | - Fungisai Siggins
- Kalpa purru Wirranjarlki, Anyinginyi Health Aboriginal Corporation, 1 Irvine Street, PO Box 40, Tennant Creek, NT, 0861, Australia
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Mullens AB, Fischer J, Stewart M, Kenny K, Garvey S, Debattista J. Comparison of Government and Non-Government Alcohol and Other Drug (AOD) Treatment Service Delivery for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community. Subst Use Misuse 2017; 52:1027-1038. [PMID: 28318357 DOI: 10.1080/10826084.2016.1271430] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 10/19/2022]
Abstract
BACKGROUND Lesbian, gay, bisexual, and transgender (LGBT) populations are more likely to misuse alcohol and other drugs (AOD), compared to the general population. However, LGBT engagement with AOD treatment is often precluded by insensitivity and misunderstanding of LGBT issues. These treatment barriers may be a consequence of either worker attitudes, organizational factors or a combination of both. Few studies have compared service context as an impediment to AOD treatment. OBJECTIVES This pilot study sought to examine and compare staff attitudes, knowledge and awareness of LGBT issues in two state-wide AOD services within Australia. One organization was a government service, whilst the other was faith based. METHODS A cross-sectional study of a convenience sample (N = 130) of workers employed in a state-wide government AOD service (n = 65), and a state-wide non-government service (n = 65) was conducted. Participants self-completed a questionnaire comprising tools previously used to assess staff attitudes, knowledge and awareness of LGBT issues. RESULTS Few significant differences in attitudes and awareness of LGBT issues between government and non-government respondents were found. Nearly all respondents were supportive of LGBT persons irrespective of organizational context, with a small number of negative views. Although most respondents demonstrated awareness of organizational policies and practices relating to LGBT clients, many were "unsure" or "neutral" of what these might be. CONCLUSION It is confirming that the majority of staff report supportive attitudes towards LGBT clients. Findings suggest that organizations need to continue to take leadership to strengthen organizational training and capacity to deliver LGBT friendly AOD treatment practices.
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Affiliation(s)
- Amy B Mullens
- a Sexual Health & HIV Service, Metro North Hospital and Health Service , Brisbane , Australia.,b School of Psychology and Counselling, University of Southern Queensland , Ipswich , Australia
| | - Jane Fischer
- c Alcohol and Other Drug Service, Metro North Hospital & Health Service , Brisbane , Australia.,d The National Centre for Education and Training on Addiction, Flinders University , Adelaide , Australia
| | - Mary Stewart
- c Alcohol and Other Drug Service, Metro North Hospital & Health Service , Brisbane , Australia
| | | | - Shane Garvey
- f QLD AIDS Council (formerly QLD Association for Healthy Communities) , Brisbane , Australia
| | - Joseph Debattista
- g Metro North Public Health Unit , Metro North Hospital and Health Service , Brisbane , Australia
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Mutch AJ, Lui CW, Dean J, Mao L, Lemoire J, Debattista J, Howard C, Whittaker A, Fitzgerald L. Increasing HIV testing among hard-to-reach groups: examination of RAPID, a community-based testing service in Queensland, Australia. BMC Health Serv Res 2017; 17:310. [PMID: 28454592 PMCID: PMC5410036 DOI: 10.1186/s12913-017-2249-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 04/19/2017] [Indexed: 01/18/2023] Open
Abstract
Background The success of ‘treatment as prevention’ (TasP) to control HIV relies on the uptake of testing across priority population groups. Innovative strategies including; rapid HIV testing (RHT) in community and outreach settings, engaging peer service providers, and not requiring disclosure of sexual history have been designed to increase access. This paper reports on the implementation of ‘RAPID’, a community-based testing program in Queensland, Australia that employs these strategies to increase access to testing. Methods Service data, including client registration forms and a satisfaction survey from all clients attending RAPID between August 2014 and July 2015 were analysed. Results In 2014/2015 1,199 people attended RAPID to receive a free HIV test. The majority were urban-based gay men. 17.1% were first-time testers and 20.1% of participants were not eligible to access Medicare, Australia’s universal health care scheme. Conclusions RAPID’s evidence-based strategies appear to facilitate access to HIV testing, particularly among those who have never tested before; however the implications for the ongoing treatment and care of people ineligible for Medicare, who test positive to HIV warrants careful consideration. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2249-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Allyson J Mutch
- The School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
| | - Chi-Wai Lui
- The School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Judith Dean
- The School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Limin Mao
- Centre for Social Research in Health (CSRH), University of New South Wales, NSW, Australia
| | - Jime Lemoire
- Queensland Positive People, Brisbane, Queensland, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Queensland Health, Brisbane, Queensland, Australia
| | - Chris Howard
- Queensland Positive People, Brisbane, Queensland, Australia
| | - Andrea Whittaker
- School of Social Sciences, Monash University, Melbourne, Victoria, Australia
| | - Lisa Fitzgerald
- The School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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Driver G, Debattista J, Gu Z, Lemoire J, Hooper J. HIV testing within the African community using home-based self collection of oral samples. Aust N Z J Public Health 2017; 41:446. [PMID: 28245516 DOI: 10.1111/1753-6405.12653] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
| | | | - Zhihong Gu
- Ethnic Communities Council of Queensland
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31
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O'Mullan C, Debattista J, Browne M. Risky business or not? FIFOs, sexual risk taking and the Australian mining industry. Health Promot J Austr 2017; 27:4-9. [PMID: 26603027 DOI: 10.1071/he15011] [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] [Received: 02/06/2015] [Accepted: 08/21/2015] [Indexed: 11/23/2022] Open
Abstract
Issue addressed The fly-in, fly-out (FIFO) and drive-in, drive-out (DIDO) models of mining in Australia have led to concerns about adverse health and psychosocial impacts. Despite speculation that increased levels of sexually transmitted infections (STIs) in Australia, including HIV, are associated with FIFO/DIDO work, we know little about sexual risk-taking behaviours in mining populations. This study explores differences in sexual risk taking and perceptions of risk between FIFO/DIDO miners and residential miners. Methods A cross-sectional survey was administered to a sample (n=444) of male miners working in Queensland, Australia. The self-completed survey contained 49 questions relating to knowledge, attitudes and behaviour and included demographic information and specific items related to sex and relationships. Results FIFO/DIDO status was not associated with any differential sexual risk-taking behaviours, except for an increased probability of reporting 'ever being diagnosed with an STI'; 10.8% of FIFO/DIDO respondents versus 3.6% of others (x(2) (1)=4.43, P=0.35). Conclusions Our results appear to counter anecdotal evidence that FIFO/DIDO miners engage in higher sexual risk behaviours when compared with residential miners. So what? Anecdotal evidence linking the rise of sexually transmitted infections with the FIFO/DIDO mining workforce could drive costly and unnecessary approaches to prevention. Further research, surveillance and monitoring are required to inform health promotion interventions.
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Affiliation(s)
- Cathy O'Mullan
- School of Human, Health and Social Sciences, Central Queensland University, Locked Bag 3333, Bundaberg, Qld 4670, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Locked Bag 2, Stafford, Qld 4053, Australia
| | - Matthew Browne
- School of Human, Health and Social Sciences, Central Queensland University, Locked Bag 3333, Bundaberg, Qld 4670, Australia
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Dean J, Mitchell M, Stewart D, Debattista J. Intergenerational variation in sexual health attitudes and beliefs among Sudanese refugee communities in Australia. Cult Health Sex 2017; 19:17-31. [PMID: 27268405 DOI: 10.1080/13691058.2016.1184316] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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
The aim of this study was to develop intergenerational understanding of the factors perceived to be influencing the sexual health and wellbeing of young Sudanese refugees in Queensland, Australia. Data from 11 semi-structured, face-to-face interviews exploring sexual health knowledge, attitudes and behaviours with young people aged 16 to 24 years, and five focus groups with adults from the broader Queensland Sudanese community, were compared and contrasted. Findings indicate that sexual health-related knowledge, attitudes and beliefs, along with patterns of sexual behaviour, are changing post-resettlement and this creates considerable intergenerational discord and family conflict. Study findings provide an understanding of how the interplay between traditional cultural gender, parenting and relationship norms and perceived normative Australian beliefs and patterns of behaviour influence the construction of both young people's and their parents' attitudes to sexual health post-arrival. We suggest that sexuality education programmes adapted to the specific cultural- and age-related contexts need to be introduced early within the resettlement process for both young people and their families.
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Affiliation(s)
- Judith Dean
- a School of Nursing and Midwifery , Griffith University , Brisbane , Australia
| | - Marion Mitchell
- a School of Nursing and Midwifery , Griffith University , Brisbane , Australia
- b Nurse Practice Development Unit , Princess Alexandra Hospital , Brisbane , Australia
| | - Donald Stewart
- c School of Medicine , Griffith University , Brisbane , Australia
| | - Joseph Debattista
- d Metro North Public Health Unit , Metro North Hospital and Health Service , Brisbane , Australia
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Debattista J, Hayes M, Marshall P, Pouchkareff N, Gordon R, Priddle A. A trial of pharmacy-based testing forChlamydia trachomatisusing postal specimen kits. J Pharm Pract Res 2016. [DOI: 10.1002/jppr.1221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Joseph Debattista
- Metro North Public Health Unit; Metro North Hospital & Health Service; Brisbane Queensland Australia
| | - Meghan Hayes
- The Pharmacy Guild of Australia (QLD Branch); Brisbane Queensland Australia
| | - Penelope Marshall
- Metro North Public Health Unit; Metro North Hospital & Health Service; Brisbane Queensland Australia
| | - Nickolas Pouchkareff
- Children's Health Queensland Hospital and Health Service; Brisbane Queensland Australia
| | - Rose Gordon
- Sexual Health Services; Townsville Hospital & Health Service; Townsville Queensland Australia
| | - Alannah Priddle
- The Pharmacy Guild of Australia (QLD Branch); Brisbane Queensland Australia
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Brown S, Debattista J, Durkin I, Hooper J. Mailed specimen collection for HIV testing in regional Queensland, Australia: a second attempt. Aust N Z J Public Health 2016; 40:397-8. [PMID: 27372726 DOI: 10.1111/1753-6405.12546] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
| | | | | | - John Hooper
- Darling Downs Sexual Health & HIV Service, Queensland
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Lambert SM, Debattista J, Bodiroza A, Martin J, Staunton S, Walker R. Effective peer education in HIV: defining factors that maximise success. Sex Health 2016; 10:325-31. [PMID: 23725575 DOI: 10.1071/sh12195] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 04/22/2013] [Indexed: 11/23/2022]
Abstract
UNLABELLED Background Peer education is considered an effective health promotion and education strategy, particularly to populations traditionally resistant to conventional forms of health information dissemination. This has made it very applicable to HIV education and prevention, where those who are affected or at risk are often amongst the most vulnerable in society. However, there still remains uncertainty as to the reasons for its effectiveness, what constitutes an effective methodology and why a consistent methodology can often result in widely variable outcomes. METHOD Between 2008 and 2010, three separate reviews of peer education were undertaken across more than 30 countries in three distinct geographical regions across the globe. The reviews sought to identify determinants of the strengths and weaknesses inherent in approaches to peer education, particularly targeting young people and the most at-risk populations. RESULTS By assessing the implementation of peer education programs across a variety of social environments, it was possible to develop a contextual understanding for peer education's effectiveness and provide a picture of the social, cultural, political, legal and geographic enablers and disablers to effective peer education. Several factors were significant contributors to program success, not as strategies of methodology, but as elements of the social, cultural, political and organisational context in which peer education was situated. CONCLUSION Contextual elements create environments supportive of peer education. Consequently, adherence to a methodology or strategy without proper regard to its situational context rarely contributes to effective peer education.
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Affiliation(s)
- Steven M Lambert
- School of Medicine, The University of Queensland, Brisbane, Qld 4072, Australia
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Bolsewicz K, Debattista J, Vallely A, Whittaker A, Fitzgerald L. Factors associated with antiretroviral treatment uptake and adherence: a review. Perspectives from Australia, Canada, and the United Kingdom. AIDS Care 2015; 27:1429-38. [PMID: 26641139 DOI: 10.1080/09540121.2015.1114992] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [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: 10/22/2022]
Abstract
International focus on reducing onward HIV transmission emphasizes the need for routine HIV testing and early uptake of antiretroviral treatment (ART). Strategic targets have been set for 2020 to achieve the goal of 90% of people infected with HIV diagnosed, 90% of identified cases on treatment, and 90% of persons on treatment virally suppressed (90-90-90). It is vital to understand the complexity of factors influencing a person's treatment decisions over time and the context which may enable better adherence. In this paper we present findings from the review of published and gray literature (2003-2013) on the documented factors associated with treatment initiation and adherence in the general adult population of Australia, Canada, and the UK. A framework developed by Begley, McLaws, Ross, and Gold [2008. Cognitive and behavioural correlates of non-adherence to HIV anti-retroviral therapy: Theoretical and practical insight for clinical psychology and health psychology. Clinical Psychologist, 12(1), 9-17] in Australia was adapted to summarize the findings. A systematic database search using keywords and a set of inclusion criteria yielded 17 studies (Australia = 6; Canada = 8; UK = 3). In addition 11 reports were included in the review. We found that a person's abilities and motivations (intrapersonal factors, reported in 7 studies) to start and continue ART are influenced by a host of interconnected factors spanning relationship (interpersonal, 3 studies) and broader structural (extrapersonal, 15 studies) factors that are situated within social determinants of health. People therefore evaluate various costs and benefits of starting and staying on treatment, in which biomedical concerns play an important yet often subsidiary role. In this review the economic barriers to care were found to be significant and under-reported, highlighting the persistent health inequities in terms of access to services. Our understanding of the context around people's use of ART remains poor. Qualitative social research within HIV-positive communities is urgently needed to capture people's lived experiences and may address some of this deficit in understanding.
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Affiliation(s)
- K Bolsewicz
- a School of Public Health, University of Queensland , Herston , Australia
| | - J Debattista
- b Metro North Public Health Unit, Metro North Hospital & Health Service , Windsor , Australia
| | - A Vallely
- c Public Health Interventions Research Group, The Kirby Institute, UNSW.,d Australian Institute of Tropical Health & Medicine, James Cook University , Cairns , Australia
| | - A Whittaker
- e School of Social Science, Faculty of Arts , Monash University , Melbourne , Victoria , Australia
| | - L Fitzgerald
- a School of Public Health, University of Queensland , Herston , Australia
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Rutkin W, Debattista J, Martin P, Hooper J. Trial of mailed specimen collection for HIV testing in regional Queensland. Aust N Z J Public Health 2015; 38:193-4. [PMID: 24690061 DOI: 10.1111/1753-6405.12182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Van Huy N, P Dunne M, Debattista J. Predictors of condom use behaviour among male street labourers in urban Vietnam using a modified Information-Motivation-Behavioral Skills (IMB) model. Cult Health Sex 2015; 18:321-336. [PMID: 26416016 DOI: 10.1080/13691058.2015.1084375] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 06/05/2023]
Abstract
HIV risk in vulnerable groups such as itinerant male street labourers is often examined via a focus on individual determinants. This study provides a test of a modified Information-Motivation-Behavioral Skills (IMB) model to predict condom use behaviour among male street workers in urban Vietnam. In a cross-sectional survey using a social mapping technique, 450 male street labourers from 13 districts of Hanoi, Vietnam were recruited and interviewed. Collected data were first examined for completeness; structural equation modelling was then employed to test the model fit. Condoms were used inconsistently by many of these men, and usage varied in relation to a number of factors. A modified IMB model had a better fit than the original IMB model in predicting condom use behaviour. This modified model accounted for 49% of the variance, versus 10% by the original version. In the modified model, the influence of psychosocial factors was moderately high, whilst the influence of HIV prevention information, motivation and perceived behavioural skills was moderately low, explaining in part the limited level of condom use behaviour. This study provides insights into social factors that should be taken into account in public health planning to promote safer sexual behaviour among Asian male street labourers.
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Affiliation(s)
- Nguyen Van Huy
- a Department of Health Management, Institute for Preventive Medicine and Public Health , Hanoi Medical University , Hanoi , Vietnam
| | - Michael P Dunne
- b School of Public Health and Social Work, Faculty of Health , Queensland University of Technology , Brisbane , Australia
- c Institute for Community Health Research , Hue University of Medicine and Pharmacy , Hue , Vietnam
| | - Joseph Debattista
- d Metro North Public Health Unit , Metro North Hospital and Health Service , Brisbane , Australia
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Bolsewicz K, Fitzgerald L, Debattista J, Gardiner B, Whittaker A. P17.16 Personal decisions around anti-retroviral therapies (art): findings from the literature and from a qualitative longitudinal study with people living with hiv (plhiv) in regional queensland, australia. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Priddle A, Debattista J, Hayes M, Marshall P, Pouchkareff N, Gordon R. P08.27 Results of a 2014 qld trial of pharmacy accessed testing for chlamydia trachomatisvia retail self-test uri swab postal specimen kits. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Despite their historical controversy as perceived public health risks, sex on premises venues (SOPV) such as saunas and sex clubs can afford structured opportunities for on-site sexual health interventions within a supportive, regulated and confidential environment. Building upon previous interventions to deliver on-site clinical and health promotion programmes, an education and referral outreach service was established at one particular SOPV within the inner Brisbane city area. This report outlines the experiences of that on-site education/referral outreach over a five-year period. The service did afford opportunities for a minority of patrons to discuss concerns, resolve misunderstandings, obtain advice and referral, and would suggest that a health promotion presence within such a venue is a useful mechanism for engaging with highly sexually active men.
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Affiliation(s)
- Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital & Health Service, Brisbane, QLD, Australia
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Bolsewicz K, Vallely A, Debattista J, Whittaker A, Fitzgerald L. Factors impacting HIV testing: a review--perspectives from Australia, Canada, and the UK. AIDS Care 2014; 27:570-80. [PMID: 25483628 DOI: 10.1080/09540121.2014.986050] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [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: 10/24/2022]
Abstract
With the current global focus on strengthening HIV prevention through greater testing and treatment uptake, it is increasingly salient to identify and address barriers to testing. A review of the published, peer-reviewed literature and national reports from Australia, Canada, and the UK (2003-2013) on barriers to HIV testing was conducted to provide new information relevant to Australia and to complement earlier reviews from Canada and the UK. A systematic database search using keywords and a set of inclusion criteria yielded 36 studies (Australia = 13; Canada = 6; and the UK = 17). In addition 17 unpublished reports were included in the review. Our study uses a novel, comprehensive framework to describe barriers to HIV testing, and thus contributes to moving beyond the traditional patient-provider-system categorization. Within that framework, barriers are categorized as either intrapersonal (reported in 15 studies), interpersonal (21), or extrapersonal (16) and conceptualized within wider sociocultural and structural contexts. People's abilities and motivations to test (intrapersonal factors) are influenced by a host of interconnected factors spanning relationship (interpersonal) and broader socioeconomic, political and cultural (extrapersonal) factors. We suggest that the relative effects of interventions targeting barriers to HIV testing at the intrapersonal and interpersonal levels are limited by the extent to which the social determinants of health are addressed. The framework may also lend itself to thinking about the enabling factors for HIV testing, and future research may investigate the application of that framework for strategizing the most effective response. Future studies should also capture the lived experiences of barriers to HIV testing experienced by patients, especially in populations which are hard to reach based on social and geographic distance. Context-specific studies to evaluate the feasibility and effectiveness of various interventions proposed in the literature to address barriers to HIV testing are needed.
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Affiliation(s)
- K Bolsewicz
- a School of Population Health , University of Queensland , Brisbane , QLD , Australia
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McNicol J, Debattista J. Use of the UriSwab collection device for testing of Chlamydia trachomatis and Neisseria gonorrhoeae: implications for a postal testing service. Int J STD AIDS 2013; 24:477-80. [DOI: 10.1177/0956462412472834] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Summary In order to demonstrate the reliability of UriSwab, a trial was conducted using urine samples that had previously returned a detected result for Chlamydia trachomatis and/or Neisseria gonorrhoeae. Urine specimens (115 samples) were received from sexual health clinics and tested using the Roche Cobas 4800 CT/NG method. Concurrently, the urine samples were pipetted directly on to the sponge applicator of the UriSwab, simulating micturition, and the urine harvested from the UriSwab was tested using the Roche Cobas 4800 method. Of the 87 standard urine specimens that were C. trachomatis detected, 85 (98%) were also detected in the corresponding UriSwab specimen (sensitivity 97.7%, specificity 95.7%). Of the 34 standard specimens that were N. gonorrhoeae detected, 33 (97%) were also detected in the corresponding UriSwab specimen (sensitivity 97.1%, specificity 100%). The performance of the UriSwab in this trial was comparable with the testing of neat first-catch urine specimens for both C. trachomatis and N. gonorrhoeae.
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Affiliation(s)
- J McNicol
- Pathology Queensland, Central Laboratory, Molecular Diagnostic Unit
| | - J Debattista
- Sexual Health & HIV Service, Metro North Health Service District, Brisbane, Australia
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Buhrer-Skinner M, Muller R, Buettner PG, Gordon R, Debattista J. Reducing barriers to testing for Chlamydia trachomatis by mailed self-collected samples. Sex Health 2013; 10:32-8. [PMID: 23158104 DOI: 10.1071/sh11065] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 06/22/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Chlamydia trachomatis (chlamydia) is the most commonly notified sexually transmissible bacterial infection in Australia, where distance to health services can be a barrier. This study investigated the acceptability of a self-collection kit for chlamydia testing (sent by mail) and assessed the risk profiles of participants with respect to locality. METHODS In total, 2587 self-collection kits were distributed opportunistically or sent directly to participants upon request, as was a self-administered questionnaire. RESULTS The return rate was 13.2% (n=341) for samples and questionnaires. The return rate did not differ with location (P=0.522) but with mode of distribution (opportunistic: 9.7%; by request: 27.4%; P<0.001). Although 37% of participants had previously been tested for chlamydia, 77.5% said that they would not have sought testing otherwise. The median age of participants was 22.6 years, 33.8% were male and 9.1% were of Aboriginal descent. Overall, 9.0% (95% confidence interval (CI)=6.1-12.5) of participants were chlamydia-positive. Prevalence of chlamydia and Aboriginal participation increased with remoteness (P<0.001), and self-reported condom use was significantly reduced for remote and very remote locations (P=0.008). Within remote and very remote locations, 30.8% (95% CI=9.1-61.4) of Aboriginal participants and 38.9% of non-Indigenous participants were chlamydia-positive (P=0.718; 95% CI=17.3-64.3). DISCUSSION Testing for chlamydia using a mailed self-collection kit opened access to a predominantly test-naïve population. The proposed model was able to reach remote populations. Actively requested kits were more likely to be returned.
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Abstract
This study assessed the prevalence of and factors associated with HIV testing among male street laborers. In a cross-sectional survey, social mapping was done to recruit and interview 450 men aged 18-59 years in Hanoi. Although many of these men engaged in multiple risk behaviors for HIV, only 19.8 percent had been tested for HIV. A modified theoretical model provided better fit than the conventional Information-Motivation-Behavioral Skills model, as it explained much more variance in HIV testing. This model included three Information-Motivation-Behavioral components and four additional factors, namely, the origin of residence, sexual orientation, the number of sexual partners, and the status of condom use.
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Stansfield SH, Patel P, Debattista J, Armitage CW, Cunningham K, Timms P, Allan J, Mittal A, Huston WM. Proof of concept: A bioinformatic and serological screening method for identifying new peptide antigens for Chlamydia trachomatis related sequelae in women. Results Immunol 2013; 3:33-9. [PMID: 24600556 DOI: 10.1016/j.rinim.2013.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 05/01/2013] [Accepted: 05/02/2013] [Indexed: 12/30/2022]
Abstract
This study aimed to identify new peptide antigens from Chlamydia (C.) trachomatis in a proof of concept approach which could be used to develop an epitope-based serological diagnostic for C. trachomatis related infertility in women. A bioinformatics analysis was conducted examining several immunodominant proteins from C. trachomatis to identify predicted immunoglobulin epitopes unique to C. trachomatis. A peptide array of these epitopes was screened against participant sera. The participants (all female) were categorized into the following cohorts based on their infection and gynecological history; acute (single treated infection with C. trachomatis), multiple (more than one C. trachomatis infection, all treated), sequelae (PID or tubal infertility with a history of C. trachomatis infection), and infertile (no history of C. trachomatis infection and no detected tubal damage). The bioinformatics strategy identified several promising epitopes. Participants who reacted positively in the peptide 11 ELISA were found to have an increased likelihood of being in the sequelae cohort compared to the infertile cohort with an odds ratio of 16.3 (95% c.i. 1.65-160), with 95% specificity and 46% sensitivity (0.19-0.74). The peptide 11 ELISA has the potential to be further developed as a screening tool for use during the early IVF work up and provides proof of concept that there may be further peptide antigens which could be identified using bioinformatics and screening approaches.
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Affiliation(s)
- Scott H Stansfield
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Qld. 4059, Australia
| | - Pooja Patel
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Qld. 4059, Australia
| | - Joseph Debattista
- Metro North and Sunshine Health Service Districts, Sexual Health and HIV Service, Queensland Health, 270 Roma Street, Brisbane, Qld. 4000, Australia
| | - Charles W Armitage
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Qld. 4059, Australia
| | - Kelly Cunningham
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Qld. 4059, Australia
| | - Peter Timms
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Qld. 4059, Australia
| | - John Allan
- The Wesley Research Institute and The Wesley Reproductive Medicine and Gynaecological Surgery Unit, The Wesley Medical Centre, 40 Chasley Street, Auchenflower, Qld. 4066, Australia
| | - Aruna Mittal
- Institute of Pathology-ICMR, Safdarjung Hospital Campus, Post Box no. 4909, New Delhi 110029, India
| | - Wilhelmina M Huston
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Qld. 4059, Australia
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Nguyen VH, Dunne MP, Debattista J. Modeling predictors of risky drug use behavior among male street laborers in urban Vietnam. BMC Public Health 2013; 13:453. [PMID: 23651704 PMCID: PMC3681656 DOI: 10.1186/1471-2458-13-453] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2012] [Accepted: 05/02/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The application of theoretical frameworks for modeling predictors of drug risk among male street laborers remains limited. The objective of this study was to test a modified version of the IMB (Information-Motivation-Behavioral Skills Model), which includes psychosocial stress, and compare this modified version with the original IMB model in terms of goodness-of-fit to predict risky drug use behavior among this population. METHODS In a cross-sectional study, social mapping technique was conducted to recruit 450 male street laborers from 135 street venues across 13 districts of Hanoi city, Vietnam, for face-to-face interviews. Structural equation modeling (SEM) was used to analyze data from interviews. RESULTS Overall measures of fit via SEM indicated that the original IMB model provided a better fit to the data than the modified version. Although the former model was able to predict a lesser variance than the latter (55% vs. 62%), it was of better fit. The findings suggest that men who are better informed and motivated for HIV prevention are more likely to report higher behavioral skills, which, in turn, are less likely to be engaged in risky drug use behavior. CONCLUSIONS This was the first application of the modified IMB model for drug use in men who were unskilled, unregistered laborers in urban settings. An AIDS prevention program for these men should not only distribute information and enhance motivations for HIV prevention, but consider interventions that could improve self-efficacy for preventing HIV infection. Future public health research and action may also consider broader factors such as structural social capital and social policy to alter the conditions that drive risky drug use among these men.
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Affiliation(s)
- Van Huy Nguyen
- Department of Health Management and Organization, Institute for Preventive Medicine and Public Health, Hanoi Medical University, 01 Ton That Tung Str., Dong Da Dist., Hanoi, Vietnam
| | - Michael P Dunne
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Joseph Debattista
- Brisbane Sexual Health and HIV Service, MetroNorth Hospital and Health Service, Brisbane, Australia
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Fischer JA, Debattista J, Rostami S, Peet AR, Dean JA, Allen KE, Stewart M. Sexual risk taking in a community sample of international backpackers visiting Brisbane, Australia. Asia Pac J Public Health 2013; 27:NP2400-9. [PMID: 23572374 DOI: 10.1177/1010539513483822] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 11/15/2022]
Abstract
We sought to examine correlations between international backpackers' alcohol consumption and sexual behaviors and determine the prevalence of Chlamydia trachomatis and Neisseria gonorrhoea in this population. A cross-sectional study design consisting of a convenience sample (N = 168) of non-treatment-seeking international backpackers visiting Brisbane, Australia was recruited. Participants were asked to self-complete a questionnaire on sexual behavior and to undertake a urine-based polymerase chain reaction test for C trachomatis and N gonorrhoea. Since arriving in Australia, 73.2% reported having had sex, with a median number of 2 different sex partners (range = 0-21). Most participants had consumed alcohol (53.7%) and used condoms (46.3%) the last time they had sex. In our sample, there was a 4.3% prevalence of C trachomatis and a 0% prevalence of N gonorrhoea. This study identified a variable pattern of risk among backpackers, with those spending longer periods in the country more likely to have sex with Australians.
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Affiliation(s)
- Jane A Fischer
- Centre for Drug and Alcohol Studies, Queensland Health, Brisbane, Queensland, Australia
| | - Joseph Debattista
- Sexual Health and HIV Service, Queensland Health, Brisbane, Queensland, Australia
| | - Soulmaz Rostami
- Ethnic Communities Council of Queensland, Brisbane, Queensland, Australia
| | - Anthony R Peet
- Metro South Health Service District, Queensland Health, Brisbane, Queensland, Australia
| | - Judith A Dean
- Sexual Health and HIV Service, Queensland Health, Brisbane, Queensland, Australia Griffith University, Brisbane, Queensland, Australia
| | - Kate E Allen
- Sexual Health and HIV Service, Queensland Health, Brisbane, Queensland, Australia
| | - Mary Stewart
- Centre for Drug and Alcohol Studies, Queensland Health, Brisbane, Queensland, Australia
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