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0000-0002-5271-2881
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Public Health and Health Services | Sociology | Sociology not elsewhere classified | Preventive Medicine | Sociology | Indigenous Health | Correctional Theory, Offender Treatment and Rehabilitation | Social and Cultural Anthropology | Health and Community Services | Health Policy | Aboriginal and Torres Strait Islander Health | Sociology of health | Social Policy | Public Health And Health Services Not Elsewhere Classified | Public Health and Health Services not elsewhere classified |
ANZSRC Socio-Economic Objective (SEO)
Expanding Knowledge through Studies of Human Society | Social Structure and Health | Aboriginal and Torres Strait Islander health | Expanding Knowledge in the Medical and Health Sciences | Rehabilitation and Correctional Services | Evaluation of Health Outcomes | Aboriginal and Torres Strait Islander Health - Health System Performance (incl. Effectiveness of Interventions) | Public health not elsewhere classified | Behaviour and health
Related Links
Publications
Characteristics and attendance patterns of a fixed-site NSP and nearby SVM: The benefits of 24-hour access to sterile injecting equipment
Publisher: Informa UK Limited
Date: 29-08-2014
Rethinking safety and fidelity: The role of love and intimacy in hepatitis C transmission and prevention
Publisher: Informa UK Limited
Date: 09-2012
Exposure to injecting drug use and hepatitis C knowledge among an online sample of young people
Publisher: Informa UK Limited
Date: 04-09-2015
Individual and population level impacts of illicit drug use, sexual risk behaviours on sexually transmitted infections among young Aboriginal and Torres Strait Islander people: results from the GOANNA
Publisher: Springer Science and Business Media LLC
Date: 19-07-2016
Hepatitis C and injecting-related discrimination in New South Wales, Australia
Publisher: Informa UK Limited
Date: 2006
Caesarean birth: Consumption, safety, order, and good mothering
Publisher: Elsevier BV
Date: 09-2007
DOI: 10.1016/J.SOCSCIMED.2007.05.025
Abstract: This article draws on qualitative data to explore the beliefs through which decisions about caesarean birth are made and to consider how these might contribute to the increasing rate of caesarean birth. A total of 36 interviews were conducted in Australia, including 12 hospital-based midwives, 6 obstetricians, and 18 women who had experienced caesarean birth within the 2 years prior to the research interview. Data reveal a belief derived from the pervasive discourse of neo-liberalism that women are self-governing autonomous subjects in their birth experience, with entitlement to the consumption of birthing information and services, as guided by obstetricians. Feeding into this belief are coexisting discourses that serve to organise 'free choice' in terms of safe/unsafe, order/disorder, life/death and with ontological meanings, by structuring women's mothering identities as good/bad. The neo-liberal obligation to manage risk and pursue success for both mothers and babies means that women (and others) are obliged to choose what is set up as the most obvious and sensible option: safe, ordered caesareans. The structuring of discourses in this way shows how caesareans can be positioned as a preferential means of birth.
Belonging, Citizenship and Ambivalence among Young Gay, Bisexual and Queer Indian Singaporean Men
Publisher: Informa UK Limited
Date: 24-06-2020
Practising care in a pandemic: Accounting for everyday life during COVID‐19 among people who inject drugs
Publisher: Wiley
Date: 04-02-2023
Abstract: From the outset of the COVID‐19 pandemic, fears have been raised worldwide regarding the unique challenges facing socially marginalised people such as those who inject drugs. This article draws on in‐depth interviews conducted during the first year of the pandemic with people who inject drugs living in urban and regional Australia. Perhaps the most surprising finding to emerge was the number of participants who reported minimal disruption to their everyday lives, even improved wellbeing in some instances. Attempting to make sense of this unanticipated finding, our analysis draws on the concept of ‘care’, not as a moral disposition or normative code but as something emergent, contingent and realised in practice. Working with Foucault’s ethics and recent feminist insights on the politics of care from the field of Science and Technology Studies, we explore how care was enacted in the everyday lives of our participants. We examine how participants’ daily routines became objects of care and changed practice in response to the pandemic how their ongoing engagement with harm reduction services afforded not only clinical support but vital forms of social and affective connection and how for some, care was realised through an ethos and practice of constrained sociality and solitude.
Initiators: An Examination of Young Injecting Drug Users Who Initiate Others to Injecting
Publisher: Springer Science and Business Media LLC
Date: 21-12-2007
DOI: 10.1007/S10461-007-9347-Z
Abstract: Research about initiation to injecting drugs emphasises the role that relationships with others plays in the experience, suggesting investigations of initiation should include an examination of both initiates and initiators. This paper uses cross-sectional data collected from 324 young, early-career injecting drug users (IDU) to describe the socio-demographic characteristics, drug and injecting practices, and harm reduction knowledge and practices of people who report initiating others to injecting. Fifty-five participants (17%) reported giving someone else their first injection. They reported initiating a total of 128 other people within the first 5 years of their own injecting. Compared to non-initiators, initiators were more likely to pass on harm reduction information [odds ratios (OR): 2.36, 95% confidence intervals (CI): 1.26-4.40]. However, the quality of this information was unknown and initiators did not have more accurate knowledge of blood borne viruses (BBV) than non-initiators, and commonly obtained needles and syringes from sources where the sterility of the equipment could not be guaranteed.
Consumers' and providers' perspectives about consumer participation in drug treatment services: Is there support to do more? What are the obstacles?
Publisher: Wiley
Date: 03-2008
DOI: 10.1080/09595230701829405
Abstract: Implementing consumer participation initiatives in Australian drug treatment services successfully is predicated on the support of those most centrally involved. This paper describes service providers' and consumers' (1) beliefs about and commitment to consumer participation and (2) perceived barriers to conducting or participating in consumer participation. Data were collected from 64 providers and 179 consumers of drug treatment services. The data showed that almost all consumers (89.9%, n = 161) and providers (84.4%, n = 54) believed in the principle of consumer participation (that consumers' views should be included in service planning and delivery) and a large proportion would be willing to conduct or participate in consumer participation activities in future. Providers were less supportive of activities in which consumers would be involved in decision-making that relates directly to staff (such as staff training, recruitment and performance appraisal), and expressed concerns about the practicality of operationalising such activities, the inadequacy of consumers' skills, consumers' lack of interest and the appropriateness of having consumers involved in such decision-making. A small proportion of consumers also indicated that they did not want to participate, expressing beliefs that it was not their place to be involved and that they lacked the required skills. Overall, these findings revealed that there was considerable support for the further development of consumer participation in drug treatment services, but the predominant obstacle was the view that it is not consumers' place to take part, and that they lack the interest and skills to do so.
Exploring the role of consumer participation in drug treatment
Publisher: Elsevier BV
Date: 11-2009
DOI: 10.1016/J.DRUGALCDEP.2009.06.016
Abstract: Despite recognition of the benefits of involving consumers in their own treatment, there is little research on consumer participation in drug treatment. This paper focuses on clients who use illicit substances and the role of consumer participation in their self-reported satisfaction with their drug treatment and sense of goal achievement in that treatment. As part of a secondary analysis, the data from 492 participants who had previously or who were currently engaged in drug treatment were analysed to assess the importance of consumer participation in drug treatment. Participants who had a history of opiate or psychostimulant use were recruited at various treatment services and health care facilities for drug users located in five urban and rural/regional sites in Australia. They were asked to complete an interviewer-assisted questionnaire assessing a range of variables including five questions about consumer participation. Findings from this study illustrate that clients' opportunity to participate in drug treatment is independently associated with greater satisfaction with drug treatment and a greater sense of achievement of treatment goals. This research provides evidence to support the importance of consumer activity in drug treatment and should encourage drug treatment programs to afford clients appropriate levels of consumer participation.
Risk practices and other characteristics of injecting drug users who obtain injecting equipment from pharmacies and personal networks
Publisher: Elsevier BV
Date: 09-2006
“Don’t think I’m going to leave you over it”: Accounts of changing hepatitis C status among couples who inject drugs
Publisher: Elsevier BV
Date: 04-2017
DOI: 10.1016/J.DRUGALCDEP.2016.12.020
Abstract: While the health-related benefits of intimate partnership are well documented, little attention has been paid to couples exposed to high levels of social stigma and exclusion. In this project we investigated an important site of stigma for partnerships by collecting accounts of changing hepatitis C (HCV) status ("sero-change") among couples that inject drugs. We explored what these accounts reveal about the meaning of HCV for these couples, and how this understanding contributes to our collective efforts at prevention and care. Drawing from a large dataset of qualitative interviews with couples, we focussed on those containing reports of sero-change. By adopting a methodology that positioned partnerships rather than in iduals as the primary unit of analysis, we addressed the commonplace tendency to either overlook or discount as dysfunctional, the sexual relationships of people who inject drugs. While some couples sought greater biomedical understanding as a means of coming to terms with sero-change, others drew on alternative logics or "rationalities" that sat firmly outside conventional biomedical discourse (privileging notions of kinship, for ex le). Regardless of which explanatory framework they drew on, participants ultimately prioritised the security of their relationship over the dangers of viral infection. Effectively engaging couples in HCV prevention and care requires acknowledging and working with the competing priorities and complex realities of such partnerships beyond simply the identification of viral risk. The "new era" of direct acting antiviral treatments will provide ongoing opportunities to learn to integrate biomedical information within more socially sophisticated, relationally aware approaches.
Hepatitis C prevention education needs to be grounded in social relationships
Publisher: Informa UK Limited
Date: 09-04-2013
Illicit and injecting drug use among Indigenous young people in urban, regional and remote Australia
Publisher: Wiley
Date: 15-09-2016
DOI: 10.1111/DAR.12320
Abstract: To examine patterns of illicit drug use among Australian Indigenous young people, identify correlates of frequent use separately in urban, regional and remote settings and characterise those who inject. Cross-sectional design at 40 Indigenous events. Self-complete surveys were administered to Indigenous people aged 16-29 years using mobile devices. 2,877 participants completed the survey. One in five reported using cannabis at least weekly in the previous year, but the use of other drugs was less prevalent. Patterns of drug use were largely similar across regions, although more participants in urban and regional areas reported using ecstasy (12% vs 11% vs 5%) and cocaine (6% vs 3% vs 1%) and more reported weekly cannabis use (18% vs 22% vs 14%). Injecting was rare (3%) but those who did inject reported a high incidence of needle sharing (37%). Meth hetamine (37%), heroin (36%) and methadone (26%) were the most commonly injected drugs, and injecting was related to prison experience (AOR 5.3 95% CI 2.8-10.0). Attention is needed in relation to cannabis use, particularly among those Indigenous young people living in regional and urban settings. Also, although injecting is uncommon, it is associated with prison involvement. Priority must be given to reducing the numbers of Indigenous youth entering justice settings, delaying the age at first entry to justice settings, and reducing the risk of BBV acquisition while in custody through, for ex le, prison-based NSP, BBV education, and Indigenous-specific treatment that emphasises connection to country and culture. [Bryant J, Ward J, Wand H, Byron K, Bamblett A, Waples-Crowe P, Betts S, Coburn T, Delaney-Thiele D, Worth H, Kaldor J, Pitts M. Illicit and injecting drug use among Indigenous young people in urban, regional and remote Australia. Drug Alcohol Rev 2016 :447-455].
Hepatitis C and injecting-related discrimination in New South Wales, Australia
Publisher: Informa UK Limited
Date: 2006
Young people at risk of transitioning to injecting drug use in Sydney, Australia: social disadvantage and other correlates of higher levels of exposure to injecting
Publisher: Hindawi Limited
Date: 04-12-2014
DOI: 10.1111/HSC.12145
Abstract: While numerous studies have examined characteristics of young people who have recently initiated injecting, little attention has focused on young people who may be at high risk of transitioning to injecting. This study sought to examine the extent that socially disadvantaged young people were exposed to injecting, determine their level of hepatitis C (HCV) knowledge and identify correlates of higher injecting exposure. A cross-sectional survey was administered to 210 young people in 2010-2011 who were exposed to injecting drug use, but had not transitioned to injecting. Respondents were primarily recruited from youth services in metropolitan Sydney. Exposure to injecting in the previous 12 months was assessed with four items that examined whether close friends, romantic/sexual partners or family members/acquaintances injected drugs, and whether they were offered an injection. Most respondents had at least a few close friends who injected drugs (65%) and almost half had been offered drugs to inject in the previous 12 months (48%). It was less common for respondents to report having a partner who injects (11%). Correlates of higher injecting exposure were examined with multivariate ordinal regression. In the multivariate model, higher exposure to injecting was independently associated with the experience of abuse or violent crime [adjusted odds ratio (AOR) = 1.80] and reporting more favourable attitudes towards injecting (AOR = 0.86). Higher exposure to injecting was not independently associated with patterns or history of drug use. HCV knowledge was low to moderate and was not associated with higher exposure to injecting. That drug use was not independently associated with higher injecting exposure may suggest that exposure is shaped more by social disadvantage than by drug use patterns. Additional research is required to investigate this, using an improved measure of exposure to injecting.
Harm reduction workers and the challenge of engaging couples who inject drugs in hepatitis C prevention
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.DRUGALCDEP.2016.09.010
Abstract: Despite injecting-equipment sharing between sexual partners leaving them at increased risk of hepatitis C (HCV), there is scant literature available to guide harm reduction workers in their encounters with couples who inject drugs. This article explored workers' understandings of such couples and their accounts of working with them in relation to HCV prevention. Semi-structured interviews were conducted with 22 staff of harm reduction services located in Sydney and Melbourne, Australia. Overall, staff represented couples as either absent from the service or as presenting with needs indiscernible from those of in idual clients. Responses to questions about HCV and couples were framed primarily in terms of risk. Staff participants questioned 'genuineness' of clients' intimate relationships, instead characterising them as inauthentic and drug-driven. Working with couples was seen to present a number of organisational and clinical challenges. The benefits of recognising and working with such partnerships received scant acknowledgement. Rather, staff tended to perceive couples as being 'impenetrable' to health promotion messaging. The framing and delivery of harm reduction in Australia remains an in idualising enterprise with little capacity to recognise the intimate partnerships, including addressing the HCV risks specific to them. More effective harm reduction strategies may be achieved by transitioning to a practice framework that addresses the social context of injecting, including the experience of couples. This would require direct involvement of couples who inject drugs.
Sexual identity and its relationship to injecting in a sample of disadvantaged young drug users
Publisher: Wiley
Date: 18-06-2015
DOI: 10.1111/DAR.12281
Abstract: People who are new to injecting are at the highest risk of acquiring blood-borne viruses, and certain other characteristics, such as sexual identity, have been known to further heighten this risk. We investigate whether disadvantaged drug-using young people who are gay, lesbian, bisexual or who identify as other sexual identity (GLBO) are more likely to have ever injected drugs compared with their heterosexual peers. Convenience s ling was employed across 15 youth services in metropolitan Sydney. Respondents were required to be 16-24 years of age, to have used an illicit drug, to have been exposed to injecting through social networks and been socially disadvantaged in the past 12 months. Participants self-completed a survey using touch screen laptops. In a s le of 250 young people, GLBO participants more commonly reported ever injecting drugs [37.1%, confidence interval (CI) 21.5-55.1% vs. 12.3%, CI 8.1-17.4%] or injecting drugs in the past 12 months [31.4%, CI 16.9-49.3% vs. 5.7%, CI 2.9-9.6%] compared with participants who identified as heterosexual. The higher rates of injecting among GLBO young people found in this s le advocates for the development of targeted prevention strategies for this group. Utilising existing networks in GLBO communities could be one strategy to limit the transition to injecting drug use and reduce the risk of drug-related harms among this group.
Normalisation of recreational drug use of among young people: Evidence about accessibility, use and contact with other drug users
Publisher: Informa UK Limited
Date: 06-2010
Young people at risk of transitioning to injecting: what do they know about where to get sterile needles?
Publisher: Informa UK Limited
Date: 31-01-2017
Does drug and alcohol use undermine concordance between doctors' assessments of major depression and patients' scores on a screening tool for depression among gay men attending general practice?
Publisher: CSIRO Publishing
Date: 2012
DOI: 10.1071/PY11011
Abstract: General practitioners (GPs) identify that depression can be difficult to diagnose in populations with high rates of alcohol and other drug (AOD) use. This is a particular concern with gay men who are a population known to engage in high rates of AOD use and who are vulnerable to depression. This paper uses data from 563 gay men and their GPs to describe concordance between assessments of major depression and, in particular, whether AOD use undermines concordance. Data were collected as part of a larger study of male patients and GPs at high HIV-caseload general practices in Australia. Concordance was measured by comparing patients’ scores on the Patient Health Questionnaire-9 screening tool, which is based on the Diagnostic and Statistical Manual of Mental Disorders IV criteria, and GPs’ ratings of the likelihood of depression for each participant. We observed high concordance between GPs’ assessments of major depression and patients’ scores on the PHQ-9 (79% agreement), although our analysis also suggested that concordance was better when it related to cases in which there was no depression. The high concordance observed in our study did not appear to be undermined by gay male patients’ AOD use, with the exception of frequent use of crystal meth hetamine. Here, men who reported frequent use of meth hetamine were significantly less likely to have concordant assessments (adjusted odds ratio 0.3, 95% CI 0.1–0.8). Overall, GPs appear to identify depression among many of their gay male patients. While GPs should be aware of the potential complications presented by frequent crystal meth hetamine use, other AOD use may have less impact on the diagnosis of depression.
Factors associated with hepatitis C knowledge among a sample of treatment naive people who inject drugs
Publisher: Elsevier BV
Date: 07-2011
DOI: 10.1016/J.DRUGALCDEP.2010.11.018
Abstract: Assessment and uptake of treatment for hepatitis C among people who inject drugs (PWID) is low and strategies to enhance hepatitis C care in this group are needed. Knowledge of hepatitis C and its treatment is one precursor to decisions about treatment. We conducted a cross-section study designed to evaluate treatment considerations in participants with self-reported hepatitis C infection in New South Wales, Australia. Participants were recruited from needle and syringe programs, opiate substitution clinics, pharmacies that dispensed opiate substitution treatment and from the mailing list of a community-based hepatitis C organisation and completed a self-administered survey. Knowledge of hepatitis C was assessed by a 48-item scale addressing the natural history and treatment of hepatitis C. Factors associated with knowledge were assessed by ordinal regression. Among the 997 participants recruited, 407 self-reported acquiring hepatitis C through injecting drug use and had never received hepatitis C treatment. Knowledge about hepatitis C was overall poor and the effects of the long term consequences of hepatitis C were over-estimated. Higher knowledge scores were associated with recruitment site, higher education levels and recent contact with a general practitioner. One-third of participants indicated that they did not intend to have treatment and one-fifth did not answer this question. Knowledge is a precursor to informed decisions about hepatitis C treatment. These results indicate that efforts to support those less engaged with hepatitis C care (and specifically those on opiate substitution treatment) and those with lower literacy are required.
Understanding decisions made about hepatitis C treatment by couples who inject drugs
Publisher: Wiley
Date: 25-08-2015
DOI: 10.1111/JVH.12451
Abstract: Efforts to increase the number of people having hepatitis C virus (HCV) treatment require understanding how to best deliver services to meet consumers' needs. The general health literature has examined the role that partners can play in supporting health outcomes. This study examines the experiences of couples who inject drugs in relation to knowledge of, decisions about and management of HCV treatment. This is a qualitative interview study of people who inject drugs in couples. Participants were recruited from harm reduction services in two major Australian cities. Couples were interviewed separately. Data were examined using the couple as the unit of analysis and to identify patterns of experience related to the HCV serostatus of couples. Knowledge of HCV and HCV treatment was low and variable but showed some relationship to serostatus. Decisions about HCV treatment were deeply informed by concerns regarding treatment side effects. Positive concordant couples considered 'staging' treatment to ensure that each partner could (in turn) care for the other. People with HCV in serodiscordant relationships may need specific support regarding HCV treatment information. Within positive concordant partnerships, our data indicated the need to support the HCV-positive 'carer' during their partner's treatment. Changing treatment regimens, and their anticipated lower side effect profiles, will need to be actively promoted to ensure that couples understand how these changes affect their treatment options.
Sexual risk‐taking among homeless young people in Pakistan
Publisher: Hindawi Limited
Date: 10-11-2020
DOI: 10.1111/HSC.13220
Health worker perceptions of the impact of COVID‐19 on harm reduction services for people who inject drugs
Publisher: Hindawi Limited
Date: 16-03-2022
DOI: 10.1111/HSC.13782
Safer sex and condom use: A convenience sample of Aboriginal young people in New South Wales
Publisher: CSIRO Publishing
Date: 2011
DOI: 10.1071/SH10138
Abstract: Background This paper examines condom use in a s le of Aboriginal young people in New South Wales (NSW) aged 16–30 years. Methods: Cross-sectional data were collected using hand-held computer devices from 293 Aboriginal people attending two Aboriginal events in NSW. Results: Almost two-thirds of respondents reported having had a casual sex partner in the previous 6 months. Of these, 39.2% reported always using a condom with casual partners. Having always used a condom with casual partners varied among respondents, and was more likely among younger respondents (adjusted odds ratio (AOR): 2.7, 95% confidence interval (CI): 1.2–6.1) and less likely among those who used illicit drugs (AOR: 0.2, 95% CI: 0.1–0.7). Conclusions: In comparison to published studies of other Australians, casual sex appears to be more common among this s le of Aboriginal young people however, the proportion who report having always used condoms with casual partners is very similar. This suggests that although casual sex is more common, Aboriginal young people do not engage in risky behaviour any more often than other young Australians. Further work should be conducted with those who do not always use condoms, such as those who are older and who use illicit drugs, particularly with regards to how abstinence from drug use supports protective behaviours such as condom use among this population of Aboriginal young people.
Harm reduction knowledge and information exchange among secondary distributors in Sydney, Australia
Publisher: Informa UK Limited
Date: 23-05-2012
Establishing the impact of consumer participation in alcohol and other drug treatment settings in Australia
Publisher: Hindawi Limited
Date: 30-07-2021
DOI: 10.1111/HSC.13525
Abstract: It is generally recognised that engaging consumers to participate in policy making, programming, and practice is fundamental to effective alcohol and other drug (AOD) treatment, however, literature continues to document challenges and barriers to its implementation in AOD settings. This study reports on an evaluation of the Consumer Participation Project implemented in key non-government AOD services in Australia. Data collection consisted of an online survey of 86 staff members at the five participating AOD services and 27 consumer interviews. The survey examined staff attitudes towards and beliefs about consumer participation, perceived current levels of consumer participation and service changes as a result of the consumer participation project. The qualitative arm explored consumer's prior knowledge and current experiences of consumer participation. Staff who took part in the consumer participation training offered as part of the project were more likely to believe that service changes could encourage greater consumer participation rather than any barriers associated with consumer circumstances. Additionally, while services offered low-level involvement consumer activities, there were fewer ex les of mid- and high-level activities being conducted at the different services. Consumers discussed the significance of being actively involved in their AOD treatment service while stressing the importance of proper training and support for those engaging in consumer participation. This research highlights the benefits of consumer participation in AOD treatment and suggests that most consumer participation activities undertaken at present are "low" level involvement concerned with providing and receiving information from consumers. Importantly, however, our study did demonstrate some support for "high" level involvement activities and service providers being open to doing more to encourage consumer participation.
Is point of access to needles and syringes related to needle sharing? Comparing data collected from pharmacies and needle and syringe programs in south-east Sydney
Publisher: Wiley
Date: 07-2010
DOI: 10.1111/J.1465-3362.2009.00154.X
Abstract: The comprehensive needle and syringe distribution system in New South Wales is partly based on the premise that different points of access to injecting equipment may attract different groups of injecting drug users. This paper examines patterns of equipment acquisition and risk for blood-borne virus transmission among injecting drug users who use pharmacies and needle and syringe programs (NSP) in south-east Sydney. Clients obtaining injecting equipment from four NSP (n = 147) and eight pharmacies (n = 227) in 2006 voluntarily completed a self-administered questionnaire. Respondents were grouped into three categories based on their needle and syringe acquisition patterns: exclusive use of NSP, exclusive use of pharmacies and use of both. Although it was common for respondents to report using both pharmacies and NSP to obtain needles and syringes (57%), a proportion reported exclusive use of pharmacies (17%) and NSP (14%). Exclusive pharmacy users were more likely to have never received treatment for their drug use and the least likely to have had a recent test for hepatitis C. Compared with respondents who exclusively used NSP, respondents who exclusively used pharmacies were more likely to report receptive sharing of injecting equipment (adjusted odds ratio 5.9, 95% confidence interval 2.02-17.14), as were respondents who reported using both sources (adjusted odds ratio 5.8, 95% confidence interval 2.35-14.40). The high prevalence of receptive equipment sharing among pharmacy clients indicates a need to improve access to needles and syringes and ancillary equipment, possibly by including ancillary equipment at no cost in existing pre-packaged pharmacy products.
Examining the pathways for young people with drug and alcohol dependence: a mixed-method design to examine the role of a treatment programme
Publisher: BMJ
Date: 05-2016
The gendered context of initiation to injecting drug use: evidence for women as active initiates
Publisher: Wiley
Date: 05-2007
DOI: 10.1080/09595230701247731
Abstract: This paper explores differences between women's and men's first experience of injecting in relation to socio-demographic context, drug use, and the role of others. We collected cross-sectional retrospective data from 334 recently initiated (<or=5 years) injecting drug users in New South Wales and Queensland, Australia using a structured questionnaire in face-to-face interviews. Logistic regression was used to estimate crude and adjusted odds ratios (OR). Findings from the adjusted analysis show that women had a shorter duration of illicit drug use prior to initiation (adjusted OR 0.84, 95%CI: 0.74 - 0.94), and were more likely to have their romantic-sexual partner facilitate the initiation by paying for the drugs (adjusted OR 4.64, 95%CI: 1.21 - 17.73). Women also reported a greater likelihood of being initiated in groups of other women (adjusted OR 2.87, 95%CI: 1.24 - 6.67), suggesting that some women play an active role in their initiation experience rather than relying on, or being lead by, a romantic-sexual partner. These findings demonstrate the crucial role that romantic-sexual partners play in women's initiation experience, but also provide evidence for the way that women can be active participants in their own initiation and in initiating other women.
Perceptions of COVID-19 Vaccines: Lessons from Selected Populations Who Experience Discrimination in the Australian Healthcare System
Publisher: Hindawi Limited
Date: 17-08-2023
DOI: 10.1155/2023/5901128
Abstract: COVID-19 vaccination is particularly challenging among populations who have experienced discrimination in healthcare settings. This paper presents qualitative findings from in-depth interviews about COVID-19 vaccination conducted in Australia between October 2020 and November 2021. Data from four different studies are presented each population has unique experiences of discrimination within the healthcare system: Aboriginal people people who inject drugs (PWID) people living with HIV (PLHIV) and gay and bisexual men (GBM). Analyses were guided by the behavioural and social determinants model that forms the basis of the World Health Organization’s “data for action: achieving high uptake of COVID-19 vaccines” interim guidance. All populations viewed vaccination as necessary for community protection, although narratives of community care were most common among Aboriginal people. Concerns about vaccine safety were expressed by all participant groups, although participants living with HIV and GBM were more trusting of vaccines possibly because of their ongoing and usually positive past experiences with biomedical technologies for HIV management and sexual health. Aboriginal participants reported distrust of mainstream government and participants who inject drugs expressed a more generalised suspicion about COVID-19 and its origins. Practical problems related to transport, booking appointments for vaccination and so forth, were more common among participants living with HIV and GBM, possibly because these specific interviews were conducted throughout 2021 when vaccines were more available, whereas data for the other populations were collected before the vaccine rollout. Findings show that vaccine willingness is shaped by past experiences of discrimination in healthcare setting, but different histories of discrimination can differently impact vaccine willingness. Promotional messaging and delivery must take account of these important differences so to not treat these populations homogenously.
Development of a Risk Algorithm to Better Target STI Testing and Treatment Among Australian Aboriginal and Torres Strait Islander People
Publisher: Springer Science and Business Media LLC
Date: 26-05-2017
DOI: 10.1007/S10508-017-0958-9
Abstract: Identifying and targeting those at greatest risk will likely play a significant role in developing the most efficient and cost-effective sexually transmissible infections (STI) prevention programs. We aimed to develop a risk prediction algorithm to identify those who are at increased risk of STI. A cohort (N = 2320) of young sexually active Aboriginal and Torres Strait Islander people (hereafter referred to as Aboriginal people) were included in this study. The primary outcomes were self-reported high-risk sexual behaviors and past STI diagnosis. In developing a risk algorithm, our study population was randomly assigned to either a development (67%) or an internal validation data set (33%). Logistic regression models were used to create a risk prediction algorithm from the development data set for males and females separately. In the risk prediction models, older age, meth hetamine, ecstasy, and cannabis use, and frequent alcohol intake were all consistently associated with high-risk sexual behaviors as well as with a past STI diagnosis identifying as gay/bisexual was one of the strongest factors among males. Those who had never tested for STIs, 52% (males) and 66% (females), had a risk score >15, and prevalence of undiagnosed STI was estimated between 30 and 40%. Since universal STI screening is not cost-effective, nor practical in many settings, targeted screening strategies remain a crucial and effective approach to managing STIs among young Aboriginal people. Risk prediction tools such as the one developed in this study may help in prioritizing screening for STIs among those most at risk.
Use of health services for sexually transmitted and blood-borne viral infections by young Aboriginal people in New South Wales
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/PY11032
Abstract: The objective of the present study was to describe use of health services for sexually transmitted infections (STI), blood borne viral infections (BBV) and drug and alcohol issues by young Aboriginal people in New South Wales (NSW). A cross-sectional survey was conducted at two Aboriginal sports and cultural events in NSW, in 2007 and 2008, among Aboriginal people aged 16–30 years to ascertain their knowledge of STI, BBV, associated risk behaviours and health service access in NSW. A total of 293 young Aboriginal people completed the survey 58% were female, the mean age was 20 years, and almost 70% were single. Just over one-third (34%) of participants had been tested for an STI in the past 12 months, and over half (58%) reported that they had ever had an STI test (including HIV). Of respondents who had had an STI test in the past 12 months, 54.0% had done so at an Aboriginal Community Controlled Health Service (ACCHS) and 29% by a GP. Just over one-third (36%) of participants had ever had a test for hepatitis C, 45% of whom had received their test at an ACCHS. Participants were also asked about the types of services they had used for advice about STI and BBV. Of the 69% who had sought STI advice, ACCHS was the most common clinical location for doing so (36% for STI and 26% for hepatitis C). This study highlights the important role that ACCHS play in the provision of STI and BBV testing care and management for a cohort of young Aboriginal people in NSW.
Family imaginaries in the disclosure of a blood-borne virus
Publisher: Wiley
Date: 23-06-2021
Abstract: Contemporary sociological work has emphasised that family is not static, but actively shaped by ideas of who and what makes family. Disclosure of an illness, including diagnosis of stigmatised infections such as HIV, hepatitis B virus and hepatitis C virus, can change the dynamics of family relationships. This paper draws on 61 qualitative semi‐structured interviews conducted between 2017 and 2019 with people in Australia with one or more of these blood‐borne viruses (BBVs) and their family members, to understand the experiences of serodiscordant (mixed viral status) families. Through a thematic analysis, we explore the family imaginaries that participants evoked when describing their disclosure practices in relation to (self‐defined) family members, revealing how some participants disclosed in ways that enabled them to shape their family, to maintain boundaries between self and family or to protect family from distress. Participants' accounts of disclosure to family revealed imaginaries of family as a precious web of connections to be nurtured or protected, but also as sites of ambivalent belonging and complex history. We conclude that BBV disclosure practices within families reveal important ideas about families that are imagined in response to the threat of loss, change and stigma.
Discrimination by health care workers versus discrimination by others: Countervailing forces on HCV treatment intentions
Publisher: Informa UK Limited
Date: 03-06-2014
DOI: 10.1080/13548506.2014.923103
Abstract: Hepatitis C virus (HCV) infection is a major public health burden. Despite recent advances in HCV treatment, uptake remains low, particularly amongst people who inject drugs. HCV-related stigma and discrimination are common, especially within the health care sector. This research examines a more nuanced approach for how HCV-related stigma and discrimination impacts treatment access and uptake. Based on a social identity framework, we explore whether perceived HCV-related discrimination is associated with attempts to remove the stigma of being HCV-positive via HCV treatment intentions. Based on the results of prior research it was also hypothesised that the source of discrimination (health care workers versus others), and whether the discrimination is perceived to be directed to oneself or to the HCV-positive group, will differentially impact treatment intentions. The s le consisted of 416 people living with HCV in New South Wales, Australia, who acquired HCV from injecting drugs. Participants were asked about their experiences of perceived discrimination directed towards themselves versus their HCV-positive group and perceived discrimination within the health care sector. Findings indicate that discrimination towards the self is a more powerful indicator of treatment intentions than discrimination aimed at the HCV-positive group. This finding is consistent with social identity theory suggesting that people from low status groups are motivated to change their stigmatised status when it is possible to do so. The source of the perceived discrimination also matters, however, as participants who report experiencing discrimination from health workers have lowered intentions to engage with HCV treatment in the future. In combination, the results indicate that while perceived discrimination is commonly understood to act as a barrier to treatment uptake, the relationship is actually more complex than previously conceptualised.
Patterns of Alcohol and Other Drug Use Associated with Major Depression Among Gay Men Attending General Practices in Australia
Publisher: Springer Science and Business Media LLC
Date: 05-05-2012
Beyond deficit: ‘strengths-based approaches’ in Indigenous health research
Publisher: Wiley
Date: 19-06-2021
Abstract: Health research concerning Indigenous peoples has been strongly characterised by deficit discourse—a ‘mode of thinking’ that is overly focused on risk behaviours and problems. Strengths‐based approaches offer a different perspective by promoting a set of values that recognise the capacities and capabilities of Indigenous peoples. In this article, we seek to understand the conceptual basis of strengths‐based approaches as currently presented in health research. We propose that three main approaches exist: ‘resilience’ approaches concerned with the personal skills of in iduals ‘social–ecological’ approaches, which focus on the in idual, community and structural aspects of a person's environment and ‘sociocultural’ approaches, which view ‘strengths’ as social relations, collective identities and practices. We suggest that neither ‘resilience’ nor ‘social–ecological’ approaches sufficiently problematise deficit discourse because they remain largely informed by Western concepts of in idualised rationality and, as a result, rest on logics that support notions of absence and deficit. In contrast, sociocultural approaches tend to view ‘strengths’ not as qualities possessed by in iduals, but as the structure and character of social relations, collective practices and identities. As such, they are better able to capture Indigenous ways of knowing and being and provide a stronger basis on which to build meaningful interventions.
Consumer participation in the planning and delivery of drug treatment services: The current arrangements
Publisher: Wiley
Date: 03-2008
DOI: 10.1080/09595230701829397
Abstract: Consumer participation in decision-making about service planning is common in certain health services in Australia but is thought to be largely underdeveloped in drug treatment services. This paper (1) describes the current practices within Australian drug treatment services that aim to include consumers in service planning and provision and (2) determines how much consumers know about the existing opportunities for involvement. Sixty-four randomly selected service providers (representing 64 separate services) completed interviews about the current arrangements for consumer participation within their services (response rate = 82%). A total of 179 consumers completed interviews assessing their knowledge of the consumer participation activities available at the service they attended. Consumer participation activities were not uncommon in drug treatment services, although the existing activities were concerned largely with providing information to or receiving information from consumers. Activities that included consumers in higher forms of involvement, such as those in which consumers took part in decision-making, were largely uncommon. Consumers had a considerable lack of knowledge about the participation activities available to them, revealing a lack of communication between providers and consumers. While service providers were making efforts to engage consumers in service planning and provision (despite the general lack of State or Commonwealth policy directives and extra funding to do so), these appear ineffectual because of poor communication between providers and consumers. As a starting point, a critical part of any meaningful consumer participation initiative must include systems to ensure that consumers know about available opportunities.
Lebanese, Indian and Anglo LGBTQ + young Australians’ experiences at school and university: an analysis from the middle
Publisher: Informa UK Limited
Date: 25-05-2023
Prevalence and correlates of a diagnosis of sexually transmitted infection among young aboriginal and Torres strait islander people: A national survey
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2016
Factors associated with specialist assessment and treatment for hepatitis C virus infection in New South Wales, Australia
Publisher: Wiley
Date: 14-09-2010
DOI: 10.1111/J.1365-2893.2010.01370.X
Abstract: Assessment and treatment for hepatitis C virus (HCV) in the community remains low. We evaluated factors associated with HCV specialist assessment and treatment in a cross-sectional study to evaluate treatment considerations in a s le of 634 participants with self-reported HCV infection in New South Wales, Australia. Participants having received HCV specialist assessment (n = 294, 46%) were more likely to be have been older (vs <35 years 35-44 OR 1.64, P = 0.117 45-54 OR 2.00, P = 0.024 ≥55 OR 5.43, P = 0.002), have greater social support (vs low medium OR 3.07, P = 0.004 high OR 4.31, P < 0.001), HCV-related/attributed symptoms (vs none 1-10 OR 3.89, P = 0.032 10-21 OR 5.01, P = 0.010), a diagnosis of cirrhosis (OR 2.40, P = 0.030), have asked for treatment information (OR 1.91, P = 0.020), have greater HCV knowledge (OR 2.49, P = 0.001), have been told by a doctor to go onto treatment (OR 3.00, P < 0.001), and less likely to be receiving opiate substitution therapy (OR 0.10, P < 0.001) and never to have seen a general practitioner (OR 0.24, P < 0.001). Participants having received HCV treatment (n = 154, 24%) were more likely to have greater fibrosis (vs no biopsy none/minimal OR 3.45, P = 0.001 moderate OR 11.47, P < 0.001 severe, OR 19.51, P < 0.001), greater HCV knowledge (OR 2.57 P = 0.004), know someone who has died from HCV (OR 2.57, P = 0.004), been told by a doctor to go onto treatment (OR 3.49, P < 0.001), were less likely to have been female (OR 0.39, P = 0.002), have recently injected (OR 0.42, P = 0.002) and be receiving opiate substitution therapy (OR 0.22, P < 0.001). These data identify modifiable patient-, provider- and systems-level barriers associated with HCV assessment and treatment in the community that could be addressed by targeted interventions.
Methods of a national survey of young Aboriginal and Torres Strait Islander people regarding sexually transmissible infections and bloodborne viruses
Publisher: Elsevier BV
Date: 04-2016
Abstract: To describe the methods and basic demographics of participants in a national survey of Aboriginal and Torres Strait Islander (Aboriginal) people specific to sexually transmissible infections and bloodborne viruses. A national cross-sectional survey of Aboriginal people aged 16-29 years in all Australian jurisdictions between 2011 and 2013 conducted at Aboriginal community events. Questions comprised demographic information, knowledge, risk behaviours and health service utilisation. Questionnaires were completed on personal digital assistants (PDAs). A total of 2,877 people at 21 unique community events completed the questionnaire. A total of 59% of participants were female, median age was 21 years and more than 60% were single at the time of the survey. Just over half the participants were resident in an urban area (53%) and 38% were from a regional area. Aboriginal health organisations played an important role in implementing the research. PDAs were found to be an acceptable method for collecting health information. This survey has recruited a large representative s le of Aboriginal people aged 16-29 years using a methodology that is feasible, acceptable and repeatable. The methodology provides a model for ongoing monitoring of this population as programs and policies are implemented to address young Aboriginal people's STI and BBV risks.
Maternal deaths in New South Wales, Australia: a data linkage project.
Publisher: Wiley
Date: 06-2008
Improving access to drug and alcohol treatment in NSW Australia: The role of self‐determination and peer support
Publisher: Hindawi Limited
Date: 08-11-2021
DOI: 10.1111/HSC.13639
Abstract: One of the key issues in the alcohol and other drug (AOD) treatment sector concerns the reported difficulties that clients have in accessing treatment. This paper draws on qualitative interview data collected from clients undergoing treatment (n = 20) and stakeholders (n = 15) of five specialist non-government AOD treatment services in New South Wales, Australia, to offer an in-depth perspective about treatment entry experiences. We identified four key themes of positive treatment entry experiences: the presence of high-quality online information which enabled clients to best match themselves to treatment flexible and simple intake procedures with skilled and welcoming staff the presence and quality of social and other resources (such as families, peers and private health insurance) which enabled quicker access and prior experience in the treatment system which helped clients to gain important knowledge and skills to improve future access. We discuss implications of these findings, including that waiting lists significantly exacerbate inequity, but that this could be ameliorated by providing peer-support to those trying to gain entry, especially clients who do not have family and friends for help during this period. The findings also point to the way that client self-determination is central to all positive treatment entry experiences, and that supporting clients to find 'the right fit' in relation to treatment options improves their experiences.
‘I just wanted a change, a positive change’: Locating hope for young people engaged with residential alcohol and drug services in Victoria, Australia
Publisher: Wiley
Date: 06-06-2023
Abstract: In this article, we investigate young people’s involvement with residential alcohol and other drug (AOD) services as part of their broader engagement with hope. This study draws on qualitative interviews conducted with 20 young people aged 17–23 from Victoria, Australia, who were either in, or had recently left, residential AOD services. Interviews explored their experiences with AOD services and included questions about their hopes for the future. We found hope located in social relationships, productive discourses and AOD settings themselves. Hope also presented differently according to the external resources young people had available to them, giving some young people greater capacity to action their hoped‐for futures than others. Given many young people seek reimagined futures as part of their use of residential AOD services, this creates a valuable opportunity for services to help shape achievable hopes and boost service engagement. We suggest that hope can materialise in a variety of ways but caution against relying on it as a motivational strategy without providing young people with other resources. A more sustainable narrative of hope may require a solid foundation of resources, allowing young people with AOD problems to gain a sense of control over their lives and their imagined futures.
‘Does anyone know where to get fits from around here?’ Policy implications for the provision of sterile injecting equipment through pharmacies in Sydney, Australia
Publisher: Informa UK Limited
Date: 2010
Comparing ‘doctor’ and ‘patient’ beliefs about the role of illicit drug use in gay men’s depression
Publisher: Hindawi Limited
Date: 28-11-2011
DOI: 10.1111/J.1365-2524.2011.01044.X
Abstract: High rates of both illicit drug use and depression are consistently reported among gay men. However, little is known about how beliefs about drug use shape clinical encounters between gay men and health professionals, and that in turn affect clinical communication and care, particularly in relation to depression. We compared 'doctor' and 'patient' beliefs about the role of illicit drug use in gay men's depression. Semi-structured interviews were conducted during August-December 2006 with 16 general medical practitioners working in seven 'gay-friendly' practices in Sydney, Adelaide and a rural-coastal city in New South Wales, and during February-May 2008 with 40 gay men with depression recruited through four Sydney and Adelaide practices. A thematic analysis of these two sets of interviews found that doctors expressed the beliefs that: illicit drug use is related to depression in gay men illicit drug use impedes effective diagnosis and treatment of depression in gay men and illicit drug use increases the level of complexity involved in caring for gay men with depression. Gay men expressed the beliefs that: illicit drug use is closely related to depression illicit drug use can be helpful in dealing with difficult experiences and illicit drug use is just what you do as a gay man living in a big city. Both groups believed drug use and depression were related, but doctors emphasised the negative outcomes of drug use and interpreted these in relation to health. Gay men believed that drugs could have both negative and positive uses and differentiated between health and social outcomes. While the doctors articulated a pragmatic position on drug use, which is consistent with harm reduction principles, communication with gay male patients could be enhanced if both groups acknowledged their ergent views of illicit drugs and their potential role in mental health.
Providing a model of health care service to stimulant users in Sydney
Publisher: Informa UK Limited
Date: 11-10-2016
Needle sharing in regular sexual relationships: An examination of serodiscordance, drug using practices, and the gendered character of injecting
Publisher: Elsevier BV
Date: 03-2010
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