ORCID Profile
0000-0003-2877-9231
Current Organisations
Burnet Institute
,
UNSW Sydney
,
University of Queensland School of Public Health
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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)
Aboriginal and Torres Strait Islander Health | Social and Cultural Anthropology | Public Health and Health Services
ANZSRC Socio-Economic Objective (SEO)
Aboriginal and Torres Strait Islander Health - Health System Performance (incl. Effectiveness of Interventions) | Social Structure and Health |
Related Links
Publications
HIV pre-test practices: an online survey examining perceptions of informed consent and pre-test information delivery in health care settings across the WHO European Region
Publisher: SAGE Publications
Date: 27-02-2016
Abstract: The objective of this study was to gather health professionals’ perceptions about gaining informed consent and delivering HIV pre-test information. An online self-report survey was completed by 338 respondents involved in HIV testing in 55 countries in the WHO European Region. Nearly two thirds (61.5%) of respondents thought that HIV testing guidelines used in their country of work included recommendations about pre-test information 83% thought they included recommendations regarding obtaining informed consent. One third (34%) of respondents thought that written informed consent was required respondents from Eastern Europe and Central Asia were more likely to perceive this as required. Respondents from Western Europe thought pre-test information about the following aspects was significantly less likely to be addressed than respondents in other regions: the right to decline a test services available after a positive test laws/regulations impacting someone being tested and receiving a positive test result potential risks for a client taking an HIV test the possible need for partner notification after a positive test result. Results offer insight into perceived HIV pre-test practices in all but two national settings across the WHO European Region, and can be used in the development and evaluation of future HIV testing guidelines in the WHO European Region. Findings highlight that practices of obtaining written informed consent depart from current guidelines in some HIV testing settings. Furthermore, findings underscore that it is uncommon for pre-test information to address legal and social risks and harms that people testing HIV-positive may incur. This differs from the most recent global WHO guidelines emphasising the importance of such information, and raises important questions regarding the implications and appropriateness of the currently dominant focus of recommendations on streamlining the HIV testing process.
Qualitative perspectives on the sustainability of sexual health continuous quality improvement in clinics serving remote Aboriginal communities in Australia
Publisher: BMJ
Date: 05-2019
DOI: 10.1136/BMJOPEN-2018-026679
Abstract: To examine barriers and facilitators to sustaining a sexual health continuous quality improvement (CQI) programme in clinics serving remote Aboriginal communities in Australia. Qualitative study. Primary health care services serving remote Aboriginal communities in the Northern Territory, Australia. Seven of the 11 regional sexual health coordinators responsible for supporting the Northern Territory Government Remote Sexual Health Program. Semi-structured in-depth interviews conducted in person or by telephone data were analysed using an inductive and deductive thematic approach. Despite uniform availability of CQI tools and activities, sexual health CQI implementation varied across the Northern Territory. Participant narratives identified five factors enhancing the uptake and sustainability of sexual health CQI. At clinic level, these included adaptation of existing CQI tools for use in specific clinic contexts and risk environments (eg, a syphilis outbreak), local ownership of CQI processes and management support for CQI. At a regional level, factors included the positive framing of CQI as a tool to identify and act on areas for improvement, and regional facilitation of clinic level CQI activities. Three barriers were identified, including the significant workload associated with acute and chronic care in Aboriginal primary care services, high staff turnover and lack of Aboriginal staff. Considerations affecting the future sustainability of sexual health CQI included the need to reduce the burden on clinics from multiple CQI programmes, the contribution of regional sexual health coordinators and support structures, and access to and use of high-quality information systems. This study contributes to the growing evidence on how CQI approaches may improve sexual health in remote Australian Aboriginal communities. Enhancing sustainability of sexual health CQI in this context will require ongoing regional facilitation, efforts to build local ownership of CQI processes and management of competing demands on health service staff.
A strengths-based analysis of social influences that enhance HIV testing among female sex workers in urban Indonesia
Publisher: CSIRO Publishing
Date: 2021
DOI: 10.1071/SH20085
Abstract: Background HIV prevalence among female sex workers in Indonesia remains high and large proportions of female sex workers have never been tested for HIV. International research highlights the importance of community-led strategies to increase HIV testing in this population. Little qualitative research has been conducted to address these issues in Indonesia or other Asia-Pacific countries. This paper documents social influences that enhance HIV testing among female sex workers in urban Indonesia. Methods: This was an interpretive qualitative study in Yogyakarta, Denpasar and Bandung. In total, 57 female sex workers participated in 11 focus group discussions, and four participated in in idual semi-structured interviews. Deductive and inductive thematic analysis techniques were used to identify narratives of strengths pertaining to uptake of HIV testing. Results: Participants described supportive relationships with peers, community-based organisations and ‘bosses’. Participants reported trusted networks with peers within which to share information about HIV testing and receive emotional support. Relationships with community outreach workers facilitated HIV testing through reminders, accompanied visits, and emotional/informational support. Community-based organisations worked with health services to facilitate mobile, community-based testing to overcome employment- and family-related constraints that inhibited women’s clinic attendance. ‘Bosses’ employed a variety of practices to encourage HIV testing among their workers. Conclusions: Relationships, practices and action in community- and workplace-based settings outside formal health service spaces enhanced HIV testing among female sex workers. Community- or workplace-based HIV testing with outreach support from health services, peer-led HIV testing within existing social and work-based networks, and working with bosses to implement HIV prevention strategies can address low HIV testing rates in this key population.
Premarital relationships and condom use among young people in Suva, Fiji
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/SH20040
Abstract: Abstract Background Young people in Fiji experience high rates of sexually transmissible infections and early pregnancy. Despite being identified as a key priority group in national strategies, little is known about use of condoms among young people in premarital relationships. This study aimed to enhance understandings of premarital sex and condom use practices among young people in Fiji. Methods: Focus group discussions with 33 young women and men aged 18–29 years and 17 interviews with young women aged 18–26 years in an urban setting in Fiji were conducted. Inductive thematic analysis examined condom use practices. Results: Participants described a range of contextual influences inhibiting or enabling condom use. Factors inhibiting condom use included sociocultural expectations regarding premarital abstinence young people’s engagement in hidden sexual relationships limited intergenerational dialogue about sexual health issues judgmental attitude of staff at condom access points male dominance of condom use preferences and belief condoms disrupt intimacy, reduce sexual pleasure and infer a lack of trust. Factors that enhanced condom use included accessing condoms through discreet methods adult beliefs that supported safe sex practices and refusing to have sex without a condom. Conclusion: Findings broaden understandings of young people’s condom use practices in Suva, Fiji. The findings illustrate the need for culturally appropriate youth-centred sexual and reproductive health (SRH) programs and services. Specific strategies that might enhance young people’s condom use include community- and youth-led responses peer condom distribution provision of condom dispensers in community settings scaling up of youth-friendly SRH services and the delivery of comprehensive sexuality and relationships education.
Negotiating trust and struggling for control: everyday narratives of unwanted disclosure of HIV status among people with HIV in Australia
Publisher: Informa UK Limited
Date: 30-12-2016
Community perceptions and acceptability of mass drug administration for the control of neglected tropical diseases in Asia-Pacific countries: A systematic scoping review of qualitative research
Publisher: Public Library of Science (PLoS)
Date: 11-03-2022
DOI: 10.1371/JOURNAL.PNTD.0010215
Abstract: Preventative chemotherapy and mass drug administration have been identified as effective strategies for the prevention, treatment, control and elimination of several NTDs in the Asia-Pacific region. Qualitative research can provide in-depth insight into the social dynamics and processes underlying effective implementation of and adherence to mass drug administration programs. This scoping review examines published qualitative literature to examine factors influencing community perceptions and acceptability of mass drug administration approaches to control NTDs in the Asia-Pacific region. Twenty-four peer reviewed published papers reporting qualitative data from community members and stakeholders engaged in the implementation of mass drug administration programs were identified as eligible for inclusion. This systematic scoping review presents available data from studies focussing on lymphatic filariasis, soil-transmitted helminths and scabies in eight national settings (India, Indonesia, Philippines, Bangladesh, Laos, American Samoa, Papua New Guinea, Fiji). The review highlights the profoundly social nature of in idual, interpersonal and institutional influences on community perceptions of willingness to participate in mass drug administration programs for control of neglected tropical diseases (NTD). Future NTD research and control efforts would benefit from a stronger qualitative social science lens to mass drug administration implementation, a commitment to understanding and addressing the social and structural determinants of NTDs and NTD control in complex settings, and efforts to engage local communities as equal partners and experts in the co-design of mass drug administration and other efforts to prevent, treat, control and eliminate NTDs. For many countries in the Asia-Pacific region, the “low hanging fruit has been picked” in terms of where mass drug administration has worked and transmission has been stopped. The settings that remain–such as remote areas of Fiji and Papua New Guinea, or large, highly populated, multi-cultural urban settings in India and Indonesia–present huge challenges going forward.
Barriers and Enablers to HIV Care Among Waria (Transgender Women) in Indonesia: A Qualitative Study
Publisher: Guilford Publications
Date: 12-2019
DOI: 10.1521/AEAP.2019.31.6.538
Abstract: Transgender women (waria) in Indonesia have high rates of HIV and experience barriers accessing HIV services. This qualitative research explored barriers and facilitators to HIV care among waria in Indonesia. Between 2015 and 2016, 42 participants were involved in focus group discussions and in-depth interviews across three urban sites in Indonesia to examine participants' experiences and views on HIV prevention, testing, treatment initiation, and treatment adherence. Data were analyzed thematically. Barriers to accessing HIV care services included perceptions of health and HIV treatment, confidentiality and stigma concerns, and poor access to health insurance. Facilitators to HIV care included recognition of health and perceived susceptibility, perceptions of treatment benefits and consequences of non-adherence, access to social support, and patient-friendly services. Research findings highlight the importance of improving HIV treatment literacy, safeguarding community responses to addressing HIV vulnerability, addressing confidentiality and stigma issues, ensuring services are transgender-friendly, and increasing health insurance coverage.
‘I Was Attracted to Him Because of His Money’: Changing Forms of Polygyny in Contemporary Papua New Guinea
Publisher: Informa UK Limited
Date: 15-03-2018
‘Mobile men with money’: HIV prevention and the erasure of difference
Publisher: Informa UK Limited
Date: 04-03-2014
DOI: 10.1080/17441692.2014.889736
Abstract: Mobile Men with Money is one of the latest risk categories to enter into HIV prevention discourse. Used in countries in Asia, the Pacific and Africa, it refers to erse groups of men (e.g. businessmen, miners and itinerant wage labourers) who, in contexts of high population movement and economic disparity, find themselves at heightened risk of HIV as members of a 'most-at-risk population', or render others vulnerable to infection. How adequate is such a description? Does it make sense to develop HIV prevention programmes from such understandings? The history of the epidemic points to major weaknesses in the use of terminologies such as 'sex worker' and 'men who have sex with men' when characterising often erse populations. Each of these terms carries negative connotations, portraying the in iduals concerned as being apart from the 'general population', and posing a threat to it. This paper examines the ersity of men classified as mobile men with money, pointing to significant variations in mobility, wealth and sexual networking conducive to HIV transmission. It highlights the patriarchal, heteronormative and gendered assumptions frequently underpinning use of the category and suggests more useful ways of understanding men, masculinity, population movement, relative wealth in relation to HIV vulnerability and risk.
Polygyny, Serodiscordance and HIV Prevention in Papua New Guinea: A Qualitative Exploration of Diverse Configurations
Publisher: Informa UK Limited
Date: 27-08-0005
Beyond patient delay, navigating structural health system barriers to timely care and treatment in a high burden TB setting in Papua New Guinea
Publisher: Informa UK Limited
Date: 02-01-2023
Accessing HIV treatment and care services in fishing communities around Lake Victoria in Uganda: mobility and transport challenges.
Publisher: National Inquiry Services Center (NISC)
Date: 27-09-2019
DOI: 10.2989/16085906.2019.1648306
Abstract: Qualitative research exploring the influence of community-level factors on access to and use of HIV treatment and care services among people living in fishing communities is limited, especially with respect to those already in receipt of HIV care and on treatment. To enhance understanding of these issues, semi-structured in-depth interviews were conducted with 42 HIV-positive fisherfolk and 15 health care providers from two HIV clinics located in two fishing communities in Uganda. Fisherfolk's mobility and poor transport systems were significant barriers to access to and use of HIV treatment and care. Mobility, which involved regular movement between communities, sometimes led to fisherfolk's inability to access HIV treatment and care. A poor transport system in fishing communities - characterised by irregular transport services and boats in a poor condition - was reported to force both fisherfolk and health care providers sometimes to cancel journeys to centres providing treatment and support. Community-level factors such as these, which relate to the organisation and provision of transport in local community settings, are significant influences on access to HIV treatment and care. Interventions that address these challenges are needed to improve access to and use of HIV treatment and care in fishing communities.
Social Influences on Engagement With HIV Testing, Treatment and Care Services Among Men Who Have Sex With Men Living in Rural Uganda
Publisher: SAGE Publications
Date: 18-12-2022
DOI: 10.1177/10497323211058162
Abstract: Men who have sex with men in Uganda are a heterogenous, discriminated population, experiencing high HIV burden, limited access to HIV testing, and low treatment adherence. We contribute to the lack of information about men who have sex with men in rural Uganda by using socio-ecological analyses to examine the social influences shaping their engagement with HIV services. Based on in-depth interviews with 16 men, our findings reveal the inhibitive influence of interpersonal relationships with sexual partners, peers and families, and institutional influences within health service and non-governmental organizational settings. Yet men take action to strategize and seek support to enhance engagement with HIV care in heavily criminalized and stigmatized settings. Future HIV prevention, testing, treatment, and care responses could draw on what affected in iduals and communities are already doing to enhance access to HIV services and the effective support strategies of some non-governmental organizations and healthcare workers.
Delivery of HIV test results, post‐test discussion and referral in health care settings: a review of guidance for E uropean countries
Publisher: Wiley
Date: 24-06-2015
DOI: 10.1111/HIV.12278
Abstract: HIV testing and counselling (HTC) guidelines support and promote best practice among service providers. Few European countries have national HTC guidelines and most rely on guidance from regional and international bodies. This study examines recommendations in current pan-European and global guidelines regarding test result delivery, post-test discussion and referral pathways in health care settings, and reviews the types of evidence upon which recommendations are based. A systematic review and comparative content analysis of relevant guidelines identified through a literature search and review of targeted organization websites were carried out. One global and three pan-European guidelines were reviewed. There was general consensus that any test result should be confidential and delivered privately to a patient positive results should be delivered in person by a health care professional negative test results could also be delivered by telephone, text message or post. Analyses show conflicting guidance relating to the provision of post-test counselling, and inconsistencies in referral pathways to specialist treatment for positive test results. There is limited reference to published evidence in support of recommendations. Instead there is heavy reliance on expert opinion/consultation and other previous/existing guidelines when developing guidelines. Scientific evidence, where stated, is often more than ten years old, and based predominantly on US/UK research. While largely in agreement, current pan-European and global HTC guidelines have inconsistencies, particularly regarding post-test counselling and referral pathways to specialized services. Our findings highlight the need for an up-to-date review of more current evidence from wider European settings to support the process of expert consultation.
Sexual agency, risk and vulnerability: a scoping review of young Indigenous Australians’ sexual health
Publisher: Informa UK Limited
Date: 18-04-2017
Working with Aboriginal young people in sexual health research: a peer research methodology in remote Australia.
Publisher: SAGE Publications
Date: 03-10-2020
Abstract: In a context of ongoing colonization and dispossession in Australia, many Aboriginal people live with experiences of health research that is done “on” rather than “with” or “by” them. Recognizing the agency of young people and contributing to Aboriginal self-determination and community control of research, we used a peer research methodology involving Aboriginal young people as researchers, advisors, and participants in a qualitative sexual health study in one remote setting in the Northern Territory, Australia. We document the methodology, while critically reflecting on its benefits and limitations as a decolonizing method. Findings confirm the importance of enabling Aboriginal young people to play a central role in research with other young people about their own sexual health. Future priorities include developing more enduring forms of coinvestigation with Aboriginal young people beyond data collection during single studies, and support for young researchers to gain formal qualifications to enhance future employability.
Youth-centred research to help prevent and mitigate the adverse health and social impacts of pregnancy amongst young Papua New Guineans.
Publisher: Informa UK Limited
Date: 27-09-2018
DOI: 10.1080/09688080.2018.1512297
Abstract: Despite persistent international attention, adolescent pregnancy remains a major public health concern in low- and middle-income countries, like Papua New Guinea (PNG), where health inequities related to social and cultural norms, gender power imbalance, education and socio-economic deprivation affect young and unmarried women in particular. In PNG - where there is high adolescent fertility, high early childbearing and high maternal mortality ratio, and evidence of high rates of unintended pregnancy and abortion among young women - adolescent pregnancy is a policy priority. Yet there are no youth-specific sexual, reproductive and maternal health services or community-based outreach programmes. There is limited in-depth qualitative data on young women's and young men's experiences of pregnancy, the social contexts within which these pregnancies occur, young people's contraception practices and experiences with existing sexual, reproductive and maternal health services. These issues inhibit the design and delivery of youth-friendly health services and outreach support programmes that could prevent or mitigate adverse health and social outcomes associated with adolescent pregnancy. In this commentary article, we propose the need for novel youth-centred research to inform the development of policies, health services and outreach programmes that pay honest and respectful attention to young people's lived experiences of pregnancy. Whilst we focus on the situation in PNG, these ideas are relevant to erse low resource settings where the harmful impacts of health inequities among young people persist and are particularly detrimental.
Young People as Agents in Development Processes: reconsidering perspectives for development geography
Publisher: Informa UK Limited
Date: 07-2009
Social influences on young people's sexual health in Uganda
Publisher: Emerald
Date: 15-02-2013
DOI: 10.1108/09654281311298795
Abstract: The purpose of this paper is to examine the influence of social context on young people's sexual lives and sexual health, and to highlight the need for HIV prevention and sexual health programmes which better take into account these contextual influences. The paper draws on findings from a multi‐method, qualitative study involving young people aged between 11‐24 years, conducted in three rural areas in Uganda. Data were collected by means of 52 single‐sex focus group discussions, 117 in‐depth interviews, and further participatory research with 23 of these young men and women. Contextual information was gathered through interviews with parents (17), teachers (7), religious leaders (7), local clan leaders (6), community‐based NGO/CBO workers (12) and local government staff (33). Local beliefs about age and gender suggest that intimate relationships and sexual behaviour among young people are forbidden, or at least should be hidden. Social norms produced and reproduced both by adults and young people themselves increase the likelihood of secretive, unprotected sexual relations, and inhibit young people's ability to seek sexual health‐related support and advice. An understanding of these contextual influences has important implications for improving the design of HIV prevention and sexual health programming in rural communities in Uganda.
Understanding the Social Influences on Engaging Key Populations With HIV Prevention: A Qualitative Study With Men Who Have Sex With Men in Three Indonesian Cities
Publisher: Guilford Publications
Date: 06-2019
DOI: 10.1521/AEAP.2019.31.3.206
Abstract: The globally recognized test and treat approach underpins Indonesian national strategies to reduce and prevent HIV among key populations, including men who have sex with men. More comprehensive understanding of how engagement with HIV prevention is shaped by social and community practices will support these efforts. Between 2015 and 2016, focus groups and semi-structured interviews were conducted with 54 men who have sex with men in three urban settings in Indonesia to elicit their views on, and experiences of, HIV prevention and care. Focused on data relating to testing, findings documented the important influence of informal peer networks, community-based organizations and outreach workers. Some social dimensions of service access complicated this, particularly fear of stigma or lack of confidentiality in large service settings. The many differences between men challenges assumptions that a single set of HIV prevention strategies will work to engage all men who have sex with men living in Indonesia.
“Vibrant Entanglements”: HIV Biomedicine and Serodiscordant Couples in Papua New Guinea
Publisher: Informa UK Limited
Date: 15-11-2018
DOI: 10.1080/01459740.2018.1530670
Abstract: The global ambition to "end AIDS" hinges on the universal uptake of HIV treatment-as-prevention and is undergirded by the assumption that biomedical technologies have consistent, predictable effects across highly erse settings. But as anthropologists argue, such technologies are actively transformed by their local encounters, with various constitutive effects. How priority populations, such as HIV "serodiscordant" couples, negotiate treatment-as-prevention remains relatively unknown. We consider the "vibrant entanglements" that can shape couples' engagement with global biomedical technologies in the local context of Papua New Guinea (PNG)-a relatively uncharted biomedical landscape-and what we hope our current research in this setting will achieve.
Caring Masculinities in the Context of HIV Serodiscordant Relationships in Papua New Guinea
Publisher: SAGE Publications
Date: 12-2019
Abstract: Globally, there is limited research exploring the positive role men play in reducing HIV vulnerability or in the care and support of women living with HIV. This paper draws on interviews conducted with men and women in heterosexual HIV serodiscordant relationships as part of a longitudinal qualitative study exploring the social aspects of biomedicine among serodiscordant couples in two high HIV-burden areas in Papua New Guinea (PNG). Findings highlight that some HIV negative men in heterosexual relationships are resisting hegemonic masculine norms they see as harmful and are embracing caring masculine identities as they seek to support their HIV-positive wives. We suggest that understandings of masculinity in the context of the HIV epidemic in PNG should be broadened from simplistic discourses and representations of men as largely uncaring and violent to incorporate deeper understanding of how men can and are embracing caring masculinities.
A ‘scoping review' of qualitative literature about engagement with HIV care in Indonesia
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/SH17163
Abstract: Background The Indonesian response to HIV has been informed largely by quantitative evidence. This review examines what is known about the Indonesian HIV care cascade from published qualitative research. Methods: A ‘scoping review’ method was used to synthesise and interpret the findings of 17 eligible peer-reviewed publications. Results: Qualitative findings are reported in relation to two themes. Factors influencing successful engagement include a lack of HIV-related knowledge among clients, fear of stigma or lack of privacy/confidentiality at services, limited accessibility and affordability, and poor linkages between services. Factors affecting the broader response include a failure to adapt programs to specific socio-cultural settings, political issues in the distribution of donor funding, distrust and poor communication between service users and providers, the need for cultural privacy in particular community settings, and systemic experiences of gendered stigmatisation. Conclusions: Enhancing understanding of the Indonesian context would benefit from future qualitative research on HIV care in urban settings, describing the experiences of the most at-risk populations, and examining the role of clinics and providers in delivering HIV care in an increasingly decentralised health system.
Making Sense of Serodiscordance: Pathways and Aftermaths of HIV Testing among Couples with Mixed HIV Status in Papua New Guinea
Publisher: Informa UK Limited
Date: 13-07-2021
Economic vulnerability and young people's sexual relationships in rural Uganda
Publisher: Informa UK Limited
Date: 22-01-2014
How Male Sex Workers and Their Clients Shifted from Reluctance About HIV Pre-exposure Prophylaxis to Advocating for Its Use: A Longitudinal Mixed Methods Study
Publisher: Springer Science and Business Media LLC
Date: 31-07-2019
DOI: 10.1007/S10461-019-02618-1
Abstract: We assessed in idual and collective responses to HIV pre-exposure prophylaxis ('PrEP') among a network of male sex workers and clients. From 2011 to May 2017, keyword searches on an online discussion forum identified 668 posts that referenced PrEP. We conducted four analyses: (i) discourse analysis identifying reactions to PrEP, (ii) thematic analysis constructing rhetorical strategies, (iii) content analysis comparing discursive positions and rhetorical strategies, and (iv) longitudinal analyses assessing trends over time. Forum posts adopted one of three discursive positions (reluctance, interest, advocacy), drawing upon four non-exclusive strategies (deference to experts and evidence, acknowledging personal and shared experiences, establishing philosophical arguments, engaging in speculation). Posts from sex workers were more likely than clients to be supportive of PrEP (96% vs. 42% χ
HIV post-test practices: an online survey examining perceived delivery of HIV test results, post-test discussion and referral in healthcare settings across the WHO European Region
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/SH15186
Abstract: Background The aim of this study was to assess perceptions of health professionals involved in HIV testing policy and practice in national settings across the WHO European Region regarding the delivery of HIV test results, post-test discussion and referral to specialist HIV services as recommended in authoritative guidelines. Methods: An online self-report survey was completed by a convenience s le of 338 respondents (response rate 34.1%) from 55 countries. Respondents worked with non-government organisations (49.4%), health services (32.8%), non-health service government agencies (6.2%) or other organisations (11.5% e.g. prisons, education and research, international development). Results: Experts’ perceptions indicate that delivery of HIV-positive test results and related post-test discussion in their country generally corresponded to recommendations. However, results pointed to a significant gap perceived by experts between recommendations and the practice of delivering HIV-negative test results. Fewer respondents thought that suitable time is taken to deliver a negative HIV-test result (54.1%) than a positive result (73.1%). Also, fewer respondents thought there was a procedure for referral to specialist treatment, care and support services for people receiving a HIV-negative test result (34.9%) than for people receiving an HIV-positive test result (86.2%). Experts also reported low perceived use of communication technologies (i.e. telephone, email, text messaging, a secure website) for delivering HIV test results. Conclusions: This expert survey offers new insight into perceived HIV post-test practices in almost all national settings across the WHO European Region. The findings provide valuable guidance for future HIV testing guidelines for the WHO European Region.
Two distinct gonorrhoea trends and risk factors among women in Australia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 31-10-2020
DOI: 10.1097/OLQ.0000000000001086
Abstract: In recent years, gonorrhea notifications have increased in women in Australia and other countries. We measured trends over time and risk factors among Australian Aboriginal and Torres Strait Islander (“Aboriginal”) and non-Aboriginal women. We conducted a cross-sectional analysis of data from 41 sexual health clinics. Gonorrhea positivity at each patient's first visit (first-test positivity) during the period 2009 to 2016 was calculated. Univariate and multivariate analyses assessed risk factors for first-test positivity in Aboriginal and non-Aboriginal women. Gonorrhea positivity decreased among Aboriginal women (7.1% in 2009 to 5.2% in 2016, P 0.001) and increased among non-Aboriginal women (0.6%–2.9%, P 0.001). Among Aboriginal women, first-test positivity was independently associated with living in a regional or remote area (adjusted odds ratio [aOR], 4.29 95% confidence interval [CI], 2.52–7.31 P 0.01) and chlamydia infection (aOR, 4.20 95% CI,3.22–5.47 P 0.01). Among non-Aboriginal women, first-test positivity was independently associated with greater socioeconomic disadvantage (second quartile: aOR, 1.68 [95% CI, 1.31–2.16 P 0.01] third quartile: aOR, 1.54 [95% CI, 1.25–1.89 P 0.01]) compared with least disadvantaged quartile: recent sex work (aOR, 1.69 95% CI, 1.37–2.08 P 0.01), recent injecting drug use (aOR, 1.85 95% CI, 1.34–2.57 P 0.01), and chlamydia infection (aOR, 2.35 95% CI, 1.90–2.91 P 0.01). For non-Aboriginal women, being aged 16 to 19 years (aOR, 0.62 95% CI, 0.49–0.80 P 0.01) compared with those ≥30 years was a protective factor. These findings highlight 2 different epidemics and risk factors for Aboriginal and non-Aboriginal women, which can inform appropriate health promotion and clinical strategies.
Seeking a disability lens within climate change migration discourses, policies and practices
Publisher: Informa UK Limited
Date: 26-08-2019
Acceptability of testing for anorectal sexually transmitted infections and self-collected anal swabs in female sex workers, men who have sex with men and transgender women in Papua New Guinea
Publisher: Springer Science and Business Media LLC
Date: 20-06-2018
Community perspectives on scabies, impetigo and mass drug administration in Fiji: A qualitative study
Publisher: Public Library of Science (PLoS)
Date: 04-12-2020
DOI: 10.1371/JOURNAL.PNTD.0008825
Abstract: Scabies is endemic in Fiji and is a significant cause of morbidity. Little is known about the sociocultural beliefs and practices that affect the occurrence of scabies and impetigo, or community attitudes towards the strategy of mass drug administration that is emerging as a public health option for scabies and impetigo control in Fiji and other countries. Data were collected during semi-structured interviews with 33 community members in four locations in Fiji’s Northern Division. Thematic analysis examined participants’ lived experiences of scabies and impetigo community knowledge and perceptions about scabies and impetigo aetiology and transmission community-based treatment and prevention measures and attitudes towards mass drug administration. Many indigenous Fijian (iTaukei) participants noted extensive and ongoing experience of scabies and impetigo among children in their families and communities, but only one participant of Indian descent (Indo-Fijian) identified personal childhood experience of scabies. Scabies and impetigo were perceived as diseases affecting children, impacting on school attendance and families’ quality of sleep. Awareness of scabies and impetigo was considerable, but there were major misconceptions around disease causation and transmission. Traditional remedies were preferred for scabies treatment, followed by biomedicines provided by local health centres and hospitals. Treatment of close household contacts was not prioritised. Attitudes towards mass drug administration to control scabies were mostly positive, although some concerns were noted about adverse effects and hesitation to participate in the planned scabies elimination programme. Findings from this first study to document perspectives and experiences related to scabies and impetigo and their management in the Asia Pacific region illustrate that a community-centred approach to scabies and impetigo is needed for the success of control efforts in Fiji, and most likely in other affected countries. This includes community-based health promotion messaging on the social dynamics of scabies transmission, and a c aign of education and community engagement prior to mass drug administration.
Increasing HIV treatment access, uptake and use among men who have sex with men in urban Indonesia: evidence from a qualitative study in three cities
Publisher: Oxford University Press (OUP)
Date: 18-10-2019
Abstract: Men who have sex with men make up one of four key populations identified as critical to a successful HIV response in Indonesia. Despite international policies supporting HIV treatment in low- and middle-income countries, Indonesia is one of the few countries experiencing low coverage of HIV treatment and little decrease in HIV incidence. There is poor retention in care and low viral suppression rates among key populations such as men who have sex with men. The national government has committed to increasing treatment access and uptake for people with HIV but little is known about how these men themselves view, use and experience these medications. Drawing on qualitative data collected in 2015–16 from 24 HIV-positive men who have sex with men living in three Indonesian cities, we observed multiple intersecting social and contextual factors that can influence effective HIV treatment use. Although shared stories of strong side effects and fear of unwanted disclosure inhibited treatment uptake, social support from ‘buddies’ helped to navigate healthcare systems and sharing medication among peers enabled adherence. In order to improve treatment uptake and adherence among Indonesian men who have sex with men living with HIV, these ergent effects of the social meanings and practices associated with HIV treatments in Indonesia must be better acknowledged. A more comprehensive understanding of social and community practices within key populations can strengthen national efforts to improve treatment access and increase adherence. Ongoing decentralization of healthcare in Indonesia, and differentiated care models that enable initiation of treatment in community settings and involve non-medical, community-based organizations in the provision of treatment services have the potential to address the needs of in iduals who fall into a key population category such as men who have sex with men.
Exploring Tuberculosis Riskscapes in a Papua New Guinean ‘Hotspot’
Publisher: SAGE Publications
Date: 04-08-2022
DOI: 10.1177/10497323221111912
Abstract: This article explores socio-spatial dimensions of risk and how they can enhance understanding of a high burden tuberculosis (TB) context in the South Fly District of Papua New Guinea. We report on select findings from a qualitative study that included 128 semi-structured in-depth interviews and 10 focus group discussions with a wide range of South Fly District community members. Using the conceptual framework of ‘riskscapes’ to examine emic perspectives on risk, space and practice, we map key elements of TB riskscapes on Daru Island, South Fly District, along with solutions for navigating through these riskscapes. Overcrowding, lack of water, sanitation and hygiene, as well as food insecurity and undernutrition, were identified as common elements within participants’ riskscapes, that compounded upon each other to create the perception of an assemblage of risk favourable to TB transmission.
HIV pre-test information, discussion or counselling? A review of guidance relevant to the WHO European Region
Publisher: SAGE Publications
Date: 04-05-2015
Abstract: In the context of a shift from exceptionalism to normalisation, this study examines recommendations/evidence in current pan-European/global guidelines regarding pre-test HIV testing and counselling practices in health care settings. It also reviews new research not yet included in guidelines. There is consensus that verbal informed consent must be gained prior to testing, in idually, in private, confidentially, in the presence of a health care provider. All guidelines recommend pre-test information/discussion delivered verbally or via other methods (information sheet). There is agreement about a minimum standard of information to be provided before a test, but guidelines differ regarding discussion about issues encouraging patients to think about implications of the result. There is heavy reliance on expert consultation in guideline development. Referenced scientific evidence is often more than ten years old and based on US/UK research. Eight new papers are reviewed. Current HIV testing and counselling guidelines have inconsistencies regarding the extent and type of information that is recommended during pre-test discussions. The lack of new research underscores a need for new evidence from a range of European settings to support the process of expert consultation in guideline development.
INTEGRATING ETHNOGRAPHIC PRINCIPLES IN NGO MONITORING AND IMPACT EVALUATION
Publisher: Wiley
Date: 17-07-2012
DOI: 10.1002/JID.2868
Developing a culturally appropriate illustrated tool for the self-collection of anorectal specimens for the testing of sexually transmitted infections: lessons from Papua New Guinea
Publisher: Springer Science and Business Media LLC
Date: 20-02-2019
Perspectives of primary health care staff on the implementation of a sexual health quality improvement program: A qualitative study in remote aboriginal communities in Australia
Publisher: Springer Science and Business Media LLC
Date: 02-04-1000
P712 “you need a cash buffer”: male sex work and condom use in the era of HIV pre-exposure prophylaxis
Publisher: BMJ Publishing Group Ltd
Date: 07-2019
Socio-structural influences on young men's experiences of sex, pregnancy and pregnancy prevention in Papua New Guinea
Publisher: Routledge
Date: 05-01-2023
Monitoring and Evaluation in Health and Social Development
Publisher: Routledge
Date: 02-2016
Young people and sexual agency in rural Uganda
Publisher: Informa UK Limited
Date: 03-2012
DOI: 10.1080/13691058.2011.635808
Abstract: This paper offers an analysis of young people's sexual agency in rural Uganda. Drawing on definitions of agency from within the international development literature, it focuses on: decision-making processes leading to young people's involvement in relationships actions undertaken to maintain 'secret' relationships in contexts where young people's sexual agency is generally prohibited transactional and gendered negotiations between young people involved within a relationship and a range of outcomes arising from young people's sexual activity. An understanding of the dynamics and temporal nature of young people's sexual agency, and the consequences that follow from it, challenges the widely held view that young people do not know what they are doing in relation to their sexual health. This should enable practitioners to identify avenues for developing HIV prevention and sexual health programmes that are more fully based in, and driven by, the realities of young people's sexual lives.
Time to invest in a ‘counterpublic health’ approach: promoting sexual health amongst sexually active young people in rural Uganda
Publisher: Informa UK Limited
Date: 11-2012
Related Organisations
Royal Holloway University Of London
Location: United Kingdom of Great Britain and Northern Ireland
University Of Leeds
Location: United Kingdom of Great Britain and Northern Ireland
Related Funding Activities
Linkage Projects - Grant ID: LP170100190
Start Date: 11-2018
End Date: 10-2022
Amount: $211,408.00
Funder: Australian Research Council
View Funded Activity