84 results on '"Holt, Martin"'
Search Results
2. Patterns of Alcohol and Other Drug Use Associated with Major Depression among Gay Men Attending General Practices in Australia
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Holt, Martin, Bryant, Joanne, Newman, Christy E., Paquette, Dana M., Mao, Limin, Kidd, Michael R., Saltman, Deborah C., and Kippax, Susan C.
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Our aim was to clarify the role of alcohol and other drug (AOD) use in major depression among gay men attending general medical practices. A secondary analysis was conducted on survey data collected from 531 gay men attending high-HIV-caseload general practices in Adelaide and Sydney, Australia. The survey contained demographic, social, behavioural and AOD variables. Participants were classified into those with (n = 130) and without major depression (n = 401) using the PHQ-9 screening tool. Although rates of drug use were very high in the sample, multivariate logistic regression analysis showed that the majority of variables independently associated with major depression were social and behavioural factors. Only one AOD variable was associated with major depression: the use of three or more drug types in the past 6 months. Attending to specific patterns of AOD use may assist in the identification of gay men most at risk of major depression.
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- 2012
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3. Managing Mental Health Problems in Everyday Life: Drug Treatment Client's Self-Care Strategies
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Holt, Martin and Treloar, Carla
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Little is understood about the self-care activities undertaken by drug treatment clients. Using data from a qualitative study of drug treatment and mental health we identify the self-care practices of drug treatment clients diagnosed with anxiety and depression. Seventy-seven participants were interviewed in four sites across Australia. Participants described a range of self-care practices for mental health including: self-medication, seeking social support, physical exercise, counselling-derived techniques, keeping busy and other less common strategies. These findings show that drug treatment clients undertake similar self-care practices to the general population and illicit drug users and that these activities echo beneficial practices identified in the research literature. The results suggest opportunities for service providers to work with clients on self-care activities that may improve mental health. Tensions between consumer and professional views of self-care, and the limits to encouraging self-care as a substitute for treatment, are discussed.
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- 2008
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4. National Surveillance of Home-Based HIV Testing Among Australian Gay and Bisexual Men, 2018–2020: Uptake After Commercial Availability of HIV Self-Tests
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Zhang, Ye, Holt, Martin, Chan, Curtis, Applegate, Tanya L., Bavinton, Benjamin R., Broady, Timothy R., Keen, Phillip, Wulandari, Luh Putu Lila, Mao, Limin, McManus, Hamish, Medland, Nicholas A., Prestage, Garrett, Wiseman, Virginia, and Guy, Rebecca J.
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- 2023
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5. Explicit Relationship Agreements and HIV Pre-exposure Prophylaxis Use by Gay and Bisexual Men in Relationships
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MacGibbon, James, Bavinton, Benjamin R., Drysdale, Kerryn, Murphy, Dean, Broady, Timothy R., Kolstee, Johann, Molyneux, Angus, Power, Cherie, Paynter, Heath, de Wit, John, and Holt, Martin
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- 2023
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6. Adjusting Behavioural Surveillance and Assessing Disparities in the Impact of COVID-19 on Gay and Bisexual Men’s HIV-Related Behaviour in Australia
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Holt, Martin, Chan, Curtis, Broady, Timothy R., Mao, Limin, MacGibbon, James, Rule, John, Wilcock, Ben, Prestage, Garrett, and Bavinton, Benjamin R.
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- 2023
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7. COVID-19 Vaccination Uptake and Hesitancy in a National Sample of Australian Gay and Bisexual Men
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Holt, Martin, MacGibbon, James, Bavinton, Benjamin, Broady, Timothy, Clackett, Shawn, Ellard, Jeanne, Kolstee, Johann, Molyneux, Angus, Murphy, Dean, Power, Cherie, and de Wit, John
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- 2022
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8. Sustaining success: a qualitative study of gay and bisexual men’s experiences and perceptions of HIV self-testing in a randomized controlled trial
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Zhang, Ye, Guy, Rebecca J., Smith, Kirsty S., Jamil, Muhammad S., Prestage, Garrett, Applegate, Tanya L., Conway, Damian P., Holt, Martin, Keen, Phillip, Bavinton, Benjamin, McNulty, Anna M., Batrouney, Colin, Russell, Darren, Vaughan, Matthew, Chen, Marcus, Fairley, Christopher K., Grulich, Andrew E., Kaldor, John M., and Callander, Denton
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- 2021
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9. Trends in illicit drug use and their association with HIV transmission risks from behavioural surveillance of Australian gay and bisexual men.
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Takeuchi, Jumpei, Chan, Curtis, MacGibbon, James, Broady, Timothy R., Lea, Toby, Mao, Limin, Bavinton, Benjamin R., and Holt, Martin
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HIV infection transmission ,BISEXUAL men ,DRUG abuse ,GAY men ,ANAL sex - Abstract
Introduction: Investigating drug trends among Australian gay and bisexual men (GBM) is crucial for understanding levels of use and the potential for harm, including HIV transmission risk. Method: Using repeated, national, cross‐sectional survey data collected between 2012 and 2021 (69,567 surveys), trends of recent (previous 6 months) and frequent (weekly) drug use were analysed, using logistic regression models. The last round of data from each jurisdiction (6709 surveys) was used to compare GBM who reported no use, infrequent (less than weekly) use and frequent (at least weekly) use of party drugs to investigate the association between party drug use and HIV transmission risk, using multinomial logistic regression models. Results: There was a significant upward trend in any recent drug use (from 58.4% in 2012 to 64.1% in 2021; p < 0.001). Frequent party drug use remained a minority practice over the period (consistently less than 3%). In cross‐sectional analysis, frequent party drug users were more likely to report behaviours with HIV transmission risks, such as condomless anal intercourse without biomedical prevention strategies (30.0% vs. 13.1%; adjusted relative risk ratio [aRRR], 2.08; 95% CI, 1.24–3.47), weekly group sex (16.3% vs. 0.6%; aRRR, 12.36; 95% CI, 5.75–26.56) and more than 20 recent sexual partners (42.5% vs. 5.0%; aRRR, 21.44; 95% CI, 5.82–78.89), compared with GBM who did not use party drugs. Discussion and Conclusion: Our findings suggest that the frequent use of party drugs remains a marker of HIV transmission risk among Australian GBM, despite the increased adoption of biomedical HIV prevention strategies over the past few years. [ABSTRACT FROM AUTHOR]
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- 2024
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10. Promoting ‘Equitable Access’ to PrEP in Australia: Taking Account of Stakeholder Perspectives
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Newman, Christy, Hughes, Shana, Persson, Asha, Truong, Hong-Ha M., and Holt, Martin
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- 2019
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11. Trends in Attitudes to and the Use of HIV Pre-exposure Prophylaxis by Australian Gay and Bisexual Men, 2011–2017: Implications for Further Implementation from a Diffusion of Innovations Perspective
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Holt, Martin, Lea, Toby, Bear, Brandon, Halliday, Dale, Ellard, Jeanne, Murphy, Dean, Kolstee, Johann, and de Wit, John
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- 2019
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12. Dosing practices made mundane: Enacting HIV pre‐exposure prophylaxis adherence in domestic routines.
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Smith, Anthony K. J., Lancaster, Kari, Rhodes, Tim, and Holt, Martin
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CLINICAL drug trials ,HIV prevention ,ANTI-HIV agents ,MEN'S health ,ORAL drug administration ,HUMAN sexuality ,INTERVIEWING ,PRE-exposure prophylaxis ,QUALITATIVE research ,SEX customs ,RESEARCH funding ,PATIENT compliance ,PSYCHOLOGICAL adaptation ,GAY men - Abstract
Maintaining routines of medication dosing requires effort amidst the variabilities of everyday life. This article offers a sociomaterial analysis of how the oral HIV prevention regimen, pre‐exposure prophylaxis (PrEP), is put to use and made to work, including in situations which disrupt or complicate dosing regimes. Other than a daily pill, PrEP can be taken less frequently based on anticipated sexual activity and HIV risk, including 'on‐demand' and 'periodic' dosing. Drawing on 40 interviews with PrEP users in Australia in 2022, we explore PrEP and its dosing as features of assemblages in which bodies, routines, desires, material objects and the home environment interact. Dosing emerges as a practice of coordination involving dosette boxes, blister packs, alarms, partners, pets, planning sex, routines and domestic space, and as an effect of experimentations with timing to suit life circumstances and manage side effects. Dosing is materialised in the mundane; a practice that is made to work, as well as domesticated, in its situations. Although there are no 'simple' solutions to adherence, our analysis offers practical insights into how routine, planning and experimentation come together to capacitate PrEP to work in people's lives, in sometimes unexpected ways, including through adaptations of PrEP dosing. [ABSTRACT FROM AUTHOR]
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- 2023
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13. Mpox (monkeypox) knowledge, concern, willingness to change behaviour, and seek vaccination: results of a national cross-sectional survey.
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MacGibbon, James, Cornelisse, Vincent J., Smith, Anthony K. J., Broady, Timothy R., Hammoud, Mohamed A., Bavinton, Benjamin R., Heath-Paynter, Dash, Vaughan, Matthew, Wright, Edwina J., and Holt, Martin
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Background: In mid-2022, a global mpox (formerly 'monkeypox') outbreak affecting predominantly gay and bisexual men emerged in non-endemic countries. Australia had never previously recorded mpox cases and there was no prior research on knowledge or attitudes to mpox among gay and bisexual men across Australia. Methods: We conducted a national, online cross-sectional survey between August 2022 and September 2022. Participants were recruited through community organisation promotions, online advertising, and direct email invitations. Eligible participants were gay, bisexual or queer; identified as male (cisgender or transgender) or non-binary; aged 16 years or older; and lived in Australia. The main outcome measures were: knowledge and concern about mpox; recognition of mpox symptoms and transmission routes; vaccination history; acceptability of behavioural changes to reduce mpox risk, and willingness to be vaccinated. Results: Of 2287 participants, most participants were male (2189/2287; 95.7%) and gay (1894/2287; 82.8%). Nearly all had heard about mpox (2255/2287; 98.6%), and the majority were concerned about acquiring it (1461/2287; 64.4%). Most of the 2268 participants not previously diagnosed with mpox correctly identified skin lesions (2087; 92%), rash (1977; 87.2%), and fever (1647; 72.6%) as potential symptoms, and prolonged and brief skin-to-skin contact as potential ways to acquire mpox (2124, 93.7%; and 1860, 82%, respectively). The most acceptable behavioural changes were reducing or avoiding attendance at sex parties (1494; 65.9%) and sex-on-premises venues (1503; 66.4%), and having fewer sexual partners (1466; 64.6%). Most unvaccinated and undiagnosed participants were willing to be vaccinated (1457/1733; 84.1%). Conclusions: People at risk of mpox should be supported to adopt acceptable risk reduction strategies during outbreaks and to seek vaccination. Mid-2022 saw a global mpox outbreak among primarily gay and bisexual men. During August–September 2022, we surveyed 2287 gay, bisexual and queer men and non-binary people about their knowledge of mpox, willingness to make behavioural changes, and be vaccinated. Nearly all participants had heard of mpox and most were familiar with common symptoms and transmission routes. We found very high willingness to be vaccinated against mpox but we identified some groups who may benefit from targeted information about vaccination. [ABSTRACT FROM AUTHOR]
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- 2023
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14. Reasons for not Using HIV Pre-Exposure Prophylaxis (PrEP) among Gay and Bisexual Men in Australia: Mixed-Methods Analyses from a National, Online, Observational Study.
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Philpot, Steven P., Prestage, Garrett, Holt, Martin, Maher, Lisa, Haire, Bridget, Bourne, Adam, and Hammoud, Mohamed A.
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HIV prevention ,THERAPEUTICS ,EMBARRASSMENT ,SCIENTIFIC observation ,ATTITUDE (Psychology) ,RESEARCH methodology ,PRE-exposure prophylaxis ,RESEARCH funding ,GAY men ,HEALTH promotion - Abstract
Although approximately 31,000 Australian gay and bisexual men (GBM) are eligible for HIV pre-exposure prophylaxis (PrEP), only 18,500 people currently use it, indicating a need to investigate why GBM do not use it. This article uses data from a national, online, observational study. It adopts a mixed-methods analysis to responses to survey questions asking about reasons Australian GBM were not using PrEP in 2018, according to their level of HIV risk as delineated by the Australian PrEP prescribing guidelines at the time. Participants responded to check-box questions and had the option to respond to a qualitative free-text question. Results showed that just over one-fifth of men were at higher risk of HIV acquisition. Compared to lower-risk men, higher-risk men were more likely to indicate PrEP was too expensive and more likely to cite embarrassment asking for it. Reasons for not using PrEP included a lack of personal relevance, poor accessibility or knowledge, concerns about PrEP's inability to protect against STIs, potential side effects, and a preference for condoms. We conclude that health promotion more effectively targeting GBM who may benefit the most from PrEP may be valuable. [ABSTRACT FROM AUTHOR]
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- 2023
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15. Familiarity with, perceived accuracy of, and willingness to rely on Undetectable=Untransmittable (U=U) among gay and bisexual men in Australia: results of a national cross-sectional survey.
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MacGibbon, James, Bavinton, Benjamin R., Broady, Timothy R., Ellard, Jeanne, Murphy, Dean, Calabrese, Sarah K., Kalwicz, David A., Heath-Paynter, Dash, Molyneux, Angus, Power, Cherie, Heslop, Andrew, de Wit, John, and Holt, Martin
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Background. The Undetectable=Untransmittable (U=U) message has been promoted since it was demonstrated that viral suppression through HIV treatment prevents sexual transmission between serodiscordant partners (HIV treatment as prevention). Our study assessed familiarity with, perceived accuracy of, and willingness to rely on U=U in a national sample of gay and bisexual men in Australia. Methods. We conducted a national, online cross-sectional survey in April-June 2021. Eligible participants were gay, bisexual and queer men and non-binary people who lived in Australia. Logistic regression was used to identify factors associated with familiarity, perceived accuracy and willingness to rely on U=U (by having condomless sex with a partner with HIV who has an undetectable viral load). Results. Of 1280 participants, most were familiar with U=U (1006/1280; 78.6%), the majority of whom believed U=U was accurate (677/1006; 67.3%). Both familiarity and perceived accuracy were higher among participants living with HIV, followed by pre-exposure prophylaxis (PrEP) users, HIV-negative participants not taking PrEP, and untested/unknown status participants. Knowing at least one person living with HIV, among other factors, was associated with familiarity and perceived accuracy of U=U; and familiarity was associated with perceived accuracy. Among participants familiar with U=U, less than half were willing to rely on U=U (473/1006; 47.0%). Familiarity with U=U and knowing at least one person living with HIV were associated with willingness to rely on U=U, among other factors. Conclusions. We found familiarity with U=U was associated with perceived accuracy and willingness to rely upon it. There is an ongoing need to educate gay and bisexual men (particularly HIV-negative men) about U=U and its benefits. [ABSTRACT FROM AUTHOR]
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- 2023
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16. Progress and Challenges in Ending HIV and AIDS in Australia
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Holt, Martin
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- 2017
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17. Explicit Relationship Agreements and HIV Pre-exposure Prophylaxis Use by Gay and Bisexual Men in Relationships
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MacGibbon, James, Bavinton, Benjamin R., Drysdale, Kerryn, Murphy, Dean, Broady, Timothy R., Kolstee, Johann, Molyneux, Angus, Power, Cherie, Paynter, Heath, de Wit, John, Holt, Martin, Leerstoel de Wit, Social Policy and Public Health, Leerstoel de Wit, and Social Policy and Public Health
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Men who have sex with men ,Arts and Humanities (miscellaneous) ,HIV prevention ,Australia ,HIV PrEP ,Male couples ,Psychology(all) ,General Psychology - Abstract
Relationship agreements are important for HIV prevention among gay and bisexual men (GBM) in relationships, with research earlier in the HIV epidemic often finding that agreements specified monogamy or condom use with casual partners. There is evidence that HIV pre-exposure prophylaxis (PrEP) has shifted sexual practices among some men in relationships, such as allowing condomless sex with casual partners, but there has been little attention paid to relationship agreements among GBM who use PrEP. In this paper, we analyzed national, Australian, cross-sectional data from an online survey completed by non-HIV-positive GBM in 2021 (N = 1,185). Using logistic regression, we identified demographic characteristics, sexual practices and the types of relationship agreement that were associated with PrEP use among GBM in relationships. Using Pearson’s chi-squared tests, we explored whether PrEP users in relationships reported similar sexual practices to PrEP users not in relationships. PrEP use among GBM in relationships was independently associated with older age, identifying as gay, being in a non-monogamous relationship, having a spoken (explicit) relationship agreement, having a primary HIV-negative partner taking PrEP or a primary partner living with HIV, reporting recent condomless casual sex, reporting an STI diagnosis in the past year, and knowing at least one other PrEP user. We found that PrEP users in relationships had similar sexual practices to PrEP users not in relationships. GBM in relationships who have casual sex and who meet PrEP suitability criteria may be good candidates for PrEP. Our findings suggest that explicit relationship agreements remain important for HIV prevention, and they support PrEP use among GBM in relationships.
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- 2022
18. Changing Attitudes Towards Condoms Among Australian Gay and Bisexual Men in the PrEP Era: An Analysis of Repeated National Online Surveys 2011-2019.
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Kolstee, Johann, MacGibbon, James, Prestage, Garrett, Clackett, Shawn, Paynter, Heath, Bavinton, Benjamin R., Broady, Timothy R., Ellard, Jeanne, Murphy, Dean A., de Wit, John, Power, Cherie, and Holt, Martin
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HIV prevention ,CONFIDENCE ,CONFIDENCE intervals ,ATTITUDES toward sex ,SURVEYS ,HEALTH literacy ,PSYCHOSOCIAL factors ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,CONDOMS ,LOGISTIC regression analysis ,ODDS ratio ,GAY men ,BISEXUAL people ,HEALTH promotion - Abstract
Condoms have been the primary form of HIV prevention for gay and bisexual men (GBM) for most of the HIV epidemic. The introduction of biomedical HIV prevention may have changed attitudes towards condoms. Data from repeated national online surveys of GBM in Australia were used to examine how attitudes towards condoms and confidence discussing condoms with partners changed in the period 2011-2019. The proportion of all participants who reported a positive experience in using condoms remained low and unchanged (9.6% in 2011 to 6.0% in 2019). Confidence in discussing condoms with partners decreased over time (from 72.2% in 2011 to 56.6% in 2019). Confidence in discussing condoms was associated with concern about sexually transmitted infections, and more consistent condom use. Sustaining confidence in using condoms may be more challenging as biomedical prevention methods become more commonly used. [ABSTRACT FROM AUTHOR]
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- 2022
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19. Clinician imaginaries of HIV PrEP users in and beyond the gay community in Australia.
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Smith, Anthony K J, Newman, Christy E., Haire, Bridget, and Holt, Martin
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PRE-exposure prophylaxis ,GAY community ,GAY men ,MEDICAL personnel ,CONDOM use ,HIV - Abstract
Through the development and implementation of HIV pre-exposure prophylaxis (PrEP), the characteristics of PrEP users have been configured in a range of ways. Drawing on the concept of 'imaginaries', we consider how clinicians imagine PrEP users and related communities. We conducted 28 semi-structured interviews in 2019–2020 with PrEP-providing clinicians based in New South Wales and Western Australia. Participants included general practitioners, sexual health nurses and sexual health doctors. We inductively developed three themes through a reflexive thematic analysis: 'PrEP users as 99% gay men/MSM', 'The informed and connected PrEP user', and 'Condom users in the PrEP era'. Participants imagined PrEP users primarily as gay men, and so we focused on how gay community was imagined in relation to PrEP users. Users were imagined as supporting one another to use PrEP effectively, but some were imagined as threatening norms of condom use amongst gay community. Analysing clinician imaginaries of PrEP users reveals insight into how clinicians speculate about and engage with changing community norms related to condom use and accessing PrEP. These imaginaries reveal ongoing tensions about who is believed to be best suited to PrEP, and PrEP's impact on norms of conduct in imagined biosocial communities like gay men. [ABSTRACT FROM AUTHOR]
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- 2022
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20. Prescribing as affective clinical practice: Transformations in sexual health consultations through HIV pre‐exposure prophylaxis.
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Smith, Anthony K J, Newman, Christy E., Haire, Bridget, and Holt, Martin
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HIV prevention ,PROFESSIONAL ethics ,NURSES' attitudes ,RESEARCH methodology ,INTERVIEWING ,UNCERTAINTY ,PHYSICIANS' attitudes ,QUALITATIVE research ,PSYCHOLOGY of nurses ,DRUG prescribing ,MEDICAL referrals ,PHYSICIAN practice patterns ,MEDICAL practice ,CONDOMS ,THEMATIC analysis ,OCCUPATIONAL adaptation ,SEXUAL health ,GAY men ,PSYCHOLOGY of physicians - Abstract
New medicines can transform routines and priorities in clinical practice, but how do clinicians think and feel about these changes, and how does it affect their work? In Australia, the HIV prevention regimen pre‐exposure prophylaxis (PrEP) has been rapidly rolled out, transforming the sexual cultures and practices of users, but less attention has been given to the ways PrEP has reconfigured clinical practice. This paper draws on 28 qualitative semi‐structured interviews conducted between 2019 and 2020 with PrEP‐providing doctors and nurses in Australia to consider how they have affectively engaged with PrEP and put it into practice. Through a reflexive thematic analysis, we explore how clinicians adapted to PrEP, how the field of HIV prevention has been transformed, and how these developments have changed how clinicians approach patients. While the introduction of PrEP was initially received with uncertainty and shock, clinicians described PrEP as enjoyable to prescribe, and better aligned with the moral duties of sexual health consultations than existing HIV prevention strategies like condoms. Through approaching clinical work as an 'affective practice', we argue for attending not only to how new interventions change expectations and practices, but also how these changes are felt and valued by clinicians. [ABSTRACT FROM AUTHOR]
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- 2022
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21. HIV Preexposure Prophylaxis Cascades to Assess Implementation in Australia: Results From Repeated, National Behavioral Surveillance of Gay and Bisexual Men, 2014-2018
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Holt, Martin, Lee, Evelyn, Lea, Toby, Bavinton, B., Broady, T., Mao, Limin, MacGibbon, J., Keen, P., Murphy, Dean, Bear, B., Crawford, David, Ellard, Jeanne, Kolstee, J., Power, C., Prestage, Garrett, Grulich, Andrew E, Guy, Rebecca, de Wit, J., Leerstoel de Wit, and Social Policy and Public Health
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preexposure prophylaxis ,Australia ,men who have sex with men ,implementation ,prevention cascade ,disparities - Abstract
BACKGROUND: HIV prevention cascades can assist in monitoring the implementation of prevention methods like preexposure prophylaxis (PrEP). We developed 2 PrEP cascades for Australia's primary HIV-affected population, gay and bisexual men. METHODS: Data were drawn from 2 national, repeated, cross-sectional surveys (the Gay Community Periodic Surveys and PrEPARE Project). One cascade had 3 steps, and the other had 7 steps. Trends over time were assessed using logistic regression. For the most recent year, we identified the biggest drop between steps in each cascade and compared the characteristics of men between the 2 steps using multivariate logistic regression. RESULTS: Thirty-nine thousand six hundred and seventy non-HIV-positive men participated in the Periodic Surveys during 2014-2018. PrEP eligibility increased from 28.1% (1901/6762) in 2014 to 37.3% (2935/7878) in 2018 (P
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- 2020
22. Qualitative Findings on the Impact of COVID-19 Restrictions on Australian Gay and Bisexual Men: Community Belonging and Mental Well-being.
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Philpot, Steven P., Holt, Martin, Murphy, Dean, Haire, Bridget, Prestage, Garrett, Maher, Lisa, Bavinton, Benjamin R., Hammoud, Mohamed A., Jin, Fengyi, and Bourne, Adam
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WELL-being , *COVID-19 , *SCIENTIFIC observation , *ATTITUDE (Psychology) , *COMMUNITIES , *GROUP identity , *PSYCHOLOGY of gay people , *QUALITATIVE research , *CONCEPTUAL structures , *SURVEYS , *QUESTIONNAIRES , *DESCRIPTIVE statistics , *RESEARCH funding , *THEMATIC analysis , *BISEXUAL people , *MENTAL health services , *LONGITUDINAL method - Abstract
COVID-19 may threaten the already poor mental health outcomes of Australian gay and bisexual men and cut ties to important social/sexual networks and community. Qualitative research into the experiences of gay and bisexual men during COVID-19 regulations is currently sparse. We report on 489 responses to a qualitative free-text question asking Australian gay and bisexual men about the impacts of COVID-19 during April 2020. Issues pertinent to gay and bisexual men include lost ties to gay and bisexual social/sexual communities, spaces, and activities, which can reduce a sense of belonging to important sexual identity spaces, as well as significant mental well-being vulnerabilities. Reminiscing the collective response to HIV/AIDS, findings reinforce the value of gay and bisexual community organizations, spaces, and networks as supports for gay and bisexual men and emphasize the need for delivering mental health services. [ABSTRACT FROM AUTHOR]
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- 2021
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23. Undiagnosed HIV infections among gay and bisexual men increasingly contribute to new infections in Australia
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Gray, Richard T, Wilson, David P, Guy, Rebecca J, Stoové, Mark, Hellard, Margaret E, Prestage, Garrett P, Lea, Toby, De Wit, John, Holt, Martin, Leerstoel de Wit, and Public Health
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transmission dynamics ,Australia ,gay and bisexual men ,undiagnosed HIV ,mathematical model ,HIV cascade - Abstract
Introduction We determined the contribution of undiagnosed HIV to new infections among gay and bisexual men (GBM) over a 12‐year period in Australia where there has been increasing focus on improving testing and HIV treatment coverage. Methods We generated annual estimates for each step of the HIV cascade and the number of new HIV infections for GBM in Australia over 2004 to 2015 using relevant national data. Using Bayesian melding we then fitted a quantitative model to the cascade and incidence estimates to infer relative transmission coefficients associated with being undiagnosed, diagnosed and not on ART, on ART with unsuppressed virus, or on ART with suppressed virus. Results Between 2004 and 2015, we estimated the percentage of GBM with HIV in Australia who were unaware of their status to have decreased from 14.5% to 7.5%. During the same period, there was a substantial increase in the number and proportion of GBM living with HIV on treatment and with suppressed virus, with the number of virally suppressed GBM increasing from around 3900 (30.2% of all GBM living with HIV) in 2004 to around 14,000 (73.7% of all GBM living with HIV) in 2015. Despite the increase in viral suppression, the annual number of new infections rose from around 660 to around 760 over this period. Our results have a wide range due to the uncertainty in the cascade estimates and transmission coefficients. Nevertheless, undiagnosed GBM increasingly appear to contribute to new infections. The proportion of new infections attributable to undiagnosed GBM almost doubled from 33% in 2004 to 59% in 2015. Only a small proportion (
- Published
- 2018
24. Declining prevalence of undiagnosed HIV in Melbourne: results from community-based bio-behavioural studies of gay and bisexual men
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Stoové, Mark, Asselin, Jason, Pedrana, Alisa, Lea, Toby, Hellard, Margaret, Wilson, David B, Prestage, Garrett, de Wit, John, Holt, Martin, Public Health, and Leerstoel de Wit
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Australia ,gay and bisexual men ,undiagnosed HIV - Abstract
OBJECTIVE: To measure changes in undiagnosed HIV among gay and bisexual men (GBM) in Melbourne. METHODS: Undiagnosed HIV was compared between GBM recruited anonymously in 2008 in gay venues only and GBM anonymously or confidentially (results delivery) recruited in 2014 at gay venues and a community festival. Surveys were completed and oral fluid specimens collected for HIV testing; positive tests among GBM reporting being HIV-negative or unknown/untested were classified as undiagnosed. Tests of proportions compared serological prevalence, undiagnosed prevalence and participant characteristics. RESULTS: HIV prevalence was 9.5% and 7.1% among 639 and 993 GBM recruited in 2008 and 2014, respectively; undiagnosed prevalence declined significantly from 31.1% to 7.1% (p
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- 2018
25. Methamphetamine use among gay and bisexual men in Australia: Trends in recent and regular use from the Gay Community Periodic Surveys
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Lea, Toby, Mao, Limin, Hopwood, Max, Prestage, Garrett, Zablotska, Iryna, de Wit, John, Holt, Martin, Leerstoel de Wit, Public Health, Leerstoel de Wit, and Public Health
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Adult ,Male ,Cross-sectional study ,Amphetamine-Related Disorders ,Medicine (miscellaneous) ,Human sexuality ,HIV Infections ,Research Support ,Methamphetamine ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Unsafe Sex ,Medicine ,Humans ,030212 general & internal medicine ,MSM ,Young adult ,Homosexuality, Male ,Non-U.S. Gov't ,Substance Abuse, Intravenous ,Reproductive health ,Harm reduction ,030505 public health ,business.industry ,Health Policy ,Research Support, Non-U.S. Gov't ,Australia ,HIV ,Crystal methamphetamine ,Cross-Sectional Studies ,Methamphetamine use ,Sexual context ,Injecting drug use ,Bisexuality ,0305 other medical science ,business ,Social psychology ,Demography ,Gay community - Abstract
BACKGROUND: Gay and bisexual men typically report high rates of illicit drug use, including methamphetamine use. This paper aimed to analyse trends in crystal methamphetamine ('crystal') and powder methamphetamine ('speed') use among gay and bisexual men in Australia, and characterise the sociodemographic, drug use, and sexual risk practices of men who reported crystal use. METHODS: The Gay Community Periodic Surveys, routinely conducted behavioural surveillance surveys of gay men in Australia, were analysed to examine trends in recent crystal and speed use during 2005-14 (any use in the previous 6 months), and trends in regular crystal and speed use during 2007-14 (at least monthly use in the previous 6 months). Covariates of recent and regular crystal use were analysed using 2014 data. RESULTS: Speed use declined from 25.0% to 10.2% during 2005-14 (p-trend
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- 2015
26. Rapid HIV testing increases testing frequency among gay and bisexual men: a controlled before-after study.
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Keen, Phillip, Jamil, Muhammad, Callander, Denton, Conway, Damian P., McNulty, Anna, Davies, Stephen C., Couldwell, Deborah C., Smith, Don E., Holt, Martin, Vaccher, Stefanie J., Gray, James, Cunningham, Philip, Prestage, Garrett, Guy, Rebecca, NSW Rapid HIV Testing Evaluation Framework, and Couldwell, Deborah L
- Abstract
Background Rapid HIV testing was introduced at 12 clinics in New South Wales (NSW) for routine testing and promoted with social marketing. The effect of the availability of rapid HIV testing on testing frequency among gay and bisexual men (GBM) was evaluated.
Methods: An observational design using patient data from 12 clinics was used. The primary outcome was the mean number of HIV tests in 12 months. The intervention group comprised GBM who had one or more rapid tests from October 2013 to September 2014 and this was compared with two control groups; a concurrent group (no rapid test in the same period) and a historical group (attended between July 2011 and June 2012). Independent sample t-tests were conducted to compare mean number of tests among men in the intervention, concurrent and historical groups. Multivariate logistic regression was used to assess the association between rapid HIV testing and testing frequency.Results: Men in the intervention group (n = 3934) had a mean of 1.8 HIV tests in 12 months, compared with 1.4 in the concurrent group (n = 5063; P < 0.001) and 1.4 in the historical group (n = 5904; P < 0.001); testing frequency was higher among men at increased risk of HIV in the intervention group compared with the other two groups (mean 2.2, 1.6 and 1.5 respectively; P < 0.001). Membership of the intervention group was associated with increased odds of having two or more HIV tests in 12 months (AOR = 2.5, 95%CI 2.2-2.8; P < 0.001) compared with the concurrent group, after controlling for demographic and behavioural factors.Conclusion: Introducing and promoting rapid HIV testing in clinics in NSW was associated with increased HIV testing frequency among GBM. [ABSTRACT FROM AUTHOR]- Published
- 2019
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- View/download PDF
27. The estimated number of potential PrEP users among gay-identifying men who have sex with men in Australia.
- Author
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Zablotska, Iryna B., Gray, Richard, Whittaker, Bill, Holt, Martin, Wright, Edwina, Prestage, Garrett, O’Donnell, Darryl, and Grulich, Andrew E.
- Subjects
GAY identity ,MEN who have sex with men ,METHAMPHETAMINE - Abstract
We estimated the size of the population of gay-identified men who have sex with men (gay men) eligible for PrEP in Australia under the current national PrEP guidelines. Using input indicators from the Australian Bureau of Statistics, the national representative survey Second Australian Study of Health and Relationships, and national HIV- behavioural surveillance, we calculated the size of the population of sexually active gay men and estimated a range for the number eligible for PrEP using different scenarios based on the guidelines. In 2015, an estimated 108,850 sexually-active 16-69-year-old gay men were classified as at risk of acquiring HIV in Australia. Of these men, 10,558 to 30,913 (9.7%-28.4%) were classified as being at high risk and therefore eligible for PrEP, most commonly due to recent receptive condomless intercourse with casual partners (6.1% to 15.5%), STI infections (5.4% to 10.6%) or the use of crystal methamphetamine (1.4% to 9.4%). The higher estimates included men who may have been at HIV risk for shorter time periods or with fewer partners. Australian PrEP guidelines recommend targeting PrEP to people at high HIV risk. Our estimation of potential PrEP users informed PrEP implementation in Australia. The choice of PrEP eligibility criteria, and interpretation of the guidelines, strongly affects the population estimates. In the future, higher numbers of gay men may become eligible for PrEP, because the estimates are largely defined by and follow trends in condomless anal intercourse. Our estimation methods can be adapted to other settings. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
28. Undiagnosed HIV infections among gay and bisexual men increasingly contribute to new infections in Australia.
- Author
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Gray, Richard T., Wilson, David P., Guy, Rebecca J., Stoové, Mark, Hellard, Margaret E., Prestage, Garrett P., Lea, Toby, de Wit, John, and Holt, Martin
- Subjects
HIV infections ,HIV-positive gay men ,HIV-positive bisexual men ,PUBLIC health ,HIV infection transmission - Abstract
Abstract: Introduction: We determined the contribution of undiagnosed HIV to new infections among gay and bisexual men (GBM) over a 12‐year period in Australia where there has been increasing focus on improving testing and HIV treatment coverage. Methods: We generated annual estimates for each step of the HIV cascade and the number of new HIV infections for GBM in Australia over 2004 to 2015 using relevant national data. Using Bayesian melding we then fitted a quantitative model to the cascade and incidence estimates to infer relative transmission coefficients associated with being undiagnosed, diagnosed and not on ART, on ART with unsuppressed virus, or on ART with suppressed virus. Results: Between 2004 and 2015, we estimated the percentage of GBM with HIV in Australia who were unaware of their status to have decreased from 14.5% to 7.5%. During the same period, there was a substantial increase in the number and proportion of GBM living with HIV on treatment and with suppressed virus, with the number of virally suppressed GBM increasing from around 3900 (30.2% of all GBM living with HIV) in 2004 to around 14,000 (73.7% of all GBM living with HIV) in 2015. Despite the increase in viral suppression, the annual number of new infections rose from around 660 to around 760 over this period. Our results have a wide range due to the uncertainty in the cascade estimates and transmission coefficients. Nevertheless, undiagnosed GBM increasingly appear to contribute to new infections. The proportion of new infections attributable to undiagnosed GBM almost doubled from 33% in 2004 to 59% in 2015. Only a small proportion (<7%) originated from GBM with suppressed virus. Discussion: Our study suggests that an increase in HIV treatment coverage in Australia has reduced the overall risk of HIV transmission from people living with HIV. However, the proportion of infections and the rate of transmission from undiagnosed GBM has increased substantially. These findings highlight the importance of HIV testing and intensified prevention for Australian GBM at high risk of HIV. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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29. Social and Behavioural Correlates of HIV Testing Among Australian Gay and Bisexual Men in Regular Relationships
- Author
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Lee, Evelyn, Murphy, Dean, Mao, Limin, de Wit, John, Prestage, Garrett, Zablotska, Iryna, Holt, Martin, Leerstoel de Wit, and Public Health
- Subjects
Adult ,Male ,Gerontology ,Community-Based Participatory Research ,Gay and bisexual men ,Social Psychology ,Health Behavior ,Human immunodeficiency virus (HIV) ,HIV Infections ,Hiv testing ,medicine.disease_cause ,Regular relationship ,Sexual and Gender Minorities ,03 medical and health sciences ,Risk-Taking ,0302 clinical medicine ,Surveys and Questionnaires ,Humans ,Mass Screening ,Medicine ,030212 general & internal medicine ,Homosexuality, Male ,030505 public health ,Unsafe Sex ,Australian ,business.industry ,Australia ,Public Health, Environmental and Occupational Health ,virus diseases ,HIV ,Middle Aged ,HIV testing ,Cross-Sectional Studies ,Sexual Partners ,Infectious Diseases ,Socioeconomic Factors ,Bisexuality ,0305 other medical science ,business - Abstract
In this study we sought to identify the social and behavioural characteristics of Australian gay and bisexual men who had and had not tested for HIV during their current relationship. The results were based on 2012 and 2013 data collected from ongoing cross-sectional and community-based surveys held in six Australian states and territories. One thousand five hundred and sixty-one non-HIV-positive men reported that they were in a primary relationship. The majority of gay and bisexual men in primary relationships had tested for HIV during the relationship (73.4 %). Among men who had not tested during the relationship, almost half of these men had never tested for HIV. As untested men within relationships are potentially at risk of acquiring and transmitting HIV to their partners unknowingly, it is important to promote HIV testing to these men.
- Published
- 2016
30. Gay Community Periodic Survey: Queensland 2010
- Author
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Hull, Peter, Holt, Martin, Mao, Limin, Prestage, Patrick, Zablotska, Iryna, Norton, Graham, Watt, Peter, and de Wit, John
- Subjects
Sexual practices ,200205 Culture, Gender, Sexuality ,111712 Health Promotion ,Gay men ,Australia ,HIV status ,virus diseases ,111799 Public Health and Health Services not elsewhere classified ,Behavioural surveillance ,HIV testing ,Gay community ,immune system diseases ,Health ,behavior and behavior mechanisms ,Sexual partners ,Drug use ,reproductive and urinary physiology - Abstract
Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics.
- Published
- 2011
- Full Text
- View/download PDF
31. Gay Community Periodic Surveys: National Report 2010
- Author
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Holt, Martin, Mao, Limin, Prestage, Garrett, Zablotska, Iryna, and de Wit, John
- Subjects
Sexual practices ,200205 Culture, Gender, Sexuality ,111712 Health Promotion ,Gay men ,Australia ,virus diseases ,HIV ,Behavioural surveillance ,Gay community ,Trend analysis ,immune system diseases ,behavior and behavior mechanisms ,Drug use ,reproductive and urinary physiology - Abstract
Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics.
- Published
- 2011
- Full Text
- View/download PDF
32. Gay Community Periodic Survey: Perth 2010
- Author
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Hull, Peter, Holt, Martin, Mao, Limin, Freijah, Rita, Comfort, Jude, Laing, Sue, Prestage, Garrett, Zablotska, Iryna, and de Wit, John
- Subjects
Sexual practices ,111712 Health Promotion ,HIV status ,Gay men ,Australia ,virus diseases ,111799 Public Health and Health Services not elsewhere classified ,Behavioural surveillance ,HIV testing ,Gay community ,immune system diseases ,Health ,behavior and behavior mechanisms ,Sexual partners ,Drug use ,reproductive and urinary physiology - Abstract
Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics.
- Published
- 2011
- Full Text
- View/download PDF
33. Gay Community Periodic Survey: Sydney February 2010
- Author
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Evelyn, Lee, Holt, Martin, Limin, Mao, Zablotska, Iryna, Prestage, Garrett, Wong, Solomon, Lake, Rob, Honnor, Geoff, and de Wit, John
- Subjects
Sexual practices ,111712 Health Promotion ,HIV status ,Gay men ,Australia ,virus diseases ,111799 Public Health and Health Services not elsewhere classified ,Behavioural surveillance ,HIV testing ,Gay community ,immune system diseases ,Health ,behavior and behavior mechanisms ,Sexual partners ,Drug use ,reproductive and urinary physiology - Abstract
Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics.
- Published
- 2010
- Full Text
- View/download PDF
34. Gay Community Periodic Survey: Adelaide 2009
- Author
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Lee, Evelyn, Holt, Martin, Zablotska, Iryna, Prestage, Garrett, Mortimer, Elissa, Lawrinson, Peter, Dinnison, Shane, Logue, William, Wentzlaff-Eggebert, Matthias, and O’Brien, Rob
- Subjects
Sexual practices ,200205 Culture, Gender, Sexuality ,111712 Health Promotion ,Australia ,HIV status ,Gay men ,virus diseases ,111799 Public Health and Health Services not elsewhere classified ,Behavioural surveillance ,HIV testing ,Gay community ,immune system diseases ,Health ,behavior and behavior mechanisms ,Sexual partners ,Drug use ,reproductive and urinary physiology - Abstract
The Adelaide Gay Community Periodic Survey is a cross-sectional survey of gay and homosexually active men recruited through a range of gay community sites in Adelaide. The project was funded by the Department of Human Services, South Australia. The Periodic Survey provides a snapshot of sexual and HIV-related practices among gay and homosexually active men., NCHSR Monograph 10/2005
- Published
- 2010
- Full Text
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35. Gay Community Periodic Survey: Canberra 2009
- Author
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Lee, Evelyn, Holt, Martin, Zablotska, Martin, Prestage, Garrett, Mills, David, Blattman, Tony, Bogie, Marcus, and de Wit, John
- Subjects
Sexual practices ,200205 Culture, Gender, Sexuality ,111712 Health Promotion ,Gay men ,Australia ,HIV status ,virus diseases ,111799 Public Health and Health Services not elsewhere classified ,Behavioural surveillance ,HIV testing ,Gay community ,immune system diseases ,Health ,behavior and behavior mechanisms ,Sexual partners ,Drug use ,reproductive and urinary physiology - Abstract
Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics.
- Published
- 2010
- Full Text
- View/download PDF
36. Gay Community Periodic Survey: Queensland 2009
- Author
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Lee, Evelyn, Holt, Martin, Zablotska, Iryna, Prestage, Garrett, Shaun, Staunton, Scott, Kevin, O'Connor, Simon, and de Wit, John
- Subjects
Sexual practices ,111712 Health Promotion ,HIV status ,Gay men ,Australia ,virus diseases ,111799 Public Health and Health Services not elsewhere classified ,Behavioural surveillance ,HIV testing ,Gay community ,immune system diseases ,Health ,behavior and behavior mechanisms ,Sexual partners ,Drug use ,reproductive and urinary physiology - Abstract
Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics.
- Published
- 2010
- Full Text
- View/download PDF
37. Gay Community Periodic Survey: Sydney February 2009
- Author
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Frankland, Andrew, Lee, Evelyn, Zablotska, Iryna, Prestage, Garrett, Down, Ian, Holt, Martin, Lake, Rob, Honnor, Geoff, and de Wit, John
- Subjects
Sexual practices ,111712 Health Promotion ,HIV status ,Gay men ,Australia ,virus diseases ,111799 Public Health and Health Services not elsewhere classified ,Behavioural surveillance ,HIV testing ,Gay community ,immune system diseases ,Health ,behavior and behavior mechanisms ,Sexual partners ,Drug use ,reproductive and urinary physiology - Abstract
Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics.
- Published
- 2009
- Full Text
- View/download PDF
38. Young people and illicit drug use in Australia
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Holt, Martin
- Subjects
Illicit drug use ,Survey data ,Australia ,Normalisation ,Social research ,Young people - Abstract
Objective: To review what is known about young people’s drug use in Australia and to evaluate whether illicit drug use has become normalised among Australian youth. Method: Survey data and social research findings on young people’s illicit drug use are reviewed and evaluated against the criteria of the normalisation thesis. The utility of the normalisation thesis is assessed in the Australian context. Results: National surveys suggest that around a third of Australian young people have tried any illicit substance. The most commonly tried and regularly used illicit substance is cannabis, although its use may be declining. The regular use of drugs other than cannabis is infrequent, although increasing numbers of young people in their twenties appear to be trying ‘designer’ or ‘party’ drugs such as ecstasy. Studies of dance music and alternative music subcultures suggest that illicit drug use within these scenes is much more common than among young people in general. Within these contexts illicit drug use could be regarded as normalised. Conclusion: Illicit drug use appears to be normalised among specific groups of young Australians and in particular contexts, not throughout the wider population. The normalisation thesis may be useful when thinking about interventions with young people for whom drug use is ‘normal’ in that it acknowledges the strategies they develop to manage their drug use. However, the notion of ‘sensible and strategic use’ should be employed carefully to avoid the further stigmatisation of injecting drug users. Keywords: Young people, illicit drug use, normalisation, Australia, survey data, social research, Social Research Issues Papers; Social Research Issues Paper Number 3
- Published
- 2005
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39. Cruising and connecting online: The use of internet chat sites by gay men in Sydney and Melbourne
- Author
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Murphy, Dean, Rawstorne, Patrick, Holt, Martin, and Ryan, Dermot
- Subjects
Internet ,Risk practices ,immune system diseases ,education ,behavior and behavior mechanisms ,Gay men ,Australia ,virus diseases ,Chat sites ,reproductive and urinary physiology - Abstract
Cruising and connecting online investigates online chat sites as environments in which gay men can socialise and look for sex partners. We conducted original survey research of gay chat site (GCS) users in Melbourne and Sydney and looked at existing data collected in the Gay Community Periodic Surveys. The overall findings of the study were: - Gay chat sites are social as well as sexual environments and support or mediate a range of relationships between gay men - Internet sex-seeking has become a popular supplement to and extension of the sexseeking repertoire of gay-community-attached men - While Internet sex-seeking allows men to meet additional sex partners and is associated with increased rates of some HIV risk behaviour, the medium of gay chat sites may also facilitate HIV risk-reduction practices such as seeking out seroconcordant partners - Gay-community-attached men express distinctive patterns of gay chat site usage, reflecting different attitudes to and experiences of online activity and Internet sex-seeking - Gay chat site users appear to be open to education and prevention activities online., Monograph 2/2004
- Published
- 2004
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40. ‘Not everyone’s gonna like me’: Accounting for race and racism in sex and dating web services for gay and bisexual men.
- Author
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Callander, Denton, Holt, Martin, and Newman, Christy E.
- Subjects
- *
ONLINE dating services , *RACISM , *GAY men , *PREJUDICES , *BISEXUAL men - Abstract
Sexual racism can be thought of as a specific form of racial prejudice enacted in the context of sex and dating. It is a contentious issue among gay and bisexual men looking for partners online. This study draws upon 14 in-depth interviews conducted between August and October 2012 with gay and bisexual men of colour in Australia. Data were thematically analysed to identify interpretations and experiences of, and reactions to sexual racism online. Understandings of online sexual racism were diverse, ranging from clear ideas about racist and non-racist practices to more ambiguous and contextual interpretations. Nevertheless, all participants described experiences of sexual racism while seeking partners online, which were, in some cases, largely indistinguishable from generic forms of racism. Most described experiences of subtle racism, but there were also cases of blatant and aggressive racial prejudice. Finally, men reacted in a range of ways when confronted with online sexual racism, with strategies ranging from disconnection to adaptation through to confrontation. Our findings highlight that sexual racism – as an expression of racism generally – is an ongoing issue for men who seek out other men online, and that men engage in a range of strategies for mitigating the negative effects of racial prejudice in this domain. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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- View/download PDF
41. HIV Prevention by Australian Gay and Bisexual Men With Casual Partners: The Emergence of Undetectable Viral Load as One of a Range of Risk Reduction Strategies.
- Author
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Holt, Martin, Lea, Toby, Limin Mao, Zablotska, Iryna, Prestage, Garrett, and de Wit, John
- Published
- 2015
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42. Alcohol use among a community-based sample of gay men: Correlates of high-risk use and implications for service provision.
- Author
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Lea, Toby, Ryan, Dermot, Prestage, Garrett, Zablotska, Iryna, Mao, Limin, Wit, John, and Holt, Martin
- Subjects
ALCOHOL & LGBTQ+ people ,GAY men ,HARM reduction ,ALCOHOLISM ,BISEXUAL men ,CROSS-sectional method ,ATTITUDE (Psychology) - Abstract
Introduction and Aims. International research has shown that gay, bisexual and other homosexually active men (hereafter 'gay men') report disproportionately higher rates of risky alcohol use and associated problems compared with heterosexual men. However, little is known about alcohol use among this population in Australia. This study aimed to examine rates of risky alcohol use among a community-based sample of gay men in Sydney and characteristics of men reporting high-risk alcohol use and adverse consequences. Design and Methods. A cross-sectional survey of gay men was conducted in Sydney in August 2013 as part of the ongoing Gay Community Periodic Surveys (n = 1546 eligible respondents). The Alcohol Use Disorders Identification Test-Consumption questions were used to assess alcohol use in the previous 12 months. Results. Nine percent of respondents were categorised as abstinent from alcohol, 33% as low-risk drinkers, 42% as moderate-risk drinkers and 16% as high-risk drinkers. In separate multivariate logistic regression analyses, high-risk drinking and reporting ≥4 adverse alcohol consequences were associated with younger age, being Australian-born, recruitment from licensed premises and having met men for sex at gay bars and dance parties. Fifty-eight percent of high-risk drinkers reported a desire to reduce their alcohol use. Discussion and Conclusions. In this community-based sample of gay men, we found high levels of moderate- to high-risk alcohol use. The results suggest that gay men should be a priority population for health promotion campaigns and treatment services. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
43. The prevalence and correlates of undiagnosed HIV among Australian gay and bisexual men: results of a national, community-based, bio-behavioural survey.
- Author
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Holt, Martin, Lea, Toby, Asselin, Jason, Hellard, Margaret, Prestage, Garrett, Wilson, David, Wit, John, and Stoové, Mark
- Abstract
Introduction: Gay and bisexual men (GBM) with undiagnosed HIV are believed to contribute disproportionately to HIV transmission in Australia but national prevalence estimates have been lacking. Methods: From November 2013 to November 2014, we recruited men at gay venues and events in six Australian states and territories. Of 7291 survey participants, 3071 men also provided an oral fluid sample for testing and decided whether to receive their test results or not. We calculated raw and population-weighted prevalence estimates and identified associations with undiagnosed infection using logistic regression. Results: Of 3071 participants, 213 men tested HIV-positive (6.9%, 95% confidence interval [CI] 6.0 to 7.8%), ofwhom19 (8.9%, 95% CI 5.8 to 13.5%) were previously undiagnosed. After weighting for the size of the gay and bisexual male population in each state or territory, national HIV prevalence was estimated to be 7.2% (95% CI 6.3 to 8.1), of which 9.1% (95% CI 6.0 to 13.6%) were estimated to be undiagnosed. Compared with HIV-negative participants, men with undiagnosed HIV were more likely to report meeting partners at sex venues, using antiretroviral drugs as pre-exposure prophylaxis, condomless anal intercourse with casual partners, using party drugs for sex, injecting drugs and using amyl nitrite, crystal methamphetamine or gamma hydroxybutyrate in the six months prior to the survey. Discussion: The results indicate that the prevalence of undiagnosed HIV is relatively low among Australian GBM but is higher among men who report riskier sex and drug practices. Conclusions: The results underline the importance of targeted HIV prevention and frequent testing formen at increased risk of infection. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
44. Willingness to Use HIV Pre-Exposure Prophylaxis Has Declined Among Australian Gay and Bisexual Men.
- Author
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Holt, Martin, Lea, Toby, Murphy, Dean, Ellard, Jeanne, Rosengarten, Marsha, Kippax, Susan, and De Wit, John
- Abstract
We surveyed willingness to use pre-exposure prophylaxis (PrEP) and the likelihood of decreased condom use among Australian gay and bisexual men in 2011 and 2013 (n = 2384). Willingness to use PrEP declined from 28.2% to 23.3% [adjusted odds ratio = 0.83, 95% confidence interval (CI): 0.68 to 1.00, P = 0.050]. Willingness to use PrEP was the greatest among men with HIV-positive partners and among those who had taken HIV postexposure prophylaxis. Among men willing to use PrEP, the likelihood of decreased condom use remained stable between 2011 and 2013 (8.0% vs. 11.9%; adjusted odds ratio = 1.40, 95% CI: 0.80 to 2.45, P = 0.23). A minority of men remain willing to use PrEP and appear to be appropriate candidates for it. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
45. Trends in drug use among gay and bisexual men in Sydney, Melbourne and Queensland, Australia.
- Author
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Lea, Toby, Prestage, Garrett, Mao, Limin, Zablotska, Iryna, Wit, John, and Holt, Martin
- Subjects
BISEXUAL men ,GAY men ,SEXUAL orientation ,ECSTASY (Drug) ,METHAMPHETAMINE ,LSD (Drug) ,SUBSTANCE abuse ,POPULATION - Abstract
Introduction and Aims The findings of Australian drug surveys are typically not stratified by sexual orientation, despite the higher prevalence of drug use generally reported among gay and bisexual men. This paper aims to examine trends in drug use among gay and bisexual men in eastern Australia between 2004 and 2011. Design and Methods Data from the cross-sectional, ongoing Gay Community Periodic Surveys ( GCPS) were used to analyse drug trends among gay and bisexual men in Sydney, Melbourne and Queensland. Between 2004 and 2011, 45 273 eligible questionnaires were completed. Results There was a downward trend in recent drug use (previous 6 months) between 2004 and 2011 from 62.2% to 57.5%. However, this trend was not found among men in Queensland, bisexual men, men aged over 40 years or HIV-positive men. Club drug use peaked in 2006 (45.1%), before steadily declining to 32.4% in 2011. There were significant reductions in use of ecstasy, methamphetamine, ketamine and cannabis, increased use of cocaine, gamma hydroxybutyrate, erectile dysfunction medications, amyl nitrite and lysergic acid diethylamide, and no change in heroin use. Recent injecting drug use fluctuated over time but experienced an overall downward trend from 5.5% in 2004 to 4.0% in 2011. Discussion and Conclusions Drug use trends among gay and bisexual men in Australia are broadly consistent with downward and upward drug trends reported in other Australian drug surveys. The risks associated with drug use in this population and high rates of use supports the ongoing role of the GCPS in monitoring drug trends among homosexually active men. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
46. Just a preference: racialised language in the sex-seeking profiles of gay and bisexual men.
- Author
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Callander, Denton, Holt, Martin, and Newman, ChristyE.
- Subjects
- *
BISEXUAL men , *CONTENT analysis , *ANTI-racism , *LANGUAGE & culture - Abstract
Racialised language is a salient and contested aspect of contemporary sexual cultures, particularly in the online domain. This paper explores the ways in which gay men in Australia employ race-related language when using online sex/dating websites. Using inductive content analysis, descriptive categories were developed to identify recurrent patterns in the racialised language employed by website users. A coding framework was then constructed to identify the ‘subject’ (self, other or concept) of each piece of race-related content, its ‘purpose’ (marketing, negative or positive discrimination, commentary) and the ‘position’ adopted (defensive, normalised or critical). Descriptive and comparative analyses revealed differences in the ways in which members of racial groups employed racialised language online. These differences are reviewed in relation to broader discourses on Whiteness and race in Australia, as well as recent community-produced anti-racism campaigns. [ABSTRACT FROM PUBLISHER]
- Published
- 2012
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47. Gay men's perceptions of sexually transmissible infections and their experiences of diagnosis: 'part of the way of life' to feeling 'dirty and ashamed.'.
- Author
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Holt, Martin, Bernard, Diana, and Race, Kane
- Abstract
The article discusses a study which examined gay men's perceptions of sexually transmitted infections (STIs) other than HIV as well as their experiences of diagnosis. The study conducted interviews with gay men living in Sydney, New South Wales to analyze these perceptions. It was shown that over half of the men that participated in the study had ever been diagnosed with an STI and these infections were generally regarded as inconvenient consequences of sexual activity. The authors also suggested the importance of community education efforts to reduce the stigma associated with STIs among gay men.
- Published
- 2010
- Full Text
- View/download PDF
48. Normalisation of recreational drug use among young people: Evidence about accessibility, use and contact with other drug users.
- Author
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Wilson, Hannah, Bryant, Joanne, Holt, Martin, and Treloar, Carla
- Subjects
YOUNG adults -- Substance use ,CANNABIS (Genus) ,ECSTASY (Drug) ,DRUGS of abuse ,DRUG abuse prevention ,MUSIC festivals ,CROSS-sectional method - Abstract
There is evidence to suggest that illicit drug use is increasingly a ‘normal’ part of the lives of many young people in Australia. The normalisation framework has been applied in limited contexts in Australia, and has not been assessed using longitudinal data. This paper uses cross-sectional periodic data collected at the Sydney Big Day Out music festival between 2006 and 2009 to examine several aspects of normalisation among festival patrons. Over the 4-year period high proportions of respondents reported that cannabis and ecstasy were ‘very easy’ or ‘fairly easy’ to obtain. In most years, over half the respondents reported ‘any illicit drug use’ in the past 12 months. A statistically significant relationship was found between recent illicit drug use and degree of contact with other people who use drugs (χ
2 = 64.391, df = 4, p = 0.001). Such results suggest that certain aspects of drug use are normalised among festival patrons and that these are particularly concentrated among certain groups of young people. These groups could to be targeted when delivering drug education and prevention activities. [ABSTRACT FROM AUTHOR]- Published
- 2010
- Full Text
- View/download PDF
49. Agency and dependency within treatment: Drug treatment clients negotiating methadone and antidepressants
- Author
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Holt, Martin
- Subjects
- *
DRUG abuse treatment , *MENTAL health , *METHADONE treatment programs , *ANTIDEPRESSANTS - Abstract
Abstract: This paper explores how drug treatment clients exercise agency while finding their ability to act curtailed by the strictures of treatment itself. Drawing on qualitative interviews with 77 male and female drug treatment clients collected in an Australian study of drug treatment and mental health, the experience of methadone maintenance treatment (MMT) and that of commonly prescribed medications for depression (antidepressants) are examined. The ways that clients engage with MMT and antidepressants are detailed, illustrating how both types of treatment can make clients feel dependent, but can also motivate clients to modify their treatment regimens. These modifications are “tactical” responses generated within the constraints of treatment regulations and can also be against clinical recommendations e.g. stopping treatment. Rather than seeing this as “non-compliance”, it is suggested that the negotiation of treatment is an inevitable response of clients trying to adapt to imperfect treatment conditions, who may have understandable anxieties about taking medication. The ways in which treatment providers might better acknowledge the capacities of MMT clients to engage with or modify treatment are discussed, as is the need to acknowledge drug treatment clients’ anxieties about dependency and pharmaceutical drugs. [Copyright &y& Elsevier]
- Published
- 2007
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50. Changing Characteristics of HIV-Positive Gay and Bisexual Men’s Relationships in the Era of Biomedical Prevention.
- Author
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Broady, Timothy R., Chan, Curtis, MacGibbon, James, Mao, Limin, Prestage, Garrett, Clifton, Brent, Paynter, Heath, Bavinton, Benjamin R., and Holt, Martin
- Abstract
Objective: To assess changes in personal and relationship characteristics among HIV-positive Australian gay and bisexual men (GBM) as rates of antiretroviral therapy and knowledge and confidence regarding the effectiveness of viral suppression in preventing HIV transmission have increased. Design: Repeated behavioral surveillance of GBM recruited from venues, events, and online in 7 Australian states and territories. Methods: HIV-positive participants were included. Trends in demographics, HIV treatment, and relationship characteristics were assessed with binary and multivariable logistic regression. Results: A total of 3643 survey responses (2016–2020) were included. Over time, HIV-positive GBM became less likely to identify as gay or report an Anglo-Australian ethnicity. The average length of time since HIV diagnosis increased and the frequency of attending HIV-related clinical appointments decreased. There were no changes in the reported number of recent sex partners or proportion reporting regular male partners over time. Among HIVpositive GBM in relationships, the proportion reporting HIV-positive partners decreased and the proportion reporting HIV-negative partners increased. Levels of condomless sex with regular partners increased over time; however, this was concentrated among HIVpositive GBM in serodiscordant relationships. Conclusion: Findings suggest that increased accessibility and trust in biomedical prevention strategies have contributed to broader relationship and sexual opportunities for HIV-positive GBM in Australia. Our findings suggest that future health promotion activities could highlight the social and relationship benefits of treatment as prevention to further increase trust in it as an HIV prevention strategy among GBM. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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