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Past efforts to address endemic rates of sexually transmissible infections amongst young Aboriginal people living in remote/very remote Australian communities have had limited success. Peer education has been used in youth sexual health promotion but has received limited evaluation and has not been tested in remote Aboriginal settings. The Young Deadly Free youth peer education programme trained Aboriginal young people in 15 remote/very remote communities as peer educators to deliver sexual health education to other young people. Semi-structured interviews were conducted with the project team and regional coordinators to understand the barriers and enablers to implementing peer education in remote communities. Programme credibility, the offer of financial gratuities, and the recruitment of peer educators with prior sexual health knowledge and/or group facilitation experience were identified as programme enablers. Implementation challenges included programme rigidity, cultural sensitivities, and retention and expectations of peer educators. Seven implications for policy and practice are identified to increase the efficacy and long term-impacts of youth peer education. Peer education for youth sexual health promotion in remote communities can be effective if young peer educators are supported appropriately and the peer education programme is part of a comprehensive sexual health promotion strategy.

This paper examines the provision of youth targeted Relationships and Sexuality Education (RSE) and sexual health interventions in the rural Australian context by examining the perspectives and experiences of a range of community stakeholders. Sixteen participants undertook one-on-one semi structured interviews. Four key themes emerged from the data and included: 'you're not going to get the whole town to start thinking about adolescent sexual health'; backlash, stigma and secrecy; being consistent, credible and available; and small-town communication. This study contributes to the limited literature about RSE and sexual health provision in regional and rural Australia and provides a voice for rural stakeholders who provide RSE and sexual health interventions by default or necessity. The findings of this study have practical implications for rural settings when addressing youth sexual health needs.

Sexual health promotion and Relationships and Sexuality Education (RSE) are influenced by interrelated social and cultural factors, particularly in a rural setting. This paper reports on findings from interviews with young people when asked about experiences and perspectives accessing RSE and sexual health services in a small rural Australian town. Fifteen young people (16-24 years) participated in semi-structured focus groups and interviews. Data was analysed and coded with four key themes emerging: relevant and credible sexual health education; make it easy; GP accessibility; and discreet condom supply. The findings of this study have practical implications when addressing community level sexual health and RSE needs.

Peer-based youth services provided by small non-profit community organisations have grown in number over the past two decades in response to an increasing need for informal, youth-friendly, accessible and confidential early intervention services. However, gaps in the evidence base and a general lack of evaluation capacity of service providers limits the validation of program benefits and threatens program sustainability. This paper reports on the development of a practitioner-centred, free online resource, the My-Peer Toolkit [1.0], which provides theory-based and practice-based guidelines for planning, implementing and evaluating peer-based youth services. An important secondary outcome of the participatory action research design used in this study was building practitioners' capacity to evaluate and deliver services and to develop solutions to local issues. (Contains 1 figure and 2 tables.)

People from culturally and linguistically diverse (CaLD) backgrounds in Australia generally experience poorer health outcomes, explained in part by low levels of health literacy. We conducted a systematic review to examine the development and evaluation of health education resources designed for CaLD populations. Five electronic databases were searched for English language, peer-reviewed studies published between 1980 and 2020. Thirty-four studies met the inclusion criteria. Twenty-four different health education resources were described and broadly categorized into four types: media campaigns (n  = 10), text-based materials (n  = 5), films (n  = 8) and radio (n  = 1). Studies were assessed against domains adapted from a health literacy guideline incorporating: need, collaboration, audience, health literacy, theory, test and process and impact evaluation. All but one study met the majority of the domains. All studies reported positive evaluation outcomes; this may be due to studies involving community early in resource design and including health literacy considerations in their design. Reporting resource design and evaluation against standard practice controls is recommended to build a more robust evidence base for developing effective health education resources for use by audiences from CaLD backgrounds. [ABSTRACT FROM AUTHOR]

Western Australia criminalises sex work whilst some other Australian jurisdictions have decriminalised the industry. This article examines the role of Western Australia's legislation in reinforcing stigma and discrimination of sex workers. It draws on stigma and discrimination-specific results from open-ended survey responses and interview data collected as part of a larger cross-sectional mixed-methods study. Experiences and/or anticipation of stigma and discrimination resulted in some sex workers concealing their involvement in sex work from family, friends and their home communities. This was a major barrier to accessing health care and protective services and impacted negatively on their mental health and wellbeing. There is a need for policy change and support to shift society's perception of sex work to that of a legitimate occupation to decrease sex workers' experiences of stigma and discrimination and improve their access to and utilisation of health care and protective services. These findings highlight the need for the decriminalisation of the Western Australian sex industry and the development of training programmes for police and healthcare workers to reduce the stigma and discrimination experienced by sex workers in these settings. [ABSTRACT FROM AUTHOR]

This paper examines the provision of youth targeted Relationships and Sexuality Education (RSE) and sexual health interventions in the rural Australian context by examining the perspectives and experiences of a range of community stakeholders. Sixteen participants undertook one-on-one semi structured interviews. Four key themes emerged from the data and included: 'you're not going to get the whole town to start thinking about adolescent sexual health'; backlash, stigma and secrecy; being consistent, credible and available; and small-town communication. This study contributes to the limited literature about RSE and sexual health provision in regional and rural Australia and provides a voice for rural stakeholders who provide RSE and sexual health interventions by default or necessity. The findings of this study have practical implications for rural settings when addressing youth sexual health needs. [ABSTRACT FROM AUTHOR]

Sexual health promotion and Relationships and Sexuality Education (RSE) are influenced by interrelated social and cultural factors, particularly in a rural setting. This paper reports on findings from interviews with young people when asked about experiences and perspectives accessing RSE and sexual health services in a small rural Australian town. Fifteen young people (16–24 years) participated in semi-structured focus groups and interviews. Data was analysed and coded with four key themes emerging: relevant and credible sexual health education; make it easy; GP accessibility; and discreet condom supply. The findings of this study have practical implications when addressing community level sexual health and RSE needs. [ABSTRACT FROM AUTHOR]

Introduction: We conducted a detailed analysis of trends in new HIV diagnoses in Australia by country of birth, to understand any changes in epidemiology, relationship to migration patterns and implications for public health programs. Methods: Poisson regression analyses were performed, comparing the age-standardised HIV diagnosis rates per 100,000 estimated resident population between 2006–2010 and 2011–2015 by region of birth, with stratification by exposure (male-to-male sex, heterosexual sex–males and females). Correlation between the number of permanent and long-term arrivals was also explored using linear regression models. Results: Between 2006 and 2015, there were 6,741 new HIV diagnoses attributed to male-to-male sex and 2,093 attributed to heterosexual sex, with the proportion of diagnoses attributed to male-to-male sex who were Australian-born decreasing from 72.5% to 66.5%. Compared with 2006–2010, the average annual HIV diagnosis rate per 100,000 in 2011–15 attributed to male-to-male sex was significantly higher in men born in South-East Asia (summary rate ratio (SRR) = 1.37, p = 0.001), North-East Asia (SRR = 2.18, p<0.001) and the Americas (SRR = 1.37, p = 0.025), but significantly lower as a result of heterosexual sex in men born in South-East Asia (SRR = 0.49, p = 0.002), Southern and Central Asia (SRR = 0.50, p = 0.014) and Sub-Saharan Africa (SRR = 0.39, p<0.001) and women born in South-East Asia (SRR = 0.61, p = 0.002) and Sub-Saharan Africa (SRR = 0.61, p<0.001). Positive associations were observed between the number of permanent and long-term arrivals and HIV diagnoses particularly in relation to diagnoses associated with male-to-male sex in men from North Africa and the Middle East, North Asia, Southern and Central Asia and the Americas. Conclusion: The epidemiology of HIV in Australia is changing, with an increase in HIV diagnosis rates attributed to male-to-male sex amongst men born in Asia and the Americas. Tailored strategies must be developed to increase access to, and uptake of, prevention, testing and treatment in this group. [ABSTRACT FROM AUTHOR]