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The broad aim of most sexuality educational programs is to improve and promote health among students (Epstein and Johnson 1998; Allen 2005; Aggleton and Campbell 2000). Various education programs aim for young people to receive preparation for their sexual lives and be educated against sexual abuse and exploitation (Carmody 2009; Bay-Cheng 2003), unintended pregnancy and sexually transmitted infections (STIs). More contemporary debates about sexuality education argue the value of endeavoring to educate students about sexual pleasure and desire, aiming to bring about attitudinal changes at the local level of social and political activity (Fields 2008; Lesko 2010). With these intentions the teaching and learning of sexuality education is positioned to be invested, not only in conveying sexual information, but also in producing a specific kind of sexual individual. In this frame, the effectiveness of the mobilization and maneuvering of this subject within schools and in the classroom is essentially based on pedagogy. A closer analysis of the intricate processes of how teachers' pedagogies regulate sexual identities and sexual behavior thus becomes paramount to better understanding effective teaching of sexuality education. This article is about the purposes and the processes of teaching comprehensive sexuality education to diverse communities. It begins with a brief exploration of current pedagogies of sexuality education in Australia and New Zealand. It then presents overlapping but often disputed understandings of sexuality education as well as critical pedagogy to demonstrate critical pedagogy's potential significance for creating comprehensive sexuality education for diverse communities. This is followed by a critical examination of the ways in which teachers' pedagogy in Australian and New Zealand schools explicitly communicates the ''critical'' oriented intent of critical pedagogy with reference to four specific areas: dialogue, critique, counter hegemony, and praxis.

This paper explores the methodological politics of researching at the intersections of sexuality, culture and religion in secondary schools. It draws on experiences during a project concerned with how to address cultural and religious diversity in sexuality education in Australia and New Zealand. The paper focuses on two methodological sticking points, one occurring inside academia and the other outside, in schools. The first coheres around the process of gaining ethics approval from multiple institutional committees and the second accesses schools for participation. These sticking points are conceptualized as effects of a set of discursive and material constraints which are idiosyncratic to school-based sexualities research. We argue that discourses of sexuality and young people are mobilized in both spaces and intersect with a social moment of "risk anxiety" in ways that shape the methodological possibilities of the research. These discourses serve to constitute sexualities research as "risky" and "controversial", an image which impedes the generation of new knowledge in the field. By rendering challenges of this research visible and discursively deconstructing the reasons for them, we refuse to dismiss school-based sexualities research as "too hard". Instead, we aim to keep this topic firmly on the educational research agenda by alerting researchers to its challenges so they may prepare for them.

From the early days of the HIV epidemic, Indigenous peoples were identified as a population group that experiences social and economic determinants-including colonialism and racism-that increase exposure to HIV. There are now substantial disparities in HIV rates between Indigenous and non-Indigenous peoples in some countries. We conducted a comprehensive literature review to assess the evidence on HIV-related behaviors and determinants in four countries-Australia, Canada, New Zealand and the United States-in which Indigenous peoples share important features of colonization and marginalization. We identified 107 articles over more than 20 years. The review highlights the determinants of HIV-related behaviors including domestic violence, stigma and discrimination, and injecting drug use. Many of the factors associated with HIV risk also contribute to mistrust of health services, which in turn contributes to poor HIV and health outcomes among Indigenous peoples. [ABSTRACT FROM AUTHOR]

Abstract: In industrial countries, a number of factors put indigenous peoples at increased risk of HIV infection. National surveillance data between 1999 and 2008 provided diagnoses for Aboriginal and Torres Strait Islanders (Australia), First Nations, Inuit and Métis (Canada excluding Ontario and Quebec) and Māori (New Zealand). Each country provided similar data for a non-indigenous comparison population. Direct standardisation used the 2001 Canadian Aboriginal male population for comparison of five-year diagnosis rates in 1999–2003 and 2004–2008. Using the general population as denominators, we report diagnosis ratios for presumed heterosexual transmission, men who have sex with men (MSM) and intravenous drug users (IDU). Age standardised HIV diagnosis rates in indigenous peoples in Canada in 2004–2008 (178.1 and 178.4/100 000 for men and women respectively) were higher than in Australia (48.5 and 12.9/100 000) and New Zealand (41.9 and 4.3/100 000). Higher HIV diagnosis rates related to heterosexual contact among Aboriginal peoples, especially women, in Canada confirm a widening epidemic beyond the conventional risk groups. This potential of a generalised epidemic requires urgent attention in Aboriginal communities; available evidence can inform policy and action by all stakeholders. Although less striking in Australia and New Zealand, these findings may be relevant to indigenous peoples in other countries. [Copyright &y& Elsevier]

Objectives: Ageing immigrant populations now pose problems for the management of chronic illness in Australia. This article asks questions about the experiences of immigrants in Australia with type II diabetes mellitus (DM). What impact, if any, have health policies had on the lives of immigrants? How do their experiences of living withDM compare with those of people with DM who were born in Australia? Methods: Semi-structured interviews were conducted with 32 participants who had DM (n¼25) or cared for someone with DM (n¼7). Fifteen participants had migrated to Australia and English was not their first language. Participants were asked to describe their experience of managing diabetes. Results: Immigrants to Australia confront linguistic and cultural barriers that create an extra layer of problems not experienced by Australian-born people. Older people who were born overseas face obstacles to effective engagement with the health system that weaken their ability to take an active part in the management of their conditions. Conclusions: Chronic disease policy is failing immigrants to Australia. Health professionals and services must recognize the central role that cultural diversity plays in self-management and the impact that this can have on health outcomes for immigrants with chronic illness. [ABSTRACT FROM AUTHOR]

Objective: To compare rates and trends of HIV diagnoses among Indigenous peoples in Canada (First Nations, Métis, Inuit, and other non-specified), Australia (Aboriginal and Torres Strait Islanders), the USA (American Indian, Alaska Native, Native Hawaiian, and Other Pacific Islanders), and New Zealand (Māori)., Design: We employed publicly available surveillance data from 2009 to 2017 to estimate the rate per 100 000 of HIV diagnoses. Estimated annual percentage change (EAPC) in diagnosis rates was calculated using Poisson regression., Setting: The four countries have passive population-based HIV surveillance programs., Participants: Population estimates from respective census programs were used as rate denominators., Main Outcome Measures: Estimated annual HIV diagnosis rate per 100 000 and EAPC were calculated for total Indigenous peoples, women, and men., Results: As of 2017, rates of HIV were highest in Canada (16.22, 95% confidence interval (CI): 14.30--18.33) and lowest in New Zealand (1.36, 95% CI: 0.65--2.50). Australia had a rate of 3.81 (95% CI: 2.59--5.40) and the USA 3.22 (95% CI: 2.85--3.63). HIV diagnosis rates among the total Indigenous population decreased in Canada (-7.92 EAPC, 95% CI: -9.34 to -6.49) and in the USA (-4.25 EAPC, 95% CI: -5.75 to -2.73) but increased in Australia (5.10 EAPC, 95% CI: 0.39--10.08). No significant trends over time were observed in New Zealand (2.23 EAPC, 95% CI: -4.48 to 9.47)., Conclusion: Despite limitations to conducting cross-national comparisons, there are substantial differences in HIV diagnosis rates in these four countries that may be reflective of divergent national policies and systems that affect the health status of Indigenous peoples., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Aboriginal and Torres Strait Islander people with chronic illness confront multiple challenges that contribute to their poor health outcomes, and to the health disparities that exist in Australian society. This study aimed to identify barriers and facilitators to care and support for Aboriginal and Torres Strait Islander people with chronic illness., Methods: Face-to-face in-depth interviews were conducted with Aboriginal and Torres Strait Islander people with diabetes, chronic heart failure or chronic obstructive pulmonary disease (n-16) and family carers (n = 3). Interviews were transcribed verbatim and the transcripts were analysed using content analysis. Recurrent themes were identified and these were used to inform the key findings of the study., Results: Participants reported both negative and positive influences that affected their health and well-being. Among the negative influences, they identified poor access to culturally appropriate health services, dislocation from cultural support systems, exposure to racism, poor communication with health care professionals and economic hardship. As a counter to these, participants pointed to cultural and traditional knowledge as well as insights from their own experiences. Participants said that while they often felt overwhelmed and confused by the burden of chronic illness, they drew strength from being part of an Aboriginal community, having regular and ongoing access to primary health care, and being well-connected to a supportive family network. Within this context, elders played an important role in increasing people's awareness of the impact of chronic illness on people and communities., Conclusions: Our study indicated that non-Indigenous health services struggled to meet the needs of Aboriginal and Torres Strait Islander people with chronic illness. To address their complex needs, health services could gain considerably by recognising that Aboriginal and Torres Strait Islander patients have a wealth of cultural knowledge at their disposal. Strategies to ensure that this knowledge is integrated into care and support programs for Aboriginal and Torres Strait Islander people with chronic illness should achieve major improvements.

Background: Understanding people's social lived experiences of chronic illness is fundamental to improving health service delivery and health outcomes, particularly in relation to self-management activity. In explorations of social lived experiences this paper uncovers the ways in which Aboriginal and Torres Strait Islander people with chronic illness experience informal unsolicited support from peers and family members., Methods: Nineteen Aboriginal and Torres Islander participants were interviewed in the Serious and Continuing Illness Policy and Practice Study (SCIPPS). Participants were people with Type 2 diabetes (N = 17), chronic obstructive pulmonary disease (N = 3) and/or chronic heart failure (N = 11) and family carers (N = 3). Participants were asked to describe their experience of having or caring for someone with chronic illness. Content and thematic analysis of in-depth semi-structured interviews was undertaken, assisted by QSR Nvivo8 software., Results: Participants reported receiving several forms of unsolicited support, including encouragement, practical suggestions for managing, nagging, growling, and surveillance. Additionally, participants had engaged in 'yarning', creating a 'yarn' space, the function of which was distinguished as another important form of unsolicited support. The implications of recognising these various support forms are discussed in relation to responses to unsolicited support as well as the needs of family carers in providing effective informal support., Conclusions: Certain locations of responsibility are anxiety producing. Family carers must be supported in appropriate education so that they can provide both solicited and unsolicited support in effective ways. Such educational support would have the added benefit of helping to reduce carer anxieties about caring roles and responsibilities. Mainstream health services would benefit from fostering environments that encourage informal interactions that facilitate learning and support in a relaxed atmosphere.

Objective: To examine current health policy in Australia and New Zealand and assess the extent to which the policies equip these countries to meet the challenges associated with increasing rates of multi-morbid chronic illnesses., Method: We examined reports from agencies holding data relating to chronic illness in both countries, looking at prevalence trends and the frequency of multiple morbidities being recorded. We undertook content analysis of health policy documents from Australian and New Zealand government agencies., Results: The majority of people with chronic illness have multiple morbidities. Multi-morbid chronic illnesses significantly effect the health of people in both Australia and New Zealand and place substantial demands on the health systems of those countries. These consequences are both predicted to increase dramatically in the near future. Despite this, neither country explicitly acknowledges multi-morbidity as a major factor in their policies addressing chronic illness., Conclusion and Implication: In addition to considering policy responses to chronic illness, policy makers should explicitly consider policies shaped to address the needs of people with multi-morbid chronic illness.