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Gay men and lesbian women often demonstrate unique settlement patterns, forming what have been referred to as 'gayborhoods'. This study sought to provide the first postcode-level estimates of population size and prevalence of gay and lesbian people in Australia. Data on same-gender-partnered households from the Australian Census were combined with information from six different surveys conducted from 2011 to 2017. We estimated that in 2016 there were 132,203 gay men (1.5% of adult males; 95% CI: 1.4–1.6) and 79,931 lesbian women (0.9% of adult females; 95% CI: 0.8–1.0) in Australia. While many postcodes were sparsely populated by gay and lesbian people (40.1% had prevalences of <0.1%), 24.6% were moderately populated (prevalences in the 50-95th percentile) and 2.7% were highly populated (95th percentile). By jurisdiction, the Australian Capital Territory had the highest prevalences of gay men (2.1%; 95% CI: 2.0–2.2) and lesbian women (1.5%; 95% CI: 1.4–1.6). Although the majority of highly populated postcodes were found in major cities (83.7%), some were also found in regional and remote area (16.3%). This method can be applied in other countries to enhance populate estimates. The accompanying dataset can be used to guide service delivery, conduct geographically contextualised research and develop policies relevant to gay men and lesbian women in Australia. [ABSTRACT FROM AUTHOR]

Background: Preexposure prophylaxis (PrEP) prevents HIV infection but relies on good adherence at times of risk, termed "prevention-effective adherence." Most studies assess adherence without reference to sexual behaviur, making it challenging to determine if poor adherence coincides with HIV risk., Setting: We examined data from a behavioral substudy of a large-scale PrEP implementation trial in New South Wales, Australia., Methods: Trial participants completed optional brief quarterly surveys, reporting the number of pills taken and sexual behavior with male partners for each day of the "last full week" before each survey. Condomless sex (CLS) was defined as "higher risk" for HIV when with HIV-positive men with detectable/unknown viral loads or unknown HIV status men. Adequate PrEP protection was defined as ≥4 pills for participants assigned male sex at birth and ≥6 pills for participants assigned female sex at birth (including transgender men)., Results: Of 9596 participants dispensed PrEP, 4401 completed baseline and ≥1 follow-up survey. Participants reported on 12,399 "last full weeks": 7485 weeks (60.4%) involved CLS and 2521 weeks (33.7% of CLS-weeks) involved higher risk CLS. There were 103 weeks in which participants did not have adequate PrEP protection and had higher risk CLS: 4.1% of higher-risk CLS weeks (n = 103/2521), 1.4% of all CLS weeks (n = 103/7485), and 0.8% of all observed weeks (n = 103/12,399)., Conclusions: In a large PrEP trial, prevention-effective adherence to PrEP was very high at 99%. Our findings illustrate the importance of measuring pill-taking and sexual behavior in the same period so that prevention-effective adherence can be better estimated., Competing Interests: The authors have no conflict of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)