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This paper explores young Aboriginal women's views on sex and relationships in Australia – including their beliefs about broader social attitudes relating to sexuality, gender, and well-being – and how these understandings can impact young women's sexual health. The project adopted a strengths-based approach and used peer interviewing to investigate how Aboriginal young people in urban settings develop and manage their sexual well-being. The findings draw on interviews with 35 Aboriginal young women, between 16 and 26 years old and living in Western Sydney, Australia. Although the young women's views and experiences were broad and diverse, several key themes were identified. In this paper, we explore how young women's understandings and experiences of sexual shame were gendered and racialised, how they reconciled shame-inducing discourses by embracing more open and positive views about sexuality and how they drew on various sources to foster self-worth and sexual agency. Moreover, the paper describes what young women saw as the defining features of positive sexual relationships which, in their views, included love, connection, respect, consent, trust, honesty and responsibility. Implications for how young women's ties to family, community and culture supported them in fostering sexual well-being are also discussed. [ABSTRACT FROM AUTHOR]

This article explores LGBTQ + young adults' schooling and university experiences at the intersection of ethnicity and sexuality in Australia. Using the lenses of sexual citizenship and belonging, a sociomaterial polytextual analysis of the 'middle' was conducted with data from qualitative in-depth narrative and photo-elicitation interviews among Lebanese, Indian and Anglo LGBTQ + young adults. The analysis found that while participants had encountered bullying and prejudicial attitudes based on sexuality, gender and ethnicity, many of them had positive experiences at school and viewed university as facilitators of opportunity and discovery. The findings suggest that educational institutions are neither inherently safe nor unsafe; rather, they are important spaces whereby the sociomaterial entanglements of identity, sexual citizenship and belonging are negotiated. Crucially, they demonstrate that minority sexuality, ethnicity and gender themselves are not immutable barriers to participation, and call for strategic investment into spaces that support both student safety and critical discussion. [ABSTRACT FROM AUTHOR]

Introduction: Cultural inclusion and competence are understood at the most basic level to be the practice of considering culture so as to provide effective services to people of different cultural backgrounds. In order to work better with clients from diverse backgrounds, alcohol and other drug (AOD) services need to offer a service that is designed to be accessible to all people, where systems in place operate in a way that considers different cultural needs. This research aimed to assess the extent to which non‐government AOD services in New South Wales are positioned to support cultural inclusion as well as to evaluate the acceptability of a cultural inclusion audit across four AOD sites. Methods: The research adopted a mixed methods approach comprising of a pre‐audit online survey (n = 85) designed to assess AOD services' attitudes and practices towards cultural inclusion, and in‐depth interviews that were conducted with nine AOD service staff and four cultural auditors to explore the acceptability of a cultural inclusion audit process. Results: Findings from the survey indicate cultural inclusion practices are limited. Interview data highlight that while staff are not fully aware of what appropriate cultural inclusions entails, they are receptive to and want a cultural inclusion program. Discussion and Conclusions: The study illustrates the benefits of implementing a cultural inclusion audit process aimed at raising awareness of what cultural inclusion entails. Including a cultural inclusion service audit is likely to enhance AOD service provision to culturally and linguistically diverse groups and thereby improve treatment outcomes. [ABSTRACT FROM AUTHOR]

This paper describes the strategies used by Aboriginal young people to build positive relationships and sexual wellbeing. It does so to counter the risk-focussed narratives present in much existing research and to showcase the resourcefulness of Aboriginal young people. We used peer-interview methods to collect qualitative data from 52 Aboriginal young people living in western Sydney, Australia. Participants reported a strong desire to stay safe and healthy in their sexual relationships and to achieve this they relied heavily on oral communication and yarning strategies. Participants viewed communication as a way to gain or give advice (about bodies, infections, pregnancy, relationships); to assess the acceptability and safety of potential partners; to negotiate consent with partners; to build positive relationships; and to get themselves out of unhealthy relationships. Participants also discussed 'self-talk' as a strategy for building sexual wellbeing, referring to narratives of self-respect and pride in culture as important in establishing Aboriginal young people's positive views of self and as deserving of respectful and safe sexual relationships. These findings suggest that future programmes and interventions based on yarning could be well-regarded, given it is a cultural form of pedagogy and a strategy Aboriginal young people already use to build positive relationships and identities. [ABSTRACT FROM AUTHOR]

Enumeration of disease is a key management tool. Setting of targets, like for hepatitis C elimination, have deep meaning and effect. We use the case of elimination in New South Wales (NSW), Australia to examine key informants' understandings of the use of targets, and the evidence that informs them, to drive action in elimination. Twenty‐eight key informants working in NSW, elsewhere in Australia and internationally in high‐income countries participated in a semi‐structured qualitative interview in 2022. Analysis was informed by scholarship calling for examination of the ways in which science constructs what is thought possible in action. Participants pointed to the power of quantified evidence and targets and their complex effects, and questioned the usefulness and certainty derived from these at the "pointy end" of elimination. Although a range of targets exist in global and local strategies, reaching testing targets was the assumed solution to achieving elimination. Achieving elimination was thought to require "off piste" and experimental approaches that went beyond available evidence. The different types of work that participants felt necessary for late‐stage elimination may require additional metrics to explain return on investment ratios. What threshold would be used to reduce efforts in elimination was a major concern. These data indicate that understandings of the evidence underpinning elimination targets and how to achieve them are far from settled. At this point, elimination efforts may need to rely on locally produced and community‐driven evidence and shift from evidence‐based to evidence‐making paradigm. [ABSTRACT FROM AUTHOR]

Aim: Young people who are socially engaged with people who inject drugs are at higher risk of transitioning to injecting drug use. We aimed to examine rates of exposure to injecting among young people in an online survey, and whether exposure to injecting was related to hepatitis C(HCV) knowledge. Methods: A cross-sectional, online survey was completed by 827 young people (aged 16-26 years) in New South Wales, Australia. Exposure to injecting in the preceding 12 months was measured by asking participants whether close friends and romantic/sexual partners had injected, and whether somebody had offered them an injection. HCV knowledge was measured using items adapted from a survey of Australian secondary school students. Findings: Eleven percent of participants reported recent exposure to injecting.Participants exposed to injecting were significantly more likely than other participants to report use of injectable drugs. Some aspects of HCV transmission were poorly understood, and exposure to injecting was not significantly associated with higher HCV knowledge. Conclusions: While online methods were only moderately successful in recruiting people exposed to injecting, higher rates of use of injectable drugs and HCV knowledge deficits in this group suggests that they are an important target for HCV education and prevention.

Most hepatitis C transmission occurs through the sharing of equipment used for injecting drugs, and in many settings, the majority of equipment sharing occurs between sexual partners. Despite this, few health promotion materials directly address sexual partnerships, couples or social relationships in general. This blindspot is one example of the ways in which prevention education in the area of drug use would benefit from careful rethinking. Focusing on the case of Australia, we argue that hepatitis C prevention education insufficiently acknowledges or mobilize social relationships, social dynamics and social contexts in its efforts to prevent hepatitis C transmission. This can lead it to reproduce the conditions for the very problems it seeks to solve. We further argue that hepatitis C prevention education is insufficiently attentive to its own social location, drawing too little on stakeholder expertise. Its effectiveness relies upon its social context, including the collaborative input and engagement of affected communities and other stakeholders. Better recognizing this would produce a stronger foundation for developing prevention strategies. As we conclude, this social foundation for hepatitis C prevention could be articulated into national, collaboratively developed guidelines on effective communication in hepatitis C and injecting drug use risk.

In Australia, the response to HIV, hepatitis C and hepatitis B has largely been through the constructed category of 'blood borne viruses' which treats these viruses as an interconnected set of conditions with respect to their mode of transmission. In this paper, we explore how people understand their viral infection, and compare the logics underpinning these different understandings. In-depth interviews were conducted with 61 participants who were either living with a blood borne virus or were the family members of people living with them. Our analysis reveals that the viral infection was often described as 'just a condition that needs to be managed', albeit in potentially exhausting ways. This understanding hinged upon a biomedical logic in which viral invasion was seen as causing illness and in turn necessitating biomedical intervention. In contrast, some participants with hepatitis B presented their infection as a condition unintelligible through Western biomedical logics, defined instead by symptomology – in terms of 'liver disease', and/or 'liver inflammation'. This focus on symptomology calls into question the soundness of prevention and management responses to hepatitis B based in biomedical logics and reveals the extent to which living with a virus involves multiple, sometimes incompatible, cultural logics. The different logics underpinning HIV, hepatitis C and hepatitis B reveal shortcomings of framing these viruses together as a coherent single construct. [ABSTRACT FROM AUTHOR]

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.

Incentivisation of general practitioners (GPs) by pharmaceutical companies is thought to affect prescribing practices, often not in patients' interest. Using a Bourdieusian lens, we examine the socially structured conditions that underpin exchanges between pharmaceutical companies and GPs in Pakistan. The analysis of qualitative interviews with 28 GPs and 13 pharmaceutical sales representatives (PSRs) shows that GPs, through prescribing medicines, met pharmaceutical sales targets in exchange for various incentives. We argue that these practices can be given meaning through the concept of 'field' – a social space in which GPs, PSRs, and pharmacists were hierarchically positioned, with their unique capacities, to enable healthcare provision. However, structural forces like the intense competition between pharmaceutical companies, the presence of unqualified healthcare providers in the healthcare market, and a lack of regulation by the state institutions produced a context that enabled pharmaceutical companies and GPs to use the healthcare field, also, as space to maximise profits. GPs believed the effort to maximise incomes and meet socially desired standards were two key factors that encouraged profit-led prescribing. We conclude that understanding the healthcare field is an important step toward developing governance practices that can address profit-led prescribing. [ABSTRACT FROM AUTHOR]

In recognition of the broader relational aspects of viral infections, family support is considered important when someone is diagnosed with a blood-borne virus (BBV), such as HIV, hepatitis C (HCV) and hepatitis B (HBV). However, families' own support needs are often not a priority in service provision within the BBV sector. In this article, we draw on qualitative interviews with 20 key informants working in various professional capacities in health, social policy, care and advocacy sectors in Australia, and explore their experiences and perspectives on family inclusivity in their services. Overall, key informants acknowledged the diversity of what constitutes family, and consistently viewed family engagement as beneficial to both diagnosed individuals and the wider familial networks affected by a diagnosis. However, prioritising individual care in support services presented barriers to engaging families, which are further complicated by the role of stigma in shaping the social realities of living with a BBV. Increasing understanding in service provision settings that serodiscordance can be a family experience has the potential to widen this analytic lens to consider the support needs of families in their own right. [ABSTRACT FROM AUTHOR]