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Background: The high prevalence of non-consensual sex, including physical force, verbal threats, intimidation, and/or verbal coercion and rape among university students, has prompted urgent calls for action from governments, statutory, and university bodies. This research aims to identify key factors students see as contributing to non-consensual sex with a view to developing effective strategies to address these issues. Methods: An online cross-sectional survey was administered to 4291 university students attending universities in south-east Queensland, Australia. Participants were recruited via email, print media, and face-to-face invitations. The survey contained closed and open-ended questions on a range of sexual health knowledge, attitudes, and behaviours, including non-consensual sexual experiences. A subset of students (n = 199) who responded 'yes' to engaging in sexual acts against their consent were the primary participants for this paper. Descriptive statistical analysis and thematic analysis, employing the theory of planned behaviour, were conducted using the quantitative and qualitative data regarding non-consensual sex, respectively. Results: Immediate and longer-term fear and partner eagerness were the most commonly identified influences on non-consensual sex. An inability to give consent due to lack of consciousness or intoxication were also frequently cited factors contributing to non-consensual sex. Conclusions: Interventions acknowledging and addressing sociocultural factors are needed. Sexuality and relationship education encompassing effective communication, relationship boundaries, and safe use of alcohol and drugs could substantially reduce the incidence of non-consensual sex. Importantly, such education should be non-judgmental and place greater responsibility on perpetrators than victim-survivors. Recent studies demonstrate the concerning extent of sexual violence experienced by Australian university students and the resulting psychological, emotional, and physical harms. This study aims to understand experiences and contributing factors of non-consensual sex among university students in south-east Queensland, Australia. Findings demonstrate that interventions to reduce non-consensual sex and promote healthy sexual experiences need to reflect the complex, relational, and highly contextual nature of affirmative consent influenced by perceived behavioural control and subjective norms. [ABSTRACT FROM AUTHOR]

Background: To gain an understanding of chlamydia (CT) and gonorrhoea (NG) testing conducted within an annual health check (AHC) and in standard clinical consultations for clients aged 15–29 years attending an urban Aboriginal Community Controlled Health Service in the period 2016–2021. Methods: De-identified electronic medical record data were extracted and analysed on CT and NG testing by sex, age, Indigenous status and the context of testing (conducted within an AHC or not). An access, testing, and diagnosis cascade for CT and NG, inclusive of an AHC, was constructed. Results: Combined testing within an AHC and outside an AHC for CT and NG ranged between 30 and 50%, except for the year 2021. Males were twice as likely to receive a CT and NG test within an AHC consultation as females. Females were almost equally likely to have a CT and NG test, both as part of an AHC consult and during other clinical consultations. Females had the highest CT positivity in 2018 (11%) and 2019 (11%), with a dip in 2020 (5%), whereas NG diagnoses remained stable at 2%. Conclusion: The study demonstrates the potential of the AHC to facilitate greater coverage of CT and NG testing in an urban Aboriginal Community Controlled Health Service. Screening conducted within an AHC alongside screening in clinical consultations might be enough to reduce CT prevalence over a sustained period. A recent study examined the trends in testing, positivity, and treatment for chlamydia and gonorrhoea among individuals aged ≥15 years at an urban Aboriginal Community Controlled Health Service from 2016 to 2021. The findings revealed variation in testing rates, with higher rates among young adults and females, and highlighted sex disparities in treatment and follow-up care. The research underscores the importance of targeted public health strategies to improve sexual health outcomes in urban Aboriginal and Torres Strait Islander peoples populations. [ABSTRACT FROM AUTHOR]

Background: This study describes chlamydia and gonorrhoea testing, positivity, treatment, and retesting among individuals aged ≥15 years attending an urban Aboriginal Community Controlled Health Service during the period 2016–2021. Method: Utilising routinely collected clinical data from the ATLAS program (a national sentinel surveillance network), a retrospective time series analysis was performed. The study assessed testing rates, positivity, treatment efficacy, retesting and trends over time within an urban Aboriginal Community Controlled Health Service. Results: Testing rates for chlamydia and gonorrhoea varied between 10 and 30% over the study period, and were higher among clients aged 15–29 years and among females. Positivity rates for both infections varied by age, with clients aged 15–24 years having higher positivity than older clients. Gonorrhoea positivity rates decreased after 2016. Treatment and retesting practices also showed sex disparities, with men having a slightly higher treatment rate within 7 days, whereas females had significantly higher retesting rates within 2–4 months, indicating differences in follow-up care between sexes. Conclusion: The study emphasises the need for clinical and public health interventions within urban Aboriginal and Torres Strait Islander populations to further reduce chlamydia and gonorrhoea. Prioritising improved access to testing, timely treatment and consistent retesting can significantly contribute to lowering STI prevalence and enhancing sexual health outcomes in these communities. A recent study examined the trends in testing, positivity, and treatment for chlamydia and gonorrhoea among individuals aged ≥15 years at an urban Aboriginal Community Controlled Health Service from 2016 to 2021. The findings revealed variation in testing rates, with higher rates among young adults and females, and highlighted sex disparities in treatment and follow-up care. The research underscores the importance of targeted public health strategies to improve sexual health outcomes in urban Aboriginal and Torres Strait Islander populations. [ABSTRACT FROM AUTHOR]

Background: Our understanding of how nursing and midwifery students in Australia are prepared to support people in unintended pregnancy prevention and care is currently limited. Objective: This study examined Australian nursing and midwifery students and recent graduates' perspectives on their preparation and confidence in providing unintended pregnancy prevention and care. Methods: A descriptive, cross-sectional online survey of nursing and midwifery students and graduates was undertaken. An invitation email with information sheet and link to the survey was sent to heads of departments at Australian universities for distribution to nursing and midwifery students. Social media platforms of professional organisations were used to promote the study to nurses and midwives within two years of graduation. The survey instrument was based on US educational competencies for unintended pregnancy prevention and care, adapted for the Australian context. Results: Participants (N = 109) from 14 institutions completed the survey. The majority of (92%) expressed that nursing and midwifery graduates should possess unintended pregnancy prevention and care knowledge and skills. Five competencies, out of 29, were identified as taught as core curriculum by 50% or more of participants; reproductive anatomy and physiology (72%); effective communication skills encompassing culture, sexual orientation, and gender identity (58%), understanding how contraceptives work (54%), obtaining a sexual/reproductive history (53%), and identifying preconception health risks (50%). Students felt well prepared to provide independent care related to pregnancy testing (44%), pregnancy prevention (26%), sexual history taking (23%), ethical/legal considerations around abortion (9%), options counseling/referral (5%), and pre/post-abortion care (5%). Conclusion: With the decriminalization of abortion care, the Australian nursing and midwifery workforce must prepare students to care for people in all aspects of pregnancy prevention, early pregnancy decision-making, and abortion services. Our data show students are interested in this preparation but the entry-to-practice curricula has not yet been standardized to enable this. [ABSTRACT FROM AUTHOR]

Objectives: Trust has been identified as a key factor associated with supporting access to sexual health interventions and digital healthcare. We aimed to explore and synthesize factors that may cultivate trust for young people (10–24-year-old) when accessing digital sexual healthcare. Methods: A total of 5950 articles were extracted from 5 databases (Scopus, PubMed, Embase, PsycINFO and CINAHL) and independently assessed for relevance by two researchers. Trust descriptions were analyzed using a narrative synthesis approach, extracted tabularly and synthesized into themes through conceptual mapping. Results: Thirteen papers between 2011 and 2021 from the United States (n = 5), Australia (n = 3), United Kingdom (n = 2), Canada (n = 2), and Netherlands (n = 1) were reviewed. Young people (n = 462), varying in gender identity and sexuality, were aged between 14 and 29 years old. Four areas cultivating trust in digital sexual healthcare were described: (1) Esthetics, language, tone: Trusted digital sexual healthcare was easy to navigate, had limited sexually explicit content or pop-up ads, was not overly teen-friendly and used a professional tone and language, reflecting communication reportedly expected from healthcare providers. (2) Privacy, anonymity, safety: Safety features that preserved young people's anonymity were important for their trust, particularly amid fear of shame or stigma. (3) Authors' expertise, authenticity, reputation: Personal accounts online which reflected the young person's own lived experience were trusted for topics considered subjective (e.g., dating and relationships). (4) Consistency: Cross-checking personal accounts and scientific information to confirm the consistency of content helped with young people's evaluation of trust. Conclusions: Considering the factors cultivating trust when designing digital sexual health interventions may improve access and use. However, given the nuance in lived experience and needs, young people should be meaningfully engaged in the design of digital sexual health interventions. Particularly as sexual health intervention and resources are increasingly being delivered and accessed online by young people. [ABSTRACT FROM AUTHOR]

People living with HIV (PLHIV) are two to three times more likely to smoke tobacco compared to the general community. Evidence from the general population suggests that nicotine vaping products (NVPs) can be acceptable and effective smoking cessation aids, but there is limited evidence on the extent to which this is the case among PLHIV. This manuscript reports findings from the Tobacco Harm Reduction with Vaporised Nicotine (THRiVe) trial, a mixed-methods study investigating the feasibility of NVPs as smoking cessation aids among 29 PLHIV who smoked tobacco. Surveys and semi-structured interviews explored participants' experiences and perceptions of NVPs, their features and functions, and support for various NVP regulatory policy options. Participants described seven reasons why NVPs were acceptable cessation aids: they satisfied nicotine cravings; differences between NVPs and cigarettes facilitated habit breaking; fewer adverse effects compared to traditional cessation aids; NVPs allowed for a "weaning process" rather than requiring abrupt abstinence; tobacco became increasingly unpleasant to smoke; NVPs provided an increased sense of control; and participants experienced a deeper understanding of personal smoking behaviours. This study provides valuable insight into the preferred features of NVPs among PLHIV and reasons why NVPs may be effective for promoting smoking cessation among PLHIV. [ABSTRACT FROM AUTHOR]

Background Aims Materials and Methods Results Conclusions Infectious syphilis among women of reproductive age continues to rise in many countries including Australia, with a resultant increase in congenital syphilis. In response, new guidelines for management of syphilis in pregnancy were published in Queensland, Australia in 2018.This study evaluates the management of women diagnosed with syphilis in pregnancy in South‐East Queensland (SEQ) after release of this guideline.This retrospective review of notification data identified women in SEQ who had a positive syphilis serology during pregnancy, without evidence of adequate treatment prior to the pregnancy, between January 2019 and December 2021 inclusive. Maternal demographics and pregnancy details including syphilis staging, testing and management were extracted, with management assessed against the 2018 Queensland syphilis in pregnancy guideline.Of the 42 women identified, 79% were diagnosed in the first or second trimester, 69% had early‐stage syphilis at the time of diagnosis and 86% were asymptomatic at the time of diagnosis. All, including the eight (19%) Aboriginal and/or Torres Strait Islander women identified, completed stage‐appropriate treatment with penicillin, 83% completed treatment four weeks prior to delivery and 60% achieved a four‐fold reduction in rapid plasma reagin at time of delivery.Our findings suggest compliance with syphilis in pregnancy management recommendations has improved in SEQ since release of the 2018 guidelines. However, congenital syphilis rates continue to rise; further initiatives addressing barriers to timely testing and management of syphilis in pregnancy are urgently needed at both healthcare system levels and for individual women. [ABSTRACT FROM AUTHOR]

Background: For many trans folks, gender-affirming hormone therapy (GAHT) is a desired affirming procedure that has been linked with positive health outcomes, however literature has had little focus on the journeys of trans people as they access GAHT. Aim: To understand trans people's journey of accessing GAHT to delineate supports necessary to better engage trans individuals into gender-affirming care. Method: This study conducted semi-structured interviews with a sample of 15 Australian trans adults who participated in a larger study investigating the effects of a cyproterone acetate titration protocol. Findings: A four-factor thematic structure was created from the data. Theme one describes early cognizance of being trans and the pivotal moments in their trans realization. The second theme explores the rapid engagement with community to begin accessing information and affirming healthcare, including GAHT. The third theme explores barriers to engaging in GAHT and theme four reflects on advice participants have for other trans people who are considering GAHT. Conclusion: Findings from this study emphasize the importance of providing support to young trans people to help reconcile their gender identity and assist them to engage into care as early as possible. It also highlights the key role that community plays in providing links to affirming information and providers of GAHT – but also emphasizes the importance of considering how to engage with community who may be missed. The experience of accessing GAHT is personal and contextual, but signaling of affirming safe spaces and access to salient information may be key strategies to better support trans people choosing to access GAHT. [ABSTRACT FROM AUTHOR]

Background: Disproportionate rates of sexually transmissible infections (STIs) among Aboriginal and Torres Strait Islander young people are often attributed to risk-taking behaviours, but research rarely conducts direct comparison with their non-Indigenous peers to address this negative discourse. Methods: 'Let's Talk About It 2019' was a cross-sectional online survey of South Australians (16–29 years). It prioritised recruitment of Aboriginal and Torres Strait Islander respondents to compare behaviours with non-Indigenous peers using multivariable Poisson regression models. Results: Aboriginal and Torres Strait Islander (n = 231) and non-Indigenous (n = 2062) respondents reported similar condom use (40% vs 43%, P = 0.477) and sexual debut median ages (16 years vs 17 years). Higher proportions of Aboriginal and/or Torres Strait Islander respondents reported a recent health check (48% vs 38%, P = 0.002), STIs (60% vs 49%, P < 0.001) and HIV (37% vs 28%, P = 0.006) testing, STI diagnosis (29% vs 21%, P = 0.042), and intoxication during last sex (30% vs 18%, P < 0.001). Conclusions: Behaviours associated with STI transmission were mostly similar among Aboriginal and Torres Strait Islander and non-Indigenous respondents. Higher STI/HIV testing among Aboriginal and Torres Strait Islander respondents suggests effectiveness of targeted programs. Interventions targeting substance use and condom use among all young people are needed. Future interventions need to focus beyond behaviours and explore social determinants of health and sexual networks as contributors to disproportionate STI rates. Sexually transmissible infections (STIs) rates among young Australians are increasing with young Aboriginal and Torres Strait Islander peoples disproportionately affected. Similar patterns of key risk behaviours, and greater engagement in sexual health care among young Aboriginal and/or Torres Strait Islander peoples, refute suggestions that higher STI rates are caused by this population engaging in more risky behaviour compared to their non-Indigenous peers. Social determinants of health and STI rates among sexual networks should be priorities for future research and intervention. [ABSTRACT FROM AUTHOR]

Gender Affirming Hormone Therapy (GAHT) is a key therapeutic approach which aims to help trans and gender diverse (or simply "trans") individuals' transition from their sex-presumed-at-birth to their experienced gender identity. Previous reviews have focused on synthesizing quantitative experiences; however, a qualitative lens is important to understand the personal journey of GAHT. This review provides a qualitative meta-synthesis of the experiences of trans people around the world who have undergone GAHT to elicit contextualized understanding of the changes experienced. Systematic searches of eight databases identified an initial 2670 papers, refined to a final 28 papers. Overall, findings suggested that the GAHT journey is unique and elicited a myriad of changes which, whilst challenging at times, were life-changing and brought about positive psychological, physical, and social changes. Other themes explored GAHT not being treated as a fix-all for associated mental health issues, the rules that govern appraisal of physical changes, how privilege and social identity evolve, and the power of affirmation. This work offers important recommendations to improve the care offered to trans people undergoing GAHT. Namely, person-centered support is essential, and peer-navigation may be a useful future direction to explore. [ABSTRACT FROM AUTHOR]