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AbstractIn 2022, a global outbreak of mpox (formerly ‘monkeypox’) emerged in non-endemic countries, including Australia, predominantly affecting gay, bisexual and other men who have sex with men. Public health advice on transmission and isolation emerged rapidly from different sources, sometimes conflicting and producing uncertainty. Using the concept of ‘counterpublic health’, which acknowledges the incorporation of official science and experiences of affected communities into embodied practice, this paper investigates how people affected by mpox in Australia managed risk of transmission and navigated self-isolation. In-depth interviews were conducted with 16 people: 13 people diagnosed with mpox and three close contacts. All participants were cisgender gay and bisexual men living in Australia. Participants thought critically about public health advice, often finding it restrictive and unresponsive to the needs of people with mpox. Participants’ decisions about reducing mpox risk and isolating often drew on experiences with other infections (i.e. HIV; COVID-19) and were made collaboratively with the people closest to them (e.g. partners, friends, family) to sustain relationships. Future public health responses to infectious disease outbreaks would benefit from identifying more opportunities to formalise and embed mechanisms to obtain feedback from affected communities so as to inform responses. [ABSTRACT FROM AUTHOR]

Background: Gay, bisexual, and other men who have sex with men (GBM) are overrepresented in diagnoses of sexually transmitted infections (STIs) relative to their population size. This study assessed trends in STI testing and diagnoses among GBM in Australia. Methods: The Gay Community Periodic Surveys are repeated cross-sectional behavioral surveillance surveys of GBM. Participants reported the number of anal swabs, throat swabs, urine samples, and blood tests for syphilis they undertook in the last year. "Frequent comprehensive testing" was defined as ≥3 of each test in the previous year. Participants reported STI diagnoses of chlamydia, gonorrhea, syphilis, and other STIs in the last year. Trends in testing and diagnoses from 2017 to 2020 and 2020 to 2021 were assessed with logistic regression models. Results: We analyzed 24,488 survey responses from participants reporting casual sex in the last 6 months. Between 2017 and 2020, frequent comprehensive STI testing decreased among HIV-negative GBM on preexposure prophylaxis (PrEP) from 71.7% to 68.9% and declined further to 58.6% in 2021. Frequent comprehensive STI testing was stable during 2017--2020 among HIV-negative/untested GBM not on PrEP (17.4%-- 14.6%) and HIV-positive GBM (30.4%--35.1%) but declined in 2021 to 7.5% among non-PrEP-users and 25.7% among HIV-positive participants. Therewereminimal changes in STI diagnoses during 2017--2020, but diagnoses declined in 2021. Conclusions: Many GBMdo not meet Australian STI testing guidelines that recommend quarterly testing. Further evaluation of whether this recommendation is realistic or necessary to reduce STIs among GBM is recommended. [ABSTRACT FROM AUTHOR]

Background: Sexual and romantic satisfaction are important aspects of sexual health and wellbeing, but they have not been thoroughly investigated among transgender and gender diverse ('trans') people in Australia. Aims: To address this gap and improve sexual health and wellbeing, we assessed the sexual behavior and relationships of a national sample of trans people in Australia, and factors associated with sexual and romantic satisfaction. Methods: We conducted a national survey of trans people from Australia in October-November 2018. Results: The sample included 1,613 trans participants, of whom 353 (21.9%) were men, 397 (24.6%) were women and 863 (53.5%) were non-binary. Over 70% of the sample had been sexually active in the previous year, and 56.9% were in a relationship, but only 32.4% were satisfied with the sexual aspects and 47.1% with the romantic aspects of their lives. Sexual satisfaction was associated with younger age, being asexual, having more trans friends, more frequent sex, and using illicit drugs in the context of sexual activity. Anxiety or fear about sex was associated with less sexual satisfaction, as was being in an open relationship. Romantic satisfaction was associated with younger age, having non-binary partners, and being in a current relationship (particularly a monogamous one). Recent distress, anxiety, or fear about sex were associated with less romantic satisfaction. Conclusion: Participants reported a broad range of sexual relationships, but low levels of satisfaction with the sexual and romantic aspects of their lives. The findings underscore the importance of supportive partners, access to social support and peer networks of trans people, as well as access to mental health support and sex-positive, trans affirming counseling in sexual health services. [ABSTRACT FROM AUTHOR]

COVID-19 may threaten the already poor mental health outcomes of Australian gay and bisexual men and cut ties to important social/sexual networks and community. Qualitative research into the experiences of gay and bisexual men during COVID-19 regulations is currently sparse. We report on 489 responses to a qualitative free-text question asking Australian gay and bisexual men about the impacts of COVID-19 during April 2020. Issues pertinent to gay and bisexual men include lost ties to gay and bisexual social/sexual communities, spaces, and activities, which can reduce a sense of belonging to important sexual identity spaces, as well as significant mental well-being vulnerabilities. Reminiscing the collective response to HIV/AIDS, findings reinforce the value of gay and bisexual community organizations, spaces, and networks as supports for gay and bisexual men and emphasize the need for delivering mental health services. [ABSTRACT FROM AUTHOR]

Homeless young people who engage in sex work are at increased risk of HIV and other sexually transmitted infections like chlamydia, gonorrhoea, syphilis and herpes. Semi‐structured interviews were conducted with 29 homeless young people between the ages of 16 and 25 years from Rawalpindi, Pakistan, to explore how sexual practices were mediated through social and contextual conditions. Participants engaged in sex for a range of reported reasons, most commonly to generate income, but also to build intimacy and to establish intimate partnerships which could bring physical protection and social and emotional support. Although participants were aware of the sexual health risks attached to condomless sex, they engaged in it due to the social obligations of intimate partnerships, financial considerations and to better manage potentially violent situations. Instead of condoms, participants used alternate methods like withdrawal, oral sex, post‐sex douching and specific sexual positions. These were not always useful, and some methods might have inadvertently increased their risk of HIV. The study findings suggest that an integrated health promotion approach that goes beyond the health sector and a singular emphasis on risk awareness may help reduce young people's risk of homelessness and sexual health risks. [ABSTRACT FROM AUTHOR]

We have tracked belief in the effectiveness of HIV treatment as prevention (TasP) among Australian gay and bisexual men (GBM) since 2013. National, online cross-sectional surveys of GBM were conducted every 2 years during 2013–2019. Trends and associations were analyzed using multivariate logistic regression. Data from 4,903 survey responses were included. Belief that HIV treatment prevents transmission increased from 2.6% in 2013 to 34.6% in 2019. Belief in the effectiveness of TasP was consistently higher among HIV-positive participants than other participants. In 2019, higher levels of belief in TasP were independently associated with university education, being HIV-positive, using pre-exposure prophylaxis, knowing more HIV-positive people, being recently diagnosed with a sexually transmitted infection (STI) and use of post-exposure prophylaxis. Belief that HIV treatment prevents transmission has increased substantially among Australian GBM, but remains concentrated among HIV-positive GBM, those who know HIV-positive people, and GBM who use antiretroviral-based prevention. [ABSTRACT FROM AUTHOR]

Purpose: To understand the characteristics of a minority of Australian gay and bisexual men (GBM) who, despite an increase in the number and availability of HIV risk reduction strategies, do not consistently use a strategy to protect themselves from HIV. Methods: This analysis is based on data from 2,920 participants in a national, online, prospective observational cohort study. GBM who never or rarely used HIV risk reduction strategies (NRR) were compared with two groups using multivariate logistic regression: i) GBM using pre-exposure prophylaxis (PrEP) and ii) GBM frequently using risk reduction strategies (FRR) other than PrEP. Results: Compared to PrEP users, NRR men were younger (p<0.0001), less socially engaged with gay men (p<0.0001) and less likely to have completed a postgraduate (p<0.05) or undergraduate degree (p<0.05). They were also less likely to have recently used amyl nitrite (p<0.05), erectile dysfunction medication (p<0.05) and cocaine (p<0.05) in the previous 6 months. Compared with FRR men, NRR men were less likely to have completed a postgraduate (p<0.0001) or undergraduate degree (p<0.05), scored higher on the sexual sensation-seeking scale (p<0.0001) and were more likely to identify as versatile (p<0.05), a bottom (p<0.05) or very much a bottom (p<0.05) during anal sex. Conclusions: NRR men were largely similar to other Australian GBM. However, our analysis suggests it may be appropriate to focus HIV prevention interventions on younger, less socially engaged and less educated GBM, as well as men who prefer receptive anal intercourse to promote the use of effective HIV risk reduction strategies. [ABSTRACT FROM AUTHOR]

The broadening of access to HIV pre-exposure prophylaxis (PrEP) in Australia has rekindled debates about which types of clinicians are best suited to deliver HIV prevention innovations: specialist HIV services or primary care physicians and general practitioners (GPs). We conducted 21 semi-structured qualitative interviews in 2017 with Australian HIV sector experts working across policy, advocacy, clinical service provision, research, and health promotion. These interviews took place before a national policy commitment to subsidising access to PrEP was achieved. We explored how participants conceptualised PrEP, patients and GPs at this key turning point in the history of HIV prevention. Participants expressed varied views regarding GPs' anticipated ability to successfully navigate the potential complexities associated with PrEP roll-out. While participants were supportive of greater patient access to PrEP, they expressed concerns about non-specialist GPs' cultural competence and expertise regarding sexuality and clinical practice, and the potential for patients to experience discrimination and homophobia from non-expert GPs. This study has broad implications for thinking about experts and expertise, the implementation of previously specialised medicine into mainstream settings, and the anticipated challenges of LGBTIQ+ inclusive healthcare. [ABSTRACT FROM AUTHOR]

Background: HIV prevention cascades can assist in monitoring the implementation of prevention methods like preexposure prophylaxis (PrEP). We developed 2 PrEP cascades for Australia's primary HIV-affected population, gay and bisexual men. Methods: Data were drawn from 2 national, repeated, crosssectional surveys (the Gay Community Periodic Surveys and PrEPARE Project). One cascade had 3 steps, and the other had 7 steps. Trends over time were assessed using logistic regression. For the most recent year, we identified the biggest drop between steps in each cascade and compared the characteristics of men between the 2 steps using multivariate logistic regression. Results: Thirty-nine thousand six hundred and seventy non--HIVpositive men participated in the Periodic Surveys during 2014-2018. PrEP eligibility increased from 28.1% (1901/6762) in 2014 to 37.3% (2935/7878) in 2018 (P, 0.001), awareness increased from 29.6% (563/1901) to 87.1% (2555/2935; P, 0.001), and PrEP use increased from 3.7% (21/563) to 45.2% (1155/2555; P, 0.001). Of 1038 non--HIV-positive men in the PrEPARE Project in 2017, 54.2% (n = 563) were eligible for PrEP, 97.2% (547/563) were aware, 67.6% (370/547) were willing to use PrEP, 73.5% (272/370) had discussed PrEP with a doctor, 78.3% (213/272) were using PrEP, 97.2% (207/213) had recently tested, and 75.8% (157/207) reported reduced HIV concern and increased pleasure because of PrEP. The break point analyses indicated that PrEP coverage was affected by geographical availability, education level, employment, and willingness to use PrEP. Conclusions: PrEP eligibility, awareness, and use have rapidly increased among Australian gay and bisexual men. The cascades identify disparities in uptake by eligible men as a result of socioeconomic factors and PrEP's acceptability [ABSTRACT FROM AUTHOR]

HIV pre‐exposure prophylaxis (PrEP) has been embraced in Australia, making PrEP available with public funding to people at risk of HIV. Here, we consider the associated 'problems' of reduced condom use and sexually transmissible infections (STIs), as seen by HIV professionals. Twenty‐one interviews were conducted during May‐August 2017. All agreed that PrEP was a valuable addition to HIV prevention, but their views about reduced condom use and STIs were variable. Using poststructural policy analysis, three main stances were identified: (1) Concerned/alarmed. PrEP was seen as causing reduced condom use, STIs and antibiotic resistance, posing threats to the general population; (2) Neutral/normalising. Stakeholders emphasised that condom use was declining and STIs increasing independently of PrEP, and that PrEP was simply a new tool to be accommodated; (3) Optimistic/critical. PrEP was seen as diminishing fear of HIV and engaging users in more frequent testing and treatment that could lead to declining STI rates. What linked all three stances was the selective performance of evidence, deploying a mixture of personal experience, clinical observations, behavioural data and epidemiology. Anticipating possible futures through evidence‐making suggested practical, political and moral consequences for what PrEP could become. We encourage others to consider these consequences with care. [ABSTRACT FROM AUTHOR]

We analyzed the concept of risk compensation and how it has been applied in HIV prevention, paying particular attention to the strategy of HIV preexposure prophylaxis (PrEP). In risk compensation, reduced perceptions of risk after the introduction of a preventative intervention lead to more frequent risk-taking behavior. Such a change may undermine the intervention's protective benefits. We found that many studies purporting to investigate risk compensation do not assess or report changes in perceptions of risk, instead relying on behavioral measures. Our analysis suggests a complex and sometimes counterintuitive relationship between the introduction of a new prevention intervention, perceptions of HIV risk, and subsequent changes in behavior. As PrEP is introduced, we believe comprehensive assessment of community-level risk compensation--that is, changes in risk perceptions and behavior as a result of increased optimism about avoiding HIV among people not directly protected by PrEP--should not be omitted. We therefore suggest ways to assess prevention optimism and community-level risk compensation. [ABSTRACT FROM AUTHOR]

Background: Men who have sex with men (MSM) are disproportionately affected by mental health concerns, including depression. Amphetamine-type-stimulants (ATS) use and homosexuality-related stigma and discrimination have been found associated with depression among MSM. Objectives: To assess the prevalence of depression and its associations with ATS use and homosexuality-related stigma and discrimination among MSM in Vietnam. Methods: 622 MSM were conveniently recruited in Hanoi and Ho Chi Minh city, Vietnam, from September to December 2014. We collected information on demographic characteristics, ATS, alcohol and other drug use, sexual behaviors, homosexuality-related and discrimination stigma, and sexual sensation-seeking. Depression and suicidal thoughts were assessed by the Patient Health Questionnaire (PHQ-9). We assessed associations of depression with ATS use and homosexuality-related stigma and discrimination using logistic regression. Results: Of 622 sampled MSM, 11.3% were classified as having major depression, 9.8% reported any suicidal thoughts in the last two weeks, 30.4% ever had used any ATS, 88.8% ever ad drank alcohol and 21.5% had ever used any other drugs. In multivariate analysis, depression was significantly associated with ATS use (Adjusted Odds Ratio [AOR: 2.20; (95% Confidence Interval (CI): 1.32–3.67], younger age of sexual debut with another man (AOR: 0.09; 95% CI: 0.02–0.50), and greater enacted homosexuality-related stigma (AOR: 1.97; 95% CI: 1.19–3.26). Conclusions: We found a moderate prevalence of depression among sampled MSM, which was associated with ATS use and enacted homosexuality-related stigma. We recommend integrating assessment and interventions regarding depression and methamphetamine use into gay-friendly, culturally adapted holistic HIV prevention for MSM in Vietnam. [ABSTRACT FROM AUTHOR]

Sexual racism can be thought of as a specific form of racial prejudice enacted in the context of sex and dating. It is a contentious issue among gay and bisexual men looking for partners online. This study draws upon 14 in-depth interviews conducted between August and October 2012 with gay and bisexual men of colour in Australia. Data were thematically analysed to identify interpretations and experiences of, and reactions to sexual racism online. Understandings of online sexual racism were diverse, ranging from clear ideas about racist and non-racist practices to more ambiguous and contextual interpretations. Nevertheless, all participants described experiences of sexual racism while seeking partners online, which were, in some cases, largely indistinguishable from generic forms of racism. Most described experiences of subtle racism, but there were also cases of blatant and aggressive racial prejudice. Finally, men reacted in a range of ways when confronted with online sexual racism, with strategies ranging from disconnection to adaptation through to confrontation. Our findings highlight that sexual racism – as an expression of racism generally – is an ongoing issue for men who seek out other men online, and that men engage in a range of strategies for mitigating the negative effects of racial prejudice in this domain. [ABSTRACT FROM AUTHOR]

HIV ‘treatment as prevention’ (TasP) is highly effective in reducing HIV transmission in serodiscordant couples. There has been little examination of gay and bisexual men’s attitudes towards TasP, particularly regarding men’s willingness to act on beliefs about TasP. We conducted an online cross-sectional survey of Australian men in late 2012 to investigate knowledge and beliefs about new developments in HIV prevention. Amongst 839 men (mean age 39.5 years), men tended to disagree that TasP was sufficiently effective to justify reduced condom use, although HIV-positive men had more favourable attitudes. Only a minority of men were aware of any evidence for TasP; and one-quarter incorrectly believed that evidence for the effectiveness of TasP already existed for the homosexual population. One-fifth (20.5%) of men reported that they would be willing to have condomless anal intercourse with an opposite-status sexual partner when the HIV-positive partner was taking HIV treatments. Factors independently associated with such willingness were: HIV-positive serostatus, reporting any serodiscordant or serononconcordant condomless anal intercourse with a regular male partner in the previous six months, reporting any condomless anal intercourse with a casual male partner in the previous six months, and having greater beliefs in the effectiveness of TasP. This indicated that the men most willing to rely on TasP to prevent transmission were already engaging in higher risk practices. Biomedical HIV prevention represents a rapidly changing environment with new research as well as community and policy responses emerging at a fast pace. For men with serodiscordant sexual partners to successfully apply TasP to reducing transmission risk, more support and education is needed to enable better utilisation of TasP in specific relational and sexual contexts. [ABSTRACT FROM AUTHOR]

Introduction: Amphetamine-type-stimulants (ATS) use is associated with HIV-related sexual risk behaviours and is an emergent problem among men who have sex with men (MSM) in Vietnam. The purpose of this study is to describe ATS use patterns and understand the correlates of recent methamphetamine use from a socio-ecological perspective.Methods: From September through December, 2014, 622 MSM were recruited in Hanoi and Ho Chi Minh City, Vietnam. We collected information on demographic characteristics, HIV testing behaviours, use of ATS and other recreational drugs (ever and recently), sexual sensation seeking, depressive mood, experienced and internalized stigma related to homosexuality, social involvement with other MSM, and perceptions of ATS use in MSM networks. We performed descriptive statistics to describe ATS use patterns and multivariate logistic regression to establish independent correlates of recent methamphetamine use.Results: Nearly one-third (30.4%) had ever used ATS, including 23.6% who had used methamphetamine, 4.3% who had used amphetamine ('speed') and 20.9% who had used ecstasy. 20.1% and 11.9% had ever used methamphetamine and ecstasy, respectively, during sex. Eighteen percent of methamphetamine users were classified as engaged in high-risk use. Recent methamphetamine use (in the last 3 months) was associated with participants perceiving more methamphetamine use in their MSM network, recent sex work, and higher sexual sensation seeking scores.Conclusions: ATS use is relatively prevalent among MSM sampled in Vietnam's main cities. Interventions to address methamphetamine are warranted for MSM in Vietnam. Methamphetamine treatments are needed for high-risk users. [ABSTRACT FROM AUTHOR]

Although approximately 31,000 Australian gay and bisexual men (GBM) are eligible for HIV pre-exposure prophylaxis (PrEP), only 18,500 people currently use it, indicating a need to investigate why GBM do not use it. This article uses data from a national, online, observational study. It adopts a mixed-methods analysis to responses to survey questions asking about reasons Australian GBM were not using PrEP in 2018, according to their level of HIV risk as delineated by the Australian PrEP prescribing guidelines at the time. Participants responded to check-box questions and had the option to respond to a qualitative free-text question. Results showed that just over one-fifth of men were at higher risk of HIV acquisition. Compared to lower-risk men, higher-risk men were more likely to indicate PrEP was too expensive and more likely to cite embarrassment asking for it. Reasons for not using PrEP included a lack of personal relevance, poor accessibility or knowledge, concerns about PrEP's inability to protect against STIs, potential side effects, and a preference for condoms. We conclude that health promotion more effectively targeting GBM who may benefit the most from PrEP may be valuable. [ABSTRACT FROM AUTHOR]

HIV pre-exposure prophylaxis (PrEP) is a prevention technology that involves prescribing antiretroviral drugs to HIV-negative people to protect them from infection. This paper considers how the development of the technology has necessitated the parallel configuration of its users, and how this process has affected the perception and uptake of the technology. In designing a technology, potential users are typically defined, enabled and constrained, partly to create a target population (or market) for the technology, but also to reassure people that it can be used safely and effectively. This process may or may not be helpful for the uptake and use of the technology. Published research on PrEP indicates that while the technology was under trial, the primary focus was on the ‘at-risk’ subject in need of PrEP, with little or no consideration of the other qualities necessary for successful use. Post-trial accounts of PrEP have begun to outline desirable qualities of successful PrEP use, such as caution, compliance and being organised. It appears that the PrEP user was only partially configured during the technology's development, and the initial focus on risk has done little to counter fears of the technology, which may partially account for its slow uptake. [ABSTRACT FROM PUBLISHER]

Introduction: Gay and bisexual men (GBM) with undiagnosed HIV are believed to contribute disproportionately to HIV transmission in Australia but national prevalence estimates have been lacking. Methods: From November 2013 to November 2014, we recruited men at gay venues and events in six Australian states and territories. Of 7291 survey participants, 3071 men also provided an oral fluid sample for testing and decided whether to receive their test results or not. We calculated raw and population-weighted prevalence estimates and identified associations with undiagnosed infection using logistic regression. Results: Of 3071 participants, 213 men tested HIV-positive (6.9%, 95% confidence interval [CI] 6.0 to 7.8%), ofwhom19 (8.9%, 95% CI 5.8 to 13.5%) were previously undiagnosed. After weighting for the size of the gay and bisexual male population in each state or territory, national HIV prevalence was estimated to be 7.2% (95% CI 6.3 to 8.1), of which 9.1% (95% CI 6.0 to 13.6%) were estimated to be undiagnosed. Compared with HIV-negative participants, men with undiagnosed HIV were more likely to report meeting partners at sex venues, using antiretroviral drugs as pre-exposure prophylaxis, condomless anal intercourse with casual partners, using party drugs for sex, injecting drugs and using amyl nitrite, crystal methamphetamine or gamma hydroxybutyrate in the six months prior to the survey. Discussion: The results indicate that the prevalence of undiagnosed HIV is relatively low among Australian GBM but is higher among men who report riskier sex and drug practices. Conclusions: The results underline the importance of targeted HIV prevention and frequent testing formen at increased risk of infection. [ABSTRACT FROM AUTHOR]

Introduction HIV diagnoses among gay and bisexual men have increased over the past decade in Australia. HIV point‐of‐care testing (POCT) was introduced in Australia in 2011 as a strategy to increase HIV testing by making the testing process more convenient. We surveyed gay and bisexual men undergoing POCT to assess barriers to HIV testing and characteristics associated with not having previously tested for HIV (never testing). Methods During 2011 and 2012, gay and bisexual men who were undergoing POCT at four Sydney sexual health clinics self‐completed questionnaires assessing testing history and psychological and structural barriers to HIV testing. Bivariate and multivariate logistic regression was used to assess associations between patient characteristics and never testing. Results Of 1093 participants, 981 (89.9%) reported ever testing for HIV and 110 (10.1%) never testing. At least one barrier to testing was reported by 1046 men (95.7%), with only 47 men (4.3%) not reporting any barrier to testing. The most commonly reported barriers to testing were annoyance at having to return for results (30.2%), not having done anything risky (29.6%), stress in waiting for results (28.4%), being afraid of testing positive (27.5%) and having tested recently (23.2%). Never testing was independently associated with being non‐gay‐identified (adjusted odds ratio [AOR]: 1.9; 95% confidence interval [CI]: 1.1–3.2), being aged less than 25 years (AOR: 2.4; 95% CI: 1.6–3.8), living in a suburb with few gay couples (AOR: 1.9; 95% CI: 1.2–3.0), being afraid of testing HIV‐positive (AOR: 1.6; 95% CI: 1.0–2.4), not knowing where to test (AOR: 3.8; 95% CI: 1.3–11.2) and reporting one or no sexual partners in the last six months (AOR: 2.7; 95% CI: 1.2–6.2). Conclusions Barriers to HIV testing were commonly reported among the clinic‐based gay and bisexual men in this study. Our findings suggest further health promotion and prevention strategies are needed to address the knowledge, attitudes and behavioural factors associated with never testing. [ABSTRACT FROM AUTHOR]

Objective: Assess the acceptability of HIV treatment as prevention and early antiretroviral treatment among gay and bisexual men in Australia and any changes in attitudes over time. Methods: National, online, cross-sectional surveys of gay and bisexual men were repeated in 2011 and 2013. Changes in attitudes to HIV treatment over time were assessed with multivariate analysis of variance. The characteristics of men who agreed that HIV treatment prevented transmission and thought that early treatment was necessary were identified with multivariate logistic regression. Results: In total, 2599 HIV-negative, untested and HIV-positive men participated (n = 1283 in 2011 and n = 1316 in 2013). Attitudes changed little between 2011 and 2013; most participants remained sceptical about the preventative benefits of HIV treatment. In 2013, only 2.6% of men agreed that HIV treatment prevented transmission; agreement was associated with being HIV-positive, having an HIV-positive regular partner, and having received HIV post-exposure prophylaxis. In contrast, 71.8% agreed that early antiretroviral treatment is necessary; younger men were more likely and HIV-positive men and participants with HIV-positive partners were much less likely to agree with this. Conclusions: Promoting the individual health benefits of HIV treatment rather than its preventative benefits remains more acceptable to Australian gay and bisexual men. [ABSTRACT FROM AUTHOR]

We surveyed willingness to use pre-exposure prophylaxis (PrEP) and the likelihood of decreased condom use among Australian gay and bisexual men in 2011 and 2013 (n = 2384). Willingness to use PrEP declined from 28.2% to 23.3% [adjusted odds ratio = 0.83, 95% confidence interval (CI): 0.68 to 1.00, P = 0.050]. Willingness to use PrEP was the greatest among men with HIV-positive partners and among those who had taken HIV postexposure prophylaxis. Among men willing to use PrEP, the likelihood of decreased condom use remained stable between 2011 and 2013 (8.0% vs. 11.9%; adjusted odds ratio = 1.40, 95% CI: 0.80 to 2.45, P = 0.23). A minority of men remain willing to use PrEP and appear to be appropriate candidates for it. [ABSTRACT FROM AUTHOR]

Since the mid-1980s, Australian social researchers have investigated the sexual practices of gay men, describing those that protect men from HIV or put them at risk of infection. Ground-breaking (and controversial) publications have highlighted a variety of ways in which gay men protect themselves and their partners, including condom use and non-condom-based risk reduction strategies. HIV social research in Australia has been heavily influenced by a distinctive network of experts or epistemic community with shared principles and beliefs and a commitment to influencing policy and practice. This epistemic community has articulated a 'social public health' view of HIV that emphasises partnership, agency, understanding practices and reflexivity. This approach has clashed with those of other epistemic communities, notably around ideas of relapse and unsafe sex. This article uses the examples of negotiated safety and serosorting to illustrate this Australian epistemic community's approach to HIV risk reduction among gay men. [ABSTRACT FROM AUTHOR]

Objectives To analyse changes in testing for sexually transmissible infections (STI) among gay and bisexual men in Melbourne, Sydney and Queensland, Australia, particularly comprehensive STI testing (at least four tests from different anatomical sites in the previous year), and the characteristics of men who had such testing. Method Data were analysed from repeated, cross-sectional, community-based surveys conducted during 2003-2012. Trends in specific STI tests and comprehensive testing were assessed and the characteristics of participants who reported comprehensive STI testing were identified using multivariate logistic regression, stratified by HIV status. Results Among HIV-negative and unknown status men (n=51 009), comprehensive STI and HIV testing increased substantially from 13% in 2003 to 34% in 2012. During the same period, comprehensive STI testing (excluding HIV testing) increased from 24% to 57% among HIV-positive men (n=5532). In both HIV status groups, comprehensive testing was more commonly reported by men who had unprotected anal intercourse with casual partners, and men with higher numbers of partners. Among HIV-negative/unknown status participants, comprehensive STI and HIV testing was also associated with education level, regional location and finding partners online. Among HIV-positive men, comprehensive STI testing was also associated with free time spent with gay men and illicit drug use. Comprehensive testing was related to a high annual rate of diagnosis with STIs (20% of HIV-negative/unknown status men and 38% of HIV-positive men). Conclusions There has been a substantial improvement in the proportion of gay and bisexual men in Melbourne, Sydney and Queensland who report comprehensive testing. Comprehensive testing is most likely among men whose practices put them at increased risk of infection, and is associated with a high rate of STI diagnosis. However, opportunities for comprehensive testing are still being missed, suggesting a need for its ongoing promotion. [ABSTRACT FROM AUTHOR]

We report the imaging of nanoscale distributions of lattice strain and rotation in complementary components of lithographically engineered epitaxial thin film semiconductor heterostructures using synchrotron x-ray Bragg projection ptychography (BPP). We introduce a new analysis method that enables lattice rotation and out-of-plane strain to be determined independently from a single BPP phase reconstruction, and we apply it to two laterally adjacent, multiaxially stressed materials in a prototype channel device. These results quantitatively agree with mechanical modeling and demonstrate the ability of BPP to map out-of-plane lattice dilatation, a parameter critical to the performance of electronic materials. [ABSTRACT FROM AUTHOR]

Background: Determine HIV Combo (DHC) is the first point of care assay designed to increase sensitivity in early infection by detecting both HIV antibody and antigen. We conducted a large multi-centre evaluation of DHC performance in Sydney sexual health clinics. Methods: We compared DHC performance (overall, by test component and in early infection) with conventional laboratory HIV serology (fourth generation screening immunoassay, supplementary HIV antibody, p24 antigen and Western blot tests) when testing gay and bisexual men attending four clinic sites. Early infection was defined as either acute or recent HIV infection acquired within the last six months. Results: Of 3,190 evaluation specimens, 39 were confirmed as HIV-positive (12 with early infection) and 3,133 were HIV-negative by reference testing. DHC sensitivity was 87.2% overall and 94.4% and 0% for the antibody and antigen components, respectively. Sensitivity in early infection was 66.7% (all DHC antibody reactive) and the DHC antigen component detected none of nine HIV p24 antigen positive specimens. Median HIV RNA was higher in false negative than true positive cases (238,025 vs. 37,591 copies/ml; p = 0.022). Specificity overall was 99.4% with the antigen component contributing to 33% of false positives. Conclusions: The DHC antibody component detected two thirds of those with early infection, while the DHC antigen component did not enhance performance during point of care HIV testing in a high risk clinic-based population. [ABSTRACT FROM AUTHOR]

The response to HIV in many countries is informed by routine behavioural surveillance of affected populations, yet the impact of this surveillance is rarely considered. In Australia, the Gay Community Periodic Surveys (GCPS) recruit 8000 men each year, surveying sexual practices, drug use and health service utilisation, in line with international guidelines. Using actor–network theory and Ian Hacking’s concept of ‘looping effects’, this article considers how knowledge of gay men is produced by behavioural surveillance, the interdependencies between the surveillance network and its subjects, and the potential for unintended consequences as a result of the mass participation of gay men in the surveillance network. The case of the GCPS is used to show how behavioural surveillance relies on a large, complex assemblage of human and non-human actors, with an emphasis on standardisation and repetition to make its practices durable. The distance of surveillance from gay men’s practices means that the network relies on an imaginary of gay men to create survey tools and to interpret data. This imaginary may be communicated to gay men during their participation in the surveillance, particularly when they are engaging with the surveillance questionnaire. This has the potential to affect their subjectivity and the practices the surveys seek to monitor. Considering the implications of this analysis, it is argued that HIV prevention could be improved if we consider how behavioural surveillance produces knowledge of gay men and the ways in which gay men affect and are affected by surveillance. [ABSTRACT FROM PUBLISHER]

This review discusses recent progress in the development of hard X-ray microscopy techniques for materials characterization at the nanoscale. Although the utility of traditionally ensemble-based X-ray techniques in materials research has been widely recognized, the utility of X-ray techniques as a tool for local characterization of nanoscale materials properties has undergone rapid development in recent years. Owing to a confluence of improvements in synchrotron source brightness, focusing optics fabrication, detection, and data analysis, nanoscale X-ray imaging techniques have moved beyond proof-of-principle experiments to play a central role in synchrotron user programs worldwide with high-impact applications made to materials science questions. Here, we review the current state of synchrotron-based, hard X-ray nanoscale microscopy techniques-including 3D tomographic visualization, spectroscopic elemental and chemical mapping, microdiffraction-based structural analysis, and coherent methods for nanomaterials imaging-with particular emphasis on applications to materials research. [ABSTRACT FROM AUTHOR]

We present a set of universal curves that predict the range and intensity of backscattered electrons which can be used in conjunction with electron beam lithography to create high fidelity nanoscale patterns. The experimental method combines direct write dose, backscattered dose, and a self-reinforcing pattern geometry to measure the dose provided by backscattered electrons to a nanoscale volume on the substrate surface at various distances from the electron source. Electron beam lithography is used to precisely control the number and position of incident electrons on the surface of the material. Atomic force microscopy is used to measure the height of the negative electron beam lithography resist. Our data shows that the range and the intensity of backscattered electrons can be predicted using the density and the atomic number of any solid material, respectively. The data agrees with two independent Monte Carlo simulations without any fitting parameters. These measurements are the most accurate electron range measurements to date. [ABSTRACT FROM AUTHOR]

Large-wave-vector phonons have an important role in determining the thermal and electronic properties of nanoscale materials. The small volumes of such structures, however, have posed significant challenges to experimental studies of the phonon dispersion. We show that synchrotron x-ray thermal diffuse scattering can be adapted to probe phonons with wave vectors spanning the entire Brillouin zone of nanoscale silicon membranes. The thermal diffuse scattering signal from flat Si nanomembranes with thicknesses from 315 to 6 nm, and a sample volume as small as 5 μm³, has the expected linear dependence on the membrane thickness and also exhibits excess intensity at large wave vectors, consistent with the scattering signature expected from low-lying large-wave-vector modes of the membranes. [ABSTRACT FROM AUTHOR]

To assess the changing health promotion needs of human immunodeficiency virus (HIV)-positive gay men in Australia, we analysed the social and behavioural characteristics of HIV-positive men in the Australian Gay Community Periodic Surveys. We looked at change over time in the characteristics of HIV-positive men (from 2000–2001 to 2008–2009) and compared HIV-positive men with their HIV-negative peers within each time period. Multivariate logistic regression analysis was used to assess independent changes over time within each HIV status group. A total of 21,620 responses were included in the analyses; 10,537 in 2000–2001 and 11,083 in 2008–2009. Between the two time periods, HIV-positive and HIV-negative men became more similar in the following areas: paid employment, sexual identity, number of male sex partners, the likelihood of having a regular male partner and having a seroconcordant regular male partner. The two groups diverged in these areas: age, ethnicity, educational level, social engagement with gay men, types of relationship with regular male partners, likelihood of unprotected anal intercourse with casual male partners and likelihood of HIV disclosure to casual male partners. Workforce participation and educational attainment have improved among HIV-positive gay men since 2000, but they still lag behind their HIV-negative peers in these areas. Because HIV-positive men are an ageing cohort, support services will need to increasingly address issues of HIV, sexuality and ageing with HIV-positive men. The increase in unprotected anal intercourse and HIV disclosure with casual partners means that education and support services will increasingly need to address effective HIV disclosure and non-condom-based risk reduction strategies with both HIV-positive and HIV-negative gay men. [ABSTRACT FROM AUTHOR]

To assess the changing health promotion needs of human immunodeficiency virus (HIV)-positive gay men in Australia, we analysed the social and behavioural characteristics of HIV-positive men in the Australian Gay Community Periodic Surveys. We looked at change over time in the characteristics of HIV-positive men (from 2000–2001 to 2008–2009) and compared HIV-positive men with their HIV-negative peers within each time period. Multivariate logistic regression analysis was used to assess independent changes over time within each HIV status group. A total of 21,620 responses were included in the analyses; 10,537 in 2000–2001 and 11,083 in 2008–2009. Between the two time periods, HIV-positive and HIV-negative men became more similar in the following areas: paid employment, sexual identity, number of male sex partners, the likelihood of having a regular male partner and having a seroconcordant regular male partner. The two groups diverged in these areas: age, ethnicity, educational level, social engagement with gay men, types of relationship with regular male partners, likelihood of unprotected anal intercourse with casual male partners and likelihood of HIV disclosure to casual male partners. Workforce participation and educational attainment have improved among HIV-positive gay men since 2000, but they still lag behind their HIV-negative peers in these areas. Because HIV-positive men are an ageing cohort, support services will need to increasingly address issues of HIV, sexuality and ageing with HIV-positive men. The increase in unprotected anal intercourse and HIV disclosure with casual partners means that education and support services will increasingly need to address effective HIV disclosure and non-condom-based risk reduction strategies with both HIV-positive and HIV-negative gay men. [ABSTRACT FROM PUBLISHER]

The Hard X-ray Nanoprobe Beamline (or Nanoprobe Beamline) is an X-ray microscopy facility incorporating diffraction, fluorescence and full-field imaging capabilities designed and operated by the Center for Nanoscale Materials and the Advanced Photon Source at Sector 26 of the Advanced Photon Source at Argonne National Laboratory. This facility was constructed to probe the nanoscale structure of biological, environmental and material sciences samples. The beamline provides intense focused X-rays to the Hard X-ray Nanoprobe (or Nanoprobe) which incorporates Fresnel zone plate optics and a precision laser sensing and control system. The beamline operates over X-ray energies from 3 to 30 keV, enabling studies of most elements in the periodic table, with a particular emphasis on imaging transition metals. [ABSTRACT FROM AUTHOR]

Racialised language is a salient and contested aspect of contemporary sexual cultures, particularly in the online domain. This paper explores the ways in which gay men in Australia employ race-related language when using online sex/dating websites. Using inductive content analysis, descriptive categories were developed to identify recurrent patterns in the racialised language employed by website users. A coding framework was then constructed to identify the ‘subject’ (self, other or concept) of each piece of race-related content, its ‘purpose’ (marketing, negative or positive discrimination, commentary) and the ‘position’ adopted (defensive, normalised or critical). Descriptive and comparative analyses revealed differences in the ways in which members of racial groups employed racialised language online. These differences are reviewed in relation to broader discourses on Whiteness and race in Australia, as well as recent community-produced anti-racism campaigns. [ABSTRACT FROM PUBLISHER]

High rates of both illicit drug use and depression are consistently reported among gay men. However, little is known about how beliefs about drug use shape clinical encounters between gay men and health professionals, and that in turn affect clinical communication and care, particularly in relation to depression. We compared 'doctor' and 'patient' beliefs about the role of illicit drug use in gay men's depression. Semi-structured interviews were conducted during August-December 2006 with 16 general medical practitioners working in seven 'gay-friendly' practices in Sydney, Adelaide and a rural-coastal city in New South Wales, and during February-May 2008 with 40 gay men with depression recruited through four Sydney and Adelaide practices. A thematic analysis of these two sets of interviews found that doctors expressed the beliefs that: illicit drug use is related to depression in gay men; illicit drug use impedes effective diagnosis and treatment of depression in gay men; and illicit drug use increases the level of complexity involved in caring for gay men with depression. Gay men expressed the beliefs that: illicit drug use is closely related to depression; illicit drug use can be helpful in dealing with difficult experiences; and illicit drug use is just what you do as a gay man living in a big city. Both groups believed drug use and depression were related, but doctors emphasised the negative outcomes of drug use and interpreted these in relation to health. Gay men believed that drugs could have both negative and positive uses and differentiated between health and social outcomes. While the doctors articulated a pragmatic position on drug use, which is consistent with harm reduction principles, communication with gay male patients could be enhanced if both groups acknowledged their divergent views of illicit drugs and their potential role in mental health. [ABSTRACT FROM AUTHOR]

Objectives To investigate willingness to use HIV preexposure prophylaxis (PrEP) and the likelihood of decreased condom use among Australian gay and bisexual men. Methods A national, online cross-sectional survey was conducted in April to May 2011. Bivariate relationships were assessed with χ² or Fisher's exact test. Multivariate logistic regression analysis was performed to assess independent relationships with primary outcome variables. Results Responses from 1161 HIV-negative and untested men were analysed. Prior use of antiretroviral drugs as PrEP was rare (n=6). Just over a quarter of the sample (n=327; 28.2%) was classified as willing to use PrEP. Willingness to use PrEP was independently associated with younger age, having anal intercourse with casual partners (protected or unprotected), having fewer concerns about PrEP and perceiving oneself to be at risk of HIV. Among men who were willing to use PrEP (n=327), only 26 men (8.0%) indicated that they would be less likely to use condoms if using PrEP. The likelihood of decreased condom use was independently associated with older age, unprotected anal intercourse with casual partners (UAIC) and perceiving oneself to be at increased risk of HIV. Conclusions The Australian gay and bisexual men the authors surveyed were cautiously optimistic about PrEP. The minority of men who expressed willingness to use PrEP appear to be appropriate candidates, given that they are likely to report UAIC and to perceive themselves to be at risk of HIV. [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. [ABSTRACT FROM AUTHOR]

The concept of 'gay community', and gay men's attachment to and involvement in gay community activities, has held both a symbolic and practical role in understanding and guiding responses to HIV in developed world contexts. In the West, the HIV epidemic has disproportionately affected gay men. Being involved in and connected to gay community activities (what, in Australia, is described as 'gay community attachment') predicted the adoption of safe sex practices. However, the meaning of gay community is changing. This presents a challenge to those working in HIV prevention. With reference to previous research, the meaning of gay community is analysed in qualitative interviews conducted with Australian gay men. The interview data indicate that gay men are often ambivalent about gay communities, suggesting a need for subtlety in the ways we think about and address gay men in HIV education and health promotion. The concept of 'personal communities' may better reflect the ways in which gay men engage with each other and their social networks. Recognising and responding to the changing nature of gay life will ensure that the flexibility and pragmatism of HIV programmes aimed at gay men are maintained. [ABSTRACT FROM AUTHOR]

Gay men's recreational use of Viagra and similar drugs has received considerable attention in the public health literature, implicating Viagra as a risk factor for HIV transmission. Framed by work on the pharmaceuticalization of everyday life and critical Viagra studies, gay men's accounts are analysed to assess the ways in which Viagra is understood, valued and experienced. Viagra was commonly described as a corrective remedy that guaranteed erectile performance, aided condom use and simplified decisions about safe sex. The mismatch between public health discourse and gay men's understandings of Viagra, as well as the reliance on Viagra for safe sex, are discussed in relation to harm reduction and HIV prevention efforts, suggesting a need to encourage critical reflection on sexuopharmaceutical use among gay men. [ABSTRACT FROM AUTHOR]

The Advanced Synthetic Aperture Radar (ASAR) on board the Envisat satellite is an important resource for observation of global ocean surface wave spectra. However, assessment of this valuable dataset is not straightforward as a result of a lack of other independent ocean wave spectral observations. The radar altimeter (RA-2) on board the same satellite measures ocean wave height at the same time as the ASAR but at a location about 200 km distant. A small number of moored buoys produce one-dimensional (1D) ocean wave spectra but few ASAR spectra fall on the buoy positions in a given period. Indirect comparison of the Envisat ASAR 2D wave spectra with the RA-2 wave heights and 1D spectra of three selected buoys from July 2004 to February 2006 is facilitated by a wave model, which provides coherent spatial and temporal links between these observations. In addition to the conventional significant wave height (SWH), four spectral subrange wave heights (SRWHs) are used to illustrate the spectral characteristics of these observations. A comparison of three Envisat ASAR 2D spectra with the closest model and buoy spectra is also attempted to illustrate the qualities of these different observations and to demonstrate the restrictions to their direct comparison. Results indicate that these three independent observations are in good agreement in terms of SWH, though the Envisat ASAR shows the largest variance. Comparison of SRWHs indicates that the ASAR spectra agree well with buoy and model in moderately long waves, but the ASAR instrument does not resolve high-frequency waves, especially along the satellite track. [ABSTRACT FROM AUTHOR]

Aims: Although mental-health problems are common among drug-treatment consumers, little is known about how mental health is discussed by service providers or understood by clients within treatment settings. We analysed how co-occurring drug and mental-health problems are discussed in Australian drug-treatment settings, particularly clinical terminology such as 'comorbidity' or 'dual diagnosis'. Method: 77 drug-treatment clients with common psychological problems (anxiety or depression) and 18 service providers were interviewed about barriers and incentives to treatment for co-occurring drug and mental-health problems. Findings: Consumers had low levels of understanding of clinical terminology for co-occurring drug and mental-health problems, except for those who had accessed literature or participated in programs developed by drug-user organizations. Service providers recognized low levels of consumer mental-health literacy, and advocated a client-centred approach that avoided the use of clinical terminology. Conclusions: Providers should encourage consumers to discuss mental-health problems, and should not avoid using clinical terminology as this may undermine the development of mental-health literacy among consumers. Treatment services may benefit from working with drug-user organizations to develop resources aimed at improving awareness and understanding of mental-health problems among drug-treatment consumers. [ABSTRACT FROM AUTHOR]

Little is understood about the self-care activities undertaken by drug treatment clients. Using data from a qualitative study of drug treatment and mental health we identify the self-care practices of drug treatment clients diagnosed with anxiety and depression. Seventy-seven participants were interviewed in four sites across Australia. Participants described a range of self-care practices for mental health including: self-medication, seeking social support, physical exercise, counselling-derived techniques, keeping busy and other less common strategies. These findings show that drug treatment clients undertake similar self-care practices to the general population and illicit drug users and that these activities echo beneficial practices identified in the research literature. The results suggest opportunities for service providers to work with clients on self-care activities that may improve mental health. Tensions between consumer and professional views of self-care, and the limits to encouraging self-care as a substitute for treatment, are discussed. [ABSTRACT FROM AUTHOR]

Background: Drug treatment clients are significantly more likely to remain in treatment if ancillary life issues and complex needs are addressed. Aim: to document and analyse the complex needs ('complex vulnerabilities') of people experiencing both problems with drug dependence and common mental health problems, with a particular focus on barriers and incentives to drug treatment. Method: A qualitative interview-based study of 77 participants in four sites (three metropolitan, one regional) in Australia. Results: Complex vulnerabilities were deeply embedded in participants' lives and unlikely to be quickly resolved. Poor housing, criminal justice issues and the experience of poverty or debt affected participants' ability to secure basic needs, and their ability to participate in drug or mental health treatment. Difficulties in finding assistance for complex vulnerabilities, especially at times of crisis, were reported by many participants. Conclusions: There is an urgent need to reform the health system to better meet the needs of this group and ensure a 'no wrong door' policy. The resilience demonstrated by participants in managing complex issues should be acknowledged, although the deleterious effect of complex vulnerabilities on treatment participation and outcomes should be recognised. [ABSTRACT FROM AUTHOR]

Abstract: This paper explores how drug treatment clients exercise agency while finding their ability to act curtailed by the strictures of treatment itself. Drawing on qualitative interviews with 77 male and female drug treatment clients collected in an Australian study of drug treatment and mental health, the experience of methadone maintenance treatment (MMT) and that of commonly prescribed medications for depression (antidepressants) are examined. The ways that clients engage with MMT and antidepressants are detailed, illustrating how both types of treatment can make clients feel dependent, but can also motivate clients to modify their treatment regimens. These modifications are “tactical” responses generated within the constraints of treatment regulations and can also be against clinical recommendations e.g. stopping treatment. Rather than seeing this as “non-compliance”, it is suggested that the negotiation of treatment is an inevitable response of clients trying to adapt to imperfect treatment conditions, who may have understandable anxieties about taking medication. The ways in which treatment providers might better acknowledge the capacities of MMT clients to engage with or modify treatment are discussed, as is the need to acknowledge drug treatment clients’ anxieties about dependency and pharmaceutical drugs. [Copyright &y& Elsevier]

Aims: To ascertain service providers’ views on barriers and incentives to illicit drug users accessing or remaining in treatment. Methods: Interviews with service providers in Australia were conducted. Results: Two main themes were explored. Service providers suggested that the perception of a person seeking treatment was strongly associated with the image of that person as deficient, defective or lacking, and that this could impede treatment. Service providers also suggested that differing treatment philosophies and their related treatment goals were at the core of many barriers to treatment. We argue that it is important to find a balance between a model of treatment which works and is responsive to clients’ needs while also avoiding the potential for feeding stigma of those who seek treatment for drug dependence. Conclusion: Our results suggest that knowledge and understanding of treatment philosophies are important for people seeking treatment so that clients can find services that match their needs and treatment goals. [ABSTRACT FROM AUTHOR]

Since the introduction of antiretroviral drug treatments, there has been increased interest in the psychological aspects of living with HIV and a growth of related research and therapeutic literature. While there has been concern about the `remedicalization' of HIV, there is apparently less concern about its `psychologization'. This article considers how the expansion of psychological discourse about HIV impacts on the lives of HIV-positive people in the era of contemporary treatments. Through analysis of group discussions with HIV-positive gay men, we examine how psychological strategies and terminology are adopted or reworked to cope with the uncertainties of living with HIV. We consider both the enabling and constraining effects of psychological modes of regulation, as they are taken up and reworked by HIV-positive people. Our analysis suggests a need for greater scrutiny of the ways in which psychological techniques are employed as solutions to the ambiguities of living with HIV. [ABSTRACT FROM AUTHOR]

Following a review of the main approaches to the study of class in the social sciences, a critical/discursive approach is adopted to show how analysing an aspect of everyday life such as leisure and 'going out' can reveal the reproduction of dominant discourses about class. Forty-two middle-class young adults were taken on 'nights out' to bars and pubs and then interviewed later to generate group accounts of the people and places they encountered. An analysis of participants' talk about going out to bars and pubs is used to illustrate the ways in which class was constituted in their dialogue. Focusing on the distinction respondents made between students and locals we consider how working-class people are simultaneously rejected and desired and how a discourse of territoriality defines and reproduces class relations in commercial leisure spaces. We argue that social psychology has much to offer contemporary understandings of the ways in which social class is constituted and mobilized in everyday accounts of leisure and consumption, and discuss our analysis in the context of existing research. We end by considering the potential value of our distinctive method for the study of class relations in social psychology research. [ABSTRACT FROM AUTHOR]

Outlines the general situation for lesbian and gay couples attempting to migrate internationally, and considers how seeking lesbian and gay marriage or partnership rights may ameliorate these problems. Lesbian and gay immigration; Immigration criteria that lesbian and gay couples must meet to prove that they have a genuine relationship; Pros and cons of same-sex marriages or civil unions.