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: Objectives: This paper examines factors that enabled successful integration of testing for sexually transmissible infections into routine care in Aboriginal Community Controlled Health Services. Methods: This paper reports analysis of qualitative interview data recorded with 19 purposively sampled key informants in New South Wales, Australia, representing six Aboriginal Community Controlled Health Services and five government health bodies supporting those services. The analysis explicitly adopted a strengths‐based approach. Results: Participants reported a strong belief that routine screening overcomes shame and increases engagement with sexual health screening. Incorporating sexual health screening into general medical consultations increases the capture of asymptomatic cases. The Medicare Benefits Schedule 715 Adult Health Check was highlighted as an ideal lever for effective integration into routine care. Conclusion: Integration of testing for sexually transmissible infections into routine care is widely perceived as best practice by senior stakeholders in Aboriginal healthcare in NSW. Findings support continued work to optimise the MBS 715 as a lever to increase testing. Implications for public health: Identifying accessible strategies to increase testing for sexually transmissible infections in Aboriginal Community Controlled Health Services can reduce disparities in notifications affecting Aboriginal young people., This paper explores expert perspectives on strategies that integrate testing for sexually transmissible infections (STIs) into routine primary care for Aboriginal young people in New South Wales (NSW), Australia. In [...]

Objective: To explore the policies of key organisations in Australian health and medical research on defining, collecting, analysing, and reporting data on sex and gender, and to identify barriers to and facilitators of developing and implementing such policies. Study design: Mixed methods study: online planning forum; survey of organisations in Australian health and medical research, and internet search for policies defining, collecting, analysing, and reporting data by sex and gender in health and medical research. Setting, participants: Australia, 19 May 2021 (planning forum) to 12 December 2022 (final internet search). Main outcome measures: Relevant webpages and documents classified as dedicated organisation‐specific sex and gender policies; policies, guidelines, or statements with broader aims, but including content that met the definition of a sex and gender policy; and references to external policies. Results: The online planning forum identified 65 relevant organisations in Australian health and medical research; twenty participated in the policy survey. Seven organisations reported at least one relevant policy, and six had plans to develop or implement such policies during the following two years. Barriers to and facilitators of policy development and implementation were identified in the areas of leadership, language and definitions, and knowledge skills and training. The internet search found that 57 of the 65 organisations had some form of sex and gender policy, including all ten peer‐reviewed journals and five of ten research funders; twelve organisations, including eight peak body organisations, had published dedicated sex and gender policies on their websites. Conclusion: Most of the organisations included in our study had policies regarding the integration of sex and gender in health and medical research. The implementation and evaluation of these policies is necessary to ensure that consideration of sex and gender is adequate during all stages of the research process. [ABSTRACT FROM AUTHOR]

In May 2022, a global outbreak of mpox (formerly monkeypox virus) affected thousands of mainly gay and bisexual men. Mpox is usually a time-limited illness that can involve fever, pain, and skin lesions, but may require hospitalisation. There is scant research into the firsthand experiences of people affected by mpox, including experiences of symptoms, healthcare, and recovery. This study considers the different illness narratives of people who experienced mpox in Australia in 2022. In-depth interviews and 6-month follow-up interviews were conducted with 16 people, including 13 people diagnosed with mpox and three close contacts. All participants were cisgender gay or bisexual men living in Australia. Participants' accounts described minor to severe periods of sickness, negative and stigmatising experiences engaging with healthcare, and some participants experienced long-term effects on their sexual well-being and complications from mpox. The emergency outbreak context meant that mpox was highly distressing, making it difficult to manage and producing varying forms of disruption to everyday life. Mpox was narrated as disruptive in different ways: as a minor interruption to holiday plans, a prolonged period of poor health, or a biographically disruptive event prompting a re-evaluation of sexual values and health. This analysis demonstrates that an unfamiliar emergent disease outbreak related to sexual practices and sociality can reconfigure personal life and sexual well-being, suggesting a need to focus on providing quality patient care in outbreaks of mpox and other infectious diseases. [ABSTRACT FROM AUTHOR]

The uptake of human papilloma virus (HPV) and other adolescent vaccinations in special schools for young people with disability is significantly lower than in mainstream settings. This study explored the factors believed to influence parental decision making regarding vaccine uptake for students with intellectual disability and/or on the autism spectrum attending special schools in New South Wales, Australia, from the perspective of all stakeholders involved in the program. Focus groups and interviews were conducted with 40 participants, including parents, school staff, and immunisation providers. The thematic analysis identified two themes: (1) appreciating diverse parental attitudes towards vaccination and (2) educating parents and managing vaccination questions and concerns. While most parents were described as pro-vaccination, others were anti-vaccination or vaccination-hesitant, articulating a marked protectiveness regarding their child's health. Reasons for vaccine hesitancy included beliefs that vaccines cause autism, concerns that the vaccination may be traumatic for the child, vaccination fatigue following COVID-19, and assumptions that children with disability will not be sexually active. Special school staff regarded the vaccination information pack as inadequate for families, and nurses described limited educational impact resulting from minimal direct communication with parents. More effective communication strategies are needed to address vaccine hesitancy among parents with children with disability. [ABSTRACT FROM AUTHOR]

Objective: Digital storytelling and other methods of self-expression and autobiography have become an increasingly important tool for those working with young people, including those from migrant, refugee or other 'culturally diverse' backgrounds. A structured scoping review was undertaken to better understand the potential value and challenges of using digital stories to promote the health and well-being of these diverse groups of young people and to identify key knowledge gaps. Design: The review process comprised a systematic search of the literature and strategic consultations with professionals working with young people in the area of sexual and reproductive health promotion and care. A descriptive-analytic method was used to collate and synthesise the literature and apply narrative and thematic analyses. Results: In total, 28 papers were deemed eligible for inclusion. Findings are presented as two analyses: what is known from the literature and key knowledge gaps. Identified themes included the use of digital stories as social activism and as research intervention, recognition of digital stories as complex terrain and recommendations for good practice. Three key gaps of particular relevance to our research aims were identified. These were (1) the lack of digital stories on sexual health and relationships by 'culturally diverse' young people in Australia, (2) the need for discussion of the ethical considerations of using digital storytelling and related methods in sexual health fields and (3) the value of exploring opportunities to employ digital methods as self-representation and autobiography to generate new knowledge and build organisational capacity. Conclusion: As confirmed in discussions with professionals working in the youth, migrant and sexual health sectors, the literature highlighted the many potential applications of digital storytelling to promoting the sexual health and well-being of young people from diverse backgrounds. Additional research is required to understand the particular ethical and contextual issues shaping, and at times constraining, this engagement in specific cultural contexts.

In a multicultural nation such as Australia, it is important for young people from migrant and refugee backgrounds to have access to quality relationships and sexuality education, as they are known to be less well engaged with mainstream services. A study was undertaken to explore the complexities and opportunities for engaging this group with sexual and reproductive health information and care in Sydney, Australia. Interviews were undertaken with 27 migrant and refugee young people (aged 16-24 years), and 34 expert informants. Relationships and sexuality education was a dominant theme throughout both data sets. Nearly all young people reported that they were unable to discuss sexuality or sexual health with their parents, and most identified secondary school as the place where they first learned about these issues. Other sources of information were identified as the Internet, friends, health professionals and pornography. Participants appeared to have limited awareness of the different services available to them. Schools, as well as other education settings such as universities, private colleges and intensive English centres, are well placed to deliver relationships and sexuality education, and for migrant and refugee young people these may be valuable settings in which to access information rarely discussed in family or community environments.

Dementia, a global health priority, poses a disproportionately high risk to lesbian, gay, bisexual and trans plus (LGBT+)/gender and sexuality diverse people. Despite this, little research has explored the lived experience of LGBT+ people with dementia or their care partners. This scoping review aims to understand what the literature reveals about their experiences, the ways in which their lives have been investigated, to inform future research, policy and practice. Using an established scoping review methodology, we identified seven papers that reported empirical research on the lived experience of LGBT+ people with dementia and their care partners. Only a single study reported on in two of the papers included people who were trans. This in itself reveals how rarely LGBT+ people are asked to speak about how dementia has shaped their lives in academic research. Our reflexive thematic analysis indicates that LGBT+ people with dementia and their care partners endure overlapping forms of disadvantage. This results in heightened experiences of fear and discrimination, lack of services and compounded social isolation. Importantly, while dementia was embodied as interference and loss by LGBT+ people, it was their gender and sexuality differences that provided solace, even in the face of disadvantage. Importantly, people's relationships with LGBT+ identities were framed as fundamental for safety, resilience and wellbeing, rather than a complicating or confounding factor in living with dementia. [ABSTRACT FROM AUTHOR]

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.

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]