Publications by authors named "Peter Aggleton"

74 Publications

Intersex: cultural and social perspectives.

Cult Health Sex 2021 Apr 30;23(4):431-440. Epub 2021 Mar 30.

The Australian National University, Australia & The Centre for Gender and Global Health, UCL, UK.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/13691058.2021.1899529DOI Listing
April 2021

Stigma as understood by key informants: A social ecological approach to gay and bisexual men's use of crystal methamphetamine for sex.

Int J Drug Policy 2021 Mar 25;94:103229. Epub 2021 Mar 25.

Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia.

This paper explores the perceptions of 35 key informants (KIs) in a range of relevant health and community sectors regarding the stigmatisation of GBM's crystal methamphetamine use and sexual practice with view to informing stigma reduction efforts. A modified social ecological model was used to guide analysis and interpretation. At the individual level, KI participants indicated that crystal methamphetamine was used by some GBM to reduce the effects of internalised stigma. At the network level, KIs thought that some drugs and types of use could attract more stigma and that this could erode support from GBM networks for men who use crystal. KIs felt that few "mainstream" organisations could provide appropriate services for GBM who use crystal and furthermore, that there was significant work to "undo" misperceptions of the harms of crystal use. At the policy level, mass media anti-drug campaigns were seen to be a significant generator of stigma with irrelevant and patronising messages that lacked useful information. Efforts to reduce stigma about crystal methamphetamine use amongst GBM must address individual, network, organisation and policy issues and be underpinned by understandings of social power in relation to sex, sexuality, drug use, infectious status and sexual minorities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.drugpo.2021.103229DOI Listing
March 2021

Waiting to be seen: social perspectives on trans health.

Health Sociol Rev 2021 Mar;30(1):1-8

Centre for Social Research in Health, UNSW Sydney, Sydney, Australia.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/14461242.2020.1868900DOI Listing
March 2021

Priorities and practices of risk reduction among gay and bisexual men in Australia who use crystal methamphetamine for sex.

Int J Drug Policy 2021 Feb 15;93:103163. Epub 2021 Feb 15.

Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia.

Crystal methamphetamine (hereafter crystal) is associated with deleterious health outcomes, such as drug dependence and physical and mental health disorders. While some harms from crystal use can affect all users, there may be additional risks for people who combine the use of drug with sex. Compared with the broader population, gay and bisexual men in Australia report a higher prevalence of methamphetamine use, and crystal is the most commonly injected illicit drug among this population. The Crystal, Pleasures and Sex between Men research project was conducted between 2017 and 2019 and examined gay and bisexual men's crystal use in four capital cities in Australia, with the aim of identifying how to best support men who use crystal for sex. In this article, we examine how risk is understood and prioritised by gay and bisexual men who combine crystal use and sex and identify the range of risk reduction practices that they used. We classified these risks as those associated with the transmission of HIV, HCV and STIs, and those associated with dependence on either crystal or the sex it facilitated. Gay and bisexual men overwhelmingly prioritised the risk of dependence over any other risks associated with crystal-enhanced sex, and this prioritization was reflected in the risk reduction practices they employed. While some of the strategies that gay and bisexual men have adopted may contradict anticipated public health principles, they derive from a carefully considered and shared approaches to the generation of pleasure, the maintenance of a controlled form of feeling "out of control", and the negotiated reduction of risk. The consolidation of these strategies effectively constitutes a "counterpublic health" underpinned by forms of "sex-based sociality", which gives primacy to the priorities and practices of gay and bisexual men in Australia who combine crystal and sex.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.drugpo.2021.103163DOI Listing
February 2021

Working with Aboriginal young people in sexual health research: a peer research methodology in remote Australia.

Qual Health Res 2021 Jan 3;31(1):16-28. Epub 2020 Oct 3.

University of Queensland, Brisbane, Queensland, Australia.

In a context of ongoing colonization and dispossession in Australia, many Aboriginal people live with experiences of health research that is done "on" rather than "with" or "by" them. Recognizing the agency of young people and contributing to Aboriginal self-determination and community control of research, we used a peer research methodology involving Aboriginal young people as researchers, advisors, and participants in a qualitative sexual health study in one remote setting in the Northern Territory, Australia. We document the methodology, while critically reflecting on its benefits and limitations as a decolonizing method. Findings confirm the importance of enabling Aboriginal young people to play a central role in research with other young people about their own sexual health. Future priorities include developing more enduring forms of coinvestigation with Aboriginal young people beyond data collection during single studies, and support for young researchers to gain formal qualifications to enhance future employability.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1049732320961348DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750674PMC
January 2021

Enhancing HIV Prevention: Social Support, Access to, and Use of HIV Testing, Treatment, and Care Services in Fishing Communities Around Lake Victoria, Uganda.

AIDS Educ Prev 2020 06;32(3):196-211

Centre for Social Research in Health and Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Australia.

In-depth interviews were conducted with 42 HIV-positive fisherfolk and 15 health care providers to identify experiences of social support and its influence on access to and use of HIV testing, treatment, and care. Fisherfolk participants reported receiving support at some point. Prior to HIV diagnosis, this usually took the form of advice on what illness they were dealing with and remedies to use. After HIV diagnosis and disclosure to friends or family, emotional support enabled fisherfolk to come to terms with an HIV diagnosis, informational support offered guidance on how best to live with HIV, while instrumental support enabled access to relevant HIV services. Finally, affiliative support, in the form of new friends met through HIV clinic visits, provided a sense of belonging. Each of these different kinds of support assisted fisherfolk to respond positively to HIV with important consequences for secondary and tertiary prevention.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1521/aeap.2020.32.3.196DOI Listing
June 2020

Young Aboriginal people's sexual health risk reduction strategies: a qualitative study in remote Australia.

Sex Health 2020 08;17(4):303-310

Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Level 6, Wallace Wurth Building, UNSW Sydney, Sydney, NSW 2052, Australia; and Burnet Institute, Melbourne, Vic. 3004, Australia.

Background Surveillance data indicate that Aboriginal and Torres Strait Islander young people are more likely than their non-Indigenous counterparts to experience sexually transmissible infections (STIs) and teenage pregnancy. Despite increasing emphasis on the need for strengths-based approaches to Aboriginal sexual health, limited published data document how young Aboriginal people reduce sexual health risks encountered in their everyday lives.

Methods: In-depth interviews with 35 young Aboriginal women and men aged 16-21 years in two remote Australian settings were conducted; inductive thematic analysis examining sexual health risk reduction practices was also conducted.

Results: Participants reported individual and collective STI and pregnancy risk reduction strategies. Individual practices included accessing and carrying condoms; having a regular casual sexual partner; being in a long-term trusting relationship; using long-acting reversible contraception; having fewer sexual partners; abstaining from sex; accessing STI testing. More collective strategies included: refusing sex without a condom; accompanied health clinic visits with a trusted individual; encouraging friends to use condoms and go for STI testing; providing friends with condoms.

Conclusion: Findings broaden understanding of young Aboriginal people's sexual health risk reduction strategies in remote Aboriginal communities. Findings signal the need for multisectoral STI prevention and sexual health programs driven by young people's existing harm minimisation strategies and cultural models of collective support. Specific strategies to enhance young people's sexual health include: peer condom distribution; accompanied health service visits; peer-led health promotion; continued community-based condom distribution; enhanced access to a fuller range of available contraception in primary care settings; engaging health service-experienced young people as 'youth health workers'.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1071/SH19204DOI Listing
August 2020

Playing Recognition Politics: Queer Theoretical Reflections on Lesbian, Gay, and Queer Youth Social Policy in Australia in the 1980s and 1990s.

Arch Sex Behav 2020 10 5;49(7):2341-2352. Epub 2020 Jul 5.

School of Sociology, Research School of Social Sciences Building 22, Haydon Allen Building, The Australian National University, Canberra, ACT, 2601, Australia.

This article provides a queer theoretical reflection on the emergence of lesbian, gay, and queer (LGQ) youth as subjects of policy attention in Australia in the late twentieth century. In particular, it focuses on the ways in which specific forms of social, bureaucratic, and organizational recognition have given shape to LGQ youth as categorical policy objects. To this end, this article critically interrogates social policy related to the provision of funding for LGQ youth support during the 1980s and 1990s in two Australian states: New South Wales and Western Australia. More specifically, it focuses on some of the ways in which LGQ youth have been discursively shaped and materially supported in three different organizations, two of which continue to be strongly associated with support of LGQ youth in Australia. This study of the emergence of these organizations, resourced by three different sectors-the state, the church, and the LGQ community itself-necessarily draws on ephemeral resources, reflecting the conditions of possibility in which this work was being enacted. We conclude with an analysis of the necessity for situating policy recognitions within specific contexts to examine the implications for LGQ youth as the subjects such recognitions simultaneously seek to constitute and serve.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10508-020-01751-6DOI Listing
October 2020

Justice in sexual and reproductive health.

Cult Health Sex 2020 07;22(7):741-743

Centre for Gender and Global Health, UCL, London, UK.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/13691058.2020.1776509DOI Listing
July 2020

Practical justice as an innovative approach to addressing inequalities facing gender and sexually diverse people: a case example from Papua New Guinea.

Cult Health Sex 2020 07 6;22(7):822-837. Epub 2020 May 6.

Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.

Cultural values and practices influence many aspects of sexual and reproductive health and rights - from access to and quality of health education and services, to gender roles and responsibilities, to family planning and sexual freedoms. Culture is frequently marginalised in epidemiologically driven analyses of sexual and reproductive health and rights yet remains central to the ways in which inequalities within these fields manifest themselves and are engaged with in society. Using Papua New Guinea (PNG) as a case example, this paper sheds light on the enabling and restrictive role of culture in efforts to work towards equity and justice for gender and sexually diverse people. Drawing on four case stories, we offer insight into where culture can and has been deployed to redress serious inequalities in what is often a hostile environment. In these stories we illustrate how practical justice provides an innovative way to approach issues to do with sexual and reproductive health, particularly as they relate to enhancing the lives of people in visible, grassroots ways. In this way, given evidence, good normative judgement and the opportunity to do good and be fair, practical justice may be seen to be taking place.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/13691058.2020.1736633DOI Listing
July 2020

Young Aboriginal people's engagement with STI testing in the Northern Territory, Australia.

BMC Public Health 2020 Apr 6;20(1):459. Epub 2020 Apr 6.

Kirby Institute for infection and immunity in society, Level 6, Wallace Wurth Building, UNSW Sydney, Sydney, NSW, 2052, Australia.

Background: Australian surveillance data document higher rates of sexually transmissible infections (STIs) among young Aboriginal people (15-29 years) in remote settings than non-Aboriginal young people. Epidemiological data indicate a substantial number of young Aboriginal people do not test for STIs. Rigorous qualitative research can enhance understanding of these findings. This paper documents socio-ecological factors influencing young Aboriginal people's engagement with clinic-based STI testing in two remote settings in the Northern Territory, Australia.

Methods: In-depth interviews with 35 young Aboriginal men and women aged 16-21 years; thematic analysis examining their perceptions and personal experiences of access to clinic-based STI testing.

Results: Findings reveal individual, social and health service level influences on willingness to undertake clinic-based STI testing. Individual level barriers included limited knowledge about asymptomatic STIs, attitudinal barriers against testing for symptomatic STIs, and lack of skills to communicate about STIs with health service staff. Social influences both promoted and inhibited STI testing. In setting 1, local social networks enabled intergenerational learning about sexual health and facilitated accompanied visits to health clinics for young women. In setting 2, however, social connectedness inhibited access to STI testing services. Being seen at clinics was perceived to lead to stigmatisation among peers and fear of reputational damage due to STI-related rumours. Modalities of health service provision both enhanced and inhibited STI testing. In setting 1, outreach strategies by male health workers provided young Aboriginal men with opportunities to learn about sexual health, initiate trusting relationships with clinic staff, and gain access to clinics. In setting 2, barriers were created by the location and visibility of the clinic, appointment procedures, waiting rooms and waiting times. Where inhibitive factors at the individual, social and health service levels exist, young Aboriginal people reported more limited access to STI testing.

Conclusions: This is the first socio-ecological analysis of factors influencing young Aboriginal people's willingness to undertake testing for STIs within clinics in Australia. Strategies to improve uptake of STI testing must tackle the overlapping social and health service factors that discourage young people from seeking sexual health support. Much can be learned from young people's lived sexual health experiences and family- and community-based health promotion practices.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12889-020-08565-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137447PMC
April 2020

Destabilising the 'problem' of chemsex: Diversity in settings, relations and practices revealed in Australian gay and bisexual men's crystal methamphetamine use.

Int J Drug Policy 2020 04 14;78:102697. Epub 2020 Feb 14.

Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2054, Australia.

In Australia, the crystalline form of methamphetamine ("crystal") is a commonly used illicit substance associated with sexual activity among gay and bisexual men. Attention to psychoactive substance use among this population is the subject of increasing global concern regarding the intentional and simultaneous combination of sex and drugs, often referred to as "chemsex". While not all gay and bisexual men who use psychoactive substances report problematic use, those who do often become representative of chemsex practices more generally, and the harms they experience become attributable to all men who use drugs for sex. The way in which these practices have been framed over the past few decades contributes to the rise of a narrow set of understandings of chemsex defined by the circumstances and behaviours presumed of drug-enhanced sexual activity. In effect, these understandings now align recognisable combinations of sexual and drug-using practices with assumed correlates of risk. The Crystal, Pleasures and Sex between Men study conducted 88 interviews with gay and bisexual men in four Australian cities between 2017 and 2018. Findings from the project revealed that men used crystal in a variety of settings and relations, which mediated their sexual practices and patterns of use. In looking at the wider context in which practices were associated with the combination of sex and drugs, we identified experiences that the contemporary discourse of chemsex-in its rhetorical proposition of at-risk behaviours and circumstances-may leave out of consideration. Our findings indicate that researchers should remain open to the variability and contingency of settings, relations and practices in gay and bisexual men's different networks when recommending public health responses to their engagement in drug-enhanced sexual activity. Accordingly, we seek to destabilise the definition of chemsex that precludes consideration of the influence of experiences beyond pre-determined risk parameters.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.drugpo.2020.102697DOI Listing
April 2020

Accessing HIV treatment and care services in fishing communities around Lake Victoria in Uganda: mobility and transport challenges.

Afr J AIDS Res 2019 Sep;18(3):205-214

Centre for Social Research in Health , UNSW Sydney , Australia.

Qualitative research exploring the influence of community-level factors on access to and use of HIV treatment and care services among people living in fishing communities is limited, especially with respect to those already in receipt of HIV care and on treatment. To enhance understanding of these issues, semi-structured in-depth interviews were conducted with 42 HIV-positive fisherfolk and 15 health care providers from two HIV clinics located in two fishing communities in Uganda. Fisherfolk's mobility and poor transport systems were significant barriers to access to and use of HIV treatment and care. Mobility, which involved regular movement between communities, sometimes led to fisherfolk's inability to access HIV treatment and care. A poor transport system in fishing communities - characterised by irregular transport services and boats in a poor condition - was reported to force both fisherfolk and health care providers sometimes to cancel journeys to centres providing treatment and support. Community-level factors such as these, which relate to the organisation and provision of transport in local community settings, are significant influences on access to HIV treatment and care. Interventions that address these challenges are needed to improve access to and use of HIV treatment and care in fishing communities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2989/16085906.2019.1648306DOI Listing
September 2019

HPV vaccination in Papua New Guinea to prevent cervical cancer in women: Gender, sexual morality, outsiders and the de-feminization of the HPV vaccine.

Papillomavirus Res 2019 12 15;8:100171. Epub 2019 Jun 15.

Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Papua New Guinea; Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Australia.

Papua New Guinea has among the highest estimated burden of cervical cancer globally, but currently lacks national cervical screening or human papillomavirus (HPV) vaccination programmes. The Papua New Guinean government is committed to introducing the HPV vaccine for primary prevention, but locally-relevant research evidence is not available to guide implementation. Experience from earlier Papua New Guinean health programmes suggests that appropriate engagement with local health cosmologies and cultures for health/wellbeing, illness/disease, and recognition of the role of 'outsiders' in preventing, promoting or contributing to sickness, are essential to the successful introduction of biomedical interventions in this setting. We describe findings from a multi-site qualitative study undertaken in three provinces in Papua New Guinea (2012-14). Twenty-one gender specific focus group discussions and 82 semi-structured interviews, with a total of 208 participants, were conducted. There was strong community support for the introduction of the HPV vaccine for cervical cancer prevention in Papua New Guinea. Significantly, and despite being officially discussed in the context of a planned future intervention focusing on vaccinating young girls to prevent cervical cancer, the intervention was de-feminised, where both girls and boys were supported to be vaccinated in any HPV programme in Papua New Guinea.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.pvr.2019.100171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6595234PMC
December 2019

The myth of LGBTQ mobilities: framing the lives of gender- and sexually diverse Australians between regional and urban contexts.

Cult Health Sex 2020 03 12;22(3):321-335. Epub 2019 Apr 12.

School of Communication and Creative Arts, Deakin University, Burwood, Victoria, Australia.

Gender- and sexually diverse youth are often represented in popular discourses through concepts of movement and mobility. Conceptual stories of LGBTQ youth transitions to adulthood in particular are marked by narratives of movement from regional (rural and/or small towns) to major urban areas. Although not wholly outside lived experience, a cultural myth that portrays the experience of gender- and sexually diverse young people entering into 'adulthood' via such mobility continues to circulate in scholarship, popular media, personal accounts of coming out, support resources and self-help guidance documents. This paper draws on a recent study of gender and sexual diversity, support and belonging to examine instances of LGBTQ youth mobility in relation to participant interviews and focus groups undertaken in an Australian project examining two generations of sexually diverse subjects' views on growing up, support and belonging. Participants differed generationally in how they experienced mobility from regional to urban settings, demonstrating that contemporary real-world accounts of such mobility are complex, nuanced and diverse and that the felt 'expectation' that one should migrate to a city in order to live a full gender- or sexually diverse life has waned among young people in the more recent generation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/13691058.2019.1600029DOI Listing
March 2020

HIV Education: Reflections on the Past, Priorities for the Future.

AIDS Educ Prev 2018 06;30(3):254-266

Afro-German social scientist and activist who has worked as an independent consultant for various United Nations agencies and the Centre for Social Research in Health at UNSW, Sydney, Australia.

From early in the epidemic, education has been central to HIV prevention, treatment, and care. This paper reflects on lessons learned over the last 30 years. It signals the limits of high level international commitments to education and HIV and the strategies of information-giving and life skills development adopted in their wake. It argues for the adoption of a more genuinely educational approach to HIV, sex, and sexuality education in which difficult questions are raised, diversity is recognized, and options are provided for a differentiated yet effective response. The lead currently offered by community organizations and the social media should be built upon in developing forms of HIV education that are more honest and contextually relevant than previously.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1521/aeap.2018.30.3.254DOI Listing
June 2018

The rush to risk when interrogating the relationship between methamphetamine use and sexual practice among gay and bisexual men.

Int J Drug Policy 2018 05 24;55:242-248. Epub 2017 Dec 24.

Centre for Social Research in Health University of New South Wales, Sydney, NSW 2052, Australia. Electronic address:

Much research concerning drug use in the context of sexual activity among gay and bisexual men derives from public health scholarship. In this paper, we critically examine how the relationship between methamphetamine use and sexual risk practice is treated and understood in this body of research. While public health has made important contributions to establishing the link between methamphetamine use and sexual risk-taking, the precise nature of the relationship is not well defined. This creates space for ungrounded assumptions about methamphetamine use to take hold. We outline what appear to be two dominant interpretations of the methamphetamine/sexual practice relationship: the first proposes that methamphetamine has specific pharmacological properties which lead to sexual disinhibition, risky behaviour and poor health outcomes; the second proposes that methamphetamine attracts men who are already inclined toward highly sexualised interactions and risky practice, and that such men are likely to engage in these practices with or without drugs. We suggest that both interpretations are problematic in that they individualise and cast drug and sex practices as inherently risky and biopsychologically determined. We outline a more historically, socially and politically engaged way to understand methamphetamine use in the context of sexual activity by drawing on the concept of sex-based sociality and the ways in which gay and bisexual men may use methamphetamine and sex as social resources around which to build identities, establish relationships, participate in gay communities, and maximise pleasure while protecting themselves and others from harm.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.drugpo.2017.12.010DOI Listing
May 2018

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights.

Glob Public Health 2018 Oct 16;13(10):1341-1356. Epub 2017 Nov 16.

a Centre for Social Research in Health , UNSW Australia , Kensington , NSW , Australia.

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described - fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/17441692.2017.1401652DOI Listing
October 2018

I shouldn't talk of medicine only: Biomedical and religious frameworks for understanding antiretroviral therapies, their invention and their effects.

Glob Public Health 2018 10 16;13(10):1454-1467. Epub 2017 Sep 16.

d Australian Institute of Health Innovation , Macquarie University , Sydney , Australia.

Medical pluralism offers a long-standing means of analysing the different ways in which health and illness can be interpreted and responded to. It is not unusual for multiple health systems and meanings to co-exist at any one moment in time, offering different ways of understanding and responding to illness and disease. In addition to biomedical frameworks, religious beliefs offer another important means of facilitating healing. Based on qualitative interviews with 36 people living with HIV on antiretroviral therapies (ART) in Papua New Guinea (PNG), this paper examines the ways in which people bring together and synthesise religious and biomedical therapeutic approaches to the treatment and management of HIV. For most, ART is viewed as a divine gift to complement a regime of spiritual salvation, and adherence to treatment carries with it strong religious undertones. At the same time, ART provides a sense of hope for those living with a virus that was previously associated only with death. Brought together, these narratives provide important insights into the meanings of ART and the role of religion, prayer and repentance for people in PNG. The study also provides new insight into how people with HIV actively synthesise different approaches to health and healing.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/17441692.2017.1377746DOI Listing
October 2018

Sex education: findings from the Second Australian Study of Health and Relationships.

Sex Health 2017 06;14(3):293-295

School of Public Health, Level 3, Edward Ford Building, University of Sydney, Sydney, NSW 2052, Australia.

In a national telephone-based survey, information on sexual behaviour and outcomes were collected from 20091 randomly selected Australians in 2012-13. Data were weighted and analysed to determine the proportion of those who had received school-based sex education and to examine the associations between sex education and sexual health outcomes, specifically a history of a sexually transmissible infection (STI), early pregnancy, contraception use at first sex, and level of STI knowledge. Just over half the respondents (53%; n=19836) reported receiving sex education that included information about condoms and contraception. Using logistic regression analysis after adjusting for age, education and non-English-speaking background, we found that sex education was strongly associated with increased odds of using contraception at first vaginal intercourse (odds ratio (OR)=1.57; 95% confidence interval (CI) 1.44-1.71; P<0.001) and higher levels of STI knowledge (OR=1.75; 95% CI 1.46-2.12; P<0.001).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1071/SH16215DOI Listing
June 2017

The trouble with 'Categories': Rethinking men who have sex with men, transgender and their equivalents in HIV prevention and health promotion.

Glob Public Health 2016 Aug-Sep;11(7-8):819-23. Epub 2016 May 18.

a Department of Sociomedical Sciences , Columbia Mailman School of Public Health , New York , NY , USA.

This double Special Issue of Global Public Health presents a collection of articles that seek more adequately to represent sexual and gender diversities and to begin to rethink the relationship to HIV prevention and health promotion - in both the resource rich nations of the global North, as well as in the more resource constrained nations of the global South. Reckoning with the reality that today the global response to HIV has failed to respond to the needs of gay, bisexual and other men who have sex with men, and transgender persons, we turn our attention to processes and practices of categorisation and classification, and the entanglement of the multiple social worlds that constitute our understanding of each of these categories and people within the categories. Jointly, these articles provide critical perspectives on how defining and redefining categories may impact the conceptual frameworks and empirical evidence that inform global understandings of HIV infection, those communities most vulnerable, and our collective response to the evolving HIV epidemic.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/17441692.2016.1185138DOI Listing
January 2018

Hepatitis C knowledge among gay and other homosexually active men in Australia.

Drug Alcohol Rev 2016 07 15;35(4):477-83. Epub 2015 Sep 15.

Centre for Social Research in Health, UNSW Australia (The University of New South Wales), Sydney, Australia.

Introduction And Aims: Gay and other homosexually active men (hereafter 'gay men') are at elevated risk of becoming infected with hepatitis C virus (HCV) via injecting drug use and sexual risk practices. This paper aimed to measure HCV knowledge among gay men in Australia and whether knowledge differed according to HCV risk.

Design And Methods: In 2013, a cross-sectional, online survey of 405 Australian gay men explored the social aspects of HCV. Bivariate and multivariate linear regressions were used to examine factors associated with higher HCV knowledge.

Results: The mean age of respondents was 39.2 years (SD = 13.3), and most men (75.3%) were born in Australia. According to self-report, 32.1% were HIV-positive, 3.0% were HCV-positive and 8.9% were HIV/HCV co-infected. The mean number of correct HCV knowledge items was 8.2 (SD = 3.9; range 0-15). In a multivariate analysis, higher HCV knowledge was associated with higher educational attainment, being HCV-positive, being HIV-positive and injecting drug use.

Discussion And Conclusions: HCV knowledge among gay men was moderately good, although knowledge of testing, treatment and natural history of HCV was generally quite poor. Encouragingly, higher knowledge was reported among men at highest HCV risk. Viral hepatitis and HIV organisations, together with general practitioners and other health services, should continue to target gay men at a high risk of acquiring HCV with education and health promotion. [Lea T, Hopwood M, Aggleton P. Hepatitis C knowledge among gay and other homosexually active men in Australia. Drug Alcohol Rev 2016;35:477-483].
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dar.12333DOI Listing
July 2016

Factors associated with women's entry into the sex industry: findings from interviews conducted with female sex workers in Chinese detention centres.

Sex Health 2015 Nov;12(6):541-5

Centre for Social Research in Health, UNSW Australia, Sydney, NSW 2052, Australia.

Background: To date, limited research has been conducted to identify the personal and contextual factors that contribute to women's entry into the sex industry in China.

Methods: The reasons for and factors associated with voluntary entry into the sex industry were explored through in-depth interviews conducted with 38 Chinese women who were held in detention centres for selling sex.

Results: Women's personal accounts reveal that entry into sex work is influenced by life aspirations, family responsibilities and social connections, which facilitate mobility to a new urban environment in which they encounter opportunities and challenges. Findings highlight the complex interactions between individual and contextual factors in relation to women's entry into sex work.

Conclusions: In a rapidly developing country such as China, entry into sex work may appeal to women of low socioeconomic status, particularly young women who have recently migrated to urban areas. For members of this mobile and relatively disadvantaged population, comprehensive social services and support are urgently needed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1071/SH14009DOI Listing
November 2015

Moving Beyond Biomedicalization in the HIV Response: Implications for Community Involvement and Community Leadership Among Men Who Have Sex with Men and Transgender People.

Am J Public Health 2015 Aug 11;105(8):1552-8. Epub 2015 Jun 11.

Peter Aggleton is with the Centre for Social Research in Health, University of New South Wales (UNSW) Australia, Sydney. Richard Parker is with the Center for the Study of Culture, Politics and Health, Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, and the Institute of Social Medicine, Rio de Janeiro State University, and the Brazilian Interdisciplinary AIDS Association (ABIA), Rio de Janeiro, Brazil.

As the world enjoys the promise of biomedical advances against HIV, numerous challenges remain. Some of these are connected to politics, others are connected to resource constraints. Other barriers are linked to the need to ensure that the concepts used to think about HIV remain current. Terms such as "MSM" (men who have sex with men) and "community" require critical interrogation at a moment when their political origins seem forgotten. Likewise, struggles between groups most affected by HIV and scientists and policymakers (an enduring feature of the epidemic) remain a key aspect of the response. The dangers of co-option and distraction remain real. In this context, it is vital to promote community ownership, political commitment, solidarity, and respect for differences, not as competing values, but as part of the ultimate solution to HIV.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2105/AJPH.2015.302614DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504295PMC
August 2015

Sex in the marketplace--what has love got to do with it?

Cult Health Sex 2015 ;17 Suppl 1:S1-4

a Columbia University , New York City , USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/13691058.2015.1009254DOI Listing
March 2016

Circumcision and HIV prevention: emerging debates in science, policies and programmes.

Glob Public Health 2015 ;10(5-6):549-51

a Department of Sociomedical Sciences, Mailman School of Public Health , Columbia University , New York , NY , USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/17441692.2015.1015705DOI Listing
February 2016

The current state of play of research on the social, political and legal dimensions of HIV.

Cad Saude Publica 2015 Mar;31(3):477-86

This paper offers a critical overview of social science research presented at the 2014 International AIDS Conference in Melbourne, Australia. In an era of major biomedical advance, the political nature of HIV remains of fundamental importance. No new development can be rolled out successfully without taking into account its social and political context, and consequences. Four main themes ran throughout the conference track on social and political research, law, policy and human rights: first, the importance of work with socially vulnerable groups, now increasingly referred to as "key populations"; second, continued recognition that actions and programs need to be tailored locally and contextually; third, the need for an urgent response to a rapidly growing epidemic of HIV among young people; and fourth, the negative effects of the growing criminalization of minority sexualities and people living with HIV. Lack of stress on human rights and community participation is resulting in poorer policy globally. A new research agenda is needed to respond to these challenges.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603422PMC
http://dx.doi.org/10.1590/0102-311x00172514DOI Listing
March 2015

Multiple strategies are required to address the information and support needs of gay and bisexual men with hepatitis C in Australia.

J Public Health (Oxf) 2016 Mar 26;38(1):156-62. Epub 2015 Jan 26.

Centre for Social Research in Health, University of New South Wales Australia, Sydney 2052, Australia.

Background: Hepatitis C virus (HCV) infection is increasingly reported among gay and bisexual men. However, little is known about the personal and social dimensions of HCV-related experience among these men in Australia.

Methods: An online survey of 474 Australian gay and bisexual men was conducted from August to December 2013. A subsample of 48 HCV mono-infected and HIV/HCV co-infected men was analysed to explore HCV knowledge, sources of information, unmet information needs and use of HCV-related services.

Results: More than half of respondents in the subsample were unaware that HIV infection increases the risk of sexually acquired HCV and most wanted information about how to prevent the sexual transmission of HCV. A majority of respondents requested gay-specific HCV services, and approximately similar proportions of men indicated that they would like these services delivered by a hepatitis organization, a lesbian, gay, bisexual, transgender and intersex (LGBTI) organization and a HIV organization. Men in receipt of HIV antiretroviral treatments were most likely to request that gay-specific HCV information and support services be delivered by a LGBTI or HIV organization (OR = 8.63).

Conclusion: These findings suggest that a variety of organizations are required to address the information and support needs of Australian gay and bisexual men with HCV.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/pubmed/fdv002DOI Listing
March 2016

Drug, sex and sociality: factors associated with the recent sharing of injecting equipment among gay and bisexual men in Australia.

Int J Drug Policy 2015 Feb 13;26(2):210-3. Epub 2014 Nov 13.

Centre for Social Research in Health, UNSW-Australia, Sydney 2052, Australia.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.drugpo.2014.10.013DOI Listing
February 2015