Effective partnership and adequate investment underpin a successful response: key factors in dealing with HIV increases

Sexual Health ◽  
2008 ◽  
Vol 5 (2) ◽  
pp. 193 ◽  
Author(s):  
Diana Bernard ◽  
Susan Kippax ◽  
Don Baxter

Background: Australia has mounted an effective response to HIV and AIDS by investing in evidence-informed policy. Recently, in response to increases in HIV in some states in Australia, the New South Wales Department of Health set up a ‘think tank’ to examine differences in epidemiological and behavioural data, policies, strategies and community responses in order to account for state-based differences and ensure an effective ongoing response to HIV. Methods: The National Centre in HIV Social Research undertook key informant interviews with major stakeholders to help understand differences in responses by the three states most affected by HIV in Australia – Queensland, New South Wales and Victoria. In parallel, the Australian Federation of AIDS Organisations completed an analysis of the investments in HIV-prevention activities targeting gay men in all jurisdictions in Australia. The Australian Federation of AIDS Organisations also analysed the strategic contexts and government responses to HIV in the three states. Results: There were significant differences between New South Wales, Queensland and Victoria in the way the HIV partnership functions. Type of prevention strategy and level of financial investment in prevention activities appear to be related to the effectiveness of the ongoing response to HIV. Conclusions: An active commitment to and adequate resourcing of HIV prevention by all stakeholders in the HIV partnership – government and non-government departments, researchers and gay community organisations – is crucial if Australia is to respond effectively to HIV among gay and other men who have sex with men.

Sexual Health ◽  
2008 ◽  
Vol 5 (2) ◽  
pp. 97 ◽  
Author(s):  
Garrett Prestage ◽  
Jason Ferris ◽  
Jeffrey Grierson ◽  
Rachel Thorpe ◽  
Iryna Zablotska ◽  
...  

Objectives: To assess the size, distribution and changes in the population of homosexual and bisexual men in Australia, and the capacity of available measures to make this estimation. Methods: We used data from five sources: the Australian Study of Health and Relationships, the Gay Community Periodic Surveys, HIV Futures, the Health in Men cohort study, the Australian National HIV and AIDS Registries and the Australian Household Census. Results: We estimated that in 2001 there were ~74 000 homosexual and bisexual men in New South Wales (NSW), ~42 000 in Victoria and ~37 000 in Queensland. There was, however, some discrepancy between datasets in the estimates of the overall proportions and distribution of homosexual and bisexual men across states. We also estimated HIV prevalence rates among homosexual and bisexual men in 2001 at ~8% in NSW, 5% in Victoria and 4% in Queensland. There were insufficient data to estimate whether the state-specific populations of homosexual men were changing with time. Conclusion: There are ~75% more homosexual and bisexual men in NSW than in Victoria and about twice as many as in Queensland. There are about two-thirds as many HIV-positive men in NSW as in Victoria and Queensland combined. Improved collection of population-based data on homosexuality are required.


Sexual Health ◽  
2008 ◽  
Vol 5 (2) ◽  
pp. 125 ◽  
Author(s):  
Iryna B. Zablotska ◽  
Garrett Prestage ◽  
Andrew E. Grulich ◽  
John Imrie

Background: In Australia, the HIV epidemic is concentrated among gay men. In recent years, the number of new diagnoses stabilised in New South Wales (NSW), but increased in other states. We reviewed the trends in sexual behaviours to explain this difference. Methods: We used the Gay Community Periodic Surveys in NSW, Victoria and Queensland during 1998–2006 and restricted analyses to the 30–49 year olds who contribute most of the HIV cases. We used the χ2-test for trends in unprotected anal intercourse with casual partners (UAIC) and regular partners, number of partners, type of relationships, knowledge of HIV serostatus and its disclosure. We compared behaviours of HIV-positive and -negative men and men across states using logistic regression adjusted for the year of report. Results: Trends in behaviours differed across the states: following a period of increase, UAIC prevalence declined in NSW since 2001, but continued to increase in Victoria and Queensland. There were other changes in NSW that were not observed in Victoria and Queensland: a decline in factors increasing HIV risk (the proportions of men with multiple sex partners and men engaging in UAIC and not knowing or not disclosing HIV serostatus) and an increase in behaviours reducing it (the proportions of men in monogamous relationships and men disclosing HIV serostatus while having UAIC). Conclusion: There were patterns of declining HIV risk behaviours in NSW, and increasing risk behaviours elsewhere, that mirrored recent changes in HIV case notifications in Australia. These data suggest that behavioural surveillance can predict changes in HIV epidemiology.


Sexual Health ◽  
2018 ◽  
Vol 15 (6) ◽  
pp. 595 ◽  
Author(s):  
Heather-Marie A. Schmidt ◽  
Ruthy McIver ◽  
Rebecca Houghton ◽  
Christine Selvey ◽  
Anna McNulty ◽  
...  

There is little evidence and no standardised model for nurse-led HIV pre-exposure prophylaxis (PrEP). In 2016, public sexual health clinics in the state of New South Wales (NSW), Australia, participating in the population-scale PrEP access trial Expanded PrEP Implementation In Communities in New South Wales (EPIC-NSW) were authorised to adopt a nurse-led model of PrEP provision in order to facilitate the rapid expansion of PrEP access to more than 8000 participants in under 2 years without additional resources. The model has been implemented successfully in public clinics in 10 of 14 local health districts, with widespread support and no serious safety events reported. With the increasing importance of PrEP as an HIV prevention tool, non-traditional models of care, including nurse-led PrEP, are needed.


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