Sex, gender and sexuality

ARCSHS is the major player in framing the agenda and delivering the evidence to understand sex and sexuality in contemporary Australia. Through national surveys of the general population, the Centre helps track patterns and practices across the life course and across time. Over the next three years, ARCSHS will seek to maintain, profile, and draw upon these major research activities to influence policy and practice.

ARCSHS will also define and build on areas of expertise in specific aspects of health and wellbeing with diverse sexuality and gender minorities, including same-sex-attracted and gender-questioning young people. The Centre also has a focus on the intersection of sexuality with ageing, disability, and mental health.

ARCSHS has a focus on gender and its intersection with sexuality and health. This involves research into the conditions that normalise violence and abuse, and the ways that these cultures can be changed to promote respect and non-violence. ARCSHS research provides evidence upon which to base policy development and culture change programs in settings in a wide range of community, sport, workplace, and education settings.

The Second Australian Study of Health and Relationships

Anthony Smith, Juliet Richters (University of New South Wales), Chris Rissel (University of Sydney), Richard de Visser (University of Sussex, UK), Judy Simpson (University of Sydney) and Andrew Grulich (Kirby Institute)

The Australian Study of Health and Relationships (ASHR) is our most important study of sexual and reproductive health. Conducted once a decade, it provides a snapshot of the sexual health and well-being of the Australian population and provides information essential for the development of policy and the delivery of sexual and reproductive health programs across Australia.

The survey is anonymous and people aged 16-69 from randomly selected households are personally invited to take part. The survey is designed to accurately reflect the experiences of all Australians regardless of their relationship status or whether they are sexually active. In order to achieve this, the interview is specifically tailored to the history the participant reports and does not ask questions that, given the history of the participant, are not relevant.

The types of questions that might be asked include a sexual history, partnership status, health status, recent sexual activity, sexual difficulties, reproductive history, sexual coercion and intimate partner violence, information about sexually transmitted infections along with knowledge and attitudes related to sexuality and sexual health. Interviews average less than 20 minutes.

Australian Longitudinal Study of Health and Relationships

Anthony Smith, Marian Pitts, Julia Shelley, Juliet Richters (University of New South Wales), Judy Simpson (University of Sydney), Richard Ryall, Wendy Heywood and Kent Patrick

This NHMRC-funded study was established in 2003 to document the natural history of sexual and reproductive health in the Australian population. Evidence provided from this study will allow for more effective sexual health interventions and will enable researchers to understand the links between ‘risk events’ and health outcomes. In 2005, the first wave of data was collected and the fifth and final wave of data collection was completed in 2010. The results of this ground-breaking study will not only provide the foundations for future research but will be used to inform government policies, health professionals, and the Australian public as a whole. Numerous articles from the study have been published or accepted for national and international publication.

Sexual Well-being and Ageing: A study of Older Australian Women

Marian Pitts, Victor Minichiello and Gail Hawkes (University of New England)

This study of the sexuality of older women is the first to examine a significant cohort of women now entering old age: the women who demanded freedom of sexual expression in the swinging sixties. They present a unique historic opportunity to explore the subjective world of the first generation of post-sexual liberation women growing old sexually. This project will undertake a qualitative analysis of the sexual subjectivities, health and wellbeing of women born between 1930 and 1950 to identify and challenge the complex relationships between ageism, sexism and sexual subjectivity, and develop a conceptual framework that advances our understanding of sex and sexuality in older women.

The Australian Sexual Health Teachers Study

Anthony Smith, Marian Pitts, Anne Mitchell, Marisa Schlichthorst, Jenny Walsh, Anthony Lyons and Pam Blackman

Teachers of sexual health in Australian government and non-government secondary schools are one of the most important sexual health promotion and STIs (including chlamydia) prevention workforces. There is a large body of national and international research on the key elements of what makes sex education effective in reducing STIs and unwanted pregnancy, delaying first sex and numbers of sexual partners and accessing sexual health services. This study develops a picture of what currently constitutes the sexual health education workforce in Australian secondary schools and documents barriers to and facilitators of successful sexual health education from the teacher’s perspective. In addition, it identifies best practice principles and minimum standards for sexual health teacher training, both pre- and in-service. More than 300 secondary teachers were surveyed and this data is currently under analysis.

Using Mathematical Models to Assess the Impact of Interventions to Reduce Sexually Transmitted Infections in Australia

Jane Hocking (University of Melbourne), David Regan (Kirby Institute), David Wilson (Kirby Institute), David Philp (University of New South Wales) and Anthony Smith

This NHRMC grant-funded study aims to: 1) develop dynamic mathematical models to describe the transmission of chlamydia, gonorrhoea, syphilis and HIV in Australian populations, 2) use these models to evaluate the impact of interventions on the incidence and prevalence of chlamydia, gonorrhoea, syphilis and HIV in Australian populations and 3) develop mathematical models describing the sexual behaviour of Australian populations. The evaluations have and will specifically consider the impact of: screening on the incidence and prevalence of chlamydia infection among heterosexuals in Australia; contact tracing strategies on the incidence and prevalence of chlamydia infection among heterosexuals in Australia; STIs screening on the incidence and prevalence of gonorrhoea, chlamydia, syphilis and HIV among men who have sex with men (MSM) in Australia; and health promotion and education activities on the incidence and prevalence of chlamydia among heterosexuals and chlamydia, gonorrhoea, syphilis and HIV among MSM in Australia.

Planning Female and Male Vaccination and Cervical Screening Strategies to Achieve Optimal Prevention of Human Papillomavirus (HPV)-related Disease

David Regan (Kirby Institute), Anthony Smith, Andrew Grulich (Kirby Institute), Lyn Conway (CSL), Dorota Gertig (University of Melbourne), Matthew Law (Kirby Institute), Jane Hocking (University of Melbourne), Alicia Stein (CSL), Marion Saville (Victorian Cytology Service) and John Kaldor (Kirby Institute)

Australia’s National HPV Vaccination Program is a world first so it is imperative that it is closely observed and its impact fully understood. Rapidly emerging information on HPV biology and epidemiology and advances in screening technology mean that HPV-related policy must be updated. This study, funded by an ARC Linkage Grant (2008-2011), links expertises in sexual behaviour, infectious disease transmission, modelling, HPV biology and disease burden, health economics, cervical screening and surveillance. Progress to date includes the development of Australia-specific mathematical models for use to determine the vaccination program’s likely impact, how best to interrupt transmission and how to best screen for HPV-related disease.

Private Lives 2: Health and Wellbeing of People from Sexual and Gender Minorities in Australia

William Leonard, Marian Pitts, Anne Mitchell, Anthony Lyons, Anthony Smith, Sunil Patel, Murray Couch and Anna Barrett

The Private Lives Two survey is the second in a series of studies conducted at ARCSHS on the health and wellbeing of Australian people who belong to sexual and gender minority communities. In 2005, Private Lives was conducted, and the results demonstrated that the health and wellbeing of those in these communities differ in negative ways from the general population, as does their experience of access to health services. Work on the Private Lives Two survey began in 2010 with the survey conducted during 2011. The project aims to improve understanding of links between minority sexual and gender identification and health, particularly mental health, and depression in particular, as well as the links between this identification and the capacity for resilience, with the aim of improving health and wellbeing for these populations. The survey was conducted online with around 5,000 participants. Items in the survey covered the following: demographic and personal history information; self-reported general, psychological and sexual health; sexual activity; depression; alcohol and drug (including prescription) use; health service utilisation; health maintenance; relationships and their legal recognition; discrimination and victimisation; social connectivity; and cancer diagnoses.

A report of the findings is scheduled to be launched on 3 April 2012 by the Hon Mary Wooldridge, Minister for Mental Health.

Prostate Cancer Survivors’ Sexual Health and Well-being: A Pilot Study of Quality of Sexual Life and Health Services

Gary Dowsett, Duane Duncan, Murray Drummond (Flinders University), Shaun Filiault (Flinders University) and Annette Street (La Trobe University)

This pilot study, funded by a La Trobe University Faculty Research grant, is a collaboration between Gary Dowsett and Duane Duncan at ARCSHS, Associate Professor Murray Drummond and Dr Shaun Filiault at Flinders University in Adelaide, and Professor Annette Street, Associate Dean, Research, Faculty of Health Sciences at La Trobe University. The sexual function implications of prostate cancer (PCa) treatment are well documented in the scientific and medical literatures. This pilot study, situated in the fields of Sociology and Health and Illness, sought to explore men’s experience of treatment effects and sexual recovery following a diagnosis of PCa, and the health service support they have accessed to assist them. Participants were men diagnosed with PCa and who have undergone either radical prostatectomy or radiation therapy in the treatment of their cancer at least 12 months prior to recruitment. Seven men in all were interviewed in Melbourne and Adelaide. To optimise the diversity of the sample, for the purposes of testing the research interview schedule, five heterosexual and two gay men, were recruited with a mixture of single and partnered men. In all, this pilot study successfully tested an interview schedule and generated preliminary findings on men’s experiences of post-treatment recovery of sexual life following radical prostatectomy or radiation therapy for prostate cancer (PCa), which are currently being written up. Three applications for further grant funding have been developed so far from the project.

The FLEX Study: An Online Survey of Sexual Activity Before and After Prostate Cancer Survey

Gary Dowsett, Richard Wassersug (Dalhousie University), Anthony Lyons, Duane Duncan and Marian Pitts

This study was developed by ARCSHS Visiting Fellow Professor Richard Wassersug. Professor Wassersug is from the Department of Anatomy and Neurobiology, Dalhousie University, Halifax, Nova Scotia, Canada. It aims to discover how men adjust their sexual practices when they are affected by prostate cancer treatments. The survey instrument has been developed and data collection began in late 2010 and continued in to 2011. In all, 558 men from 25 countries completed the survey, the vast majority coming from the US, Australia, the UK and Canada. Analysis of the data has continued throughout 2011 and the first abstract submitted in an international conference in 2011, the Canadian Association of Psychosocial Oncology (CAPO) 2012 Conference, has been accepted. The findings of the survey should benefit all men who are overcoming the challenges of prostate cancer treatments. It will also help to guide the development of new ways for men to maintain sexual activity when affected by prostate cancer.

Men, Sexuality and Health: New Issues, New Directions – further outcomes

Gary Dowsett

Victorian Health Promotion Foundation Senior Research Fellowship, 2005-2010.

Although Professor Dowsett’s fellowship work concluded in February 2010, he and colleague Duane Duncan have continued to publish from this program of research. In addition to journal articles and book chapters published in previous years, a further refereed journal article was submitted in 2011 and is currently under review. ARCSHS would like to thank the Victorian Health Promotion Foundation (VicHealth) for its support.

“Out” on the Reef: 10 Years On

Garrett Prestage and Ian Down

In early 2000, a study was undertaken to document what it meant to live as a gay man in Cairns at that time. The resulting report, “Out” on the Reef, described the experiences of a group of men as they lived their lives in tropical north Queensland. Ten years on, this study has been repeated, to address the question: What is it like for gay men living in Cairns today: what has changed and what remains the same? A series of focus groups with community members and interviews with key informants were conducted, exploring a range of issues relevant to gay men in Cairns. The findings are presented in “Out” on the Reef: 10 years on, a study of the experiences of gay men in Cairns, 2010.

Application of Gay Community Mapping Research

Graham Brown, Kylie Johnston and Anthony Smith

To support the further translation of the Gay Community Mapping study (2008) into policy, program and practice that supports both gay and lesbian community health and HIV prevention, this project undertook a tailored application of the results with three Victorian Gay Community organisations to develop recommendations with each of the three agencies. In partnership with each agency, the project interrogated the Gay Community Mapping report and appendices to identify implications for programs and practice with particular attention to strategic partnerships, dissemination networks, tailored messaging, and two way influence and information flow through existing and potential networks. Three groups were invited to participate using a criteria of:

  • the profile of the agency or group within the results of the Gay Community Mapping project,
  • the capacity of the agency or group to engage with the process and implement recommendations, and
  • having three distinctly different groups or agencies across the domains of media, festival, and social groups.

Overall, the analysis proved very fruitful. There was strong engagement from the organisations in the study generally, the tailored analysis, and the recommendations. The analysis and recommendations provided the organisations with a different perspective on their male audience or participants that challenged some assumptions and provided evidence for other assumptions. The implications of the tailored recommendations for organisational planning and strategy are now being considered. This project was funded by the Victorian Department of Health and commenced in April 2011. It was completed in December 2011.

Work, Love and Play: Understanding Resilience in Same-Sex Parent Families

Amaryll Perlesz (Bouverie Centre), Andrew Bickerdike (Relationships Australia), Jen Power (Bouverie Centre), Marian Pitts and Margot Schofield (School of Public Health, La Trobe University)

Same-sex attracted parents and their children can experience discrimination within health, welfare, education and legal systems. This national and international longitudinal study, the largest ever conducted with same-sex parented families, aims to examine family patterns and relationships, and factors supporting resilience in same-sex attracted parents and their children. The study explores ways that health and community service providers can enhance the health and wellbeing of same-sex parented families. A major outcome of the study will be the development of Good Practice Guidelines for working with same-sex parented families that will inform policy and practice in a range of sectors, including health, counselling, education and courts.

Well Proud Women

Catherine Barrett and Anne Mitchell

This project was supported by a grant from the Australian Lesbian Medical Association and ACON. The project aim was to assist Breast Screen Victoria to develop services that were inclusive of lesbian and bisexual women. The project involved a survey of lesbian and bisexual women to determine their knowledge of breast cancer and the importance of mammography as well as consultations to identify how Breast Screen Victoria could make their services more accessible to lesbian and bisexual women. Breast Screen Victoria is currently utilising this data to create specific information encouraging lesbians and bisexual women to have regular mammograms as well as developing education for Breast Screen staff on inclusive services.

Exploring the Relationships Between Hazardous Drinking, Depression and Anxiety in Lesbian, Bisexual and Same-sex Attracted Women: Culture, Motivation and Behaviour

Ruth McNair (University of Melbourne), Dan Lubman (Turning Point Alcohol and Drug Centre), Tonda Hughes (University of Illinois), Kelsey Hegarty (University of Melbourne), William Leonard, Rhonda Brown (Deakin University), Amy Pennay (Turning Point Alcohol and Drug Centre)

The study will look at the reciprocal influence of hazardous alcohol use and depression and/or anxiety amongst women of minority sexual orientations. The study will explore the cultural significance of alcohol use among lesbian, bisexual and same-sex attracted women, and the relationships between their experiences of discrimination, stress and abuse and hazardous drinking and mental health problems. The study will also look at the barriers these women face in accessing mental health services and in particular a perception that mental health care professionals lack cultural awareness of and sensitivity to their issues. The project is funded for two years (2012-2013) by beyondblue as part of its Victorian Centre of Excellence in Depression, Anxiety and Related Disorder grants round.

Developing Contemporary Issues in Sex and Sexuality: An Online, Cross-faculty Elective for all First Year Undergraduates at La Trobe University

Gillian Fletcher and Gary Dowsett

2011 saw ARCSHS achieve a first for the centre, the faculty and the university when it ran an online, undergraduate subject called Contemporary Issues in Sexuality Studies. The subject was notable for its subject matter, its mode of teaching—which included the use of both synchronous and asynchronous sessions designed specifically to promote active learning—its cross-faculty availability and its status as Faculty of Health Sciences ‘Signature Unit’. Contemporary Issues in Sex and Sexuality (unit code HLT1CSS) cut across disciplinary boundaries to offer a valuable and interesting learning experience for students from all backgrounds. Offered entirely online, the unit used advanced web-teaching and learning technologies and drew on a wide range of sources including media, web-based material and theory from the social sciences to help students examine and reassess the range of meanings, values, assumptions and expectations embedded in societal understandings of sex and sexuality. The first offering of the subject was completed by a total of 100 students from the Melbourne, Bendigo and Albury-Wodonga campuses, representing a range of disciplines including: prosthetics and orthotics; health systems information management; occupational therapy; speech pathology; journalism, psychiatric science; and law. Contemporary Issues in Sex and Sexuality has now been identified as a La Trobe University ‘Exemplar of Flexible and Online Learning’.

Compromised Fertility in Contemporary Indonesia

Linda Bennett

ARC Future Fellowship (2009-2013)

This project involves the first extensive research into infertility in Indonesia. While it focuses on women’s experiences and needs in relation to compromised fertility, it also involves working closely with the partners and families of infertile women and their treating doctors. There are currently four sites across Indonesia included in the project, which involves extensive collaboration with the University of Indonesia, Airlangga University, The University of Mataram and Udayana University.

This research will benefit the community by informing service provision for infertility treatment and by identifying the potential for prevention strategies. It will consolidate Australia's position at the forefront of research into assisted reproductive technologies through the extension of this expertise to its near neighbours. It is contributing to the current gap in knowledge of infertility in Southeast Asia and in developing countries more broadly, and advancing the research on infertility conducted from human rights and anthropological perspectives. The project also reinforces the relevance of the United Nations definition of reproductive health for all people regardless of whether they live in highly or lesser-developed nations.

The Primary Prevention of the Sexual Assault of Older Women

Catherine Barrett, Rosemary Mann (The McCaughey Centre), Jean Tinney (The National Ageing Research Institute) and Philomena Horsley (Centre for Women's Health, Gender and Society). This project is also a collaboration with the Council on the Ageing Victoria and the Alzheimer's Australia Consumer Dementia Research Network.

This project was funded by the Department of Families, Housing, Community Services and Indigenous Affairs in November 2011. The three year study, the first of its kind nationally, aims to strengthen the community’s ability to prevent, respond to and speak out about the sexual assault of older women in aged care services and the broader community. The project will begin by developing an evidence base on the underlying causes of sexual assault and then develop a framework and resource for primary prevention. A key component of the project is engaging and working with the community, including the aged care sector.

Building Equal and Respectful Relationships Between Men and Women at Work: Evaluation

Gillian Fletcher and Sue Dyson

2011 saw VicHealth award a three year tender to ARCSHS for a collaborative evaluation of an innovative new pilot project, which aims to better understand how to build equal and respectful relationships between men and women and to promote gender equality in the workplace, drawing on an organisational and systems approach. Building Equal and Respectful Relationships Between Men and Women at Work forms part of a broader VicHealth program; the Creating Healthy Workplaces Program aims to build a body of evidence about designing and delivering interventions that effectively promote health in and through the workplace. ARCSHS will be undertaking a collaborative evaluation, in which the lead evaluator is embedded within the project and contributes to ongoing learning within the project cycle, rather than at the end of the project.

Beyond the Glass Box of Silence and Invisibility: Examining Inclusion and Participation Programs from a GLBT Perspective

Gillian Fletcher and Sue Dyson

ARCSHS researchers Dr Gillian Fletcher and Dr Sue Dyson received one of just five VicHealth Innovation grants announced by the State Government in late 2011. The grant, for $200,000 over two years, will fund research into whether approaches and implementation processes within current safe sports participation and inclusion culture change projects in Victoria enable, or constrain, the participation and inclusion of GLBT people in mainstream sporting settings. The two year project will include use of innovative online methods to create discussion communities among GLBT, and non-GLBT, sports people from across Victoria, and will result in development of practical, evidence-based, principles for effective promotion of greater inclusion of GLBT people in sport in Victoria.

Fair Go, Sport! Collaborative Evaluation

Gillian Fletcher and Sue Dyson

The Fair go, sport! project, implemented in 2011 by the Victorian Equal Opportunity and Human Rights Commission (VEOHRC) in partnership with Hockey Victoria and Hockey Australia, aimed to “increase awareness of sexual and gender diversity in hockey and promote safe and inclusive environments, and develop a flexible model of engagement that can be adapted for other sporting codes and their governing bodies” (VEOHRC, 2010a). The project resulted in notable achievements at pilot club, State Sporting Association and National Sporting Organisation levels, as well as having an impact beyond the bounds of hockey. ARCSHS’ collaborative evaluation of the project (in which an evaluator was embedded in the project, asking questions and providing feedback to facilitate learning throughout the project, rather than simply at the end) was acknowledged by project partners as having played an integral role in that success. Project Officer Peter Gourlay commented: “The big difference between this model and other, standard [evaluation] models is that we didn’t want “what happened and was it successful”, we wanted “what could happen, why, and how”. We were always interested in the why and how."

Evaluation of AFL Victoria’s Fair Game Respect Matters Project

Sue Dyson and Jo Grzelinska

The Fair Game Respect Matters (FGRM) program is funded by VicHealth and its goal is to prevent violence against women and girls through changing cultures of disrespect. The program is being piloted by AFL Victoria because team sports have been associated with cultures that are sometimes disrespectful towards women. 2011 was the fourth year of the FGRM program evaluation, which will continue until April 2014. Reports and valuation information can be found at www.latrobe.edu.au/arcshs/publications.

Fair Game Respect Matters: Research with Women in Country Football Clubs

Sue Dyson, Jo Grzelinska and Carmel Hobbs

This six month research project was funded by VicHealth to inform the introduction of the FGRM program in a country football league for the first time. Focus groups were held with women from country Victoria football clubs, and key informant interviews were also conducted with stakeholders in the Ballarat area, where the program will be introduced in 2012. The report was delivered at the end of 2011 and makes recommendations about the way forward for the program in 2012.

Taking a Stand: A Case Study of the Respect and Responsibility Program in the AFL 2005-2011

Sue Dyson, Julienne Corboz, Moira Carmody (University of Western Sydney) and Michael Flood (University of Wollongong)

Taking a Stand is an ARC Linkage project, with partnerships between ARCSHS and the AFL. VicHealth has also contributed funding for the project. In July 2010, the project will investigate the inception, implementation and establishment of the AFL’s Respect and Responsibility program. It will focus on players who have been exposed to the Respect and Responsibility training since 2005, and on key informants from within the AFL who have been instrumental in the program. Data collection will commence early in 2011. An APAI PhD scholarship is associated with the project and Ms Alissar El-murr has been appointed to this position, commencing in 2011.

‘Breaking the Silence’ Evaluation

Sue Dyson, Catherine Barrett and Maria Platt

This project evaluated the first year of training for school principals in the Sydney Department of Education Region. The evaluation report made a number of recommendations for future work in schools and research. Notably, these include confidence building and resources for school principals concerning how to introduce issues of violence against women to staff members in their schools and with staff members as they work with children to introduce culture change. Furthermore, the evaluation suggested work be done to develop strategies for engaging parent and community networks to understand and support primary prevention messages. The report is available from www.latrobe.edu.au/arcshs/publications.

Living Safer Sexual Lives: Respectful Relationships

Patsie Frawley and Amie O’Shea

This Commonwealth Department of Families, Housing, Community Services and Indigenous Affairs funded program ended in July 2011. Living Safer Sexual Lives was a community development intervention and action research project based on the fact that people with an intellectual disability are at risk of sexual abuse and exploitation. The project worked with a team of peer educators in five sites in Victoria and Tasmania to develop a Respectful Relationships education program for people with an intellectual disability using the Living Safer Sexual Lives model.

Living Safer Sexual Lives Evaluation

Sue Dyson, Catherine Barrett and Maria Platt

The program evaluation, which identified key learnings from the program, also finished in 2011. The evaluation focused on the processes involved in engaging communities and on the outcomes of the program for workers who have participated in the community reference groups established to drive the program. The combined program and evaluation report will be available early in 2012 from www.latrobe.edu.au/arcshs/publications.

The Tensions for Parents, Educators and Children in Building Respectful Relationships Early in Life

Sue Dyson, Marisa Monagle, Moira Carmody (University of Western Sydney) and Kerry Robinson (University of Western Sydney)

This three year ARC Discovery project commenced early in 2011 in partnership with the University of Western Sydney. It is investigating how parents, educators and children aged between 5 and 11 years develop the knowledge and skills necessary to build respectful relationships. Interviews and focus groups have been conducted in rural and metro centres in NSW and Victoria and will continue during 2012. An online survey is also seeking parent’s input.

Evaluation of the Healthy Sporting Environments Program

Sue Dyson, Russel Hoye, Matthew Nicholson and Emma Sherry (Faculty of Law and Management, Research Centre for Sport and Social Impact, La Trobe University)

This project is evaluating a three year VicHealth funded program in the Geelong region of Victoria. Around 80 sporting clubs are being supported by Leisure Networks to introduce cultural changes to a range of health related issues, including cultures of disrespect. The research component is monitoring the process and outcomes of the interventions in participating clubs between 2010 and 2012.

Healthy Workplaces – Preventing Violence Against Women Evaluation

Gillian Fletcher and Sue Dyson

This three year program evaluation will work alongside a large organisation funded by VicHealth to introduce strategies to prevent violence against women in the workplace. The intervention will commence early in 2012, and we will use a constructivist approach to the evaluation in partnership with the selected workplace.

Writing Themselves In 3: The Third National Study on the Sexual Health and Wellbeing of Same Sex Attracted and Gender Questioning Young People

Lynne Hillier, Tiffany Jones, Marisa Monagle, Naomi Overton, Luke Gahan and Anne Mitchell

This study, part of a VicHealth Public Health Fellowship, is the third national study on the sexual health and wellbeing of same-sex attracted and gender-questioning young people. The first was in 1998 and the second was in 2004. In this 2010 study, 3134 young people aged 14-21 took part in an online qualitative and quantitative survey about their sexual attractions, identity and behaviours, experiences of homophobic abuse, experiences of disclosure and support and their experiences of school. The data showed that homophobic abuse continued to rise and that 80% of those abused were abused at school. Significant links between abuse, self-harm, suicide attempts, drug use and feeling unsafe were identified. Despite this, young people felt better about their sexuality than in 1998 and 2004 and were more likely to disclose and receive support. Sexuality education in most cases failed to be inclusive with most young people finding it useless. It may not be surprising, therefore, that these young people had higher rates of pregnancy and sexually transmitted infections. There was evidence that support can be a buffer against the negative impacts of homophobia with young people who received support being less likely to self-harm or attempt suicide. Moreover, schools with protective policies against homophobic abuse and those which young people deemed supportive rather than homophobic had lower rates of self-harm and suicide and young people who attended them felt safer. This research will be used to inform policy in education and other government sectors. The report was launched on November 19th 2010. In 2011, the research findings were presented in NSW, ACT, WA, Victoria and SA. Dissemination will continue in Tasmania and Queensland in 2012.

POSH Interviews: Peers Outsmarting Homophobia

Lynne Hillier

VicHealth Public Health Research Fellowship (2006-2011).

This longitudinal study gathered the experiences of 25 same-sex attracted young people at six-monthly intervals to see how they managed the many critical events that happen in their lives. Of interest to the study were the discourses young people drew on and the resources they used in the production of themselves as same-sex attracted. This is important because the research demonstrates that when young people feel bad about their same-sex attractions they are more likely to self-harm and attempt suicide than those who feel good. Moreover, how young people feel about their sexuality is related to the discourses they use to explain their feelings. In Foucauldian terms, the use of reflection, care of self and others, mentoring and support were all of interest to the study. Over the period of the project, young people were exposed to a range of experiences including homophobic abuse and discrimination, school problems, family problems and mental health challenges such as drug abuse, self-harm and suicide attempts.

Young people produced themselves in many ways over the course of the study. In almost all of them there was evidence of growing sophistication in how they managed meanings that were thrust upon them, how they resisted, how they garnered support and, for many of them, how they triumphed and transcended. Of importance also was the tendency for many of them to become involved in activism to make the world a better place for young people in the future. During 2011 a number of conference presentations focussed on findings and peer reviewed papers are in progress.

The Use of the Internet by LGB and non-LGB Young People

Lynne Hillier and Michelle Y’Barra (Internet Solutions for Kids)

This study was funded by the National Institute for Health in the United States of America. ARCSHS’ primary involvement was in the development of the qualitative components of the two-phase project. The first phase is an online discussion board with three groups of young people in the USA. The first two groups were lesbian, gay and bisexual (LGB), and the third group was heterosexual (non-LGB). There were approximately 20 young people in each LGB group and 30 in the non-LGB group. Each of the three discussion boards were held separately and lasted for a week. Young people were asked questions about their internet use and its history, and what they used the internet for, including sex and relationships, online friendships, threats they had experienced and how they dealt with them, meeting people offline, activism and the use of the internet to explore sexuality. Online discussion boards have been completed with differences between the LGB and non-LGB groups concerning internet friendships, sexual exploration, fear and activism. LGB young people were more likely to meet new people on the internet, meet people offline from the internet and to be involved in internet activism. LGB young people were also more sophisticated in their internet use and less fearful of the medium. These findings have been used to inform the second phase of the study which involves a large-scale survey of young people in the USA about their internet use. In 2011 the survey phase was completed and data analysis and writing are ongoing. One peer reviewed paper had been accepted for publication from the online discussion data.

Looking Beyond the Risk Factors: Socio-Cultural Influences on the Sexual Health of Indigenous Youth

Kate Senior (Menzies School of Health Research), Victoria Burbank (University of Western Australia), Richard Chenhall (University of Melbourne), Tricia Nagel (Menzies School of Health Research), Marian Pitts and Sherry Saggers (National Drug Research Institute)

Indigenous youth have been the target of many interventions to address poor sexual health, but there has been little evidence for improvement. It is clear that a different approach is needed, and that this should be built on a detailed understanding of the lives of young Indigenous people, and with significant input from young people. This project will involve young people at all levels, and will include their explanations of sexuality and relationships through to their recommendations for more appropriate resources and services. The outcomes will be sexual health services which have an evidence base from which to develop their interventions and more appropriate resources to engage with young people about their sexuality.

The Male Body Beautiful: Young Men, Masculinity, Health and Body Image in Contemporary Australia

Duane Duncan

This project is funded by a La Trobe University, Faculty of Health Sciences Faculty Research Grant for Early Career Researchers, and began in early 2011. The aims of the project are to use a qualitative methodology to explore the body image pressures faced by young Australian men aged 18-28, and the related 'body projects' they engage in. Recent research has indicated that body image is a significant concern for young Australian men with increasing evidence of engagement in unhealthy body-image practices leading to injury, poor self-esteem, anxiety and depression, and eating disorders. This projects seeks to contextualise these issues within the wider significance placed on men's bodies and individual identity in 'late' modernity. In exploring the bodily practices young men engage in, their motivations for engaging in those practices, and their understandings of their meanings of those practices in regard to contemporary notions of masculinity, the project hopes to provide insight into an emerging area of men's health. The expected outcomes include a Discovery Early Career Research Award application to the ARC in 2012. This project is due to be completed in mid-2012.

Sexual Health and Relationships in Young Indigenous People

James Ward (Kirby Institute), Heather Worth (University of New South Wales), Anthony Smith, Dea Thiele (NACCHO), John Kaldor (Kirby Institute), Joanne Bryant (NCHSR) and Marian Pitts

This study was funded by an ARC Council linkage grant to conduct the first Australian study describing levels of knowledge, risk practice and health service access of young indigenous people in relation to sexually transmissible infections and blood-borne viruses. It will determine behavioural, demographic, access and socio-cultural predictors of STIs and BBV acquisition. It will establish the foundation for a repeatable study to assess changes over time in these areas. Information will be collected, using innovative technology, from attendees at Indigenous community events. The study includes research capacity and partnership initiatives with Indigenous communities. It will provide compelling evidence to shape policy and programs in this area.

The Sexual Network Structure of Young Adults in Australia: Understanding Risk and How this relates to Sexual Health

Anthony Smith and Marisa Schlichthorst

National and international research has documented that social network characteristics contribute to epidemic dynamics and to the likely success of initiatives in the area of both prevention and health service utilisation. So there is a clear need for a formal network study among young people in Australia. A better understanding of young people’s networks will help to lower the still high number of new infections in STIs within this group. This study aims to define the structure and composition of peer networks among young Australians in terms of size, gender, age and geographical mix.

Childhood Determinants of Risky Sexual Behaviour in Adolescence: A Prospective Cohort Study

Rachel Skinner (University of Sydney), Martha Hickey (University of Melbourne), Eugen Mattes (University of Western Australia), Dorota Doherty (University of Western Australia), Anthony Smith, Susan Rosenthal (Columbia University, NY) and Spring Chenoa Cooper Robbins (University of Sydney)

The Western Australian Pregnancy (Raine) Cohort Study is a unique longitudinal birth cohort of just under 3000 subjects recruited in the antenatal period and followed up at two- to three-yearly intervals. By September 2009, data collection up to 17 years of age was complete. Extensive biological, psychological, psychosocial, family, individual and environmental characteristics have been collected at all ages. The resultant data drew on a biopsychosocial and developmental life course model of health behaviour, which encompasses health factors at the individual, family, school, and neighbourhood level over the lifespan. This cohort study will use this unique dataset to undertake a world-first analysis of causal pathways through early life to sexual risk-taking in adolescence.

Victorian Same-sex Attracted and Sex and Gender Diverse (SSASGD) Youth Suicide Prevention

William Leonard

The Victorian same-sex attracted and sex and gender diverse (SSASGD) youth suicide prevention project is an initiative funded by the Department of Health Victoria (DH) aimed at reducing self-harm and suicide among SSASGD youth and improving their mental health. The project will be funded for four years, commencing in 2011, at a total cost of $4 million.

The project involves funding of seven separate agencies and programs with proven expertise and success in working with, and on behalf of, SSASGD young Victorians. The project aims to increase the capacity of each of these organisations to address a particular area of need among SSASGD youth. It also aims to encourage these agencies to work in partnership with each other, and with mainstream youth, and youth mental health, services, to build an SSASGD youth platform within the mainstream youth sector. Gay and Lesbian Health Victoria in partnership with the Youth Affairs Council of Victoria will be responsible for project management and coordination.