Sex and sexuality in contemporary Australia
ARCSHS conducts a comprehensive program that addresses broad issues around sex, sexuality, and sexual health among adult men and women. From large national and international surveys to in-depth interviews, this program utilises a range of sophisticated research methodologies to inform theorists, researchers, health service providers and policymakers about contemporary experiences of sex and sexuality, the spread of sexually transmissible infections and the many complex risk factors for a diverse range of sexual health problems. Researchers involved in this program also provide crucial data about the sexual health of minorities, such as Indigenous Australians, and are involved in developing and evaluating sexual or public health interventions. This program of research also complements and informs other specialised programs, conducted by ARCSHS staff, such as HIV prevention, hepatitis social research, and improving the sexual health of young Australians.
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.
9 May 2012