Sex, Health and Society

Researchers: 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 ARCSHS’ 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.

Researchers: 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 high 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 in 2010. And the findings have been presented in most states and territories. Funding is being sought for a fourth national survey.

Researchers: 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 investigated 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.

Researchers: Jeffrey Grierson, Marian Pitts, Rachel Koelmeyer

This national project is a self-complete cross-sectional survey of Australian people living with HIV (PLWH). The Seventh National HIV Futures Survey entered the field in late 2011 after extensive review and revision in collaboration with NAPWA, AFAO, ASHM and their member organisations.

Data collection will continue through the early part of 2012 with the main report released mid year. Extensive community and HIV sector briefing on the findings and implications of the study will follow.

HIV Futures 6 achieved a sample of 1106 respondents. The sustained commitment to this project from the HIV positive population in Australia demonstrates the power of information to enhance the lives of HIV-positive people.

The first HIV Futures Survey was undertaken in 1997, with a sample size of 925, the second in 1999 with a sample of 924, the third in 2001 with a sample size of 894, the fourth in 2003 with a sample of 1059 and the fifth in 2005 with a sample of 970 respondents. The survey aims to: establish and maintain baseline data on social, economic, cultural and clinically related aspects of the experience of living with HIV; and examine changes in, and newly emerging aspects of, the experience of living with HIV. Information collected through the HIV Futures Survey is used in the development and provision of education and support services for PLWH. This survey has provided valuable insights into the use of new therapies among PLWH as well as the social and personal impact of HIV on their lives. This study has added significantly to the discourse on living with HIV both nationally and internationally at both academic and community levels.

Researchers: Graham Brown and Kylie Johnston

REACH is a collaborative research and practice initiative to develop evidence building frameworks, capacity, tools and resources with the Victorian HIV community partnership.

The aim is to facilitate the building of the evidence base for HIV prevention policy and program decisions in Victoria. The outcomes that the REACH Partnership aims to achieve in the first three years are:

1. increase organisational culture and capacity within the Victorian HIV partnership for sustained evidence building and evaluation;
2. collaboratively develop monitoring and evaluation approaches for identified HIV prevention programs and projects at the discrete project level as well as the collective policy level;
3. to contribute to building the evidence base about “what works” that informs policy, programs and agencies;
4. support and influence decision making at the policy and program level; and
5. contribute to the evidence base nationally and internationally in HIV prevention.

Overall, the focus of the REACH Partnership is to build a shared evidence base that is recognised in policy and practice as credible, applicable and useable. The role of ARCSHS is to facilitate this process in collaboration with the key organisations in the HIV prevention partnership in Victoria. The detail of the program will be developed in collaboration with the HIV community sector. However the approach and principles guiding the REACH Partnership are:

1. Evidence building in partnership
2. Realist evaluation approaches
3. Participatory action research, capacity building and sustainability
4. Continuous contribution to the published evidence and literature in HIV prevention
5. Partnerships for policy, practice and governance Collaborating organisations include: ALSO Foundation; Country Awareness Network; Family Planning Victoria; Gamma Project; Gay and Lesbian Health Victoria; Multicultural Health and Support Service; People Living with HIV/AIDS Victoria; Positive Women; Straight Arrows; Victorian AIDS Council; Victorian Department of Health; as well as the supporting research programs of ARCSHS, Burnet Institute and Partnership Solutions. The role and participation of each organisation will vary in relation to the resources and capacity of their programs, and appropriate timing of active participation. The project commenced in April 2011 and is funded by the Victorian Department of Health.
   

Researchers: Jack Wallace, Behzad Hajarizadeh and Jacqui Richmond

It is estimated that up to 200,000 people in Australia have chronic hepatitis B with more than half of these people born in the Asia-Pacific region. Other groups at greater risk of infection in Australia include people born in other highly endemic regions, Indigenous people, men who have sex with men, and people who inject drugs. The hepatitis B virus is difficult to eradicate and the goals of pharmaceutical treatment are to permanently suppress replication of the virus, and to reduce the risk of progressing to advanced liver disease and developing complications such as cirrhosis, liver failure or liver cancer. Successful clinical management of chronic hepatitis B infection requires lifelong monitoring and for many people, pharmaceutical treatment. Up to one-third of people in Australia infected with the virus remain undiagnosed, and only a small proportion of people (approximately 2%) for whom clinical management is recommended access treatment services.

This project uses qualitative and quantitative methods and will be undertaken in three stages to identify potential and perceived barriers to effective hepatitis B clinical management from the perspective of people with chronic hepatitis B. This project seeks to determine barriers to optimal clinical management from the perspective of patients by:

• Describing the patient’s experience of hepatitis B clinical management in the tertiary health clinics, including any discrepancy between the expectations and reality of the process
• Investigating knowledge, attitudes and practices of people with hepatitis B to the clinical management of hepatitis B
• Identifying broader social and psychological barriers to undertaking or maintaining clinical management including treatment
• Seeking patients’ perspective and understanding of the referral processes and experiences with general practice
• Identifying other issues affecting treatment or clinical management compliance.

Researchers: Anthony Smith, Marian Pitts, Anne Mitchell, Paul Agius, Catherine Barrett, Nona Cameron

The aims of this project are:

• To survey the knowledge, attitudes, beliefs and practices of year 10 and 12 students in relation to sexual health, including knowledge of HIV, sexually transmitted diseases, and blood borne viruses
• To compare the results with those of the 1992, 1997, 2002 and 2008 studies to provide evidence of change in the knowledge, the attitudes, beliefs, and practices
• To obtain the above information to enable the development of appropriate interventions to enhance the sexual health and well-being of young people

To do this, a random sample of Australian secondary schools was taken. The sample included State, Catholic and Independent schools. Students completed a questionnaire dealing with their knowledge of HIV, sexually transmissible infections and viral hepatitis. They also provided information on the sexual behaviour, if any, their use of alcohol and other drugs, and their use of, and trust in, a range of sources of advice about sexual health.