Medicine & Health

Publication Search Results

Now showing 1 - 10 of 123
  • (2001) Prestage, Garrett; Song, Angela; Grierson, Jeffrey; Race, Kane; Rawstorne, Patrick; Grulich, Andrew; Kippax, Susan
    Report
    The Positive Health (pH) project is a cohort study of HIV positive people. The aim of the study is to monitor responses to HIV and treatments over time, particularly in relation to engagement with health care services, health beliefs, preventive behaviour and medication use. The main focus of the study is on positive people’s health management strategies and the impact of HIV on their lives. Participants were recruited through two research centres: one in NSW and one in Victoria. The criterion for entry into the study was being HIV positive. The project is administered collaboratively through the National Centre in HIV Social Research (NCHSR), the National Centre in HIV Epidemiology and Clinical Research (NCHECR), the Australian Research Centre in Sex, Health and Society (ARCSHS), the National Association of People Living with HIV/AIDS (NAPWA) and the Australian Federation of AIDS Organisations (AFAO).

  • (2009) Adam, Philippe; de Wit, John; Toskin, I; Mathers, Bradley; Nashkhoev, I; Lyerla, Rob; Rugg, D
    Journal Article
    Background: HIV prevalence data suggest that men who have sex with men (MSM) in low-income and middle-income countries (LMIC) are at increased risk of HIV The aim of this article is to present global estimates on key HIV prevention needs and responses among MSM in LMIC. Methods: Data on HIV testing, HIV prevention coverage, HIV knowledge and condom use among MSM were derived from UNGASS country progress reports submitted in 2008. Eligible country estimates were used to calculate global and regional estimates, weighted for the size of MSM populations. Results: Of 147 LMIC, 45% reported at least 1 indicator that reflects the HIV prevention needs and responses in MSM. Global weighted estimates indicate that on average 31 % of MSM in LMIC were tested for HIV; 33% were reached by HIV prevention programs; 44% had correct HIV knowledge; and 54% used condoms the last time they had anal sex with a man. Conclusions: The 2008 UNGASS country reports represent the largest harmonized data set to date of HIV prevention needs and responses among MSM in LMIC. Although reporting is incomplete and does not always conform to requirements, findings confirm that, in many LMIC, HIV prevention responses in MSM need substantial strengthening.

  • (2009) Zablotska, I; Imrie, John; Prestage, Garrett; Crawford, June; Rawstorne, Patrick; Grulich, Andrew; Jin, Feng Yi; Kippax, Susan
    Journal Article
    We explored seroguessing (serosorting based on the assumption of HIV seroconcordance) and casual unprotected anal intercourse (UAIC) associated with seroguessing. The ongoing Positive Health and Health in Men cohorts, Australia, provided data for trends in seroconcordant UAIC and HIV disclosure to sex partners. In event-level analyses, we used log-binomial regression adjusted for within-individual correlation and estimated prevalence rate ratios (PRRs) and 95% confidence intervals (95% CIs) for the association between the knowledge of a casual partner`s seroconcordance and UAIC. UAIC and HIV disclosure significantly increased during 2001-2006. HIV-positive men knew partners were seroconcordant in 54% and assumed it in 13% of sex encounters (42 and 17% among HIV-negative men). Among HIV-positive men, the likelihood of UAIC was higher when a partner`s status was known (Adjusted PRR = 5.17, 95% CI: 3.82-7.01) and assumed seroconcordant because of seroguessing (Adjusted PRR = 3.70, 95% CI: 2.56-5.35) compared with unknown. Among HIV-negative men, the likelihood of UAIC was also higher when a partner`s status was known (Adjusted PRR = 1.88, 95% CI: 1.58-2.24) and assumed seroconcordant (Adjusted PRR = 2.12, 95% CI: 1.72-2.62) compared with unknown. As levels of UAIC remain high, seroguessing increasingly exposes gay men to the risk of HIV infection. Because both HIV-positive and HIV-negative men often seroguess, education and prevention programs should address the fact that HIV-negative men who engage in UAI due to this practice may be at high risk of HIV infection. HIV prevention should take into account these contemporary changes in behaviors, especially among HIV-negative gay men.

  • (2007) Zablotska Manos, Iryna; Prestage, Garrett; Sutherland, R; Grulich, Andrew; Kaldor, John; Imrie, John; Kippax, Susan
    Report
    Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics.

  • (2003) Reid, A.; Worth, Heather; McMillan, Karen
    Journal Article

  • (2005) Worth, Heather; McMillan, Karen; Simmons, Laurence; Molloy, Maureen; Worth, Heather
    Book Chapter

  • (2003) McMillan, Karen; Worth, Heather
    Book Chapter

  • (2004) Fin, F; Prestage, Garrett; Pell, Catherine; Donovan, Basil; van der Ven, P.; Kippax, Susan; Kaldor, John; Grulich, Andrew
    Journal Article
    Objectives: To determine the prevalence and incidence of hepatitis A (HAV) and B (HBV) infection and vaccination in HIV-negative homosexual men in Sydney, and associated risk factors. Methods: An open prospective cohort study was conducted among a community-based sample of HIV-negative homosexual men in Sydney in 2001-02. Participants underwent a face-to-face interview, regarding demographics, sexual behavioural risk factors and sexually transmitted infections, and blood samples were collected. They were followed annually. Results: Nine hundred and three men completed a baseline interview by the end of 2002. Among them, 68% were seropositive to hepatitis A. The seroprevalence of prior hepatitis B infection was 19%, and 53% had serological evidence of HBV vaccination. Younger men were much more likely to be seronegative, with 48% and 46% of <25-year-olds being seronegative to HAV and HBV respectively. In multivariate analysis HAV and HBV infection were associated with increasing age, greater number of lifetime sex partners and HBV infection was also associated with previous sexually transmitted infections. HAV vaccination was associated with increasing age, greater number of lifetime sex partners, overseas travel in the last year and self-reported anogenital warts. HBV vaccination was associated with higher occupational status, greater lifetime number of sex partners and previous sexually transmitted infections. Conclusion: Substantial proportions of gay community attached young homosexual men are still at risk of HAV and HBV infection. This study points to a need for vaccination strategies which ensure high levels of hepatitis A and B immunity in young sexually active gay men.

  • (2005) Pell, Catherine; Donovan, Basil; Kippax, Susan; Kaldor, John; Grulich, Andrew; Jin, Feng Yi; Prestage, Garrett
    Journal Article

  • (2009) Mao, Limin; Prestage, Garrett; Donovan, Basil; Imrie, John; Kippax, Susan; Kaldor, John; Grulich, Andrew; Templeton, David; Jin, Feng Yi
    Journal Article
    Objective: To assess circumcision status as a risk factor for HIV seroconversion in homosexual men. Design, setting and participants: The Health in Men (HIM) study was a prospective cohort of homosexual men in Sydney, Australia. HIV-negative men (n = 1426) were recruited primarily from community-based sources between 2001 and 2004 and followed to mid-2007. Participants underwent annual HIV testing, and detailed information on sexual risk behaviour was collected every 6 months. Main outcome measure: HIV incidence in circumcised compared with uncircumcised participants, stratified by whether or not men predominantly practised the insertive role in anal intercourse. Results: There were 53 HIV seroconversions during follow-up; an incidence of 0.78 per 100 person-years. On multivariate analysis controlling for behavioural risk factors, being circumcised was associated with a nonsignificant reduction in risk of HIV seroconversion [hazard ratio 0.78, 95% confidence interval (CI) 0.42-1.45, P = 0.424]. Among one-third of study participants who reported a preference for the insertive role in anal intercourse, being circumcised was associated with a significant reduction in HIV incidence after controlling for age and unprotected anal intercourse (UAI) (hazard ratio 0.11, 95% CI 0.03-0.80, P = 0.041). Those who reported a preference for the insertive role overwhelmingly practised insertive rather than receptive UAI. Conclusions: Overall, circumcision did not significantly reduce the risk of HIV infection in the HIM cohort. However, it was associated with a significant reduction in HIV incidence among those participants who reported a preference for the insertive role in anal intercourse. Circumcision may have a role as an HIV prevention intervention in this subset of homosexual men.