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(2008)Journal ArticleObjective: In 2002, New South Wales (NSW) Health introduced an updated policy for occupational screening and vaccination against infectious diseases. This study describes healthcare worker (HCW) immunity to hepatitis B, measles, mumps, rubella (MMR) and varicella based on serological screening, following introduction of this policy. Methods: HCW screening serology performed at two healthcare facilities in south western Sydney (Bankstown and Fairfield) was extracted for the period September 2003 to September 2005. Immunity to hepatitis B, MMR and varicella was quantitated and cross-tabulated against age, sex and staff risk category. Results: A total of 1,320 HCWs were screened. Almost two thirds were immune to hepatitis B while immunity to MMR and varicella ranged from 88% to 94%. Age stratification showed lower levels of measles immunity in those born after 1965. Conclusions: Despite availability of vaccination for over two decades, a significant proportion of HCWs at these two facilities were non-immune to hepatitis B. This is of concern for those non-immune staff involved in direct clinical care, who are at risk of blood and body fluid exposures. The small group of HCWs non-immune to MMR and varicella pose a risk to themselves and others in the event of an outbreak. Implications: There is a need for improved implementation of the occupational screening and vaccination policy, including better education of HCWs about the risks of non-immunity to vaccine preventable diseases. The revised 2007 NSW Health policy may assist this process and will need evaluation to determine whether HCW immunity improves in the coming years.
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(2011)Journal Article
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(2010)Journal ArticlePapua New Guinea (PNG) is in a phase of scaling up access to antiretroviral therapy (ART), and adherence to the newly available drug therapy is becoming an important issue. This paper examines adherence to ART in a sample of 374 HIV-positive people in six provinces in PNG. Participants were recruited to the study using non-probability sampling. Sixty-two % of participants reported complete adherence (no missed or late doses in the past week) and 79% reported not missing any doses in the last week. Revival church members were significantly more likely to report having missing a treatment dose(s) (66%). Those living in the Highlands and those attending Catholic health clinics were significantly more likely to be adherent to their treatment. Age, gender, marital status, education level and employment type did not show significant association with treatment adherence. Adherence rates in PNG are not alarming, indicating that people with HIV can adhere to treatment despite the challenges of living in PNG.
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(2011)Journal ArticleWe analysed HIV disclosure between Australian men who have sex with men (MSM) who reported anal intercourse with their last casual male partner. Of 804 MSM included in the analysis, 413 reported HIV disclosure and 391 reported no disclosure. After identifying bivariate associations with HIV disclosure, we developed three models of HIV disclosure (one for untested, one for HIV-negative and one for HIV-positive MSM). A range of factors was found to be associated with HIV disclosure. Having previously had sex with the last casual male partner and expecting HIV-negative and HIV-positive men to disclose before sex were predictors of HIV disclosure shared by more than one serostatus group. As unprotected anal intercourse was more common among MSM who disclosed (across all serostatus groups), we suggest caution should be exercised before encouraging HIV disclosure as a prevention strategy. Nondisclosure remains more strongly associated with safe sex among Australian MSM.
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(2000)ReportThe Linked Care Trial was an innovative approach to linking health and community care services for people in need of ongoing care, established in 1996-97 in the municipalities of Hornsby and Ku-ring-gai in Sydney’s northern suburbs. The trial formed part of a national program of Coordinated Care Trials (CCTs) established in 1996 to test whether it was possible to coordinate the care currently provided by a variety of different health and community care services and practitioners using funds pooled from a number of Commonwealth and State programs. This flexible use of funding was to be managed by care coordinators (CCs) assigned to each participant, 1 using an individual care plan to help organise the medical care and social assistance that each would receive. The local evaluation of the Linked Care Trial was to test whether this approach could be practically implemented in the local community and, if so, to determine whether this led to a more effective use of existing resources with improved outcomes for participants and caregivers. This final evaluation report reviews progress with Linked Care and the evaluation from commencement of the Live Phase of the trial in 1997 to its formal conclusion in December 1999. Drawing on quantitative and qualitative data collected as part of the local evaluation, the report presents an analysis of findings with respect to a number of separate components of Linked Care. It also identifies the conditions which underlie the achievements of Linked Care and considers obstacles that constrained the achievement of trial goals or which could have affected the evaluation.
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(2000)ReportThe Linked Care Trial was an innovative approach to linking health and community care services for people in need of ongoing care, established in 1996-97 in the municipalities of Hornsby and Ku-ring-gai in Sydney’s northern suburbs. The trial formed part of a national program of Coordinated Care Trials (CCTs) established in 1996 to test whether it was possible to coordinate the care currently provided by a variety of different health and community care services and practitioners using funds pooled from a number of different Commonwealth and State programs. This flexible use of funding was to be managed by care coordinators (CCs) assigned to each participant, 1 using an individual care plan to help organise the medical care and social assistance that each would receive. The local evaluation of the Linked Care Trial was to test whether this approach could be practically implemented in the local community and, if so, to determine whether this led to a more effective use of existing resources with improved outcomes for participants and caregivers.