Community-based sexual health care works: a review of the ACT outreach program

Background: Men who have sex with men, sex workers, youth and university students are at increased risk for sexually transmissible infections (STI) and blood-borne viruses (BBV) and are therefore targets for sexual health services. In recognition of this, a collaborative project offering sexual health care in various outreach settings frequented by these groups was developed. Methods: Data collected by clinicians during consultations in five outreach venues (a sex-on-premises venue, a community AIDS organisation, a university campus, brothels and a youth centre) between 2002 and 2005 were analysed. Results: During 119 clinics (~547 clinician hours), 313 individuals (205 males and 108 females) received education and/or testing. Of those screened, 6.0% (15/249) were positive for chlamydia and 12.7% (9/71) tested positive for hepatitis C (HCV) antibodies. No new cases of hepatitis B (HBV) or HIV were identified and 37.2% (71/191) of patients reported never having been previously tested for HIV. Seroprevalence of hepatitis A and HBV antibodies were 53.8% (91/169) and 52.1% (135/259), respectively. More than half of all four groups reported inconsistent use of condoms and 8.6% reported intravenous drug use. Conclusions: Collaborations between agencies to provide outreach services facilitate community-based sexual health education and screening for groups at higher risk of STI and BBV. The database audit showed that through these outreach services cases of chlamydia and HCV that may have remained undetected were identified. The results also highlight the need for continuing hepatitis vaccination, testing, health promotion and education in these populations.

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Urban gentrification and declining access to HIV/STI, sexual health, and outreach services amongst women sex workers between 2010-2014: Results of a community-based longitudinal cohort

Health & Place ◽

10.1016/j.healthplace.2020.102288 ◽

2020 ◽

Vol 62 ◽

pp. 102288

Author(s):

Shira M. Goldenberg ◽

Ofer Amram ◽

Melissa Braschel ◽

Sarah Moreheart ◽

Kate Shannon

Keyword(s):

Sexual Health ◽

Sex Workers ◽

Community Based ◽

Longitudinal Cohort ◽

Outreach Services

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Group sex events among female sex workers in Melbourne, Australia

Sexual Health ◽

10.1071/sh20136 ◽

2020 ◽

Vol 17 (6) ◽

pp. 534

Author(s):

Evelyn M. Turek ◽

Christopher K. Fairley ◽

Marjan Tabesh ◽

Tiffany R. Phillips ◽

Eric P. F. Chow

Keyword(s):

Sexual Health ◽

Sex Workers ◽

Female Sex Workers ◽

Health Centre ◽

Cross Sectional Survey ◽

The Past ◽

Female Sex ◽

Increased Risk ◽

Sexually Transmissible Infections ◽

Group Sex

Background Group sex is associated with increased risk of HIV and sexually transmissible infections (STIs), but there is limited data on group sex among female sex workers (FSW). Understanding current group sex practices among FSW may assist with understanding and addressing the rise in STIs observed among Australian FSW in the 2010s. The aim of this study was to examine the proportion of FSWs who had engaged in group sex. Methods: A cross-sectional survey was conducted among FSWs attending the Melbourne Sexual Health Centre, Australia, between March and April 2019. Females aged ≥18 years who self-reported as a sex worker were invited to participate in the survey asking whether they had had group sex in the past 3 months. Group sex was defined as sex that involved two or more sexual partners. Results: Of the 51 FSWs who completed the survey, the median age was 29 years (IQR 24–34). Almost half (49%; n = 25) reported having group sex in the past 3 months, with a median number of group sex events of two (IQR 1–4). Australian-born FSW were more likely to report group sex than overseas-born FSW (76% vs 42%; P = 0.02). Age, number of paid clients and injecting drug use were not associated with group sex. Conclusion: The present study findings show that group sex is common among FSW and should be included in peer sexual health education and interventions among FSW.

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2016 United Kingdom national guideline on the sexual health care of men who have sex with men

International Journal of STD & AIDS ◽

10.1177/0956462417746897 ◽

2018 ◽

pp. 095646241774689 ◽

Cited By ~ 11

Author(s):

Dan Clutterbuck ◽

David Asboe ◽

Tristan Barber ◽

Carol Emerson ◽

Nigel Field ◽

...

Keyword(s):

Health Care ◽

United Kingdom ◽

Sexual Health ◽

National Guideline ◽

Sexual Health Care ◽

Sex With Men

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Are Australian sexual health clinics attracting priority populations?

Sexual Health ◽

10.1071/sh13066 ◽

2013 ◽

Vol 10 (5) ◽

pp. 456 ◽

Cited By ~ 6

Author(s):

Hammad Ali ◽

Basil Donovan ◽

Christopher K. Fairley ◽

Nathan Ryder ◽

Anna McNulty ◽

...

Keyword(s):

General Population ◽

Sexual Health ◽

Sex Workers ◽

Health Clinics ◽

Sexually Transmissible Infections ◽

Sex With Men ◽

Using Data ◽

Australian Bureau Of Statistics ◽

Sexual Health Clinics ◽

Priority Populations

To answer a key question (‘Are Australian sexual health clinics attracting priority populations?’), we used data from 44 Australian sexual health clinics between 2004 and 2011. We assessed the proportion of patients that were from priority populations (deemed to be at risk of sexually transmissible infections) and compared this to their proportions in the general population using data from Australian Bureau of Statistics and the Australian Study of Health and Relationships. A χ2-test was used. A total of 278 154 new patients attended during 2004–2011. The proportions from each priority population were significantly higher (P < 0.01 for all) than for the general population: young people aged 15–29 years (58.1% v. 20.1%), men who have sex with men (26.0% v. 6.0%), female sex workers (10.8% v. 0.5%), and Aboriginal and Torres Strait Islander people (4.2% v. 2.3%). This study confirms that Australian sexual health clinics attract higher proportions of priority populations and are thus meeting their mandate as defined in the 2010–2013 National Sexually Transmissible Infections Strategy.

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The importance of striving for greater efficiency

Sexual Health ◽

10.1071/sh10059 ◽

2011 ◽

Vol 8 (1) ◽

pp. 3 ◽

Cited By ~ 8

Author(s):

Christopher K. Fairley ◽

Lenka A. Vodstrcil ◽

Tim Read

Keyword(s):

Health Care ◽

Sexual Health ◽

Health Care Costs ◽

Developed Countries ◽

Computer Assisted ◽

Sexual Health Care ◽

Sexually Transmissible Infections ◽

Almost All ◽

Care Costs

Health care costs are rising faster than inflation in almost all developed countries. Improving the efficiency of health care will go some way to address this issue. There has been a significant improvement in the delivery of sexual health care with a particular focus on innovation. In this issue, Baraitser et al. evaluate their services, that uses computer-assisted interviewing combined with self-collected samples in London. This editorial discusses this service in the context of the control of sexually transmissible infections and other recent health care innovations.

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Cisgenderism and transphobia in sexual health care and associations with testing for HIV and other sexually transmitted infections: Findings from the Australian Trans & Gender Diverse Sexual Health Survey

PLoS ONE ◽

10.1371/journal.pone.0253589 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0253589

Author(s):

Shoshana Rosenberg ◽

Denton Callander ◽

Martin Holt ◽

Liz Duck-Chong ◽

Mish Pony ◽

...

Keyword(s):

Health Care ◽

Sexual Health ◽

Well Being ◽

Community Based ◽

Sexual Health Care ◽

Sti Testing ◽

Gender Diverse ◽

And Gender ◽

Community Based Services ◽

Health And Well Being

Transgender and gender diverse people have unique risks and needs in the context of sexual health, but little is known about sexual health care for this population. In 2018, a national, online survey of sexual health and well-being was conducted with trans and gender diverse people in Australia (n = 1,613). Data from this survey were analysed to describe uptake of sexual health care and experiences of interpersonal and structural cisgenderism and transphobia. Experiences of cisgenderism and transphobia in sexual health care were assessed using a new, four-item scale of ‘gender insensitivity’, which produced scores ranging from 0 (highly gender sensitive) to 4 (highly gender insensitive). Logistic and linear regression analyses were conducted to determine if experiences of gender insensitivity in sexual health care were associated with uptake and frequency of HIV/STI testing in the 12 months prior to participation. Trans and gender diverse participants primarily accessed sexual health care from general practice clinics (86.8%), followed by publicly funded sexual health clinics (45.6%), community-based services (22.3%), and general hospitals (14.9%). Experiences of gender insensitivity were common overall (73.2% of participants reported ≥2 negative experiences) but most common in hospitals (M = 2.9, SD = 1.3) and least common in community-based services (M = 1.3, SD = 1.4; p<0.001). When controlling for sociodemographic factors, social networks, general access to health care, and sexual practices, higher levels of gender insensitivity in previous sexual health care encounters were associated with a lower likelihood of recent HIV/STI testing (adjusted prevalence ratio = 0.92, 95% confidence interval [CI]:091,0.96, p<0.001) and less-frequent HIV/STI testing (B = -0.07, 95%CI:-0.10,-0.03, p = 0.007). Given the high rates of HIV and other STIs among trans and gender diverse people in Australia and overseas, eliminating cisgenderism and transphobia in sexual health care may help improve access to diagnostic testing to reduce infection rates and support the overall sexual health and well-being of these populations.

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A Mixed-Methods Study on the Acceptability of Using eHealth for HIV Prevention and Sexual Health Care Among Men Who Have Sex With Men in China

Journal of Medical Internet Research ◽

10.2196/jmir.3370 ◽

2015 ◽

Vol 17 (4) ◽

pp. e100 ◽

Cited By ~ 28

Author(s):

Kathryn E Muessig ◽

Cedric H Bien ◽

Chongyi Wei ◽

Elaine J Lo ◽

Min Yang ◽

...

Keyword(s):

Health Care ◽

Mixed Methods ◽

Hiv Prevention ◽

Sexual Health ◽

Mixed Methods Study ◽

Sexual Health Care ◽

Sex With Men

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Latina Sexual Health Care the US: Community-based Participatory Research and Her Lived Experience

Journal of Feminist Family Therapy ◽

10.1080/08952833.2020.1755167 ◽

2020 ◽

Vol 32 (1-2) ◽

pp. 76-96

Author(s):

Angela L. Lamson ◽

Rebekah J. Clark ◽

Roberta W. Bellamy ◽

Jennifer L. Hodgson ◽

Sharon M. Knight ◽

...

Keyword(s):

Health Care ◽

Sexual Health ◽

Lived Experience ◽

Participatory Research ◽

Community Based Participatory Research ◽

Community Based ◽

Sexual Health Care ◽

The Us

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Learnings from a decade experience of a community-based HIV and STI testing and counseling center in Lisbon – Portugal

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.736 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

F Fernandes ◽

P Meireles ◽

M Rocha ◽

M Duque ◽

H Barros

Keyword(s):

Sexual Health ◽

Sexual Behaviors ◽

Community Based ◽

Sexually Transmitted ◽

Sexual Health Care ◽

Sti Testing ◽

Free Service ◽

History Of ◽

Hiv And Sti Testing ◽

Sex With Men

Abstract Background In the context of an increased number of men who have sex with men (MSM) being diagnosed with HIV infection in many European countries, it became a matter of maximum priority to consider new strategies to monitor and tackle the epidemic. In this scenario, CheckpointLX and a cohort study were projected as a sexual health and research center oriented towards MSM in Portugal. Methods In 2011 CheckpointLX was launched in Lisbon as a community-based center for anonymous and free rapid HIV and other sexually transmitted diseases (STI) testing with a strong component of counseling for sexual health, specially targeted at MSM. In the case of a reactive test, a medical appointment is proposed and scheduled. The Lisbon Cohort of MSM is an ongoing observational prospective study conducted at CheckpointLX. Collected data include sexual behaviors, preventive strategies, and history of STI. Results Until July 2019, 7,351 HIV-negative MSM chose to participate in the Lisbon Cohort of MSM. 3,523 had at least one follow-up visit. The median age was 29 (IQR 25 - 37), and 27% were born in a foreign country, including 15% born in Africa and South America. HIV incidence increased up until 2015, reaching 5 reactive tests per 100 tested annually. There has been a sustained decrease in HIV observed since 2015. The use of HIV prevention tools was provided: 31% used condoms consistently, 3% reported PrEP, and 4% PEP. Conclusions A decade since the beginning of this experience shows positive results, such as increased access and testing. We promoted a stigma-free service that facilitated MSM's and other key population's access to sexual health care. We contribute unique data for assisting in the monitoring of the Dublin Declaration in Portugal.

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