Reliability of prisoners’ survey responses: comparison of self-reported health and biomedical data from an australian prisoner cohort

Objective Prisoner health surveys primarily rely on self-report data. However, it is unclear whether prisoners are reliable health survey respondents. This paper aimed to determine the level of agreement between self-report and biomedical tests for a number of chronic health conditions. Method This study was a secondary analysis of existing data from three waves (1996, 2001, 2009) of the New South Wales (NSW) Inmate Health Survey. The health surveys were cross-sectional in nature and included a stratified random sample of men (n=2,114) from all NSW prisons. Self-reported histories of hepatitis, sexually transmissible infections, and diabetes were compared to objective biomedical measures of these conditions. Results Overall, the sensitivity (i.e., the respondents who self-reported having the condition also had markers indicative of the condition using biomedical tests) was high for hepatitis C (96%) and hepatitis B (83%), but low for all other assessed conditions (ranging from 9.1% for syphilis using RPR to 64% for diabetes). However, Kappa scores indicated substantial agreement only for hepatitis C. That is, there were false positives and false negatives which occurred outside of chance leading to poor agreement for all other assessed conditions. Conclusions Prisoners may have been exposed to serious health conditions while failing to report a history of infection. It may be possible that prisoners do not get tested given the asymptomatic presentation of some conditions, were unaware of their health status, have limited health-service usage preventing the opportunity for detection, or are subject to forgetting or misunderstanding prior test results. These findings demonstrate the importance of the custodial environment in screening for health conditions and referral for treatment should this be needed. Testing on entry, periodically during incarceration, and prior to release is recommended.

“I always prefer to withdraw than use a condom”: contextualising condomless sex among East Asian and sub-Saharan African international students in Sydney

Background Incidence and prevalence of blood-borne viruses and sexually transmissible infections among young people continue to necessitate population-based studies to understand how contextualised sexual health services can be developed and implemented to promote protective behaviours such as consistent condom use. This study examined condomless sexual practice among a sample of East Asian and sub-Saharan African international university students in Sydney, Australia. Methods This qualitative study was methodologically guided by interpretative phenomenological analysis. Data was provided by 20 international students sampled from five universities in Sydney, who participated in either face-to-face or telephone semi-structured in-depth interviews. The interview sessions were audio-recorded, transcribed verbatim, coded in NVivo and analysed using reflexive thematic analysis. Results Condomless sexual practices appear to be common among the study group based on participants’ self-reports of their own practices and the practices of friends and peers. Three themes contextualising condomless among the study participants were generated from the interview transcripts: (1) unanticipated sex, condom related stigma and alcohol use (2) pleasure-seeking, curiosity and intimacy (3) condomless sex as a gendered practice. Conclusions The result of this study has implications for public health research, practice and policy around design, implementation and evaluation of multi-layered and population-specific sexual health services that are tailored to addressing the needs of international students, who migrate from traditional sexual cultures to Australia, where sexual norms are more liberal.

Scaling up sexually transmissible infections point-of-care testing in remote Aboriginal and Torres Strait Islander communities: healthcare workers’ perceptions of the barriers and facilitators

Background Sexually transmissible infections (STIs), such as gonorrhoea and chlamydia, are highly prevalent, particularly in remote Aboriginal and Torres Strait Islander communities in Australia. In these settings, due to distance to centralised laboratories, the return of laboratory test results can take a week or longer, and many young people do not receive treatment, or it is considerably delayed. Point-of-care testing (POCT) provides an opportunity for same day diagnosis and treatment. Molecular POC testing for STIs was available at 31 regional or remote primary health care clinic sites through the Test-Treat-And-GO (TANGO2) program. This qualitative study sought to identify barriers and facilitators to further scaling up STI POCT in remote Aboriginal communities within Australia. Methods A total of 15 healthcare workers (including nurses and Aboriginal health practitioners) and five managers (including clinic coordinators and practice managers) were recruited from remote health services involved in the TTANGO2 program to participate in semi-structured in-depth interviews. Health services’ clinics were purposively selected to include those with high or low STI POCT uptake. Personnel participants were selected via a hybrid approach including nomination by clinic managers and purposive sampling to include those in roles relevant to STI testing and treatment and those who had received TTANGO2 training for POCT technology. Milat’s scaling up guide informed the coding framework and analysis. Results Acceptability of STI POCT technology among healthcare workers and managers was predominantly influenced by self-efficacy and perceived effectiveness of POCT technology as well as perceptions of additional workload burden associated with POCT. Barriers to integration of STI POCT included retention of trained staff to conduct POCT. Patient reach (including strategies for patient engagement) was broadly considered an enabler for STI testing scale up using POCT technology. Conclusions Remote healthcare clinics should be supported by both program and clinic management throughout scaling up efforts to ensure broad acceptability of STI POCT as well as addressing local health systems’ issues and identifying and enhancing opportunities for patient engagement.

Neue und wiederkehrende sexuell übertragbare Erreger: Nachwuchs- und Überlebenskünstler

ZusammenfassungNoch vor 50 Jahren waren nur wenige bakterielle Infektionen bekannt, die durch direkten Sexualkontakt auf den Partner oder die Partnerin übertragen werden. Neben der Syphilis und Gonorrhoe wurden der weiche Schanker (Ulcus molle) und das Lymphogranuloma venereum in der Gruppe der klassischen Geschlechtskrankheiten zusammengefasst. Die Infektionszahlen der klassischen Venerea haben am Ende des letzten Jahrhunderts durch die Gefahr einer tödlichen HIV-Infektion abgenommen, sind aber nach der Einführung der hochaktiven antiretroviralen Therapie (HAART) erneut rapide angestiegen und stellen weiterhin trotz erfolgreicher Therapiemöglichkeiten ein nicht zu unterschätzendes Gesundheitsrisiko dar. Durch moderne molekularbiologische Nachweisverfahren, „contact tracing“ und epidemiologische Studien ist nun bekannt, dass die Zahl jener Infektionen, die durch engen Kontakt übertragen werden, wesentlich größer ist. In die Gruppe der „sexually transmitted infections“ werden u. a. neben bakteriellen Infektionen wie Chlamydia trachomatis und Mycoplasma genitalium auch virale Infekte wie Herpes-simplex-, Hepatitis‑B- und humane Papillomviren zusammengefasst. Für einige Erreger, wie das Zika- und Ebolavirus, die Hepatitis A, für gewisse Darmkeime oder die Meningokokken stellt der Sexualkontakt nur einen der möglichen Übertragungswege dar, sie werden „sexually transmissible infections” genannt. Diese Erkenntnisse tragen dazu bei, dass die Bedeutsamkeit von „contact tracing“, einer genauen Diagnostik sowie sexueller Abstinenz über einen gewissen Zeitraum eine wichtige Rolle für die Prophylaxe darstellt, um eine Infektion der zahlreichen Mikroben auf den Sexualpartner zu verhindern.

“I Always Prefer To Withdraw Than Use A Condom”: A Phenomenological Study of Condomless Sexual Practice Among International Students in Sydney

Background: Incidence and prevalence of blood-borne viruses and sexually transmissible infections among young people continue to necessitate population-based studies to understand how contextualised sexual health services can be developed and implemented to promote protective behaviours such as consistent condom use. This study examined condomless sexual practice among a sample of East Asian and sub-Saharan African international university students in Sydney, Australia. Methods: This phenomenological qualitative study involved face-to-face and telephone semi-structured in-depth interviews with 20 international students from various universities in Sydney. The interview sessions were audio-recorded, transcribed verbatim, coded using NVivo and analysed using reflexive thematic analysis. Results: Condomless sexual practices appear to be common among the study group based on participants’ self-reports and social practices of friends and peers. Themes describing contexts where condomless sex occur among the participants are classified into three: (1) unanticipated sex, condom related stigma and alcohol use (2) pleasure-seeking, curiosity and intimacy (3) condomless sex as a gendered practice. Conclusions: The results of this study add to growing evidence for multi-layered and population-specific sexual health services for international students from traditional sexual cultures.

Reproductive Health: Need of the Hour

Reproductive health of women remains a major development task in any country. Reproductive health is a state of complete physical, mental and social well-being and not simply the absence of any disease, in all matters relating to the reproductive system and to its functions and processes. The Review Article outlines the current literature on women's reproductive health which consist abortion, sexually transmitted disease, child and forced marriage, contraceptive methods etc. current statistics related to women reproductive health also discussed in this paper. Reproductive health of women is maintained by reducing fertility rate and spacing among births. The use of various contraceptives is best known alternative. Health status of women has ramification and impact on the human well-being, economic growth and on their families also. Woman with poor health are likely to give birth to low weight infants and less care to their children. Moreover, Indian women have high mortality rates, particularly during childhood and in their reproductive years. Other problems in women in India are low level of education, son preference, pressure of dowry, lack of independence and decision making. All these factors also have impact on the health of women (Reproductive Health Strategy, 2010). In this review paper, the efforts are made to discuss reproductive health and related issues of Indian women. Review article concluded that reproductive system of females comprises of the ovaries, fallopian tubes, vagina uterus, mammary glands, breasts, and vulva. All of these female genital organs play significant roles in the production and transportation of gametes and also production of sex hormones. There are different life stages accompanying with sexual subsists and reproductive health issues that include fertility, contraception, menstruation, menopause, sexually transmissible infections and chronic health problems like PCOS or PCOD etc. Taking care of reproductive systems in the female body requires attention to one’s health and regular check-ups.

Australia’s notifiable disease status, 2016: Annual report of the National Notifiable Diseases Surveillance System

In 2016, a total of 67 diseases and conditions were nationally notifiable in Australia. The states and territories reported 330,387 notifications of communicable diseases to the National Notifiable Diseases Surveillance System. Notifications have remained stable between 2015 and 2016. In 2016, the most frequently notified diseases were vaccine preventable diseases (139,687 notifications, 42% of total notifications); sexually transmissible infections (112,714 notifications, 34% of total notifications); and gastrointestinal diseases (49,885 notifications, 15% of total notifications). Additionally, there were 18,595 notifications of bloodborne diseases; 6,760 notifications of vectorborne diseases; 2,020 notifications of other bacterial infections; 725 notifications of zoonoses and one notification of a quarantinable disease.

Exchange Sex and Condom Use Among Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Social and Sexual Networking Technologies

The practice of sex work or exchange sex (having sex in exchange for money, drugs, shelter, or other things) and the risks for HIV and sexually transmissible infections (STIs) associated with it differ based on the venues where partners meet (e.g., streets, agencies, or the Internet). Although there is evidence that gay, bisexual, and other men who have sex with men (MSM) use social media and dating/hookup applications and websites to find exchange sex, little is known about this phenomenon. We used online survey data collected among MSM in New York City recruited through social/sexual networking technologies to learn more about the practice of exchange sex in this population. Overall, 28.8% of participants had ever exchanged (sold) sex, including 8.4% who had done so in the prior three months. Almost half (46.4%) of those who had ever exchanged sex had met their first client through a social/sexual networking app/website (that was not a website dedicated to sex work), and the majority (88%) of those who had exchanged sex in the prior three months had done so with a client met through these technologies. In multivariable analyses, those who had exchanged sex in the prior three months reported at least twice the number of condomless anal sex partners in that period (compared to those who never exchanged sex) after controlling for covariates (incidence-rate ratio [IRR] = 2.08, 95% confidence interval [CI] 1.52–2.84). Social/sexual networking technologies are important venues for finding exchange sex among MSM, a practice that may present high risk for HIV and/or STI transmission.