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Harfield S, Elliott S, Barzi F, Minto K, Dean JA, Ward J. Sexual risk and testing for sexually transmissible infections in Aboriginal and Torres Strait Islander peoples and non-Indigenous young South Australians: results of an online survey. Sex Health 2024; 21:SH24041. [PMID: 38950143 DOI: 10.1071/sh24041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 06/13/2024] [Indexed: 07/03/2024]
Abstract
Background Disproportionate rates of sexually transmissible infections (STIs) among Aboriginal and Torres Strait Islander young people are often attributed to risk-taking behaviours, but research rarely conducts direct comparison with their non-Indigenous peers to address this negative discourse. Methods 'Let's Talk About It 2019' was a cross-sectional online survey of South Australians (16-29 years). It prioritised recruitment of Aboriginal and Torres Strait Islander respondents to compare behaviours with non-Indigenous peers using multivariable Poisson regression models. Results Aboriginal and Torres Strait Islander (n =231) and non-Indigenous (n =2062) respondents reported similar condom use (40% vs 43%, P =0.477) and sexual debut median ages (16 years vs 17 years). Higher proportions of Aboriginal and/or Torres Strait Islander respondents reported a recent health check (48% vs 38%, P =0.002), STIs (60% vs 49%, P P =0.006) testing, STI diagnosis (29% vs 21%, P =0.042), and intoxication during last sex (30% vs 18%, P Conclusions Behaviours associated with STI transmission were mostly similar among Aboriginal and Torres Strait Islander and non-Indigenous respondents. Higher STI/HIV testing among Aboriginal and Torres Strait Islander respondents suggests effectiveness of targeted programs. Interventions targeting substance use and condom use among all young people are needed. Future interventions need to focus beyond behaviours and explore social determinants of health and sexual networks as contributors to disproportionate STI rates.
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Affiliation(s)
- Stephen Harfield
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia; and School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia; and Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Salenna Elliott
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Federica Barzi
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Kiara Minto
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Judith A Dean
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia; and School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - James Ward
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia
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Bourchier L, Temple-Smith M, Hocking J, Bittleston H, Malta S. Engaging older Australians in sexual health research: SHAPE2 survey recruitment and sample. Sex Health 2024; 21:NULL. [PMID: 38071758 DOI: 10.1071/sh23116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/14/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Sexual health research rarely includes older age groups and the sexual health needs of older Australians are not well understood. Older adults are online in increasing numbers; however, internet surveys involving samples of older adults and sensitive topics remain uncommon. In 2021, we developed an online survey to explore the sexual health needs of Australians aged 60+years. We describe here survey recruitment and sample obtained, comparing it with national population data (Australian Bureau of Statistics) and the sample of the similar 'Sex, Age and Me' study from 2015. METHODS We recruited 1470 people with a staggered three-phase strategy: (1) emails to organisations and community groups; (2) paid Facebook advertising; and (3) passive recruitment. Half (50.6%) found out about the study via an organisation or group and just over a third (35.7%) from Facebook. RESULTS The sample was equally balanced between men (49.9%) and women (49.7%) (0.4% other gender identities). Participants were aged 60-92years (median 69years) with all Australian States/Territories represented. Facebook recruits were younger, more likely to be working rather than retired, and more likely to live outside a major city, than those recruited by other means. CONCLUSIONS Using the recruitment methods described, we successfully obtained a diverse and fairly representative sample of older Australians within the constraints of a convenience sample and on a modest budget. This research sheds light on ways to engage an under-served demographic in sexual health research. Our experience shows that many older adults are amenable to recruitment for online sexual health surveys using the approaches outlined.
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Affiliation(s)
- Louise Bourchier
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Meredith Temple-Smith
- Department of General Practice and Primary Care, University of Melbourne, Melbourne, Vic., Australia
| | - Jane Hocking
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Helen Bittleston
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Sue Malta
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
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Vujcich D, Reid A, Brown G, Durham J, Guy R, Hartley L, Mao L, Mullens AB, Roberts M, Lobo R. HIV-Related Knowledge and Practices among Asian and African Migrants Living in Australia: Results from a Cross-Sectional Survey and Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4347. [PMID: 36901357 PMCID: PMC10002009 DOI: 10.3390/ijerph20054347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 06/18/2023]
Abstract
Australian HIV notification rates are higher for people born in Northeast Asia, Southeast Asia and sub-Saharan Africa compared to Australian-born people. The Migrant Blood-Borne Virus and Sexual Health Survey represents the first attempt to build the national evidence base regarding HIV knowledge, risk behaviors and testing among migrants in Australia. To inform survey development, preliminary qualitative research was conducted with a convenience sample of n = 23 migrants. A survey was developed with reference to the qualitative data and existing survey instruments. Non-probability sampling of adults born in Northeast Asia, Southeast Asia and sub-Saharan Africa was undertaken (n = 1489), and descriptive and bivariate analyses of data were conducted. Knowledge of pre-exposure prophylaxis was low (15.59%), and condom use at last sexual encounter was reported by 56.63% of respondents engaging in casual sex, and 51.80% of respondents reported multiple sexual partners. Less than one-third (31.33%) of respondents reported testing for any sexually transmitted infection or blood-borne virus in the previous two years and, of these, less than half (45.95%) tested for HIV. Confusion surrounding HIV testing practices was reported. These findings identify policy interventions and service improvements critically needed to reduce widening disparities regarding HIV in Australia.
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Affiliation(s)
- Daniel Vujcich
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Alison Reid
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Graham Brown
- Centre for Social Impact, UNSW, Sydney, NSW 2052, Australia
| | - Jo Durham
- Centre for Healthcare Transformation, Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | - Rebecca Guy
- Kirby Institute, UNSW, Sydney, NSW 2052, Australia
| | - Lisa Hartley
- Centre for Human Rights Education, Curtin University, Bentley, WA 6102, Australia
| | - Limin Mao
- Centre for Social Research in Health, UNSW, Sydney, NSW 2052, Australia
| | - Amy B. Mullens
- School of Psychology & Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Qld, Ipswich, QLD 4305, Australia
| | - Meagan Roberts
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Roanna Lobo
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
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4
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Lew C, Fairley CK, Tran J, Phillips TR, Ong JJ, Aung ET, Maddaford K, Bradshaw CS, Chen MY, Chow EPF. Sexual activities and condom use among heterosexual men and women engaged in mixed-gender group sex events in Melbourne, Australia. Sex Health 2023; 20:49-56. [PMID: 36411061 DOI: 10.1071/sh22045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 10/25/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Few studies investigate group sex among heterosexuals. The aim of this study was to provide an exploration of characteristics and practices among heterosexual men and women who engage in group sex. METHOD We conducted a cross-sectional survey between May 2019 and March 2020 among heterosexual men and women attending a sexual health clinic in Melbourne, Australia. Participants were asked whether they had participated in group sex (sex involving more than two participants) in the past 3months, the size of the most recent event, sexual activities in which they engaged, and condom use. RESULTS Of 3277 heterosexuals surveyed (1509 women and 1768 men), the mean age was 29.9years (s.d. 8.8) and more than half (56.0%, n =1834) were born outside Australia. One in 20 participants (5.4%) had engaged in group sex in the past 3months with the number of events ranging 1-10times. Kissing was the most common activity in group sex, and women were significantly more likely to kiss a same-sex partner than men. Overall, of 165 participants who engaged in vaginal sex, 57 (34.5%) reported always using condoms and changing condoms between consecutive partners. Of the 100 men and women who had condomless vaginal sex, 79 (79.0%) received or performed fellatio after condomless vaginal sex. CONCLUSION About two-thirds of heterosexuals who engaged in group sex neither used condoms nor changed condoms between partners in the most recent group sex event. Safe sex messages on changing condoms between partners and between sexual activities should be reinforced for sexually transmitted infections prevention.
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Affiliation(s)
- Chen Lew
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Vic., Australia
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Vic., Australia
| | - Julien Tran
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Vic., Australia
| | - Tiffany R Phillips
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Vic., Australia
| | - Jason J Ong
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Vic., Australia
| | - Ei T Aung
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Vic., Australia
| | - Kate Maddaford
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia
| | - Catriona S Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Vic., Australia; and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia
| | - Marcus Y Chen
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Vic., Australia
| | - Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Vic., Australia; and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia
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5
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Youssef E, Wright J, Davies K, Delpech V, Brown A, Cooper V, Sachikonye M, de Visser R. Factors associated with HIV testing in people aged ⩾50 years: an integrated qualitative analysis of patients and healthcare providers. Ther Adv Infect Dis 2023; 10:20499361231186873. [PMID: 37492278 PMCID: PMC10363875 DOI: 10.1177/20499361231186873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 06/22/2023] [Indexed: 07/27/2023] Open
Abstract
Background Older people continue to be disproportionately affected by late HIV diagnosis, which results in increased morbidity and mortality. Despite high acceptance of HIV testing generally, older people are less likely to undergo testing than younger people. Two previous studies have been conducted, one focussing on patient-related and one focussing on clinician-related factors associated with HIV testing in older age (⩾50 years). Objective This study is an integrated analysis from two linked studies - one focussed on patients, and one focussed on clinicians - to understand overlap in views and experiences of HIV testing in older age, to outline the clinical implications of the findings, and to highlight potential interventions to improve testing in this group. Methods This qualitative study utilised semi-structured interviews conducted with 20 clinicians who were not HIV care specialists, but who had recently seen an older person prior to their HIV diagnosis, and 20 people who had been diagnosed late with HIV aged 50+. Interviews were audio recorded, transcribed verbatim and thematically analysed. The combined synthesis reported here was planned a priori as part of a sequential design. Results Seven clinician- and seven patient-related themes were associated with undergoing HIV testing in older age. This article discusses the four themes that were common to both groups: poor knowledge, incorrect symptom attribution, inaccurate perception of risk, and stigma. Conclusion Both clinician and patient factors associated with testing will have to be addressed in order to increase HIV testing in older people, and reduce the likelihood of late diagnosis. Findings from overlapping themes suggest several areas for intervention: (1) routine screening as part of existing clinical contacts aimed at older people to eliminate the need to attribute symptoms to HIV or assess risk; (2) specific and tailored education materials for clinicians and older people which utilise appropriate modalities; (3) tailored HIV testing services: either specific clinics for older people at existing sexual health services, or dedicated services in primary care.
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Affiliation(s)
- Elaney Youssef
- Department of Medical Education, Brighton and Sussex Medical School, University of Brighton, Falmer Campus, Watson Building, Brighton BN1 9PH, UK
| | | | - Kevin Davies
- Brighton and Sussex Medical School, Brighton, UK
| | | | | | | | | | - Richard de Visser
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, UK, University of Brighton, Brighton, UK
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6
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Tran J, Fairley CK, Ong JJ, Bradshaw CS, Aung ET, Maddaford K, Chen MY, Hocking JS, Chow EPF. The duration and body position during tongue-kissing among heterosexual men and women. Front Public Health 2022; 10:934962. [PMID: 36620298 PMCID: PMC9814118 DOI: 10.3389/fpubh.2022.934962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022] Open
Abstract
Background Emerging data suggest tongue-kissing may transmit gonorrhea. We aim to examine the duration or body position of heterosexual men and women during tongue-kissing (henceforth, known as kissing). Methods A cross-sectional survey among heterosexual men and women attending the Melbourne Sexual Health Centre in Australia between May 2019 and March 2020 collected data on the duration and body position (i.e., on top of or lying down underneath) of their most recent kissing partner in the past 3 months. Univariable and multivariable linear regressions were performed to examine the association between gender and kissing duration. Results Of 2,866 individuals, 93.6% (n = 2,683) had at least one kissing partner in the past 3 months, which included 1,342 (50.1%) men and 1,341 (49.9%) women, and 87.2% (n = 2,339) had sex with their opposite-gender kissing partner. The adjusted mean duration of kissing with the most recent opposite-gender kissing partner did not differ between men and women (12.2 vs. 11.5 min, p = 0.170). More men were on top of their most recent opposite-gender kissing partner compared to women (87.9 vs. 82.9%, p < 0.001). Men reported a longer kissing duration than women when they were on top of the opposite-gender kissing partner (8.3 vs. 7.4 min, p = 0.006). More women had same-gender kissing partners than men (9.6 vs. 2.8%, p < 0.001). Conclusion Men spending longer than women on top of their opposite-gender kissing partner suggests a potential alternative explanation for oropharyngeal gonorrhea being seen more commonly in women. Further research should investigate whether body positioning and duration of kissing influence the risk of gonorrhea transmission.
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Affiliation(s)
- Julien Tran
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia,*Correspondence: Julien Tran, ✉
| | - Christopher K. Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Jason J. Ong
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Catriona S. Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Ei T. Aung
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Kate Maddaford
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
| | - Marcus Y. Chen
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Jane S. Hocking
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Eric P. F. Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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Kolstee J, MacGibbon J, Prestage G, Clackett S, Paynter H, Bavinton BR, Broady TR, Ellard J, Murphy DA, de Wit J, Power C, Holt M. Changing Attitudes Towards Condoms Among Australian Gay and Bisexual Men in the PrEP Era: An Analysis of Repeated National Online Surveys 2011-2019. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:453-466. [PMID: 36454135 DOI: 10.1521/aeap.2022.34.6.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Condoms have been the primary form of HIV prevention for gay and bisexual men (GBM) for most of the HIV epidemic. The introduction of biomedical HIV prevention may have changed attitudes towards condoms. Data from repeated national online surveys of GBM in Australia were used to examine how attitudes towards condoms and confidence discussing condoms with partners changed in the period 2011-2019. The proportion of all participants who reported a positive experience in using condoms remained low and unchanged (9.6% in 2011 to 6.0% in 2019). Confidence in discussing condoms with partners decreased over time (from 72.2% in 2011 to 56.6% in 2019). Confidence in discussing condoms was associated with concern about sexually transmitted infections, and more consistent condom use. Sustaining confidence in using condoms may be more challenging as biomedical prevention methods become more commonly used.
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Affiliation(s)
| | - James MacGibbon
- Centre for Social Research in Health, UNSW Sydney, Australia
| | | | | | - Heath Paynter
- Australian Federation of AIDS Organisations, Sydney, Australia
| | | | | | - Jeanne Ellard
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia
| | | | - John de Wit
- Kirby Institute, UNSW Sydney, Australia
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
| | | | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Australia
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8
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Pehlivan N, Brown E, Sanchez AYA, McMillan F, Moore D, Bhaduri A, Monson K, Badcock P, Thompson K, Killackey E, Chanen A, O'Donoghue B. What impact does illness severity have on the sexual health of young people affected by mental health disorders? A comparison of inpatients and outpatients. Australas Psychiatry 2022; 30:705-711. [PMID: 33118366 DOI: 10.1177/1039856220960373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Young people affected by mental health disorders have greater sexual health needs compared to their peers. Less is known about this need across illness severity. METHOD A cross-sectional survey of the sexual health of those attending outpatients or inpatients within a youth mental health service was conducted. Statistical differences between groups were explored. RESULTS One hundred and seven young people (18-25 years) participated and of these, 37.7% were inpatients who had more severe psychiatric symptoms than outpatients. While inpatients were as likely to be sexually active as outpatients, they were significantly less likely to have a regular sexual partner (25% vs 64.5%). Additionally, they used amphetamines more frequently during sex (28.6% vs 5.8%). Sexual dysfunction was experienced by 55.6% of inpatients and 37.9% of outpatients. CONCLUSIONS High-risk sexual behaviours and sexual dysfunction were highly prevalent in both groups. For some behaviours and dysfunction, this prevalence was higher in the inpatient population. Holistic clinical services that address the mental, physical and sexual health needs of consumers are needed both within inpatient and outpatient settings.
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Affiliation(s)
| | - Ellie Brown
- Orygen, Australia; and Centre for Youth Mental Health, University of Melbourne, Australia
| | | | | | - Danielle Moore
- Orygen, Australia; and Centre for Youth Mental Health, University of Melbourne, Australia
| | | | | | - Paul Badcock
- Centre for Youth Mental Health, University of Melbourne, Australia
| | | | - Eoin Killackey
- Orygen, Australia; and Centre for Youth Mental Health, University of Melbourne, Australia
| | - Andrew Chanen
- Orygen, Australia; and Centre for Youth Mental Health, University of Melbourne, Australia
| | - Brian O'Donoghue
- Orygen, Australia; and Centre for Youth Mental Health, University of Melbourne, Australia
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9
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Okeke SR. "It was protected, except, it wasn't [with] a condom": a mixed-methods study of BBVs/STIs protective practices among International University Students in Sydney, Australia. BMC Public Health 2022; 22:2168. [PMID: 36434571 PMCID: PMC9700902 DOI: 10.1186/s12889-022-14512-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/01/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A number of previous sex-related studies among international students in Australia and other Western societies may be limited by conflating students from conservative and non-conservative sexual backgrounds. Such conflation leads to situations where nuances and complexities around sex-related experiences are lost or, at most, tangentially investigated. To address this research problem, this study used a mixed-methods design to examine protective practices against blood-borne viruses and sexually transmissible infections (BBVs/STIs) among Sydney-based East Asian and sub-Saharan African international students. METHODS This mixed-methods study generated quantitative data using anonymous online survey (n = 149), and qualitative data through in-depth interviews (n = 20). The main recruitment strategy involved advertising the study through paper and electronic flyers. Quantitative data were analysed using logistic regression, while interviews data were analysed using reflexive thematic analysis. RESULTS Self-reported BBVs/STIs protective practices in the last 12 months include abstinence (28.7%), consistent condom use (19.9%), occasional condom use (18.7%), single partner fidelity (25.1%), other strategies (1.8%), and nothing (5.8%). Further, findings from the bivariate analysis showed higher BBVs/STIs prevention knowledge, lower acculturation into Australian sexual culture, greater access to sexual health information, less conservative sexual norms, greater emotional social support and older age were significantly associated with increased protective practices. Variables significant at bivariate level were entered into a logistic regression. The model was statistically significant, (X2(6) = 31.33, p < 0.01) and explained 33.1% of the variance in BBVs/STIs protective practices. However, only acculturation to sexual norms in Australia (OR = 0.883, 95% CI = 0.820-0.952) was found to be independent predictor of BBVs/STIs protective practices. The results of the study based on the quantitative data, indicated condom use (consistent and occasional) was the most reported BBVs/STIs protective behaviour among sexually active participants. Therefore, interviews data was used to explore condom-use motives and practices. The interviews results showed participants primary concern as regards condom use was around pregnancy and not BBVs/STIs. Thus, some participants described safe sex largely as contraception, with BBVs/STIs constituting a secondary concern or no concern at all. CONCLUSIONS Based on the results of this study, tailored sexual health interventions for international students; which incorporate strategies for modifying perceived sexual norms in Australia, are advocated. In addition, this study recommends sexual health interventions that promote dual protection of condoms for both contraception and BBVs/STIs.
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Affiliation(s)
- Sylvester Reuben Okeke
- grid.1005.40000 0004 4902 0432Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
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10
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Engel JL, Fairley CK, Greaves KE, Vodstrcil LA, Ong JJ, Bradshaw CS, Chen MY, Phillips TR, Chow EPF. Patterns of Sexual Practices, Sexually Transmitted Infections and Other Genital Infections in Women Who Have Sex with Women Only (WSWO), Women Who Have Sex with Men Only (WSMO) and Women Who Have Sex with Men and Women (WSMW): Findings from a Sexual Health Clinic in Melbourne, Australia, 2011-2019. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2651-2665. [PMID: 35776396 PMCID: PMC9293838 DOI: 10.1007/s10508-022-02311-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 06/15/2023]
Abstract
Despite rises in sexually transmitted infection (STI) notifications among Australian women in the last decade, limited STI surveillance data exist specifically for women who have sex with women. This study aimed to compare differences in sexual practices and positivity for STIs and other genital infections among women who have sex with men only (WSMO), women who have sex with women only (WSWO), and women who have sex with men and women (WSMW), and whether these changed over time. In this retrospective repeated cross-sectional study, women attending the Melbourne Sexual Health Centre for the first time between 2011 and 2019 were categorized as "WSMW," "WSWO," or "WSMO" according to self-reported sexual practices in the previous 12 months. Demographic information, sexual practices, and positivity for STIs and other genital infections were compared between the three groups and over time. A total of 36,147 women (2618 WSMW, 534 WSWO, and 32,995 WSMO) were included. WSMW reported more sexual partners (median = 6; IQR = 4-10) than WSMO (median = 3; IQR = 2-5) and WSWO (median = 2; IQR = 1-4) (p < .001). A higher proportion of WSMW always used condoms with casual male partners compared to WSMO (20.4% vs 15.9%; p < .001). The proportion of women who always used condoms with casual male partners decreased over time in WSMO, (19.9% in 2011 to 15.2% in 2019, ptrend < .001) but not in WSMW. Bacterial vaginosis was more common in WSWO (14.8%) than in WSMW (11.8%) and WSMO (7.7%) (p < .001). Chlamydia was more common in WSMO (9.3%) than in WSMW (6.6%) and WSWO (1.2%) (p < .001). Syphilis was more common in WSMO (1.0%) than in WSMW (0.3%) and WSWO (0.0%) (p = .004). Over time, chlamydia positivity in WSWO increased (from 0.0% to 2.7%, ptrend = .014), and syphilis positivity in WSMW increased (from 0.0% to 0.7%, ptrend = .028); however, positivity of these STIs did not change in other groups. Sexual practices and positivity for STIs and other genital infections differed according to the sex of women's partners in the previous 12 months. Knowledge of these differences is important to account for future changes in STI trends that may occur in these subpopulations.
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Affiliation(s)
- Jaimie L Engel
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, VIC, 3053, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, VIC, 3053, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Kate E Greaves
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, VIC, 3053, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Lenka A Vodstrcil
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, VIC, 3053, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Jason J Ong
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, VIC, 3053, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Catriona S Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, VIC, 3053, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Marcus Y Chen
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, VIC, 3053, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Tiffany R Phillips
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, VIC, 3053, Australia.
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
| | - Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, VIC, 3053, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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11
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Youssef E, Wright J, A Davies K, Delpech V, Brown A, Cooper V, Sachikonye M, de Visser R. Factors associated with offering HIV testing to people aged ≥ 50 years: A qualitative study. Int J STD AIDS 2021; 33:289-295. [PMID: 34964409 DOI: 10.1177/09564624211059369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Individuals aged ≥ 50 years continue to be disproportionately affected by late HIV diagnosis, which is associated with poorer health outcomes and onward transmission. Despite HIV testing guidelines and high acceptability of HIV testing among all patients, clinicians are less likely to offer a test to an older individual. The aim of this study was to identify clinician-related factors associated with offering HIV testing to patients aged ≥ 50 years. METHODS Twenty clinicians who had been involved in the care of an older patient diagnosed late with HIV were interviewed. RESULTS Thematic analysis identified seven factors associated with offering HIV testing to older people: knowledge, stigma, stereotyping and perception of risk, symptom attribution, discussing HIV with patients, consent procedures and practical issues. CONCLUSIONS Although some factors are not unique to older patients, some are unique to this group. Many clinicians lack up-to-date HIV-related knowledge, feel anxious discussing HIV with older patients and perceive asexuality in older age. In order to increase the offer of HIV testing to this group, we identified clinician-related barriers to test offer that need to be addressed.
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Affiliation(s)
| | - Juliet Wright
- 12190Brighton and Sussex Medical School, Brighton, UK
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12
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Bingham AL, De Silva AP, Vaisey AM, Temple-Smith MJ, Spark SY, Hocking JS. Alcohol availability and prevalent Chlamydia trachomatis in young Australians: a multi-level analysis. Sex Health 2021; 18:460-465. [PMID: 34844665 DOI: 10.1071/sh21098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/03/2021] [Indexed: 11/23/2022]
Abstract
Background Prevalence of sexually transmissible infections (STIs) has been associated with availability of alcohol. This paper investigates potential associations between prevalent cases of chlamydia in young people in Australia and the availability of alcohol within their local area, defined as postcode of residence. Methods Alcohol availability was determined at the postcode level using liquor licensing data, classified as total number of licences, number of 'take-away' licences and number of licenses by population. Participant data were drawn from a survey targeting Australians aged 16-29years in rural and regional Australia, capturing demographic details including postcode of residence, indicators of sexual behaviour including condom use and chlamydia test results. Mixed-effects logistic regression was used to examine potential associations between first, alcohol availability and chlamydia, and second, between condom use and chlamydia. Results We found little evidence of associations between alcohol availability and chlamydia in either unadjusted or adjusted models. After adjusting for alcohol availability, we observed significant associations between inconsistent condom use and chlamydia prevalence, whether alcohol availability was measured as total number (adjusted odds ratio (AOR) 2.20; 95% confidence interval (CI) 1.20, 3.70), number of take-away licenses (AOR 2.19; 95% CI1.30, 3.69) or licenses per 1000 population (AOR 2.19; 95% CI 1.30, 3.68). Conclusion Little evidence of association between alcohol availability and chlamydia at the postcode level was found. Further research is required to determine appropriate measures of 'local area' and how characteristics thereof may impact on sexual health.
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Affiliation(s)
- Amie L Bingham
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Anurika P De Silva
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Alaina M Vaisey
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | | | - Simone Y Spark
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Jane S Hocking
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
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13
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Bourchier L, Malta S, Temple-Smith M, Hocking J. Do we need to worry about sexually transmissible infections (STIs) in older women in Australia? An investigation of STI trends between 2000 and 2018. Sex Health 2020; 17:517-524. [PMID: 33334416 DOI: 10.1071/sh20130] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/05/2020] [Indexed: 11/23/2022]
Abstract
Background This study examined trends in chlamydia, gonorrhoea and syphilis diagnosis, and chlamydia testing and positivity, among older women in Australia between 2000 and 2018. METHODS Using national notifiable disease data and Medicare data, diagnosis rates were calculated for each sexually transmissible infection (STI), as well as testing and positivity rates for chlamydia. Data were compared between two older groups (55-64 and 65-74 years) and two younger groups (15-24 and 25-34 years). Poisson regression examined trends for 2000-18 and 2014-18 separately. RESULTS Rates for all STIs increased across all age groups and were highest in the two youngest age groups. From 2014 to 2018, chlamydia rates increased the most among those aged 55-64 years [incidence rate ratio (IRR) = 1.06; 95%CI: 1.02-1.10] and declined in those aged 15-24 years (IRR = 0.99; 95%CI: 0.99-0.99). Gonorrhoea rates increased the most among those aged 65-74 years (IRR = 1.47; 95%CI: 1.23-1.77) and least in those aged 15-24 years (IRR = 1.12; 95%CI: 1.10-1.13). Syphilis rates increased the most among those aged 55-64 years (IRR = 1.58; 95%CI: 1.25-1.99) and least in those aged 15-24 years (IRR = 1.29; 95%CI: 1.23-1.35). Chlamydia test positivity declined among younger women but remained stable in older women. CONCLUSIONS In general, STIs are increasing among older women in Australia at a faster rate than among younger women. Although the greatest burden is among younger women, STIs need to be considered and monitored among older women.
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Affiliation(s)
- Louise Bourchier
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3053, Australia; and Corresponding author.
| | - Sue Malta
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3053, Australia; and National Ageing Research Institute, Poplar Road, Parkville, Vic. 3052, Australia
| | - Meredith Temple-Smith
- Department of General Practice, The University of Melbourne, 780 Elizabeth Street, Melbourne, Vic. 3004, Australia
| | - Jane Hocking
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3053, Australia
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14
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Malta S, Temple‐Smith M, Bickerstaffe A, Bourchier L, Hocking J. ‘That might be a bit sexy for somebody your age’: Older adult sexual health conversations in primary care. Australas J Ageing 2020; 39 Suppl 1:40-48. [DOI: 10.1111/ajag.12762] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Sue Malta
- Melbourne School of Population and Global Health University of Melbourne Melbourne Vic Australia
- National Ageing Research Institute Parkville Vic Australia
| | | | - Adrian Bickerstaffe
- Melbourne School of Population and Global Health University of Melbourne Melbourne Vic Australia
| | - Louise Bourchier
- Melbourne School of Population and Global Health University of Melbourne Melbourne Vic Australia
| | - Jane Hocking
- Melbourne School of Population and Global Health University of Melbourne Melbourne Vic Australia
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15
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Gilmore W, Chikritzhs T, McManus H, Kaldor J, Guy R. The Association between the Australian Alcopops Tax and National Chlamydia Rates among Young People-an Interrupted Time Series Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1343. [PMID: 32093092 PMCID: PMC7068511 DOI: 10.3390/ijerph17041343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/14/2020] [Accepted: 02/17/2020] [Indexed: 01/28/2023]
Abstract
A national tax increase, which became known as the "alcopops tax", was introduced in Australia on the 27th April 2008 on ready-to-drink alcoholic beverages, which are consumed predominantly by young people. The affordability of alcohol has been identified as the strongest environmental driver of alcohol consumption, and alcohol consumption is a well-known risk factor in the spread of sexually transmitted infections via its association with sexual risk-taking. We conducted a study to investigate whether there was any association between the introduction of the tax and changes in national chlamydia rates: (i) notification rates (diagnoses per 100,000 population; primary outcome and standard approach in alcohol taxation studies), and (ii) test positivity rates (diagnoses per 100 tests; secondary outcome) among 15-24 and 25-34-year-olds, using interrupted time series analysis. Gender- and age-specific chlamydia trends among those 35 and older were applied as internal control series and gender- and age-specific consumer price index-adjusted per capita income trends were controlled for as independent variables. We hypothesised that the expected negative association between the tax and chlamydia notification rates might be masked due to increasing chlamydia test counts over the observation period (2000 to 2016). We hypothesised that the association between the tax and chlamydia test positivity rates would occur as an immediate level decrease, as a result of a decrease in alcohol consumption, which, in turn, would lead to a decrease in risky sexual behaviour and, hence, chlamydia transmission. None of the gender and age-specific population-based rates indicated a significant immediate or lagged association with the tax. However, we found an immediate decrease in test positivity rates for 25-34-year-old males (27% reduction-equivalent to 11,891 cases prevented post-tax) that remained detectable up to a lag of six months and a decrease at a lag of six months for 15-24-year-old males (31% reduction-equivalent to 16,615 cases prevented) following the tax. For no other gender or age combination did the change in test positivity rates reach significance. This study adds to the evidence base supporting the use of alcohol taxation to reduce health-related harms experienced by young people and offers a novel method for calculating sexually transmitted infection rates for policy evaluation.
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Affiliation(s)
- William Gilmore
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Australia;
| | - Tanya Chikritzhs
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Australia;
| | - Hamish McManus
- Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, High Street, Kensington NSW 2052, Australia; (H.M.); (J.K.); (R.G.)
| | - John Kaldor
- Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, High Street, Kensington NSW 2052, Australia; (H.M.); (J.K.); (R.G.)
| | - Rebecca Guy
- Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, High Street, Kensington NSW 2052, Australia; (H.M.); (J.K.); (R.G.)
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16
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Cheng Y, McGeechan K, Bateson D, Ritter T, Weisberg E, Stewart M. Age differences in attitudes toward safer sex practices in heterosexual men using an Australian Internet dating service. Sex Health 2019; 15:223-231. [PMID: 29262985 DOI: 10.1071/sh17074] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 09/25/2017] [Indexed: 11/23/2022]
Abstract
Background This cross-sectional study investigated sexually transmissible infection (STI) knowledge, safer sex attitudes and behaviours of sexually active, heterosexual men using an Internet dating service, and explored factors associated with protective attitudes. METHODS An anonymous online survey was sent to men who had logged onto an Internet dating service within the previous year. Factors associated with discussing STIs before sex and condom use intention with a new partner were analysed. RESULTS In total, 2339 responses were analysed. Men had lower STI knowledge scores, lower use of condoms and greater beliefs that condoms reduced interest in sex as age increased. Younger men (aged 18-29 years) were more likely to report intentions of only having sex with a new partner if a condom was used compared with older men aged over 60 years. Predictors of having a discussion about STIs with a new partner were older age, better knowledge of STIs, greater distress at a potential diagnosis of an STI and stronger future condom use intention. Intention to only have sex with a new female partner if a condom was used was associated with higher STI knowledge, discussing STIs with a new partner and distress at a diagnosis of an STI. Men with a higher number of sexual partners in the last year were less likely to have an STI discussion with new partners or intend to use a condom with a new partner. CONCLUSIONS Older Internet-dating, heterosexual men are vulnerable to STIs. Health promotion interventions to increase STI awareness, condom use and STI testing in older men are warranted.
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Affiliation(s)
- Yan Cheng
- Family Planning NSW, 328-336 Liverpool Road, Ashfield, NSW 2131, Australia
| | - Kevin McGeechan
- Family Planning NSW, 328-336 Liverpool Road, Ashfield, NSW 2131, Australia
| | - Deborah Bateson
- Family Planning NSW, 328-336 Liverpool Road, Ashfield, NSW 2131, Australia
| | - Todd Ritter
- Family Planning NSW, 328-336 Liverpool Road, Ashfield, NSW 2131, Australia
| | - Edith Weisberg
- Family Planning NSW, 328-336 Liverpool Road, Ashfield, NSW 2131, Australia
| | - Mary Stewart
- Family Planning NSW, 328-336 Liverpool Road, Ashfield, NSW 2131, Australia
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17
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Matos B, Haze L. Bottoms up: a whorelistic literature review and commentary on sex workers’ romantic relationships. SEXUAL AND RELATIONSHIP THERAPY 2019. [DOI: 10.1080/14681994.2019.1636958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Bella Matos
- Department of Psychology, The American University of Paris, Paris, France
| | - Lola Haze
- The University of Lived Experience, New York City, USA
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18
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Fileborn B, Brown G, Lyons A, Hinchliff S, Heywood W, Minichiello V, Malta S, Barrett C, Crameri P. Safer Sex in Later Life: Qualitative Interviews With Older Australians on Their Understandings and Practices of Safer Sex. JOURNAL OF SEX RESEARCH 2018; 55:164-177. [PMID: 28276933 DOI: 10.1080/00224499.2017.1280121] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Rates of sexually transmitted infections (STIs) are increasing in older cohorts in Western countries such as Australia, the United Kingdom, and the United States, suggesting a need to examine the safer sex knowledge and practices of older people. This article presents findings from 53 qualitative interviews from the study Sex, Age, and Me: A National Study of Sex and Relationships Among Australians Aged 60+. Participants were recruited through an online national survey. We consider how participants understood "safer sex," the importance of safer sex to them, the safer sex practices they used (and the contexts in which they used them), and the barriers to using safer sex. Older adults had diverse understandings, knowledge, and use of safer sex practices, although participants tended to focus most strongly on condom use. Having safer sex was strongly mediated by relationship context, trust, perceived risk of contracting an STI, concern for personal health, and stigma. Common barriers to safer sex included erectile difficulties, embarrassment, stigma, reduced pleasure, and the lack of a safer sex culture among older people. The data presented have important implications for sexual health policy, practice, and education and health promotion campaigns aimed at improving the sexual health and well-being of older cohorts.
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Affiliation(s)
- Bianca Fileborn
- a Australian Research Centre in Sex, Health, and Society
- b School of Psychology and Public Health, La Trobe University
- c School of Social Sciences , University of New South Wales
| | - Graham Brown
- a Australian Research Centre in Sex, Health, and Society
- b School of Psychology and Public Health, La Trobe University
| | - Anthony Lyons
- a Australian Research Centre in Sex, Health, and Society
- b School of Psychology and Public Health, La Trobe University
| | | | - Wendy Heywood
- a Australian Research Centre in Sex, Health, and Society
- b School of Psychology and Public Health, La Trobe University
| | - Victor Minichiello
- a Australian Research Centre in Sex, Health, and Society
- b School of Psychology and Public Health, La Trobe University
- e School of Medicine Public Health , University of Newcastle and School of Justice
- f Faculty of Law , Queensland University of Technology
| | - Sue Malta
- g National Ageing Research Institute, University of Melbourne
- h Swinburne Institute of Social Research , Swinburne University of Technology
| | - Catherine Barrett
- a Australian Research Centre in Sex, Health, and Society
- b School of Psychology and Public Health, La Trobe University
| | - Pauline Crameri
- a Australian Research Centre in Sex, Health, and Society
- b School of Psychology and Public Health, La Trobe University
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Grant R, Nash M. Navigating unintelligibility: Queer Australian young women's negotiations of safe sex and risk. J Health Psychol 2017; 23:306-319. [PMID: 29134821 DOI: 10.1177/1359105317741658] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Australian public health promotion positions safe sex as a biomedical, heteronormative concept. Consequently, there is a dearth of scholarly research examining queer young women's sexual health. To fill this knowledge gap, this article considers how Australian bisexual and queer young women understand 'safe sex' and conceptualise 'good' sexual citizenship. Drawing on qualitative interviews with 15 participants in Tasmania, findings reveal that although queer women understand heterosexual safe sex, there is little awareness of safer sexual practices with female partners. We argue that gendered sexual scripts shape perceptions of sexual health risk whereby queer women adopt multiple situation-dependent approaches to safer sex.
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20
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Lyons A, Heywood W, Fileborn B, Minichiello V, Barrett C, Brown G, Hinchliff S, Malta S, Crameri P. The Sex, Age, and Me study: recruitment and sampling for a large mixed-methods study of sexual health and relationships in an older Australian population. CULTURE, HEALTH & SEXUALITY 2017; 19:1038-1052. [PMID: 28276921 DOI: 10.1080/13691058.2017.1288268] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 01/25/2017] [Indexed: 06/06/2023]
Abstract
Older people are often excluded from large studies of sexual health, as it is assumed that they are not having sex or are reluctant to talk about sensitive topics and are therefore difficult to recruit. We outline the sampling and recruitment strategies from a recent study on sexual health and relationships among older people. Sex, Age and Me was a nationwide Australian study that examined sexual health, relationship patterns, safer-sex practices and STI knowledge of Australians aged 60 years and over. The study used a mixed-methods approach to establish baseline levels of knowledge and to develop deeper insights into older adult's understandings and practices relating to sexual health. Data collection took place in 2015, with 2137 participants completing a quantitative survey and 53 participating in one-on-one semi-structured interviews. As the feasibility of this type of study has been largely untested until now, we provide detailed information on the study's recruitment strategies and methods. We also compare key characteristics of our sample with national estimates to assess its degree of representativeness. This study provides evidence to challenge the assumptions that older people will not take part in sexual health-related research and details a novel and successful way to recruit participants in this area.
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Affiliation(s)
- Anthony Lyons
- a Australian Research Centre in Sex, Health and Society , La Trobe University , Melbourne , Australia
| | - Wendy Heywood
- a Australian Research Centre in Sex, Health and Society , La Trobe University , Melbourne , Australia
| | - Bianca Fileborn
- a Australian Research Centre in Sex, Health and Society , La Trobe University , Melbourne , Australia
| | - Victor Minichiello
- a Australian Research Centre in Sex, Health and Society , La Trobe University , Melbourne , Australia
| | - Catherine Barrett
- a Australian Research Centre in Sex, Health and Society , La Trobe University , Melbourne , Australia
| | - Graham Brown
- a Australian Research Centre in Sex, Health and Society , La Trobe University , Melbourne , Australia
| | - Sharron Hinchliff
- b School of Nursery and Midwifery , University of Sheffield , Sheffield , UK
| | - Sue Malta
- c National Ageing Research Institute , Melbourne , Australia
- d Swinburne Institute of Social Research , Swinburne University of Technology , Hawthorn , Australia
| | - Pauline Crameri
- a Australian Research Centre in Sex, Health and Society , La Trobe University , Melbourne , Australia
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21
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Freilich K, Holton S, Rowe H, Kirkman M, Jordan L, McNamee K, Bayly C, McBain J, Sinnott V, Fisher J. Sociodemographic characteristics associated with the use of effective and less effective contraceptive methods: findings from the Understanding Fertility Management in Contemporary Australia survey. EUR J CONTRACEP REPR 2017; 22:212-221. [PMID: 28492087 DOI: 10.1080/13625187.2017.1304534] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Unintended pregnancy and abortion may, in part, result from suboptimal use of effective contraception. This study aimed to identify sociodemographic factors associated with the use of effective and less effective methods among women and men of reproductive age living in Australia. METHODS In a cross-sectional national survey, 1544 women and men aged 18-51 were identified as being at risk of pregnancy. Chi-square and logistic regression analyses were used to assess the sociodemographic factors related to contraceptive use. RESULTS Most respondents (n = 1307, 84.7%) reported using a method of contraception. Use of any contraceptive was associated with being born in Australia (Odds Ratio [OR] 1.89; 95% Confidence Interval [CI]1.186, 3.01; p = .008), having English as a first language (OR 1.81; 95% CI: 1.07, 3.04; p = .026), having private health insurance (OR 2.25; 95% CI 1.66, 3.04; p < .001), and not considering religion important to fertility choices (OR 0.43; 95%CI 0.31, 0.60; p < .001). A third used effective contraceptive methods (n = 534, 34.6%; permanent methods: 23.1%, and long-acting reversible contraception (LARC): 11.4%). Permanent methods were more likely to be used in rural areas (OR 0.62; 95%CI 0.46, 0.84; p = .002). Use of the least effective, short-term methods was reported by nearly half (condoms: 25.6%, withdrawal: 12.5%, and fertility-awareness-based methods: 2.8%). Those who relied on withdrawal were more likely to live in a metropolitan area (OR 2.85; 95% CI 1.95, 4.18; p < .001), and not have private health insurance (OR 0.52; 95% CI 0.38, 0.71; p < .001). CONCLUSIONS Targeted promotion of the broad range of available contraceptives may raise awareness and uptake of more effective methods and improve reproductive autonomy in certain population groups.
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Affiliation(s)
- Karen Freilich
- a Jean Hailes Research Unit , Monash University , Melbourne , Australia
| | - Sara Holton
- a Jean Hailes Research Unit , Monash University , Melbourne , Australia
| | - Heather Rowe
- a Jean Hailes Research Unit , Monash University , Melbourne , Australia
| | - Maggie Kirkman
- a Jean Hailes Research Unit , Monash University , Melbourne , Australia
| | - Lynne Jordan
- b Family Planning Victoria , Melbourne , Australia
| | | | | | | | - Vikki Sinnott
- e Victorian Government Department of Health and Human Services , Melbourne , Australia
| | - Jane Fisher
- a Jean Hailes Research Unit , Monash University , Melbourne , Australia
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O'Mullan C, Debattista J, Browne M. Risky business or not? FIFOs, sexual risk taking and the Australian mining industry. Health Promot J Austr 2017; 27:4-9. [PMID: 26603027 DOI: 10.1071/he15011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 08/21/2015] [Indexed: 11/23/2022] Open
Abstract
Issue addressed The fly-in, fly-out (FIFO) and drive-in, drive-out (DIDO) models of mining in Australia have led to concerns about adverse health and psychosocial impacts. Despite speculation that increased levels of sexually transmitted infections (STIs) in Australia, including HIV, are associated with FIFO/DIDO work, we know little about sexual risk-taking behaviours in mining populations. This study explores differences in sexual risk taking and perceptions of risk between FIFO/DIDO miners and residential miners. Methods A cross-sectional survey was administered to a sample (n=444) of male miners working in Queensland, Australia. The self-completed survey contained 49 questions relating to knowledge, attitudes and behaviour and included demographic information and specific items related to sex and relationships. Results FIFO/DIDO status was not associated with any differential sexual risk-taking behaviours, except for an increased probability of reporting 'ever being diagnosed with an STI'; 10.8% of FIFO/DIDO respondents versus 3.6% of others (x(2) (1)=4.43, P=0.35). Conclusions Our results appear to counter anecdotal evidence that FIFO/DIDO miners engage in higher sexual risk behaviours when compared with residential miners. So what? Anecdotal evidence linking the rise of sexually transmitted infections with the FIFO/DIDO mining workforce could drive costly and unnecessary approaches to prevention. Further research, surveillance and monitoring are required to inform health promotion interventions.
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Affiliation(s)
- Cathy O'Mullan
- School of Human, Health and Social Sciences, Central Queensland University, Locked Bag 3333, Bundaberg, Qld 4670, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Locked Bag 2, Stafford, Qld 4053, Australia
| | - Matthew Browne
- School of Human, Health and Social Sciences, Central Queensland University, Locked Bag 3333, Bundaberg, Qld 4670, Australia
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Hall KM, Brieger DG, De Silva SH, Pfister BF, Youlden DJ, John-Leader F, Pit SW. Errors and Predictors of Confidence in Condom Use amongst Young Australians Attending a Music Festival. JOURNAL OF SEXUALLY TRANSMITTED DISEASES 2016; 2016:6054870. [PMID: 27957381 PMCID: PMC5124483 DOI: 10.1155/2016/6054870] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 09/24/2016] [Accepted: 10/10/2016] [Indexed: 11/17/2022]
Abstract
Objectives. To determine the confidence and ability to use condoms correctly and consistently and the predictors of confidence in young Australians attending a festival. Methods. 288 young people aged 18 to 29 attending a mixed-genre music festival completed a survey measuring demographics, self-reported confidence using condoms, ability to use condoms, and issues experienced when using condoms in the past 12 months. Results. Self-reported confidence using condoms was high (77%). Multivariate analyses showed confidence was associated with being male (P < 0.001) and having had five or more lifetime sexual partners (P = 0.038). Reading packet instructions was associated with increased condom use confidence (P = 0.011). Amongst participants who had used a condom in the last year, 37% had experienced the condom breaking and 48% had experienced the condom slipping off during intercourse and 51% when withdrawing the penis after sex. Conclusion. This population of young people are experiencing high rates of condom failures and are using them inconsistently or incorrectly, demonstrating the need to improve attitudes, behaviour, and knowledge about correct and consistent condom usage. There is a need to empower young Australians, particularly females, with knowledge and confidence in order to improve condom use self-efficacy.
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Affiliation(s)
- Karina M. Hall
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- University Centre for Rural Health, Western Sydney University, 61 Uralba Street, Lismore, NSW 2480, Australia
| | - Daniel G. Brieger
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- University Centre for Rural Health, Western Sydney University, 61 Uralba Street, Lismore, NSW 2480, Australia
| | - Sukhita H. De Silva
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- University Centre for Rural Health, Western Sydney University, 61 Uralba Street, Lismore, NSW 2480, Australia
| | - Benjamin F. Pfister
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- University Centre for Rural Health, Western Sydney University, 61 Uralba Street, Lismore, NSW 2480, Australia
| | - Daniel J. Youlden
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- University Centre for Rural Health, Western Sydney University, 61 Uralba Street, Lismore, NSW 2480, Australia
| | - Franklin John-Leader
- Harm Reduction and Health Promotion Programs, HIV and Related Programs (HARP), North Coast Public Health, Mid-North Coast Local Health District, P.O. Box 419, Lismore, NSW 2480, Australia
| | - Sabrina W. Pit
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- University Centre for Rural Health, Western Sydney University, 61 Uralba Street, Lismore, NSW 2480, Australia
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Dalrymple J, Booth J, Flowers P, Lorimer K. Psychosocial factors influencing risk-taking in middle age for STIs. Sex Transm Infect 2016; 93:32-38. [PMID: 27388457 DOI: 10.1136/sextrans-2016-052588] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 06/09/2016] [Accepted: 06/18/2016] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To increase the knowledge of the psychosocial factors influencing sexual risk-taking for STIs among adults in late middle age. METHODS Individual interviews were conducted either face to face or by telephone with 31 heterosexual men and women aged between 45 and 65. They were recruited from NHS sexual health services (n=16) and council run culture and leisure facilities (n=15) in a large Scottish city. A total of 18 women and 13 men were interviewed. All interviews were transcribed in full and thematically analysed. RESULTS Analysis detailed important psychosocial and sociocultural factors; the prioritisation of intimacy above and beyond concerns about risks for STI in sexual partnerships; the importance of unwanted pregnancy in shaping risk perceptions throughout the life course; vulnerability associated with periods of relationship transition (eg, bereavement, divorce or separation); social norms and cultural expectations relating to age-appropriate sexual and health-seeking behaviours. CONCLUSIONS This is the first qualitative study to examine the factors associated with sexual risk-taking among heterosexual adults in late middle age in the UK. Many factors associated with sexual risk-taking are similar to those reported within other populations. However, we also detail population-specific factors, which should be considered in terms of the development of interventions for 'at risk' older adults, or the tailoring of wider behaviour change interventions to this specific age group.
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Affiliation(s)
- Jenny Dalrymple
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Joanne Booth
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Paul Flowers
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Karen Lorimer
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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Richters J, Fitzadam S, Yeung A, Caruana T, Rissel C, Simpson JM, de Visser RO. Contraceptive practices among women: the second Australian study of health and relationships. Contraception 2016; 94:548-555. [PMID: 27373543 DOI: 10.1016/j.contraception.2016.06.016] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 06/21/2016] [Accepted: 06/22/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To document the use of contraception by a representative sample of Australian women aged 16-49 years and compare it with 2001-2002. METHODS Women were asked about their use of contraception and method used or reason for non-use during computer-assisted telephone interviews in 2012-2013. Women were sampled by random digit dialling of landline and mobile phones (participation rate 67.2%). RESULTS Of a weighted sample of 5654 heterosexually active women interviewed 81% were using a method of contraception including sterilisation; this amounts to 66% of all women aged 16-49. Of those who were not using a method, 42% were pregnant or wanted a baby, 25% said they or their partners were infertile, 5% were currently not having intercourse, 3% were past menopause and 25% were apparently at risk of unintended pregnancy. Of those who used a method, 33% used oral contraceptives, 30% condoms and 19% sterilisation as their primary method. Use of condoms, intrauterine devices, implants and emergency contraception has increased since 2002, and use of sterilisation has fallen. Method used varied by age group, location, occupational group, relationship status and parity. A third of women had ever used emergency contraception, with the highest rate among women in their 20s. CONCLUSION Australian women have access to a wide range of effective contraceptive methods. IMPLICATIONS Given the high levels of use, most unintended pregnancies in Australia are likely to be attributable to method failure or inconsistent use.
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Affiliation(s)
- Juliet Richters
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
| | - Suzanne Fitzadam
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Anna Yeung
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Theresa Caruana
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Chris Rissel
- Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Judy M Simpson
- Sydney School of Public Health, University of Sydney, Sydney, Australia
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Binns C, Howat P, Jancey J. Health promotion success in Australia and a note of warning. Health Promot J Austr 2014; 25:157-9. [DOI: 10.1071/hev25n3_ed] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Rissel C, Badcock PB, Smith AMA, Richters J, de Visser RO, Grulich AE, Simpson JM. Heterosexual experience and recent heterosexual encounters among Australian adults: the Second Australian Study of Health and Relationships. Sex Health 2014; 11:416-26. [PMID: 25376995 DOI: 10.1071/sh14105] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 08/19/2014] [Indexed: 11/23/2022]
Abstract
UNLABELLED Background Current information about numbers of other-sex partners, experiences of different heterosexual behaviours and the recent heterosexual experiences among a representative sample of Australian adults is needed. It is not known whether these practices have changed between 2001-02 and 2012-13. METHODS Computer-assisted telephone interviews were completed by a representative sample of 9963 men and 10131 women aged 16-69 years from all states and territories. The overall participation rate among eligible people was 66.2%. RESULTS Men reported more sexual partners than women, although the lifetime number of heterosexual partners reported by women increased significantly between 2001-02 and 2012-13. In 2012-13, 14.7% of men and 8.6% of women reported two or more sexual partners in the last year. Reporting multiple partners was significantly associated with being younger, being bisexual, living in major cities, having a lower income, having a blue-collar occupation and not being married. The proportion of respondents reporting ever having had oral sex or anal intercourse increased significantly since the last survey. At the last heterosexual encounter, 91.9% of men and 66.2% of women had an orgasm, oral sex was reported in only approximately one in four encounters and anal intercourse was uncommon. CONCLUSION There were increases between 2001-02 and 2012-13 in partner numbers among women and in the lifetime experience of oral and anal sex. The patterns of heterosexual experience in Australia are similar to those found in studies of representative samples in other countries.
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Affiliation(s)
- Chris Rissel
- Sydney School of Public Health, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW 2006, Australia
| | - Paul B Badcock
- Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
| | - Anthony M A Smith
- Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
| | - Juliet Richters
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | | | - Andrew E Grulich
- The Kirby Institute, Wallace Wurth Building, University of New South Wales, Sydney, NSW 2052, Australia
| | - Judy M Simpson
- Sydney School of Public Health, Edward Ford Building (A27), University of Sydney, Sydney, NSW 2006, Australia
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de Visser RO, Richters J, Rissel C, Badcock PB, Simpson JM, Smith AMA, Grulich AE. Change and stasis in sexual health and relationships: comparisons between the First and Second Australian Studies of Health and Relationships. Sex Health 2014; 11:505-9. [PMID: 25377003 DOI: 10.1071/sh14112] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 09/06/2014] [Indexed: 11/23/2022]
Affiliation(s)
| | - Juliet Richters
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Chris Rissel
- Sydney School of Public Health, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW 2006, Australia
| | - Paul B Badcock
- Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
| | - Judy M Simpson
- Sydney School of Public Health, Edward Ford Building (A27), University of Sydney, Sydney, NSW 2006, Australia
| | - Anthony M A Smith
- Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
| | - Andrew E Grulich
- Kirby Institute, Wallace Wurth Building, University of New South Wales, Sydney, NSW 2052, Australia
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Richters J, Badcock PB, Simpson JM, Shellard D, Rissel C, de Visser RO, Grulich AE, Smith AMA. Design and methods of the Second Australian Study of Health and Relationships. Sex Health 2014; 11:383-96. [PMID: 25376992 DOI: 10.1071/sh14115] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 09/03/2014] [Indexed: 11/23/2022]
Abstract
UNLABELLED Background This paper describes the methods and process of the Second Australian Study of Health and Relationships. METHODS A representative sample of the Australian population was contacted by landline and mobile phone modified random-digit dialling in 2012-13. Computer-assisted telephone interviews elicited sociodemographic and health details as well as sexual behaviour and attitudes. For analysis, the sample was weighted to reflect the study design and further weighted to reflect the location, age and sex distribution of the population at the 2011 Census. RESULTS Interviews were completed with 9963 men and 10131 women aged 16-69 years from all states and territories. The overall participation rate among eligible people was 66.2% (63.9% for landline men, 67.9% for landline women and 66.5% for mobile respondents). Accounting for the survey design and adjusting to match the 2011 Census resulted in a weighted sample of 20094 people (10056 men and 10038 women). The sample was broadly representative of the Australian population, although as in most surveys, people with higher education and higher status occupations were over-represented. Data quality was high, with the great majority saying they were not at all or only slightly embarrassed by the questionnaire and almost all saying they were 90-100% honest in their answers. CONCLUSIONS The combination of methods and design in the Second Australian Study of Health and Relationships, together with the high participation rate, strongly suggests that the results of the study are robust and broadly representative of the Australian population.
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Affiliation(s)
- Juliet Richters
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Paul B Badcock
- Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
| | - Judy M Simpson
- Sydney School of Public Health, Edward Ford Building (A27), University of Sydney, Sydney, NSW 2006, Australia
| | - David Shellard
- Hunter Valley Research Foundation, PO Box 322, Newcastle, NSW 2300, Australia
| | - Chris Rissel
- Sydney School of Public Health, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW 2006, Australia
| | | | - Andrew E Grulich
- The Kirby Institute, Wallace Wurth Building, University of New South Wales, Sydney, NSW 2052, Australia
| | - Anthony M A Smith
- Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
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