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Graham S, Guy RJ, Ward JS, Kaldor J, Donovan B, Knox J, McCowen D, Bullen P, Booker J, O'Brien C, Garrett K, Wand HC. Incidence and predictors of annual chlamydia testing among 15-29 year olds attending Aboriginal primary health care services in New South Wales, Australia. BMC Health Serv Res 2015; 15:437. [PMID: 26424655 PMCID: PMC4588905 DOI: 10.1186/s12913-015-1116-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 09/24/2015] [Indexed: 11/10/2022] Open
Abstract
Background For the past two decades, chlamydia has been the most commonly notified infectious disease among young people (15–29 year olds) in Australia, the United States of America and the United Kingdom and rates have increased annually in these three countries. In Australia, rates of chlamydia are three times higher in Aboriginal compared with non-Aboriginal people. Australian sexually transmissible infection guidelines recommend annual chlamydia testing for 15–29 year old females and males. This analysis will examine the incidence and predictors of annual chlamydia testing in 15–29 year olds attending four Aboriginal Community Controlled Health Services (ACCHS) in Australia. Methods From 2009–2011, attendance and chlamydia testing data were extracted from the patient system to calculate the number and proportion of 15–29 year olds that were tested for chlamydia and that tested positive for chlamydia by gender (male, female), age-group (15–19, 20–24, 25–29 years), Aboriginal status (Aboriginal, non-Aboriginal people) and by the four ACCHSs sites (1, 2, 3 and 4). A cohort was created to calculate the incidence rate per 100 person-years (PY) and predictors of an annual chlamydia test (a test within 12-months of a previous test/visit) by the above factors using Cox regression. Unadjusted and adjusted hazard ratios (AHR) and their 95 % confidence intervals (CIs) and p-values were calculated with significance at p < 0.05. Results From 2009–2011, there were 2896 individuals who attended the four ACCHSs. Overall , 17 % (22 % of females and 10 % of males) were tested for chlamydia and 9 % tested positive (8 % of females and 14 % of males). The median time to an annual chlamydia test was 10.7 months. The cohort included 2318 individuals. Overall the incidence rate of an annual chlamydia test was 9.1 per 100 PY (11.6 in females and 5.8 in males). Predictors of an annual chlamydia test were being female (AHR: 1.7, 95 % CI: 1.2-2.2, p < 0.01), being 15–19 years old (AHR: 1.6, 95 % CI: 1.1-2.3, p < 0.01) and attending ACCHS site 2 (AHR: 3.8, 95 % CI: 1.8-8.0, p < 0.01). Conclusions This analysis highlights that opportunistic STI testing strategies are needed to increase annual chlamydia testing in young people; especially males.
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Affiliation(s)
- Simon Graham
- Kirby Institute, UNSW Australia, Sydney, NSW, 2052, Australia. .,Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3052, Australia.
| | - Rebecca J Guy
- Kirby Institute, UNSW Australia, Sydney, NSW, 2052, Australia.
| | - James S Ward
- South Australian Health and Medical Research Institute, Adelaide, SA, 5000, Australia.
| | - John Kaldor
- Kirby Institute, UNSW Australia, Sydney, NSW, 2052, Australia.
| | - Basil Donovan
- Kirby Institute, UNSW Australia, Sydney, NSW, 2052, Australia. .,Sydney Sexual Health Centre, Sydney Hospital, Sydney, NSW, 2000, Australia.
| | - Janet Knox
- Kirby Institute, UNSW Australia, Sydney, NSW, 2052, Australia.
| | - Debbie McCowen
- Aboriginal Community Controlled Health Service, New South Wales, NSW, Australia.
| | - Patricia Bullen
- Aboriginal Community Controlled Health Service, New South Wales, NSW, Australia.
| | - Julie Booker
- Aboriginal Community Controlled Health Service, New South Wales, NSW, Australia.
| | - Chris O'Brien
- Aboriginal Community Controlled Health Service, New South Wales, NSW, Australia.
| | - Kristine Garrett
- Aboriginal Community Controlled Health Service, New South Wales, NSW, Australia.
| | - Handan C Wand
- Kirby Institute, UNSW Australia, Sydney, NSW, 2052, Australia.
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Negin J, Aspin C, Gadsden T, Reading C. HIV Among Indigenous peoples: A Review of the Literature on HIV-Related Behaviour Since the Beginning of the Epidemic. AIDS Behav 2015; 19:1720-34. [PMID: 25731659 PMCID: PMC4551545 DOI: 10.1007/s10461-015-1023-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
From the early days of the HIV epidemic, Indigenous peoples were identified as a population group that experiences social and economic determinants-including colonialism and racism-that increase exposure to HIV. There are now substantial disparities in HIV rates between Indigenous and non-Indigenous peoples in some countries. We conducted a comprehensive literature review to assess the evidence on HIV-related behaviors and determinants in four countries-Australia, Canada, New Zealand and the United States-in which Indigenous peoples share important features of colonization and marginalization. We identified 107 articles over more than 20 years. The review highlights the determinants of HIV-related behaviors including domestic violence, stigma and discrimination, and injecting drug use. Many of the factors associated with HIV risk also contribute to mistrust of health services, which in turn contributes to poor HIV and health outcomes among Indigenous peoples.
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Affiliation(s)
- Joel Negin
- Sydney School of Public Health, University of Sydney, Edward Ford Building (A27), Sydney, NSW, 2006, Australia,
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RETIRED: Chapter 5 First Nations, Inuit, and Métis Women’s Sexual and Reproductive Health. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2013; 35:S28-S32. [DOI: 10.1016/s1701-2163(15)30705-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Steenbeek A, Bailey G, Simandl D. Culturally relevant HIV/AIDS education, prevention, screening and treatment for Canadian Inuit. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2013; 104:e184. [PMID: 23618216 PMCID: PMC6973624 DOI: 10.1007/bf03405687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 03/06/2013] [Accepted: 02/15/2013] [Indexed: 06/02/2023]
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Kaai S, Bullock S, Burchell AN, Major C. Factors that affect HIV testing and counseling services among heterosexuals in Canada and the United Kingdom: an integrated review. PATIENT EDUCATION AND COUNSELING 2012; 88:4-15. [PMID: 22196985 DOI: 10.1016/j.pec.2011.11.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 10/01/2011] [Accepted: 11/26/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To examine factors that affect the utilization of HIV testing and counseling (HTC) services among heterosexual populations in Canada and the U.K. METHODS We conducted an integrated review of published and unpublished literature (1996-September 2010) using Scopus, OVID-EMBASE, CSA illumina, CINHAL, PROQuest, Web of Science, and Google. RESULTS Twenty-seven studies met the inclusion criteria. We identified and categorized the key factors into three broad categories depending on their source. Personal-related factors included socio-demographic characteristics, risk perception, illness, HIV-related stigma, level of HIV and testing knowledge, and culture. Provider-related factors included provider-recommended HIV testing, provision of culturally and linguistically appropriate services, and doctor-patient relationship. System-related factors included integrating HIV testing with other health care services, anonymity of testing services, suitability of testing venues, technical aspects of HIV testing, and funding for immigrant health services. CONCLUSION The findings from our review indicate that HTC behaviors of heterosexuals in the Canada and the U.K. are likely influenced by several unchangeable (socio-demographic characteristics) and amenable factors. There is need to step-up research to confirm whether these associations are causal using stronger research designs. PRACTICAL IMPLICATION: We have made several recommendations that could be used to improve existing services in Canada.
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Affiliation(s)
- Susan Kaai
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada.
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Worthington C, Jackson R, Mill J, Prentice T, Myers T, Sommerfeldt S. HIV testing experiences of Aboriginal youth in Canada: service implications. AIDS Care 2010; 22:1269-76. [DOI: 10.1080/09540121003692201] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Catherine Worthington
- a Faculty of Social Work , University of Calgary , 2500 University Drive NW, Calgary , AB , T2N 1N4 , Canada
| | - Randy Jackson
- b School of Social Work , McMaster University , Hamilton , ON , Canada
- c Canadian Aboriginal AIDS Network , Vancouver , BC , Canada
| | - Judy Mill
- d Faculty of Nursing , University of Alberta , Edmonton , AB , Canada
| | - Tracey Prentice
- e Institute of Population Health , University of Ottawa , Ottawa , ON , Canada
| | - Ted Myers
- f HIV Social, Behavioural and Epidemiological Studies Unit , University of Toronto , Toronto , ON , Canada
| | - Susan Sommerfeldt
- d Faculty of Nursing , University of Alberta , Edmonton , AB , Canada
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Orchard TR, Druyts E, McInnes CW, Clement K, Ding E, Fernandes KA, Anema A, Lima VD, Hogg RS. Factors behind HIV testing practices among Canadian Aboriginal peoples living off-reserve. AIDS Care 2010; 22:324-31. [DOI: 10.1080/09540120903111510] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Treena R. Orchard
- a Faculty of Health Sciences , University of Western Ontario , Arthur and Sonia Labatt Health Sciences Building, London , ON , N6A 5B9 , Canada
- b British Columbia Centre for Excellence in HIV/AIDS , St. Paul's Hospital , 608–1081 Burrard Street, V6Z 1Y6 , Vancouver , BC , Canada
| | - Eric Druyts
- b British Columbia Centre for Excellence in HIV/AIDS , St. Paul's Hospital , 608–1081 Burrard Street, V6Z 1Y6 , Vancouver , BC , Canada
| | - Colin W. McInnes
- b British Columbia Centre for Excellence in HIV/AIDS , St. Paul's Hospital , 608–1081 Burrard Street, V6Z 1Y6 , Vancouver , BC , Canada
| | - Ken Clement
- c Healing Our Spirit , British Columbia Aboriginal HIV/AIDS Society , 644-1979 Marine Drive, Vancouver , BC , V7P 3G1 , Canada
| | - Erin Ding
- b British Columbia Centre for Excellence in HIV/AIDS , St. Paul's Hospital , 608–1081 Burrard Street, V6Z 1Y6 , Vancouver , BC , Canada
| | - Kimberly A. Fernandes
- b British Columbia Centre for Excellence in HIV/AIDS , St. Paul's Hospital , 608–1081 Burrard Street, V6Z 1Y6 , Vancouver , BC , Canada
| | - Aranka Anema
- b British Columbia Centre for Excellence in HIV/AIDS , St. Paul's Hospital , 608–1081 Burrard Street, V6Z 1Y6 , Vancouver , BC , Canada
- d Department of Medicine, Faculty of Medicine , University of British Columbia , 3300–950 West 10th Avenue, Vancouver , BC , V5Z 4E3 , Canada
| | - Viviane D. Lima
- b British Columbia Centre for Excellence in HIV/AIDS , St. Paul's Hospital , 608–1081 Burrard Street, V6Z 1Y6 , Vancouver , BC , Canada
- d Department of Medicine, Faculty of Medicine , University of British Columbia , 3300–950 West 10th Avenue, Vancouver , BC , V5Z 4E3 , Canada
| | - Robert S. Hogg
- b British Columbia Centre for Excellence in HIV/AIDS , St. Paul's Hospital , 608–1081 Burrard Street, V6Z 1Y6 , Vancouver , BC , Canada
- e Faculty of Health Sciences , Simon Fraser University , 8888 University Drive, Burnaby , BC , V5A 1S6 , Canada
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