In Papua New Guinea (PNG), sexual violence (SV) is widespread and best practices are being implemented to improve responses to SV. One area has been legislate and programing reform. Such reforms aim to increase access to legal support for victims of SV to pursue prosecution of the perpetrator, a process predicated on the reporting such acts.
As part of a qualitative longitudinal study on masculinity in Bena, Eastern Highlands, young men were interviewed on three occasions; the final interview addressed men’s knowledge and experiences of SV (N=18). Interviews were conducted in Tok Pisin, digitally recorded, transcribed verbatim, translated into English and coded in Nvivo 9.
SV is common in this community and most knew that such violence was illegal, yet many believed that there were times when (and to whom) SV was justified. Despite the illegal nature of SV, most acts of SV recounted were not dealt with through the law enforcement agencies. Local, culturally sanctioned means of dealing with SV in the community were preferred; responses depended on the relationship between the “victim” and the perpetrator. Local approaches to resolving SV were important for maintaining ongoing social and reciprocal relationships rather than individual justice to an individual victim. Compensation is ordered for “victim’s” relatives validating the damage of SV to the collective.
The stark contrast between best practices which privilege the international criminal justice system, a system that advocates pro-prosecution which finds an individual person accountable for SV and how SV is resolved locally begs the question of justice for whom? The former is based on western notions of individual personhood and responsibility while the latter is based on reciprocal social relationships. The ways that SV is resolved locally will only change as wider socio-cultural structures do.
The majority of HIV diagnoses including delayed diagnoses in Australia occur among men who report homosexual contact – hereafter called gay and bisexual men (GBM). Delayed diagnosis is strongly associated with increased HIV-related mortality and morbidity. People who are unaware of their HIV-positive status may also be unwittingly transmitting HIV. We assessed trends in delayed HIV diagnoses among GBM in Australia.
HIV-associated leishmaniasis, endemic in the Mediterranean basin is a growing problem in India, Brazil and East Africa. Despite surviving for than 20 years, the clinical course of our visceral-leishmania (VL)-HIV co-infected patient illustrates several management challenges including diagnosis, speciation and drug resistance; monitoring burden of disease; access to and use of VL-treatments; end-organ toxicity and the combined immunosuppressive effects of HIV-VL.
Adherence to combination antiretroviral therapy (cART ) plays an important role on treatment outcomes. The TREAT Asia Studies to Evaluate Resistance – Monitoring Cohort Study (TASER-M) collects patients’ adherence based on a Visual Analogue Scale. The aim of this analysis was to assess the rates of, and factors associated with, suboptimal adherence in the first 24 months of initial cART in Asian patients.
REACH was a collaborative research and practice initiative to develop evidence building frameworks, capacity, tools and resources with the Victorian HIV community partnership.
HIV disease is associated with chronic inflammation and activation of the innate immune system. This state, as measured using plasma markers of inflammation, persists following suppression of HIV viremia using antiretroviral therapy, and may increase risk of non-AIDS co-morbidities. The causes of innate immune activation in the setting of virological suppression are unclear. Natural killer (NK) cells are innate immune cells that kill virus-infected and transformed cells without prior sensitization. We have shown that NK cells are activated both phenotypically (elevated expression of HLA-DR) and functionally (increased spontaneous degranulation measured by CD107a surface expression) in virologically suppressed (VS) HIV+ individuals. NK cells also lose expression of CD16, the receptor which mediates antibody-dependent cellular cytotoxicity.
Regular HIV testing is recommended in men who take sexual risks. We assessed the relationship between perceived barriers to HIV testing, and frequency of testing among men who engaged in unprotected anal intercourse with casual partners (UAIC), to inform HIV testing strategies.
Gay men remain the primary population affected by HIV in Australia. While recent attention has been focused on increasing HIV testing and the use of antiretroviral-based prevention to reduce infections, it is equally important to sustain safe sex and other risk reduction practices. Increases in unprotected anal intercourse (UAI), for example, may counteract any beneficial changes in testing and treatment.