This study used matched samples from schools in Victoria, Australia and Washington, USA to undertake a cross national comparison of sexual behaviours in early adolescence. It is hypothesised that the contrasting policy contexts of harm minimisation in Australia and abstinence in the United States will result in significant state differences for markers of sexual risk.
A two stage cluster sampling approach was taken to recruit students from Washington, USA and Victoria, Australia. Data were examined from 1,888 students who traversed from Grade 7 in 2002 to Grade 9 in 2004. Students were asked if they had previously had sex; in Grade 9 they were also asked about frequency of sex, contraception use, number of sexual partners and pregnancy. Prevalence estimates were derived for each measure of sexual behaviour, and comparisons were made between gender groups in each state.
State differences were found for girls’ sexual debut with significantly more girls in Washington than Victoria having had sex by Grade 7. By Grade 8, no difference was evident, and in Grade 9, a significantly higher number of Victorian girls had had sex compared to Washington girls. Further state differences were found in measures of Grade 9 sexual behaviour. Most notably, number of sexual partners for girls was significantly higher in Victoria compared to Washington, but there were no cross national differences in contraceptive use for either gender.
The findings demonstrate that differences in sexual engagement and behaviour are evident that inform the different policy contexts of Victoria, Australia and Washington, USA. Contradicting the abstinence policy objective, early sexual debut was more common in Washington than Victoria. Whilst sexual behaviour was more prevalent in Grade 9 in Victoria than Washington, there were no clear differences in markers of risk such as contraception use and pregnancy outcomes, despite the contrasting policy objectives.
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.