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NCHSR publications

December 2012 to February 2013

National Centre in HIV Social Research  

Dear colleague

This is an update of articles and reports published by our Centre in conjunction with project partners between December 2012 and February 2013.

For further information about NCHSR and our activities please go to our website.


Released: January 2013

Risk perception of HIV transmission

Limin Mao

A recent paper published in AIDS and Behavior by Dr Limin Mao (NCHSR) and her colleagues reassessed the HIV-related risk perceptions of HIV-negative gay men. Using data from the Sydney Gay Community Periodic Surveys, gay men’s perceptions of the risk of HIV transmission were assessed for a range of anal intercourse practices, and casual encounters with partners who have different HIV status and viral load levels. While gay men in Sydney were found to be generally well informed about potential risks of HIV infection, some results merit attention.

Firstly, men who engaged in unprotected anal intercourse with casual partners appeared to perceive risk of HIV transmission to be lower than men who used condoms consistently. This suggests a false sense of ‘personal immunity’ in some men. Secondly, the survey helps to better understand how gay men order risk depending on sexual practices, serological status and viral load. Gay men’s evaluation of HIV transmission risk is broadly based on their understandings of the hierarchy of these risks depending on sexual practices, with insertive sex being perceived as less risky than receptive sex. To a lesser extent, gay men’s evaluation of the risk is based on their casual partners’ HIV status and viral load levels. Together these results suggest that there is a need to better recognise the complex associations between risk perceptions, risk practices, serological status and viral load levels. These findings point to the importance of continued efforts to reinforce HIV behavioural prevention alongside recent breakthroughs in HIV biomedical interventions.

 

Citation: Mao, L., Adam, P., Kippax, S., Holt, M., Prestage, G., Calmette, Y., Zablotska, I., & de Wit, J. (2013). HIV-negative men’s perceived HIV risk hierarchy: imaginary or real? AIDS and Behavior. Advance online publication. http://dx.doi.org/10.1007/s10461-012-0406-8 
 



Released: December 2012

What do marginalised young people know and think about injecting and hepatitis C?

Joanne Bryant

Lately discussions about hepatitis C prevention have reframed the focus on young people to include not only those who are injecting but those at risk for taking up injecting. By focussing on this group the hope is to reduce harms among those who might eventually inject, including of course to reduce the incidence of hepatitis C infection. Indeed the highest incidence of hepatitis C infection occurs among people who have been injecting for three years or less. A new report released by NCHSR describes one of the first known studies of this group, The Exposure and Transition Study. It collected data from young socially marginalised drug users in Sydney, asking them about a range of issues including their own drug use and that of their peers, their experiences and knowledge of harm reduction services and what they thought about hepatitis C.

One key finding was that there was a general silence about hepatitis C. Respondents struggled to articulate anything about hepatitis C and how it affected the body. They also had little knowledge about where to find sterile needles and syringes, with many either not knowing where to get them or identifying secondary outlets such as pharmacies and hospitals as a source of this equipment. This suggests that young people new to injecting would be very poorly placed to reduce the harms they might encounter in the first few years of injecting. As the report outlines, one way to address this would be to improve the skills of staff at secondary outlets to liaise with young new injectors, as they appear to be the first point of contact for vulnerable new injectors.

Citation: Bryant, J., Ellard, J., Fisher, D., & Treloar, C. (2012). The exposure and transition study: exposure to injecting and hepatitis C among young people at risk (Monograph 2/2012). Sydney: National Centre in HIV Social Research, The University of New South Wales.
 


 
Released: January 2013

Making (new) sense of serodiscordance

Asha Persson

Serodiscordant primary relationships, in which one partner is HIV-positive and the other is HIV-negative, are increasingly recognised as a key context for the transmission of HIV globally. Yet insights into the dynamics of serodiscordance remain relatively limited. In this article, Asha Persson argues that to understand what makes serodiscordant couples engage in sexual practices that increase the chance of transmission, we need to move beyond the scientific conceptualisation of HIV 'risk' as an objective 'fact' and instead examine what HIV ‘risk’, as well as 'serodiscordance', actually mean in different cultures and contexts.

 

Citation: Persson, A. (2013). Notes on the concepts of ‘serodiscordance’ and ‘risk’ in couples with mixed HIV status. Global Public Health, 8, 209–220. http://dx.doi.org/10.1080/17441692.2012.729219
 


 
Released: January 2013

The waiting room

Christy Newman

Many of the community-based health services which provide HIV care in Australia are also known as ‘gay-friendly’ clinics, and have a long history of serving the gay communities of our largest cities. These clinics and those who work in them have made an incredibly valuable contribution to both HIV and gay men’s healthcare over the last few decades, providing expert primary healthcare to a particularly diverse patient population, and supporting those who may not feel safe in the mainstream health system. However, this paper was interested in exploring some of the potential tensions and dissonances which may be associated with the aim of providing socially inclusive HIV care, particularly in light of the increasing number of new HIV diagnoses attributed to heterosexual transmission in Australia. Drawing on interviews with clinicians and key informants conducted as part of the HIV General Practice Workforce Project, in dialogue with the findings of the Straightpoz study, this paper reflects on the complex meanings attributed to ‘inclusive’ HIV clinics in the context of a changing epidemic.

 

Citation: Newman, C. E., Persson, A., Paquette, D., Kidd, M. R. (2013). The new cultural politics of the waiting room: Straight men, gay-friendly clinics and ‘inclusive’ HIV care. Sexuality Research and Social Policy. Advance online publication.
http://dx.doi.org/10.1007/s13178-013-0111-z  



 

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