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Although approximately 31,000 Australian gay and bisexual men (GBM) are eligible for HIV pre-exposure prophylaxis (PrEP), only 18,500 people currently use it, indicating a need to investigate why GBM do not use it. This article uses data from a national, online, observational study. It adopts a mixed-methods analysis to responses to survey questions asking about reasons Australian GBM were not using PrEP in 2018, according to their level of HIV risk as delineated by the Australian PrEP prescribing guidelines at the time. Participants responded to check-box questions and had the option to respond to a qualitative free-text question. Results showed that just over one-fifth of men were at higher risk of HIV acquisition. Compared to lower-risk men, higher-risk men were more likely to indicate PrEP was too expensive and more likely to cite embarrassment asking for it. Reasons for not using PrEP included a lack of personal relevance, poor accessibility or knowledge, concerns about PrEP's inability to protect against STIs, potential side effects, and a preference for condoms. We conclude that health promotion more effectively targeting GBM who may benefit the most from PrEP may be valuable. [ABSTRACT FROM AUTHOR]

Although many studies reported on decreases in sexual partner numbers among gay and bisexual-identifying men in the early period of the COVID-19 pandemic, few studies have explored COVID-19 risk-reduction strategies. Drawing on free-text responses in an online survey (from April to July 2020), we describe the ways in which men sought to minimise the risk of COVID-19 in sexual encounters. Partner selection was an important strategy, in particular, restricting sex to men they already knew. Accounts also indicate how participants assessed risk from potential sex partners based on symptoms, residential location, recent travel, work role, and number of other sexual contacts. Less common were in situ practices, such as avoiding kissing. Participants' responses provide insight into creative community-based responses in the early months of the pandemic, some of which have resonances with early responses to HIV. Findings are discussed in relation to the concepts of 'lay epidemiology' and 'counterpublic health'. In particular, we examine how risks and health are experienced and valued in relation to local knowledges, meanings, and practices; and how practices emerge in response to dominant public health discourses that produce an idealised public based on (hetero)normative assumptions. [ABSTRACT FROM AUTHOR]

Background: Gay and bisexual men (GBM) report distinctive patterns and contexts of drug use, yet little has been published about their attitudes toward drug use. Objectives: We developed measures of attitudes and perceived social norms toward drug use, and examined covariates of more accepting attitudes and norms among GBM in Australia. Methods: We analyzed baseline data from the Following Lives Undergoing Change (Flux) study. Flux is an online prospective observational study of drug use among Australian GBM. We used principal components factor analysis to generate two attitudinal scales assessing "drug use for social and sexual enhancement" and "perceptions of drug risk." A third perceived social norms scale examined "acceptability of drug use among gay friends." Results: Among 2,112 participants, 61% reported illicit drug use in the preceding six months. Stronger endorsement of drug use for social and sexual engagement and lower perceptions of drug risk were found among men who were more socially engaged with other gay men and reported regular drug use and drug use for sex. In multivariate analyses, all three scales were associated with recent drug use (any use in the previous six months), but only the drug use for social and sexual enhancement scale was associated with regular (at least monthly) use. Conclusions: Drug use and sex are difficult to disentangle for some GBM, and health services and policies could benefit from a better understanding of attitudinal and normative factors associated with drug use in gay social networks, while recognizing the role of pleasure in substance use. [ABSTRACT FROM AUTHOR]

Epipalaeolithic hunter-gatherer communities in the Southern Levant exhibit numerous complex trends that suggest that the transition to the Neolithic was patchy and protracted. This paper explores the changing nature of occupation at the Epipalaeolithic site Kharaneh IV, Jordan, through an in-depth analysis of the lithic and faunal assemblages. Focusing on the analysis of a single deep sounding (unit AS42), we address how Kharaneh IV occupations link to the local landscape and environmental changes. As an aggregation site, Kharaneh IV represents an interesting locale to explore the changing nature of aggregation and social cohesion prior to the origins of agriculture, as well as changes in technology and subsistence between the Early and Middle Epipalaeolithic. We explore the tempo and nature of transition from one archaeological culture to the next through changes in technology and how this reflects the people making and using tools, to understand how foragers adapted to a changing landscape. [ABSTRACT FROM AUTHOR]

This review of qualitative research examining young Indigenous Australians’ sexual health highlights the profoundly social nature of young people’s sexual lives. Nineteen peer reviewed published papers were identified for inclusion. Findings reveal efforts made by some young Indigenous Australians to control their sexual lives, mitigate risk and maintain their sexual health. The review identified factors which are conducive to sexual health risks and vulnerability, including incomplete knowledge about STIs and safer sexual practices; gossip and ridicule concerning sexual activity and its consequences; damaging expectations about male prerogatives with respect to sexual relationships; limited inter-generational communication about sexual health issues; inadequate school-based sexual health education; and tensions between Indigenous and biomedical explanations of sexual health issues. Future research priorities include a focus on young Indigenous people in cities and towns across Australia, and in regional and remote settings in New South Wales and Victoria; understanding how Indigenous cultural values support young people’s sexual health; young men’s sexual and service-based practices; and the experiences of same-sex attracted and gender diverse youth. This research would inform the design and delivery of culturally safe and acceptable sexual health services and programmes, underpinned by an understanding of factors in young Indigenous Australians’ everyday sexual lives. [ABSTRACT FROM PUBLISHER]

Copyright of Culture, Health & Sexuality is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Culture, Health & Sexuality is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cambodia's 100% Condom Use Programme is credited with an increase in consistent condom use in commercial sexual interactions and a decrease in HIV prevalence among female sex workers (FSWs). There has been little improvement in condom use between FSWs and non-commercial partners, prompting calls for more innovative approaches to increasing condom use in these relationships. To understand why condoms are used or not used in sexual interactions involving FSWs, we examined condom negotiation across different types of relationships. We conducted 33 in-depth interviews with young (15 to 29 years) women engaged in sex work in Phnom Penh. There was an important interplay between the meanings of condom use and the meanings of women's relationships. Commercial relationships were characterised as inherently risky and necessitated condom use. Despite a similar lack of sexual fidelity, sweetheart relationships were rarely construed as risky and typically did not involve condom use. Husbands and wives constructed their sexual interactions with each other differently, making agreement on condom use difficult. The lack of improvement in condom use in FSWs' non-commercial sexual relationships needs to be understood in relation to both sex work and the broader Cambodian sexual culture within which these relationships are embedded. [ABSTRACT FROM AUTHOR]

Research with injecting drug users (IDUs) suggests greater willingness to report sensitive and stigmatised behaviour via audio computer-assisted self-interviewing (ACASI) methods than during face-to-face interviews (FFIs); however, previous studies were limited in verifying this within the same individuals at the same time point. This study examines the relative willingness of IDUs to report sensitive information via ACASI and during a face-to-face clinical assessment administered in health services for IDUs. During recruitment for a randomised controlled trial undertaken at two IDU-targeted health services, assessments were undertaken as per clinical protocols, followed by referral of eligible clients to the trial, in which baseline self-report data were collected via ACASI. Five questions about sensitive injecting and sexual risk behaviours were administered to participants during both clinical interviews and baseline research data collection. “Percentage agreement” determined the magnitude of concordance/discordance in responses across interview methods, while tests appropriate to data format assessed the statistical significance of this variation. Results for all five variables suggest that, relative to ACASI, FFI elicited responses that may be perceived as more socially desirable. Discordance was statistically significant for four of the five variables examined. Participants who reported a history of sex work were more likely to provide discordant responses to at least one socially sensitive item. In health services for IDUs, information collection via ACASI may elicit more reliable and valid responses than FFI. Adoption of a universal precautionary approach to complement individually tailored assessment of and advice regarding health risk behaviours for IDUs may address this issue. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Culture, Health & Sexuality is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Urban frontline services have recorded increases in psychostimulant-related presentations. A convenience sample of 183 street-based psychostimulant injectors recruited in April 2006 was administered the Kessler Psychological Distress Scale (K10) to assess psychological distress. Homelessness, unemployment, and recent public injection, along with gender (female) and financial and relationship problems, best predicted clinically significant K10 scores. Drug use measures were not significantly associated with distress once indicators of social marginalization were included. The risk environment of the street-based drug market accounts for much of the distress experienced in this milieu, highlighting the need for broad structural interventions, together with drug-specific responses. [ABSTRACT FROM AUTHOR]

Ethnic Vietnamese heroin users in Australia typically experience high rates of blood-borne virus infection, opioid overdose, criminal justice system involvement and poor retention in substance use treatment, particularly methadone maintenance treatment. This paper explores the experiences of twenty ethnic Vietnamese heroin users and examines the specific role of families in treatment from the perspective of the person going through treatment. What emerged from this study was a picture of a young, ethnically distinct subgroup of opiate-dependent people struggling to engage in treatment in an environment where heroin was easily accessible. The relational dynamics between participants and their family appears as a key mediator of the experience of treatment: it can be a source of motivation, grounding and connectedness; or it can be alienating and fragmenting. The extended nature of Vietnamese family systems meant that these relationships had implications for family members geographically and relationally close and distant. I think it is just like the worst thing when your parents find out because it feels like they have to suffer for like no reason, you know. It is too hard for them, they know but they never want to admit it. I would say the family stuff is the hardest. (Lien My [1], female 19 years) [ABSTRACT FROM AUTHOR]

Microbicides currently in development have the potential to provide new options for the prevention of sexually transmitted infections if proven safe and efficacious. We examined the experiences of healthy male volunteers in a male tolerance study in Victoria, Australia in relation to trial participation and product use. Men (N=36) enrolled in a seven-day, phase 1 clinical safety trial of SPL7013 were interviewed pre and post-use of the gel using a semi-structured interview guide. Interviews were digitally recorded and transcribed verbatim, and transcripts were analysed using a framework approach. All but one man completed the trial. The median age was 34 years (range 22-67 years). Most men had little pre-study knowledge of microbicides and almost all participated for altruistic or personal reasons. Men expressed few concerns about product safety during the trial and indicated trust in the information received through the consent process and from study staff. Three men were non-adherent to the request to be abstinent and an additional two did not refrain from masturbation. Most were positive about the gel, although they described it as “sticky” and found that it stuck to clothes, bed sheets and pubic hair. The type of applicator used was unfamiliar to the men, and some found it “clinical” in appearance. Men are willing to participate in male tolerance studies, often for altruistic reasons. However, counseling about ways to maintain abstinence and further research to inform anticipatory guidance regarding the “sticky” quality of gels, may be important. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background : In early 2001 Australia experienced a dramatic disruption to heroin supply. In order to investigate the impact of this phenomenon, heroin users were interviewed retrospectively to determine drug use behaviour over a two year period. Aim : To examine the reliability of the timeline follow-back (TLFB) technique in determining heroin users' patterns of drug use and related behaviours over a 24 month period. Method : 27 current heroin users were recruited through drug use services and interviewed about their drug use behaviour retrospectively using the calendar method of the TLFB. Test-retest reliability was measured over seven days. Results : Recall of regular drug use was generally reliable. Recall was poorest during January-April 2001, the peak period of the heroin shortage. Recall of criminal activity and weekly expenditure on drugs was variable, though generally poor. Recall of treatment entry and drug related health problems such as overdose was also variable. Conclusion : The 24 month TLFB did not obtain information reliable enough to examine sporadic drug use or overall changes in the patterns of drug use associated with the heroin shortage. To avoid this situation cohorts of injecting drug users need to be established as these phenomena cannot be accurately studied retrospectively. [ABSTRACT FROM AUTHOR]

The article presents a study showing the relation of the spread of hepatitis C and risk behavior among Indochinese regarding their use of heroin. Indochinese new injecting drug users((NIDU) are exposed to risk associated with their drug administrating practice such as disease transmission and overdose. Research shows that heroin abuse through injecting contributes to the transmission of hepatitis C. It also mentions that campaigns should be done against drug administration through injection to discourage the practice thus prevent the spread of the disease.

Presents a research on the experiences and perceive policing of Indo-Chinese youth in Sydney, New South Wales. Interview of Indo-Chinese youth involved in heroin use and distribution; Detention of young people; Perception of youths on the treatment administered by the police force.

Relatively little research has focused specifically on elderly offenders with severe mental illness. This study assessed psychosocial and legal issues in 83 male detainees, age 62 and above, who were hospitalized on a psychiatric forensic unit. This group included 38 Non-Hispanic whites, 31 blacks, 12 Hispanics, and 2 from other groups. Forty percent were diagnosed with a psychotic disorder. A series of chi-square tests found that patients charged with nonviolent crimes were more likely to report experiencing delusions. The victims of these alleged violent acts were primarily family members. There was no significant association between ethnic background and severity of legal charge or having a competency evaluation ordered. Suicidal ideation and thought disorders were more prevalent in nonwhite mentally ill elderly jail detainees. [ABSTRACT FROM PUBLISHER]

Examines recent claims of the success of penal rehabilitation and efforts to revive penal rehabilitation programs. Increased moral and philosophical legitimacy; Questions of effectiveness; Questions of humaneness and fairness; Concluding thoughts; More.

Examines the appropriate ways in monitoring the availability and use of illicit drugs in Australia. Collection of quantitative and qualitative information of illicit drug users; Validity in the implication of methods; Significance injecting drug users within the population of illicit drug users.

This paper presents a descriptive analysis of female crack dealers in New York City. It focuses on the various roles women perform and the ways women have been incorporated into existing roles within drug distribution networks. The paper examines the niches some women have carved out for themselves in the crack economy exhibiting broader patterns and relationships among supply, demand, and consumption. The need to finance consumption by female crack users has led to the creation of additional roles specifically associated with crack distribution. Even though these roles are within the confines of low-level sales and distribution activities, they account for a significant element of female participation in the drug economy. [ABSTRACT FROM PUBLISHER]

This paper will attempt to situate the current discourse on 'crack pregnancies' within the context of a broader regulatory discourse.' It will argue that defining and locating state intervention solely within the confines of formal legal discourse not only privileges the criminal law, but (1) occludes recognition of the ways in which regulation and control are effected by administrative law and welfare policy and (2) fails to specify the role of the welfare state in the construction and reproduction of dominant cultural norms of womanhood and mothering. The paper draws on feminist literature and fieldwork-in-progress to suggest that many of these women are already subject to substantial mechanisms of social control and cultural reproduction. In concluding, it is suggested that the construction of this debate to date has served to deflect attention away from the fissures of gender, race and class that render these women's lives as publicly problematic. [ABSTRACT FROM PUBLISHER]