Background: During the COVID-19 pandemic, governments worldwide introduced law enforcement measures to deter and punish breaches of emergency public health orders. For example, in Victoria, Australia, discretionary fines of A$1,652 were issued for breaching stay-at-home orders, and A$4,957 fines for 'unlawful gatherings'; to date, approximately 30,000 fines remain outstanding or not paid in full. Studies globally have revealed how the expansion of policing powers produced significant collateral damage for marginalized populations, including people from low-income neighboorhoods, Indigenous Peoples, sex workers, and people from culturally diverse backgrounds.
View Article and Find Full Text PDFBackground: We aimed to identify motivators for people who inject drugs to pursue treatment for hepatitis C virus (HCV) infection and uncover opportunities that could make treatment more appealing.
Methods: Between November 2023 and January 2024, we conducted semi-structured interviews with 15 HCV RNA-positive individuals with a history of injecting drug use and self-reported as either untreated or treated but delayed treatment for more than 6 months. Thematic and framework data analysis was employed and interpreted using the Capability, Opportunity and Motivation (COM-B) framework of behaviour change.
Background: Needle exchange programs are effective public health interventions that reduce blood-borne infections, including hepatitis C, and injection-related infections. We sought to assess the return on investment of existing Prison Needle Exchange Programs (PNEPs) in Canadian federal prisons and their expansion to all 43 institutions.
Methods: We developed a stochastic compartmental model that estimated hepatitis C and injection-related infections under different PNEP scenarios in Canadian federal prisons.
Objectives: Whilst public health measures were effective in reducing COVID-19 transmission, unintended negative consequences may have occurred. This study aims to assess changes alcohol consumption and the heavy episodic drinking (HED) during the pandemic.
Methods: Data were from the Optimise Study, a longitudinal cohort of Australian adults September 2020-August 2022 that over-sampled priority populations at higher risk of contracting COVID-19, developing severe COVID-19 or experiencing adverse consequences of lockdowns.
Background: Reversing declining rates of people initiating and completing hepatitis C (HCV) treatment, observed in many countries, is needed to achieve global HCV elimination goals. Providing financial incentives to increase HCV testing and treatment uptake among people at-risk of or living with HCV infection could be an effective intervention. We conducted a systematic review to assess evidence regarding the effectiveness of financial incentives to improve engagement and progression through the HCV care cascade.
View Article and Find Full Text PDFBackground: Gay and bisexual men (GBM) remain overrepresented among syphilis diagnoses in Australia and globally. The extent to which changes in sexual networks associated with HIV pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) may have influenced syphilis transmission among GBM at the population-level is poorly understood. We describe trends in syphilis testing and incidence among GBM in Australia over eleven years spanning widespread uptake of HIV PrEP and TasP.
View Article and Find Full Text PDFBackground: Prison needle exchange programs (PNEPs) are a critical component for harm reduction in prisons. Little is known about the PNEP access barriers for people who are incarcerated, but the low uptake in the Canadian program highlights these constraints. We aimed to identify the barriers and potential solutions for increasing PNEP coverage in the nine Canadian federal prisons where they operate.
View Article and Find Full Text PDFBackground: Elimination of bloodborne viruses including HIV and hepatitis C virus from prisons requires high coverage of evidence-based interventions that prevent bloodborne virus transmission, including needle and syringe programs. Canada launched a Prison Needle Exchange Program (PNEP) in nine federal prisons in 2018; however, uptake among people who inject drugs in prison remains low. We aimed to explore barriers and facilitators to improving PNEP uptake identified by correctional officers and healthcare workers.
View Article and Find Full Text PDFHepatitis C is a global public health threat, affecting 56 million people worldwide. The World Health Organization has committed to eliminating hepatitis C by 2030. Although new treatments have revolutionised the treatment and care of people with hepatitis C, treatment uptake has slowed in recent years, drawing attention to the need for innovative approaches to reach elimination targets.
View Article and Find Full Text PDFIntroduction: To ascertain the adverse health outcomes experienced by those using prescribed testosterone and non-prescribed anabolic-androgenic steroids presenting to general practitioner (GP) clinics.
Methods: Retrospective clinical audit from nine GP clinics in major metropolitan areas across three Australian states. Data included demographic and individual characteristics (age, sexuality, body mass index, smoking status and HIV status); performance and image-enhancing drug use (type, reasons for use, patient-reported adverse effects); and blood biochemistry measurements (lipid profiles, liver function tests and red blood cell tests).
Mandatory drug testing is commonly used in Australian prisons to detect and deter drug use. In this commentary, we review the limited evidence for mandatory drug testing programs, highlight potential harms associated with their implementation and provide recommendations for drug surveillance in prisons concordant with a harm minimisation framework.
View Article and Find Full Text PDFIntroduction: Despite universal access to government-funded direct-acting antivirals (DAAs) in 2016, the rate of hepatitis C treatment uptake in Australia has declined substantially. Most hepatitis C is related to injecting drug use; reducing the hepatitis C burden among people who inject drugs (PWID) is, therefore, paramount to reach hepatitis C elimination targets. Increasing DAA uptake by PWID is important for interrupting transmission and reducing incidence, as well as reducing morbidity and mortality and improving quality of life of PWID and meeting Australia's hepatitis C elimination targets.
View Article and Find Full Text PDFObjective: To identify groups more likely to be referred for HIV testing because of symptomatic presentation rather than as part of asymptomatic screening.
Design: A retrospective analysis of Australian National HIV Registry (NHR) surveillance data including sociodemographic and clinical data, as well as reasons for HIV test.
Methods: Using notification records from 2017 to 2022, we summarised reasons for testing leading to an HIV diagnosis.
Background: Achieving virtual elimination of HIV transmission in Australia requires a combination of high treatment rates and high testing coverage among individuals at risk of acquiring HIV. HIV self-testing (HIVST) is an additional testing approach for key populations.
Objective: We aimed to examine the knowledge, attitudes, and practices of HIVST among Asian-born gay, bisexual and other men who have sex with men (GBMSM).
Background: In Australia, the incidence of hepatitis C virus (HCV) has declined among gay and bisexual men (GBM) with human immunodeficiency virus (HIV) since 2015 and is low among GBM using HIV preexposure prophylaxis (PrEP). However, ongoing HCV testing and treatment remains necessary to sustain this. To assess the potential utility of sexually transmissible infections (STIs) to inform HCV testing among GBM with HIV and GBM using PrEP, we examined the association between bacterial STI diagnoses and subsequent primary HCV infection.
View Article and Find Full Text PDFTo reach World Health Organization elimination targets for hepatitis C, different strategies are needed to reach people who have not yet been diagnosed and treated. In the context of declining treatment initiation rates, innovation in service design and delivery is necessary: testing and treatment needs to be offered to people in non-traditional settings. The community corrections (probation and parole) population is larger than the prison population, which has high prevalence of hepatitis C and-in some countries-established diagnosis and treatment programs.
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