A journey to HIV prevention research: From social psychology to social health via multidisciplinarity.

This is a personal account of my research in HIV prevention from 1984 to the present day. It demonstrates my disquiet with the individualism of psychology as a way of thinking about what was needed to prevent HIV transmission. HIV prevention requires social transformation which is produced via changes in social practices and norms of communities and networks rather than by changes in behaviours of individuals.

Awareness and knowledge of HIV pre-exposure prophylaxis among Australian gay and bisexual men: results of a national, online survey.

Expanded access to HIV pre-exposure prophylaxis (PrEP) is being actively debated in Australia. Awareness and knowledge of this HIV-prevention method have not been assessed in detail in the primary affected population, gay and bisexual men. Awareness and knowledge of PrEP were assessed among Australian gay and bisexual men, who were asked to complete a national, anonymous, online survey in 2015.

Evolving views and practices of antiretroviral treatment prescribers in Australia.

Objective: To examine whether there have been recent changes in Australian antiretroviral treatment (ART) prescribers' perceptions and practices relating to early ART initiation, which was defined as commencing ART when a patient's CD4+ T-cell count approaches 500 cells/mm3 or immediately after a patient is diagnosed with HIV.

Design, Participants And Setting: Self-completed, anonymous, cross-sectional surveys, targeting all ART prescribers in Australia, were conducted online in 2012 and 2013. The surveys included questions on prescriber factors, CD4+ T-cell count at which prescribers would most strongly recommend ART initiation, and perceived patient characteristics that could change prescribers' practices of early initiation of ART.

Interest in using rectal microbicides among Australian gay men is associated with perceived HIV vulnerability and engaging in condomless sex with casual partners: results from a national survey.

Objective: We assessed interest in using rectal microbicides to prevent HIV transmission among gay men in Australia.

Methods: A national online survey was conducted in 2013. Interest in using rectal microbicides was measured on a seven-item scale (α=0.

Australian gay and bisexual men's attitudes to HIV treatment as prevention in repeated, national surveys, 2011-2013.

Objective: Assess the acceptability of HIV treatment as prevention and early antiretroviral treatment among gay and bisexual men in Australia and any changes in attitudes over time.

Methods: National, online, cross-sectional surveys of gay and bisexual men were repeated in 2011 and 2013. Changes in attitudes to HIV treatment over time were assessed with multivariate analysis of variance.

Willingness to use HIV pre-exposure prophylaxis has declined among australian gay and bisexual men: results from repeated national surveys, 2011-2013.

We surveyed willingness to use pre-exposure prophylaxis (PrEP) and the likelihood of decreased condom use among Australian gay and bisexual men in 2011 and 2013 (n = 2384). Willingness to use PrEP declined from 28.2% to 23.

No ordinary mainstream illness: how HIV doctors perceive the virus.

Research has shown that social representations of HIV can constitute barriers to health workers' willingness to provide HIV care. Considering a growing shortage in the HIV primary workforce in Western countries, we examine how HIV is perceived today by doctors involved in its care. In 1989 Sontag predicted that once the virus became better understood and treatable, the dehumanizing meanings that defined the early epidemic would vanish and HIV would turn into an ordinary illness.

Between individual agency and structure in HIV prevention: understanding the middle ground of social practice.

When HIV prevention targets risk and vulnerability, it focuses on individual agency and social structures, ignoring the centrality of community in effective HIV prevention. The neoliberal concept of risk assumes individuals are rational agents who act on information provided to them regarding HIV transmission. This individualistic framework does not recognize the communities in which people act and connect.

Engaging non HIV specialist general practitioners with new priorities in HIV prevention and treatment: qualitative insights from those working in the field.

Background: The science of HIV prevention and treatment is evolving rapidly, resulting in renewed calls to increase rates of HIV testing and, in particular, facilitate the timely and possibly earlier initiation of treatment, as this has the potential to dramatically reduce new infections. Little is known about how to engage non HIV specialist Australian general practitioners (GPs) with these new priorities.

Methods: Content related to the engagement of non HIV specialist GPs in the HIV response was identified within the transcripts of in-depth interviews with policy key informants (n=24) and general practice clinicians (n=47) engaged with HIV medicine.

At the coalface and the cutting edge: general practitioners' accounts of the rewards of engaging with HIV medicine.

Background: HIV has become a chronic manageable infection in the developed world, and early and lifelong treatment has the potential to significantly reduce transmission rates in the community. A skilled and motivated HIV medical workforce will be required to achieve these health management and prevention outcomes, but concerns have been noted in a number of settings about the challenges of recruiting a new generation of clinicians to HIV medicine.

Methods: As part of a larger qualitative study of the HIV general practice workforce in Australia, in-depth interviews were conducted with 31 general practitioners accredited to prescribe HIV medications in community settings.

Expert perspectives on the contribution of HIV general practice nursing to the 'extraordinary story' of HIV medicine in Australia.

Aim: This paper explores cultural and professional dynamics of HIV general practice nursing in Australia. It highlights specific contributions that HIV general practice nurses make to HIV medicine and considers how nurses' clinical practice has been shaped by past experiences of the AIDS crisis and subsequent developments in HIV medicine.

Background: In international contexts, nurses in HIV medicine commonly work as part of shared-care teams.

Women hold up half the sky - and half the burden of the HIV epidemic.

It has been said that women hold up half the sky. In the HIV epidemic, women carry half the burden of the epidemic, perhaps even more. The HIV burden on women is dramatically higher in some regions, certain age groups and among marginalized groups, such as female sex workers.

Australian prescribers' perspectives on ART initiation in the era of "treatment as prevention".

This study explores Australian prescribers' attitudes towards Treatment as Prevention (TasP) and their practices around initiating combination antiretroviral treatment (cART) for HIV. A brief online survey was conducted nationally amongst antiretroviral treatment (ART) prescribers in Australia. The sample broadly represented ART prescribers in Australia (N = 108), with 40.

HIV-negative and HIV-positive gay men's attitudes to medicines, HIV treatments and antiretroviral-based prevention.

We assessed attitudes to medicines, HIV treatments and antiretroviral-based prevention in a national, online survey of 1,041 Australian gay men (88.3% HIV-negative and 11.7% HIV-positive).

Addressing the structural drivers of HIV: a luxury or necessity for programmes?

The social, economic, political and environmental structural factors that increase susceptibility to HIV infection and undermine prevention and treatment efforts continue to pose a challenge. The papers in this series highlight the importance of sustaining those efforts to address the structural drivers of the HIV epidemic, and that initiatives to achieve HIV elimination will only come about through a comprehensive HIV response, that includes meaningful responses to the social, political, economic and environmental factors that affect HIV risk and vulnerability. In the context of declining resources for HIV/AIDS, the papers speak to the need to integrate responses to the structural drivers of HIV/AIDS into future HIV investments, with both initiatives to integrate HIV into broader gender and development initiatives, as well as adaptations of current service models, to ensure that they are sensitive to and able to respond to the broader economic and social responsibilities that their clients face.

Effective HIV prevention: the indispensable role of social science.

This paper examines the ways in which HIV prevention is understood including "biomedical", "behavioural", "structural", and "combination" prevention. In it I argue that effective prevention entails developing community capacity and requires that public health addresses people not only as individuals but also as connected members of groups, networks and collectives who interact (talk, negotiate, have sex, use drugs, etc.) together.

Does drug and alcohol use undermine concordance between doctors' assessments of major depression and patients' scores on a screening tool for depression among gay men attending general practice?

General practitioners (GPs) identify that depression can be difficult to diagnose in populations with high rates of alcohol and other drug (AOD) use. This is a particular concern with gay men who are a population known to engage in high rates of AOD use and who are vulnerable to depression. This paper uses data from 563 gay men and their GPs to describe concordance between assessments of major depression and, in particular, whether AOD use undermines concordance.