ASHM Report Back

Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.

What a great session!! 

The importance of STI screening post sexual assault, the relevance and role of technology in violence, and the great initiatives in response to violence in Aboriginal communities. 

My future practice will definitely change to incorporate conversations around violence to both potential victims and perpetrators of sexual violence.  Often questions are not routinely asked of potential perpetrators regarding behaviors that are unacceptable. 

Incorporating technology and its potential risks has been highlighted as an often forgotten element of health and sex education to the younger generation. Emphasizing the risks of private photos and events being shared needs to be stressed when delivering health education in an attempt to encourage people to think about the potential consequences before sharing photos or film clips seems simple, however is frequently not discussed when delivering education. 

Great presentations by everyone and very moving personal stories shared. 

Posted by on in Social and behavioural research

Khadija Gbla is an inspirational woman who settled in Adelaide after attaining refuges status via the United Nations Refugee Program. In 2004 she became a peer educator in the Women’s Health State Wide program ‘Female Genital Mutilation’ (FGM) and is now the Director of 'No FGM Australia'.

Khadija raised an interesting point about the different values some cultures put on sexual health. For some CALD communities’ sexual health is not a priority as they have competing factors such as poverty or homelessness. Another interesting point made is clinicians need to consider women’s safety when discussing contraceptive options as partners may not be supportive of contraception and this could lead to violence.

 

Take home message:

Women should be asked about FGM and appropriate referrals can be made. Sexual health is a human right and we should support people to make informed decisions about their sexual health.

Khadija has an interesting Ted Talk available from https://www.ted.com/talks/khadija_gbla_my_mother_s_strange_definition_of_empowerment

Notes:

Family Planning Victoria have had a large push to help create resources to help youth engage and navigate sexual health services and education.

Through alliance with schools, medical teams, educators the moderation and creation of resources has been helpful in engaging youth.

Resources can be reviewed at rse.fpv.org.au

There is very little in the way of research into non heteronormative society in indigenous and TSI communities. Sadly the majority of portrayals are hyper sexualised and not representative of diverse gender queer indigenous community.

This is a need to understand that "gay health" is not exclusive to "sexual heath" there are many more areas of gay male health to be explored and engaged.

Many GLBTI youth are suffering significant prejudicial treatment within the schooling system. Schools without GLBTI policy have increased self harm, suicide, bullying and harassment of GLBTI youth. 

GLBTI policy has been shown to be protective creating increased safety as well as retention in the school system.

Many trans and intersex youth are leaving schooling rather than face the poor treatment while attending school. Trans and intersex youth are at higher risk of self harm, suicide, and bullying.

Many resources provided at schools are not inclusive and not helpful or supportive for GLBTI youth.

Current estimates are that 2 in every 30 students are GLBTI and without inclusion they can be lost to schooling, bullied, self harm and be at risk of attempted and completed suicide.

Gemma Sharp from the School of Psychology, Flinders University,S.A talked to us about the project she's involved in looking at Labiaplasty. I found this really interesting but results were pretty predictable.

She told us it's the most popular form of genital cosmetic surgery and Australia has seen a 3-fold increase from 2000-2014. It involves the reduction of the labia minora.

She was looking at the factors that motivate women to undergo labiaplasty and the psychological outcomes using two studies.

In study 1 (qualitative study) She interviewed 14 Australian women 5-16 months post surgery and identified five themes:

1 Media influence - comparing themselves with online genital images

2 Negative comments about genital appearance

3 Physical discomfort over aesthetic concerns

4 Satisfaction with surgery

5 Sexual wellbeing

86% of the women expressed concerns with labial appearance, large labia impacting their sex lives and feeling ashamed about how their labia looks.

After labiaplasty 71% of the women stated an improvement in self- consciousness, feeling more comfortable having sex and feeling more free. But 29% still had concerns after labiaplasty. 

She concluded that psychosexual counselling might be an option for these women.

In study 2 (quantitative study) she looked at the effects on intimate relationships and psychological well being, using 29 labiaplasty patients compared to 22 general gyne patients.

She found that overall the labiaplasty patients were satisfied >80% and only 35% reported complications (infections/severe discomfort) but there were no significant changes in relationship quality, sexual confidence, psychological distress, self-esteem or life satisfaction.

She concluded that although labiaplasty improves genital appearance, it has no effect on psychological factors and preoperative relationship status and psychological distress predict dissatisfaction with outcomes.

Again she thought it was important to think about psychological treatment.

 

Influencing Community Engagement in Research.

First Conference session that I have attended.  really a preconference workshop for "young Researchers"

Three perspectives HIV -ve African women, traditional urban PLWHIV communities, young ( <25yrs) men of colour.

Some common themes emerged. HIV positivity and higher risk of becoming infected need to be examined within the contexts of peoples general health needs and risk activities.  eg young black women feel only of interest to HIV researchers if their body contains a foetus. High maternal mortality rates in Uganda certainly relate to many factors not just HIV. Often Researchers are older white males - that young urban blacks have difficulty relating to. Often little is understood about young black or white males - how they see themselves in terms of sexual identity or sexual health risk. Wrong to transfer knowledge/ notions about what are now older black gay men to younger age groups. Recent PrEP studies with young men of colour did not engage well with at risk groups. No members of the target group were involved in the development of the studies and only belatedly involved in the implementation of the study. Best to find out first how they like to be categorised. eg MSM is not a term commonly used or related to by this group.  Young men of colour will say very different things to peer researchers as opposed to older black or white gay male researchers. Rebellion is a normal part of growing up needs to be taken into account. "Rebellion" in these studies ( lack of cooperation/ failure to complete followup etc ) directly related to lack of consultation around what words were used/ recognition of individuals time constraints from their perspective etc.

Maybe we used to know this when "we" were young - but we have all gotten older and are now part of the establishment/ authority structures that we used to come up against.

Tokenism was discussed by all- Are representatives of the targets of research included in all stages of the development and implementation of social research. Are these bona fide reps or are they individuals with little actual community attachment ( there to make the research proposal look good) and therefore not really useful conduits of information back with little community accountability.

Tagged in: CROI2016

Please join us for a memorial event celebrating the life of one of Australia’s leading HIV advocates, Levinia Crook… https://t.co/N7dof5xaGa

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