Gay community periodic survey: Melbourne 2015

This study finds that HIV testing by gay and bisexual men in Melbourne continues to increase. Executive summary The Melbourne Gay Community Periodic Survey is a cross-sectional survey of gay and homosexually active men recruited at a range of gay community sites in Melbourne. The major aim of the survey is to provide data on sexual, drug use, and testing practices related to the transmission of HIV and other sexually transmissible infections (STIs) among gay men. The most recent survey, the seventeenth in Melbourne, recruited a total of 3,006 men in January 2015. The majority of these men (n=2,429, 81%) were recruited using face-to-face recruitment by trained staff at gay social venues (e.g. bars and community organisations), sex-on-premises venues, sexual health clinics, and the Midsumma Carnival. The remaining 577 men (19%) participated through an online version of the survey. Online recruitment was conducted for the first time in 2015 through the social networking site Facebook. Men were directed to a website with an online version of the GCPS questionnaire (http://gcpsonline.net). The advertisements were targeted to all men aged 16 and above who were located in Victoria and indicated in their Facebook profile that they were ‘interested’ in men. From its start in 1998, the project has been funded by the Victorian Department of Health and supported by the Victorian AIDS Council and Living Positive Victoria. The Centre for Social Research in Health coordinates the survey, with support from the Kirby Institute. The overall response rate for the 2015 survey was 77%. The data presented in this report are from the period 2011 to 2015. Since 2011, there have been significant decreases in the proportions of men recruited at sexual health clinics, social venues, and the Midsumma Carnival. The proportion of men recruited from sex-on-premises venues has remained stable over time. The online sample was analysed before we incorporated it into the survey database. There were a number of differences between men recruited online and men recruited through venues and events. Men in the online sample were younger and were more likely to be born in Australia. Men in the online sample were also less likely to report testing for HIV in the 12 months prior to the survey and were more likely to report that they were HIV-negative. Compared to men recruited through physical venues, men recruited through online survey were more likely to be in a monogamous relationship and have condomless anal intercourse with their regular partner. They were also more likely to report condomless anal intercourse with casual partners and were less likely to know that PEP was available. The online and offline samples reported similar rates of STI testing and drug use. However, despite these differences, when we merged the online and offline samples, the majority of key indicators did not appear to be affected by the change in sampling methods. We have therefore incorporated the online sample into the combined database and the reporting of trends. We will, however, continue to monitor the impact of online recruitment on the sample over time

Demonstration and Operation of Quantum Harmonic Oscillators in AlGaAs/GaAs Heterostructure

The quantum harmonic oscillator (QHO), one of the most important and ubiquitous model systems in quantum mechanics, features equally spaced energy levels or eigenstates. Here we report on the design, demonstration and operation of nearly perfect QHOs in AlGaAs/GaAs heterostructure. On the basis of model calculations, we demonstrate that, when a substitutional Si donor substitutes the Ga/Al lattice site close to AlGaAs/GaAs heterointerface, a hydrogenic Si QHO, characterized by a restoring Coulomb force producing square law harmonic potential, is formed. This gives rise to QHO states with energy spacing of ~8-9 meV. We experimentally confirm this proposal by utilizing Stark effect and measuring QHO states using an aluminum single-electron transistor (SET). A sharp and fast oscillation with period of ~7-8 mV appears in addition to the regular Coulomb blockade (CB) oscillation with much larger period, for positive gate biases above 0.5 V. The observation of fast oscillation and its behavior is qualitatively consistent with our theoretical result, manifesting the harmonic motion of electrons from the QHO. Our results might establish a general principle to design, construct and manipulate QHOs in semiconductor heterostructures.Comment: 17 pages, 4 figure

Identification of key subsystems for urban rail vehicles based on fuzzy comprehensive evaluation

Abstract Identification of key subsystems for urban rail vehicles is important for the selection of maintenance strategy. The fuzzy comprehensive evaluation technique is applied to determine the key subsystems of urban rail vehicles. Firstly, the vehicle is divided into nine subsystems according to the module partition method. Then, the degrees of occurrence, severity, detection and maintenance cost are chosen as the evaluation factors that are quantified based on fuzzy theory and collected historical data. Finally, the calculation model of critical degree is established based on the fuzzy comprehensive evaluation method. The proposed approaches are applied to Guangzhou Metro Corporation, and five key subsystems are selected. The experiment results, which are consistent with those of most knowledgeable engineers and experts, indicate the validity of the proposed method

GPs understanding of how depression affects gay and HIV positive men

In contrast to the broad literature on depression in the general population, little is known about the management of depression affecting gay men and HIV-positive men attending general practice clinics. GPs identified a range of features in their experience of managing depression in gay men and in HIV-positive men. Some were common to the care of other groups with depression, but this paper reports on features unique to this patient group. These include capitalizing on the high frequency of contact with this patient group, taking advantage of the specialist multidisciplinary teams who provide support, building upon the unusual willingness of this patient group to take medication, appreciating the central importance to many gay men of sexual functioning, and recreational drug use, responding to social isolation in this patient group and coping with increasing challenges for the HIV general practice workforce

Patient-centred approaches to providing care at HIV diagnosis: perspectives from healthcare and peer-support workers

Background. Early uptake of HIV treatment among those newly diagnosed with HIV can improve individual health and prevent onward transmission. Patient-centred care is considered an important aspect in health care, the management of HIV, and can improve uptake of and adherence to HIV treatments. Methods. Semi-structured interviews were conducted with sexual health clinicians (n, 10) and HIV support workers (n, 4) to understand how they approached HIV diagnosis delivery and care immediately thereafter. Results. Our thematic analysis identified three themes: (1) centring patient needs at diagnosis; (2) assessing patients’ readiness to begin treatment; and (3) referrals to psychosocial support services. Our findings highlight centring patients was an important aspect of how participants delivered HIV diagnoses. By taking this approach, clinicians were best able to consider patient readiness to initiate treatment and referrals to social support services. Conclusions. Given HIV diagnoses are increasingly occurring in generalist health services, our findings offer an important opportunity to learn from the experiences of specialist sexual health clinicians and HIV support workers

Variations in HIV Prevention Coverage in Subpopulations of Australian Gay and Bisexual Men, 2017–2021: Implications for Reducing Inequities in the Combination Prevention Era

Using repeated behavioural surveillance data collected from gay and bisexual men (GBM) across Australia, we assessed trends in HIV prevention coverage (the level of ‘safe sex’ achieved in the population by the use of effective prevention methods, including condoms, pre-exposure prophylaxis [PrEP] and having an undetectable viral load). We stratified these trends by age, country of birth/recency of arrival, sexual identity, and the proportion of gay residents in the participant’s suburb. Among 25,865 participants with casual male partners, HIV prevention coverage increased from 69.8% in 2017 to 75.2% in 2021, lower than the UNAIDS target of 95%. Higher levels of coverage were achieved among older GBM (≥ 45 years), non-recently-arrived migrants, and in suburbs with ≥ 10% gay residents. The lowest levels of prevention coverage (and highest levels of HIV risk) were recorded among younger GBM (< 25 years) and bisexual and other-identified participants. Younger, recently-arrived, and bisexual GBM were the most likely to use condoms, while PrEP use was concentrated among gay men, 25–44-year-olds, and in suburbs with more gay residents. The use of undetectable viral load was most common among participants aged ≥ 45 years. Our analysis shows that high HIV prevention coverage can be achieved through a mixture of condom use, PrEP use, and undetectable viral load, or by emphasising PrEP use. In the Australian context, younger, bisexual and other-identified GBM should be prioritised for enhanced access to effective HIV prevention methods. We encourage other jurisdictions to assess the level of coverage achieved by combination prevention, and variations in uptake

Adjusting Behavioural Surveillance and Assessing Disparities in the Impact of COVID-19 on Gay and Bisexual Men’s HIV-Related Behaviour in Australia

COVID-19 has disrupted sexual behaviour and access to health systems. We adapted regular HIV behavioural surveillance of gay and bisexual men (GBM) in Australia in response to COVID-19, assessed the impact on the profile of the sample, the participants’ HIV-related behaviour, and whether COVID-19 may have accentuated existing disparities in the Australian HIV epidemic. Data collected from five states during July 2017–June 2021 were included (N = 31,460). The emphasis on online recruitment after COVID-19 led to smaller sample sizes, greater geographic reach, and a higher proportion of bisexual-identifying participants. Most participants (88.1%) reported physical distancing and 52.1% had fewer sex partners due to COVID-19. In the COVID-19-affected rounds (July 2020–June 2021), the number of male partners, recent HIV testing and pre-exposure prophylaxis (PrEP) use all fell, and HIV risk among the smaller group of participants who reported casual sex increased. COVID-related changes were generally more pronounced among GBM aged under 25 years, participants from suburbs with fewer gay residents, and bisexual men. These groups should be prioritised when encouraging GBM to reengage with HIV testing services and effective prevention methods, like condoms and PrEP