Smoking prevalence among lesbian, bisexual and queer women in Sydney remains high: analysis of trends and correlates

Introduction and Aims: To investigate smoking prevalence trends and correlates among lesbian, bisexual and queer-identifying (LBQ) women in Sydney, Australia. Design and Methods – Data from 5007 respondents to a repeated cross-sectional community survey were used to examine smoking trends between 2004 and 2014. Multinomial logistic regression was used to examine smoking correlates. Results – 30% of respondents were current smokers including 48% of 16-24 year olds. A slight decrease in all-ages smoking over time was not reflected in the youngest age group. LBQ women who smoke have fewer economic, social and psychological resources than both women who never smoke and ex-smokers. High levels of alcohol and illicit drug use are also correlated with current smoking. Discussion and conclusions – Population-wide interventions have failed to address the persistently high prevalence of smoking among this sample of LBQ women. Tailored interventions may find utility focusing on personal resilience to deal with general and sexuality-specific stressors, as well as attending to poly-substance use. Acknowledgment of LBQ women as a priority group for tobacco reduction is urgently needed. We call on tobacco control agencies to consider sexuality and gender orientation in policy and partner with LGBT community organisations to develop culturally appropriate interventions

The cultural significance of women’s sexual identities should guide health promotion

The Sydney Women and Sexual Health (SWASH) survey has run biennially since 1996 as a collaboration of ACON Health and researchers at local universities. We conducted a sub-analysis to a) identify the major risk behaviors and health issues for young lesbian, bisexual and queer identified women, and b) combine lifestyle and community engagement data to guide targeted health promotion for these groups. To explore these aims we used 379 completed SWASH surveys from women aged 17-30 years attending community events during the Sydney Gay and Lesbian Mardi Gras Festival period in February 2010 and 2012. We found concerning rates of tobacco, alcohol and illicit drug use across all groups; a mental illness diagnosis and formal psychological support access were common. Queer women had the highest rates of illicit drug use, experiences of sexual coercion and anti-LGBTQ discrimination; they were also the most proactive with their health. Bisexual women had low STI testing despite having high rates of sexual activity with both men and women. Lesbian women had the poorest uptake of Pap smears and STI testing. Sexual behaviour is irrelevant for the majority of health disparities affecting young sexual minority women. Meaningful engagement with contemporary self-selected sexual identities - and their local social and cultural significance - is essential for the development of appropriate and effective targeted public health interventions

Pap smear rates among Australian lesbian and bisexual women: some good news but disparities persist

Background: Research in the US and UK shows lesbian women are less likely than their heterosexual peers to attend for routine Pap smear tests. This study examined Pap smear test rates among community-attached lesbian, bisexual and queer (LBQ) women in New South Wales, to investigate if rates had changed between 2002 and 2012, compare rates to the general NSW population and identify predictive factors for Pap smear test attendance. Method: Data was taken from the Sydney Women and Sexual Health (SWASH) survey, a self-completed biennial questionnaire of LBQ women’s health and wellbeing. Results: Of the 4083 respondents, 83% had ever had a Pap smear test. Recent attendance rates were slightly higher than the general population. Significant predictors for ever having attended for a Pap smear test were older age, post-year 12 education, ever having had an STI test, being out about sexuality to a regular doctor and ever having had sex with men. Conclusions: Pap smear rates for LBQ women are encouraging when compared to rates in similar countries. A significant proportion of LBQ women are never receiving Pap smear tests. Predictive factors suggest a continued perception that women who have not had sex with men are not at risk of HPV, and highlight the importance of health providers providing a safe and welcoming environment for LBQ women to openly discuss their health

The social and cultural significance of women’s sexual identities should guide health promotion: an analysis of the Sydney Women and Sexual Health (SWASH) survey

Our analysis aimed to identify the major risk behaviors and health issues for young lesbian, bisexual and queer women, and combine this with lifestyle and community engagement data to guide targeted health promotion for these groups.We conducted statistical analysis of 379 self-complete surveys from women aged 17–30 years attending lesbian, gay, bisexual, trans, and queer (LGBTQ) community events during the Sydney Gay and Lesbian Mardi Gras Festival period in February 2010 and 2012. We found concerning rates of tobacco, alcohol, and illicit drug use across all groups; a mental illness diagnosis and formal psychological support access were common. Queer women had the highest rates of illicit drug use, experiences of sexual coercion, and anti-LGBTQ discrimination. They were also the most proactive with their health. Bisexual women had low STI testing despite having high rates of sexual activity with both men and women. Lesbian women had the poorest uptake of Pap smears and STI testing. Findings demonstrate that meaningful sexual behavior is irrelevant for the majority of health disparities affecting sexual minority women. Meaningful engagement with contemporary sexual identities and their local social and cultural significance is essential for the development of appropriate and effective targeted public health interventions.SWASH owes a deep debt of gratitude to ACON (a leading health promotion organization specializing in HIV and lesbian, gay, bisexual, transgender and intersex [LGBTI] Health), particularly the staff in Policy, Strategy, and Research, and the staff and volunteers in the Lesbian and Same Sex Attracted Women’s Health Project, for continued practical and financial support

The elemental mechanism of transcriptional pausing.

Transcriptional pausing underlies regulation of cellular RNA biogenesis. A consensus pause sequence that acts on RNA polymerases (RNAPs) from bacteria to mammals halts RNAP in an elemental paused state from which longer-lived pauses can arise. Although the structural foundations of pauses prolonged by backtracking or nascent RNA hairpins are recognized, the fundamental mechanism of the elemental pause is less well-defined. Here we report a mechanistic dissection that establishes the elemental pause signal (i) is multipartite; (ii) causes a modest conformational shift that puts γ-proteobacterial RNAP in an off-pathway state in which template base loading but not RNA translocation is inhibited; and (iii) allows RNAP to enter pretranslocated and one-base-pair backtracked states easily even though the half-translocated state observed in paused cryo-EM structures rate-limits pause escape. Our findings provide a mechanistic basis for the elemental pause and a framework to understand how pausing is modulated by sequence, cellular conditions, and regulators

Women in contact with the Sydney gay and lesbian community: Report of the Sydney Women and Sexual Health (SWASH) Survey 2006, 2008, 2010, 2012, 2014

The Sydney Women and Sexual Health (SWASH) survey is run by a collaboration of ACON and researchers at the University of Sydney (prior to 2009, researchers were based at the University of New South Wales). It was first carried out in 1996, initiated by workers from two ACON projects, Women Partners of Gay and Bisexual Men and the Gay and Lesbian Injecting Drug Use Project, who were faced with a lack of empirical evidence on which to base their intervention work. The survey is regularly revised to reflect the needs of the community and knowledge deficits identified through research literature. Over its lifetime, SWASH has become a comprehensive survey of sexual health and wellbeing, violence, mental health and levels of psychological distress, and a number of other important health issues relevant to lesbian, bisexual and queer (LBQ) women, such as tobacco use, illicit drug use, alcohol consumption, and cancer screening behaviours. Where possible, questions have been used from established national surveys such as the Australian Health Survey, National Drug Strategy Household Survey, Australian Study of Health and Relationships, and Australian Longitudinal Survey of Women’s Health. While research on LBQ women’s health and wellbeing has increased since the birth of the survey, epidemiological data on sexual health, mental health, experiences of abuse and violence and behaviours such as screening, illicit drug use, alcohol and smoking that can leave women vulnerable to adverse health outcomes, is still inconsistent. Moreover, as long as the inclusion of sexuality questions in large epidemiological surveys remains patchy or data is reported only by sexuality and not by sexuality and gender, SWASH provides a unique and important source of health-related information about Australian LBQ women. This report presents results from surveys conducted at the Sydney Gay and Lesbian Mardi Gras Fair Day and other community events and venues during the Sydney Gay and Lesbian Mardi Gras seasons in 2006, 2008, 2010, 2012 and 2014.SWASH owes a deep debt of gratitude to ACON, particularly the staff in the Policy, Planning and Research and the Lesbian Health Project, for continued practical and financial support. This research could not have happened without their commitment, enthusiasm and contact

Public Perception of Natural Gas Export: The Jordan Cove Energy Project

Fracking and natural gas have been widely studied in public opinion research over the years, but few studies evaluate natural gas export and the perceptions of its associated economic benefits and environmental risks. Since the shale revolution in the early 2000s, the U.S. transitioned from a net natural gas importer to exporter, all while concerns about the climate crisis have increased pressures to transition away from fossil fuels like natural gas to renewable energy sources. As a result, natural gas export projects, like the proposed Jordan Cove Energy Project in Oregon have become a subject of controversy, particularly in the Pacific Northwest where activists are attempting to hold a “thin green line” between fossil fuel extraction sites in the Mountain West and energy-hungry Asian markets. This study evaluates the role of place-based, socio-demographic, political ideology, and risk-benefit perception factors in shaping how the public perceives natural gas export in Oregon. Men, conservatives, urban residents, and those who perceive that their community’s economic identity is tied to extractive industries are less likely to perceive risks and more likely to perceive benefits from natural gas export. On the other hand, younger respondents, those without a bachelor’s degree, and those who perceive that their community’s economic identity is tied to renewable energy are more likely to perceive risks and less likely to perceive benefits from natural gas export. The overwhelmingly important factors in shaping support for natural gas export seem to be risk and benefit perceptions, with many of the other included people and place factors losing significance once risk/benefit perceptions are incorporated in the model of support. Overall, results indicate that any export proposal in the state will experience an uphill battle in terms of gaining public support.Keywords: natural gas export, public opinion, risk-benefit perceptions, pipelin

Women in contact with the Northern Rivers and Mid North Coast LGBTQ communities: Report of the SWASH Lesbian, Bisexual and Queer Women’s Health Survey 2018

A lack of systematic, nuanced research on the health and wellbeing of Australian lesbian, bisexual and queer (LBQ) women has been a significant barrier to understanding, recognising and addressing their health needs. At worst, LBQ women’s health needs have been largely ignored. At best, they have been considered to be synonymous with general women’s health. While sex between women is considered relatively low risk to health, a range of social, psychological and economic factors mean that this minority group has poorer health outcomes than their heterosexual peers. Stigma, family and community rejection and discrimination can impact on health and wellbeing, the delivery of health services, and women’s access to services. The SWASH survey is a comprehensive survey of important health issues relevant to LBQ and other non-heterosexual identifying women engaged with Sydney’s lesbian, gay, bisexual, transgender and queer (LGBTQ) communities. The survey covers sexual health and wellbeing, violence, mental health, tobacco use, illicit drug use, alcohol consumption, and cancer screening behaviours. SWASH has run every two years since 1996, and since 2009 has been run by researchers at the University of Sydney in collaboration with ACON. The survey is regularly revised to reflect the needs of LGBTQ communities and knowledge deficits identified through research literature. Where possible, questions are sourced from established national surveys such as the Australian Health Survey (AHS), National Drug Strategy Household Survey (NDSHS), Australian Study of Health and Relationships (ASHR), and Australian Longitudinal Survey of Women’s Health (ALSWH). SWASH provides a much needed local evidence base to inform best practice in healthcare and prevention for chronic diseases, mental health and wellbeing, sexual and reproductive health and ageing. Full background on the SWASH project and the results from the 2018 survey can be found in the main SWASH report. For the 2018 iteration of SWASH, we undertook sustained community engagement in the Northern Rivers and Mid North Coast region of NSW to generate sufficient numbers for a regional analysis. The SWASH NR-MNC report presents results based on surveys where participants who resided in this region.ACO

Women in contact with the Sydney gay and lesbian community: Report of the Sydney Women and Sexual Health (SWASH) Survey 2006, 2008, 2010, 2012, 2014, 2016

The Sydney Women and Sexual Health (SWASH) survey is a comprehensive survey of important health issues relevant to lesbian, bisexual and queer (LBQ) women including sexual health and wellbeing, violence, mental health, tobacco use, illicit drug use, alcohol consumption, and cancer screening behaviours. SWASH is run by a collaboration of ACON and researchers at the University of Sydney (since 2009; prior to this researchers were based at the University of New South Wales). It was first carried out in 1996, initiated by workers from two ACON projects, Women Partners of Gay and Bisexual Men and the Gay and Lesbian Injecting Drug Use Project, who were faced with a lack of empirical evidence on which to base their intervention work. The survey is regularly revised to reflect the needs of the community and knowledge deficits identified through research literature. Where possible, questions are used from established national surveys such as the Australian Health Survey, National Drug Strategy Household Survey, Australian Study of Health and Relationships, and Australian Longitudinal Survey of Women’s Health. Australian epidemiological data on sexual health, mental health, experiences of abuse and violence, preventive health practices, and behaviours such as illicit drug use, alcohol use and smoking remains inconsistent. The inclusion of sexuality questions in large epidemiological surveys remains patchy, and data is often reported only by sexuality and not by sexuality and gender. In this context, SWASH provides a unique and important source of health-related information on Australian LBQ women. This report presents results from surveys conducted at the Sydney Gay and Lesbian Mardi Gras Fair Day and other community events and venues during the Sydney Gay and Lesbian Mardi Gras seasons in 2006, 2008, 2010, 2012, 2014, and 2016. It highlights several areas of particular concern – many of which have persisted over time – where mainstream preventive health interventions that are inclusive of this group or targeted to LBQ women, are needed.ACON Healt

Exploring the health and wellbeing of lesbian, bisexual, queer and same sex attracted women living in the Illawarra and Shoalhaven regions

The Labrys Project is a partnership initiative between ACON and Women’s Health – Illawarra Shoalhaven Local Health District (ISLHD) carried out between 2014 and 2015. While lesbian, bisexual and queer (LBQ) women’s health research is increasing in Australia, epidemiological data around key issues affecting LBQ women’s health is inconsistent. The Labrys Project extended objectives from the Sydney Women and Sexual Health Survey (SWASH) to provide a snapshot of LBQ women’s health and wellbeing in the Illawarra and Shoalhaven regions of NSW, in order to provide a regional and rural perspective to LBQ women’s health and to inform local services and strategies. Between October 2014 and March 2015, 107 LBQ women completed the Illawarra Shoalhaven Women’s Health and Wellbeing Survey; in addition, two focus groups were held in Warilla and Nowra involving 7 LBQ women.ACON; Women’s Health – Illawarra Shoalhaven Local Health Distric