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

The interviews we conducted with GPs suggest that an engagement with HIV medicine enables clinicians to develop strong and long-term relationships with and expertise about the care needs of people living with HIV ‘at the coalface’, while also feeling connected with a broader network of medical practitioners and other professionals concerned with and contributing to the ever-changing world of science: ‘the cutting edge’. The general practice HIV prescriber is being modelled here as the interface between these two worlds, offering a rewarding opportunity for general practitioners to feel intimately connected to both community needs and scientific change

Gay Community Periodic Survey: Queensland 2005

Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics

Audit of Antenatal Testing of Sexually Transmissible Infections and Blood Borne Viruses at Western Australian Hospitals

In August 2007, the Western Australian Department of Health (DOH) released updated recommendations for testing of sexually transmissible infections (STI) and blood-borne viruses (BBV) in antenates. Prior to this, the Royal Australian & New Zealand College of Obstetricians & Gynaecologists (RANZCOG) antenatal testing recommendations had been accepted practice in most antenatal settings. The RANZCOG recommends that testing for HIV, syphilis, hepatitis B and C be offered at the first antenatal visit. The DOH recommends that in addition, chlamydia testing be offered. We conducted a baseline audit of antenatal STI/BBV testing in women who delivered at selected public hospitals before the DOH recommendations. We examined the medical records of 200 women who had delivered before 1st July 2007 from each of the sevenWAhospitals included in the audit. STI and BBV testing information and demographic data were collected. Of the 1,409 women included, 1,205 (86%) were non-Aboriginal and 200 (14%) were Aboriginal. High proportions of women had been tested for HIV (76%), syphilis (86%), hepatitis C (87%) and hepatitis B (88%). Overall, 72% of women had undergone STI/BBV testing in accordance with RANZCOG recommendations. However, chlamydia testing was evident in only 18% of records. STI/BBV prevalence ranged from 3.9% (CI 1.5– 6.3%) for chlamydia, to 1.7% (CI 1–2.4%) for hepatitis C, 0.7% (CI 0.3–1.2) for hepatitis B and 0.6% (CI 0.2–1) for syphilis. Prior to the DOH recommendations, nearly three-quarters of antenates had undergone STI/BBV testing in accordance with RANZCOG recommendations, but less than one fifth had been tested for chlamydia. The DOH recommendations will be further promoted with the assistance of hospitals and other stakeholders. A future audit will be conducted to determine the proportion of women tested according to the DOH recommendations. The hand book from this conference is available for download Published in 2008 by the Australasian Society for HIV Medicine Inc © Australasian Society for HIV Medicine Inc 2008 ISBN: 978-1-920773-59-

PrEP in Practice: a sociological study of HIV pre-exposure prophylaxis prescribing

HIV pre-exposure prophylaxis (PrEP) is a highly effective strategy for preventing new HIV infections. Since 2015, PrEP has been rapidly implemented with gay and bisexual men in Australia. While there is recognition of the importance of optimising the clinical delivery of PrEP, there has been scarce empirical research in Australia documenting how clinicians engage with prescribing PrEP, and minimal international social science research considering how PrEP has (re)shaped clinical practice. In this thesis I explore the role of clinicians in delivering PrEP in Australia. Drawing on the sociology of prescribing, I approach PrEP prescribing as a social practice, and attend to how clinicians anticipate and imagine patients, and how they think and feel about PrEP. This study draws on qualitative methodologies, including findings from semi-structured interviews conducted with clinicians who provide PrEP in New South Wales and Western Australia between 2019 and 2020, and with HIV expert stakeholders across Australia in 2017. Through empirical findings, I consider debates about which types of clinicians are best suited to prescribing PrEP and workforce challenges for providing PrEP in different clinical settings. I analyse clinician imaginaries of PrEP users and broader patient collectives, as well as clinicians’ views on providing PrEP to alleviate different types of ‘HIV anxiety’. I also examine prescribing as an affective clinical practice. I identify recommendations for supporting clinical workforces to improve the implementation of PrEP across Australian communities. This thesis demonstrates how PrEP has transformed HIV prevention for clinicians, requiring them to adapt to new ways of approaching HIV and sexual health. Clinicians develop expertise through routine opportunities to prescribe, and they develop imaginaries about patients and communities through consultations that shape their future interactions with patients. Conversely, a lack of patient demand makes it challenging for general practitioners to develop confidence and competence with PrEP prescribing. Providing PrEP involves the complexity of discussing sex and managing ideas about risk and responsibility, which are persistent challenges for both HIV-experienced and inexperienced clinicians. I argue for the value of sociological perspectives on clinical workforces to support and sustain effective HIV prevention

Asian Gay Men in Sydney December 1999 - January 2000

The Sydney Asian Gay Men's Survey is a cross-sectional survey of gay and homosexually active men of Asian background recruited through a range of gay community sites in Sydney. It provides a snapshot of sexual and HIV-related practices among gay and homosexually active men of Asian background

Health Psychology in Autobiography: Three Canadian Critical Narratives

Three Canadian colleagues in health psychology recount their careers in a field of research and practice whose birth they witnessed and whose developments they have critiqued. By placing the development of health psychology in Canada in a context that is both institutional and personal, Stam, Murray and Lubek raise a series of questions about health psychology and its propagation. While uniquely Canadian on the one hand, their professional careers were affected by international colleagues as well as others – patients and community members – whose views shaped their perspectives. This article is a plea for the continuing development of critical voices in health psychology