HIV-positive people in Australia: findings from selected NCHSR research


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Martin Holt (Senior Research Fellow, NCHSR), outlines findings from NCHSR studies of living with HIV: the Straightpoz Study (positive heterosexuals & their partners); and the Gay Community Periodic Surveys: HIV-positive gay men.

This presentation was given at the AFAO Positive Services Forum 2012.

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HIV-positive people in Australia: findings from selected NCHSR research

  1. 1. HIV-positive people in Australia:findings from selected NCHSR research Dr Martin Holt National Centre in HIV Social Research
  2. 2. NCHSR studies of living with HIV• Straightpoz Study: positive heterosexuals (& their partners)• Gay Community Periodic Surveys: HIV-positive gay men• AFAO Barometer Survey of stigma/discrimination• NAPWA HIV Stigma Audit• NHMRC Project on when & why people start ART• Serodiscordant Couples Study
  3. 3. Straightpoz study – key findings• High levels of stigma and silence about HIV in heterosexual society.• Positive heterosexuals are largely disconnected from the HIV sector.• Relationships with doctors are highly important – participants have faith in medicine to normalise and contain HIV.• Emphasis on HIV care in clinics, not GPs. Clinics are the safe space in which HIV is discussed. (Persson et al, 2009)
  4. 4. Serodiscordance from Straightpoz• HIV-negative partners of HIV-positive men and women are ‘living with’ & affected by HIV.• In discordant couples, the risk of transmission is well understood... but unprotected sex still happens.• Unprotected sex often framed as the negative partner’s choice... by both partners.• Maintaining normality, spontaneity, intimacy & trust can work against protected sex – ‘risks’ are contextual and the risk of HIV may be secondary. (Persson et al, 2009; Persson, 2011)
  5. 5. Gay Community Periodic Surveys• HIV-positive gay men comprise the largest group of PLHIV in Australia• Changes in this population may significantly affect service delivery• Changes among HIV-positive gay men may be a result of changes in gay life as well as the evolving experience of living with HIV.• We analysed social/behavioural characteristics of men in the GCPS, 2000-2009 (n=21620)
  6. 6. Age (in years) 50 42.1 40 39.2 34.9 35.7 30 HIV-positive HIV-positive men are older in both periods 20 (p<0.001). HIV-negative 10 The age gap is widening over time. 0 2000-2001 2008-2009
  7. 7. University education100% Proportion of HIV-positive men who have completed university education has doubled in 10 years.80% However, the gap with HIV-negative men has widened.60% 53% 42% HIV-positive40% HIV-negative 24%20% 17% 0% 2000-2001 2008-2009
  8. 8. Employment A small but significant increase in the proportion of HIV- positive men in paid employment, closing the gap slightly100% with HIV-negative men. 82% 81%80% 70% 66%60% HIV-positive40% HIV-negative20% 0% 2000-2001 2008-2009
  9. 9. Unprotected anal intercourse with casual partners100% The likelihood of any UAIC being reported has significantly increased in both groups, but the 80% increase has been larger among HIV-positive men. 60% 45% HIV-positive 40% 38% HIV-negative 18% 20% 20% 0% 2000-2001 2008-2009
  10. 10. 10 or more partners in last 6 months100% Both HIV-positive and HIV-negative men are less likely to report 10 or more sex partners in the last 680% months, although HIV-positive men remain more likely to do so.60% 42% HIV-positive40% 34% HIV-negative 27% 23%20% 0% 2000-2001 2008-2009
  11. 11. Summary of GCPS analysis• HIV-positive gay men are older (and age gap with negative men has increased)• Increased workforce participation (gap has closed)• Increased university participation (gap has widened)• Increased likelihood of UAIC (gap has widened)• Decreased likelihood of 10 or more partners in 6 month period (gap has closed)
  12. 12. NCHSR contacts• Gay Community Periodic Surveys Dr Martin Holt,• Straightpoz Study; Serodiscordant Couples Study Dr Asha Persson,• AFAO Barometer Survey Mr Dean Murphy,• NAPWA Stigma Audit Dr Loren Brener,• NHMRC Project on ART uptake Prof John de Wit,