Comparison of Government and Non-Government Alcohol and Other Drug (AOD) Treatment Service Delivery for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community

Mullens, Amy B.; Fischer, Jane; Stewart, Mary W.; Kenny, Kathryn; Garvey, Shane; Debattista, Joseph

doi:10.1080/10826084.2016.1271430

Cited by 19 publications

(10 citation statements)

References 38 publications

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“…Community-based, peer-led HIV/STI testing models have been demonstrated to be beneficial for individuals who have difficulty accessing mainstream health services [8–11]. Mobile clinic interventions utilising POCT testing have been an acceptable and feasible way to engage MSM in urban areas [12–15].…”

Section: Introductionmentioning

confidence: 99%

Point-of-care testing (POCT) for HIV/STI targeting MSM in regional Australia at community ‘beat’ locations

Mullens

Duyker²,

Brownlow

et al. 2019

BMC Health Serv Res

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BackgroundInnovative health promotion strategies are needed to improve access to HIV testing among regional people in Australia, particularly for men who have sex with men (MSM). This project aimed to establish proof of concept for point-of-care-testing (POCT) via a mobile van clinic at community ‘beat’ locations. Surveys evaluated client satisfaction, characteristics and testing preferences among ‘early adopters’. Sequential mixed-methods approach was used which included secondary qualitative analysis of field notes written by peer-testers (i.e., trained lay providers from the key population being targeted; to extend the contextualise the pilot evaluation), documenting barriers/facilitators and innovations, per action research and to guide recommendations for future health promotion initiatives.MethodsA POCT ‘proof of concept’ project (2, 3-hourly sessions/week; 20 weeks) was delivered in a regional town by peer-testers using a mobile clinic van, recruited by geosocial ‘apps’ targeting MSM. Clients completed surveys regarding demographics, and testing satisfaction, frequency and preferences. Peer-testers completed detailed field notes for each session including client characteristics and impressions, salient events, concerns and recommendations.ResultsThe program resulted in 34 online health promotion conversations with MSM and 34 POCT tests (19 HIV, 15 Syphilis; 18 unique client visits; 17 identified as MSM, with 1 heterosexual female. Rates of satisfaction among early adopters of POCT was high. Analysis of field notes revealed three major themes: 1) Practical challenges; 2) Barriers to engagement; and 3) Recruitment method/project promotion.ConclusionsAmongst early adopters satisfaction was high, with 47% of clients reported infrequent testing (over 12 months ago) or having ‘never tested’. No tests were reactive. Challenges associated with this health promotion initiative and recommendations for future HIV testing promotion and programs were outlined.Electronic supplementary materialThe online version of this article (10.1186/s12913-019-3899-2) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Point-of-care testing (POCT) for HIV/STI targeting MSM in regional Australia at community ‘beat’ locations

Mullens

Duyker²,

Brownlow

et al. 2019

BMC Health Serv Res

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“…Greater promotion and utilisation of PrEP and routine HIV testing are also useful targets for future interventions . It can be argued from the results from the current study that given the role of stimulant use and expectancies regarding sexual activity (including barriers to sexual communication and negotiation), psychological intervention aimed at reducing stimulant use could be a form of HIV prevention in and of itself, and could be incorporated with other brief interventions (eg, point‐of‐care testing) in settings associated with substance use or sexual activity (eg, sex on premises venues) and enhanced training of alcohol and drug staff regarding issues relevant to MSM . Other treatment approaches (including brief interventions) could include challenging and modifying expectancies in other community and clinical interventions …”

Section: Discussionmentioning

confidence: 99%

Stimulant expectancy questionnaire for men who have sex with men: A measure of substance‐related beliefs

Mullens

Fein

Young

et al. 2019

Health Prom J of Aust

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Issue addressed: Stimulant use has been identified as a key risk factor for sexual behaviours leading to HIV transmission. Substance-related expectancies are associated with substance use and postsubstance use thoughts, feelings and behaviours.Expectancies held by specific cultural subgroups have rarely been investigated, particularly regarding a range of commonly used stimulants. Method: The Stimulant ExpectancyQuestionnaire for Men who have Sex with Men (SEQ-MSM) was initially generated through consumer panel and interviews regarding the most commonly used stimulants among MSM in Australia (methamphetamine, amphetamines and ecstasy), with initial administration among 98 MSM to facilitate item reduction. A community sample of 427 MSM was used to validate the SEQ-MSM, with exploratory factor analysis (EFA; n = 202) and confirmatory factor analysis (CFA; n = 225). Results: EFA revealed three distinct substance reinforcement domains ('Enhanced sexual experience', 'Sexual communication and negotiation' and 'Cognitive impairment'). The scale was associated with stimulant consumption patterns (including greater expectancies regarding sexual enhancement among methamphetamine users), and the factor structure, comprising a final form of the MSM-SEQ, was confirmed through CFA. Conclusions: The SEQ-MSM represents a reliable measure of outcome expectancies related to the range of commonly used stimulants among Australian MSM. Development of applied validation studies with the SEQ-MSM is a key next step in advancing health promotion, clinical interventions and research efforts to reduce harm (eg, HIV transmission) associated with stimulant use (particularly methamphetamine) among MSM. So what? Objectives: This research maps expectancies specific among gay and men who have sex with men (MSM), and relationships between expectancies and stimulant use patterns and behaviours postuse -including sexual activity (eg, condomless anal sex). SummarySubstance-related expectancies are associated with substance use and postsubstance use thoughts, feelings and behaviours. Expectancies held by specific cultural

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“…The gender diverse people in that study were most likely to report depression, and also most likely to fear discrimination in healthcare. Other emerging work is showing that trans and gender diverse people have higher levels of unmet need and untreated depression than bisexual people 44 and service providers are even less educated about gender identity issues than LBQ issues 45 . Raising awareness of treatment providers to this emerging disadvantaged group is timely.…”

Section: Discussionmentioning

confidence: 99%

Improving alcohol and mental health treatment for lesbian, bisexual and queer women: Identity matters

Pennay

McNair

Hughes

et al. 2018

Australian and New Zealand Journal of Public Health

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Objective: Lesbian, bisexual and queer (LBQ) women experience substantial unmet alcohol and mental health treatment needs. This paper explores the way in which sexual identity shapes experience, and needs, in relation to alcohol and mental health treatment, and presents key messages for improving treatment.Methods: Twenty-five in-depth interviews were undertaken with same-sex attracted Australian women, aged 19-71. Interview transcripts were analysed thematically.Results: Key messages offered by participants focused on language, disclosure and practitioner training. Variation in sexual identity did not alter treatment expectations or needs; however, we noted an important difference with respect to identity salience, with high LBQ identity salience linked with preference for disclosure and acknowledgement of sexual identity in treatment interactions, and low identity salience linked with a preference not to disclose and for sexual identity not to require acknowledgement in treatment.Conclusions: Treatment providers may find it useful to gather information about the centrality of sexual identity to LBQ women as a means of overcoming treatment barriers related to heteronormative conventions and discrimination, language and disclosure.Implications for public health: Treatment providers should adopt more inclusive language, seek information about identity salience and the importance of sexual identity to the current treatment, and regularly pursue LBQ-related professional development upskilling.

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Comparison of Government and Non-Government Alcohol and Other Drug (AOD) Treatment Service Delivery for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community

Cited by 19 publications

References 38 publications

Point-of-care testing (POCT) for HIV/STI targeting MSM in regional Australia at community ‘beat’ locations

Point-of-care testing (POCT) for HIV/STI targeting MSM in regional Australia at community ‘beat’ locations

Stimulant expectancy questionnaire for men who have sex with men: A measure of substance‐related beliefs

Improving alcohol and mental health treatment for lesbian, bisexual and queer women: Identity matters

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