Mobilisation, politics, investment and constant adaptation: lessons from the Australian health‐promotion response to HIV

Brown, Graham; O'Donnell, Daryl; Crooks, Levinia; Lake, Rob

doi:10.1071/he13078

Cited by 44 publications

(55 citation statements)

References 23 publications

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“…This figure has remained consistent over time (1, 2). Australia is recognized internationally for its early implementation of effective HIV harm minimization and prevention strategies, facilitated through a partnership involving affected communities, government, clinicians, and researchers (3). Compared with other Western countries, the Australian response has successfully minimized HIV cases among injecting drug users, sex workers, and heterosexual populations (3, 4).…”

Section: Introductionmentioning

confidence: 99%

HIV Futures 8: Protocol for a Repeated Cross-sectional and Longitudinal Survey of People Living with HIV in Australia

Power

Brown

Lyons

et al. 2017

Front. Public Health

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IntroductionMore than 27,000 Australians currently live with HIV. Most of these people have access to quality clinical care and antiretroviral treatment (ART) and can expect good general health. However, HIV-related stigma is a problem and many people living with HIV experience poorer than average mental health. Issues of aging are also of increasing concern. This paper describes the methods and sample for the HIV Futures 8 study, a national survey of people living with HIV in Australia that aimed to identify factors that support health and well-being among this population. HIV Futures 8 forms part of a series of cross-sectional surveys (The “HIV Futures” studies) that have been repeated periodically since 1997. In the most recent survey, participants were able to opt into a prospective longitudinal study.Materials and equipmentHIV Futures 8 was open to people aged over 17 who were living with HIV. Data were collected in 2015/2016 using a self-complete survey that contained approximately 250 items related to physical and mental health, use of ART, HIV exposure and testing, financial security, social connectedness, relationships, life satisfaction, resilience, stigma, use of health and support services, and health literacy. To enable comparison of cross-sectional data over time, questionnaire items were consistent with those used in previous HIV Futures surveys. In HIV Futures 8, participants were invited to volunteer coded information that will allow longitudinal follow-up when participants complete subsequent HIV Futures surveys. The survey was advertised through the networks of HIV organizations, on social media and through HIV clinics and services. HIV Futures 8 was completed by 895 participants. This represents approximately 3.8% of the total number of people living with diagnosed HIV in Australia in 2014.Expected impact of the study on public healthFindings from HIV Futures 8 will contribute important insights into the complexity of factors that support physical and mental well-being among people living with HIV. The findings will also assist HIV services to align with broader public health goals related to increasing ART use and improving quality of life among people living with HIV.

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Section: Introductionmentioning

confidence: 99%

HIV Futures 8: Protocol for a Repeated Cross-sectional and Longitudinal Survey of People Living with HIV in Australia

Power

Brown

Lyons

et al. 2017

Front. Public Health

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“…It recognises that public health interventions can increase as well as decrease citizen's autonomy capabilities, and that this is not necessarily tied to health. It is possible that interventions that aim explicitly to increase people's opportunities (and so capacity for self-determination), skills (and so capacity for self-governance) and self-evaluative attitudes (and so capacity for self-authorisation) also enable people to engage in more autonomous health promoting actions, 30 however the value of fostering of autonomy is not contingent on any associated health improvement.…”

Section: The Implications Of Relational Autonomy For Paternalismmentioning

confidence: 99%

Relational conceptions of paternalism: a way to rebut nanny-state accusations and evaluate public health interventions

2015

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Objectives: 'Nanny-state' accusations can function as powerful rhetorical weapons against interventions intended to promote public health. Public health advocates often lack effective rebuttals to these criticisms. Nanny-state accusations are largely accusations of paternalism. They conjure up emotive concern about undue governmental interference undermining peoples' autonomy. But autonomy can be understood in various ways. We outline three main conceptions of autonomy, argue that these that can underpin three different conceptions of paternalism, and consider implications for responses to nanny-state accusations and the assessment of public health interventions.Study design and methods: Detailed conceptual analysis.Results: The conceptions of paternalism implicit in nanny-state accusations generally depend on libertarian conceptions of autonomy. These reflect unrealistic views of personal independence and do not discriminate sufficiently between trivial and important freedoms. Decisional conceptions of paternalism, like their underlying decisional conceptions of autonomy, have limited applicability in

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“…The ways in which stigma may impact on the policy and health systems intended to support HIV responses has also been raised by several reviewers. 16,25,26,[32][33][34][35] For example, does stigma within policy circuits influence the focus of funded research into GMSM communities, the availability and sustainability of such services to meet the needs of GMSM in the first place, or the trust that community and policy have in GMSM community-led responses? Does HIV stigma within health services, such as excessive infection control measures, accentuate already existing race-related discrimination?…”

Section: Impact Of Hiv and Gmsm Sexuality Stigma On Hiv Preventionmentioning

confidence: 99%

“…16,33,51 In many settings, the engagement in the response of GMSM, including many cultural minority GMSM, 'has often been complicated by a history of neglect and mistreatment by researchers, healthcare systems, and government'. 16 Responding to issues of background prevalence, access to care and different cultural manifestations of stigma in different communities of GMSM, will be key to the successful implementation of new biomedical technologies.…”

Section: Enhance the Mobilisation And Participation Of Gmsm And Plhivmentioning

confidence: 99%

Stigma, gay men and biomedical prevention: the challenges and opportunities of a rapidly changing HIV prevention landscape

et al. 2017

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Abstract. Improvements in biomedical technologies, combined with changing social attitudes to sexual minorities, provide new opportunities for HIV prevention among gay and other men who have sex with men (GMSM). The potential of these new biomedical technologies (biotechnologies) to reduce HIV transmission and the impact of HIV among GMSM will depend, in part, on the degree to which they challenge prejudicial attitudes, practices and stigma directed against gay men and people living with HIV (PLHIV). At the structural level, stigma regarding gay men and HIV can influence the scale-up of new biotechnologies and negatively affect GMSM's access to and use of these technologies. At the personal level, stigma can affect individual gay men's sense of value and confidence as they negotiate serodiscordant relationships or access services. This paper argues that maximising the benefits of new biomedical technologies depends on reducing stigma directed at sexual minorities and people living with HIV and promoting positive social changes towards and within GMSM communities. HIV research, policy and programs will need to invest in: (1) responding to structural and institutional stigma; (2) health promotion and health services that recognise and work to address the impact of stigma on GMSM's incorporation of new HIV prevention biotechnologies; (3) enhanced mobilisation and participation of GMSM and PLHIV in new approaches to HIV prevention; and (4) expanded approaches to research and evaluation in stigma reduction and its relationship with HIV prevention. The HIV response must become bolder in resourcing, designing and evaluating programs that interact with and influence stigma at multiple levels, including structural-level stigma.Additional keywords: community mobilisation, health promotion, men who have sex with men, policy, social inequality.

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Mobilisation, politics, investment and constant adaptation: lessons from the Australian health‐promotion response to HIV

Cited by 44 publications

References 23 publications

HIV Futures 8: Protocol for a Repeated Cross-sectional and Longitudinal Survey of People Living with HIV in Australia

HIV Futures 8: Protocol for a Repeated Cross-sectional and Longitudinal Survey of People Living with HIV in Australia

Relational conceptions of paternalism: a way to rebut nanny-state accusations and evaluate public health interventions

Stigma, gay men and biomedical prevention: the challenges and opportunities of a rapidly changing HIV prevention landscape

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