Location:
The Kirby Institute Level 6 Seminar Room Wallace Wurth Building UNSW Australia Sydney NSW 2052
Open to
All
Contact for enquiries
Rata Joseph +61 (0)2 9385 0900 rjoseph@kirby.unsw.edu.au
The Kirby Institute is pleased to present:
Belinda Hengle- TTANGO Queensland Coordinator-Apunipima Cape York Health Council, Kirby Institute
“What works? Improving the uptake of STI testing and management among young people in remote Aboriginal and Torres Strait Islander communities in Australia ”
Tuesday 5th May 2015
Lunch will be served at 12.30pm
1pm - 2pm
Please RSVP to rjoseph@kirby.unsw.edu.au for catering purposes before COB Monday 4th May 2015.
Abstract:
“What works? Improving the uptake of STI testing and management among young people in remote Aboriginal and Torres Strait Islander communities in Australia ”
Aboriginal people living in remote areas experience a disproportionately high burden of sexually transmissible infections. To interrupt the transmission of STIs and prevent the development of complications, regular testing and timely treatment is required. However no studies have been undertaken to explore these factors in remote Aboriginal communities. The aim of this thesis is to provide new knowledge about the uptake, barriers and facilitators to regular STI testing and timely treatment in this setting. Four studies were undertaken. The first, a longitudinal analysis which showed that among patients attending 68 remote health services only 20.3% were re-tested in 12 months, higher in young people and females. Among females, re-testing was also more likely if they attended a health service which was Aboriginal community controlled, saw predominantly Aboriginal clients or used electronic medical records. For males, re-testing was more likely if they attended a service where male staff were employed. Studies 2 and 3, involved qualitative interviews with 36 staff of remote Aboriginal health services. Barriers for staff offering STI tests included: existing cultural norms requiring the separation of genders; conflicting clinical demands; concerns about client confidentiality and a limited staff capacity. For timely treatment; the large distances between the health centre and reference laboratories was a strong barrier, in addition delays occurred when checking and actioning test results, under-utilisation of recall systems, and difficulties in physically locating clients. The fourth study systematically reviewed the international literature to assess the reach, uptake and outcomes of outreach as a strategy to increase testing and treatment coverage. The review revealed that despite the number of people tested being relatively small, the yield of infections was high, and in regards to efficiency, the proportion of the target population tested was highest in venues (community centres etc.) but lower in street/public areas. In conclusion, the research in this thesis has identified client, cultural, health centre and systematic factors which impact on regular testing and timely treatment. Many of the barriers identified are modifiable, while others may require innovative strategies to overcome; such as outreach programs, point-of-care testing, incentives and testing modalities outside the clinic.
Biography:
Belinda has over ten years experience working as a sexual health nurse across a wide range of communities in both urban and remote Australian areas. Previously working on the STRIVE trial, Belinda now works with the TTANGO trial coordinating point-of-care testing in Far North Queensland communities. Currently she is a PhD candidate under the supervision of Assoc. Prof Rebecca Guy, Prof John Kaldor and Prof Lisa Maher.