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Disparities in characteristics in accessing public Australian sexual health services between Medicare-eligible and Medicare-ineligible men who have sex with men.
Aust N Z J Public Health. 2020 Oct; 44(5):363-368.AN

Abstract

OBJECTIVES

Accessible health services are a key element of effective human immunodeficiency virus (HIV) and sexually transmitted infection (STI) control. This study aimed to examine whether there were any differences in accessing sexual health services between Medicare-eligible and Medicare-ineligible men who have sex with men (MSM) in Melbourne, Australia.

METHODS

We conducted a retrospective, cross-sectional study of MSM attending Melbourne Sexual Health Centre between 2016 and 2019. Demographic characteristics, sexual practices, HIV testing practices and STI diagnoses were compared between Medicare-eligible and Medicare-ineligible MSM.

RESULTS

We included 5,085 Medicare-eligible and 2,786 Medicare-ineligible MSM. Condomless anal sex in the past 12 months was more common in Medicare-eligible compared to Medicare-ineligible MSM (74.4% vs. 64.9%; p<0.001) although the number of partners did not differ between groups. There was no difference in prior HIV testing practices between Medicare-eligible and Medicare-ineligible MSM (76.1% vs. 77.7%; p=0.122). Medicare-ineligible MSM were more likely to have anorectal chlamydia compared to Medicare-eligible MSM (10.6% vs. 8.5%; p=0.004).

CONCLUSIONS

Medicare-ineligible MSM have less condomless sex but a higher rate of anorectal chlamydia, suggesting they might have limited access to STI testing or may be less willing to disclose high-risk behaviour. Implications for public health: Scaling up access to HIV and STI testings for Medicare-ineligible MSM is essential.

Authors+Show Affiliations

Melbourne Sexual Health Centre, Alfred Health, Victoria. Central Clinical School, Monash University, Victoria.Melbourne Sexual Health Centre, Alfred Health, Victoria. Central Clinical School, Monash University, Victoria.Melbourne Sexual Health Centre, Alfred Health, Victoria. Central Clinical School, Monash University, Victoria.Melbourne Sexual Health Centre, Alfred Health, Victoria. Central Clinical School, Monash University, Victoria.Melbourne Sexual Health Centre, Alfred Health, Victoria. Central Clinical School, Monash University, Victoria. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32865864

Citation

Walia, Anysha M., et al. "Disparities in Characteristics in Accessing Public Australian Sexual Health Services Between Medicare-eligible and Medicare-ineligible Men Who Have Sex With Men." Australian and New Zealand Journal of Public Health, vol. 44, no. 5, 2020, pp. 363-368.
Walia AM, Fairley CK, Bradshaw CS, et al. Disparities in characteristics in accessing public Australian sexual health services between Medicare-eligible and Medicare-ineligible men who have sex with men. Aust N Z J Public Health. 2020;44(5):363-368.
Walia, A. M., Fairley, C. K., Bradshaw, C. S., Chen, M. Y., & Chow, E. P. F. (2020). Disparities in characteristics in accessing public Australian sexual health services between Medicare-eligible and Medicare-ineligible men who have sex with men. Australian and New Zealand Journal of Public Health, 44(5), 363-368. https://doi.org/10.1111/1753-6405.13029
Walia AM, et al. Disparities in Characteristics in Accessing Public Australian Sexual Health Services Between Medicare-eligible and Medicare-ineligible Men Who Have Sex With Men. Aust N Z J Public Health. 2020;44(5):363-368. PubMed PMID: 32865864.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disparities in characteristics in accessing public Australian sexual health services between Medicare-eligible and Medicare-ineligible men who have sex with men. AU - Walia,Anysha M, AU - Fairley,Christopher K, AU - Bradshaw,Catriona S, AU - Chen,Marcus Y, AU - Chow,Eric P F, Y1 - 2020/08/31/ PY - 2020/02/01/received PY - 2020/07/01/revised PY - 2020/07/01/accepted PY - 2020/9/1/pubmed PY - 2020/12/1/medline PY - 2020/9/1/entrez KW - HIV KW - health service KW - men who have sex with men KW - sexual health SP - 363 EP - 368 JF - Australian and New Zealand journal of public health JO - Aust N Z J Public Health VL - 44 IS - 5 N2 - OBJECTIVES: Accessible health services are a key element of effective human immunodeficiency virus (HIV) and sexually transmitted infection (STI) control. This study aimed to examine whether there were any differences in accessing sexual health services between Medicare-eligible and Medicare-ineligible men who have sex with men (MSM) in Melbourne, Australia. METHODS: We conducted a retrospective, cross-sectional study of MSM attending Melbourne Sexual Health Centre between 2016 and 2019. Demographic characteristics, sexual practices, HIV testing practices and STI diagnoses were compared between Medicare-eligible and Medicare-ineligible MSM. RESULTS: We included 5,085 Medicare-eligible and 2,786 Medicare-ineligible MSM. Condomless anal sex in the past 12 months was more common in Medicare-eligible compared to Medicare-ineligible MSM (74.4% vs. 64.9%; p<0.001) although the number of partners did not differ between groups. There was no difference in prior HIV testing practices between Medicare-eligible and Medicare-ineligible MSM (76.1% vs. 77.7%; p=0.122). Medicare-ineligible MSM were more likely to have anorectal chlamydia compared to Medicare-eligible MSM (10.6% vs. 8.5%; p=0.004). CONCLUSIONS: Medicare-ineligible MSM have less condomless sex but a higher rate of anorectal chlamydia, suggesting they might have limited access to STI testing or may be less willing to disclose high-risk behaviour. Implications for public health: Scaling up access to HIV and STI testings for Medicare-ineligible MSM is essential. SN - 1753-6405 UR - https://www.unboundmedicine.com/medline/citation/32865864/Disparities_in_characteristics_in_accessing_public_Australian_sexual_health_services_between_Medicare_eligible_and_Medicare_ineligible_men_who_have_sex_with_men_ L2 - https://doi.org/10.1111/1753-6405.13029 DB - PRIME DP - Unbound Medicine ER -