A cross-sectional investigation of the factors associated with awareness of PEP and PrEP among Queensland university students.

OBJECTIVE: University creates unique social environments for many young people that can result in behaviour changes that can impact sexual health-related risks and facilitate transmission of HIV. Little is known about HIV knowledge, risk, and awareness of pre-exposure prophylaxis/post-exposure prophylaxis (PrEP/PEP) among Australian university students. METHODS: A 2019 online survey distributed through Queensland universities, using active recruitment/snowball sampling. Descriptive and logistical regression analysis investigated HIV knowledge/risk and PrEP/PEP awareness. RESULTS: Of the 4,291 responses, 60.4% were 20-29 years old, 57.0% identified as heterosexual, and 31.8% were born-overseas. Mean HIV knowledge score was 9.8/12. HIV risk scores were higher among men-who-have-sex-with-men (MSM) (mean=5.2/40) compared to all other sexual behaviours (mean=3.1/40). Logistic regression indicated PrEP and PEP awareness was associated with older age (p<0.05), being non-binary/gender-diverse (p<0.05), and MSM (p<0.05). Lower odds of PrEP awareness were associated with international student status (p<0.05). CONCLUSION: This study highlights the need for future health promotion targeting younger Australians at risk of HIV to increase uptake of PrEP/PEP, particularly among overseas-born young people and those ineligible for appropriate health care in Australia. IMPLICATIONS FOR PUBLIC HEALTH: Addressing these gaps will improve sexual health outcomes for young Australians at risk of HIV and work towards virtual elimination of HIV transmission in Australia.

Developing critical HIV health literacy: insights from interviews with priority migrant communities in Queensland, Australia.

In Australia, surveillance data establish that there are higher rates of late HIV diagnoses among heterosexual migrants from Sub-Saharan Africa and new HIV diagnoses among gay and bisexual men (GBM) from Southeast and Northeast Asia and Latin America. Together, these groups are identified as priority migrant communities in current efforts to eliminate HIV transmissions. HIV health literacy is recognised as a key means of improving access to services and health outcomes. This qualitative paper explores critical HIV health literacy among priority migrant communities in Queensland, Australia. To foreground community voices, peer researchers from priority migrant communities participated in the project design, data collection and analysis, with 20 interviews completed. The findings demonstrate how participants' engagement with HIV health information and services is highly relational and situated within the framework of sexual health and wellbeing. Participants strategically selected where to seek information and who they trusted to help them appraise this information. They further demonstrated reflective capacities in identifying the contextual barriers that inhibit the development of their HIV health literacy. The findings highlight the need for HIV health promotion strategies that embrace a sex positive approach, promote cultural change, and involve collaboration with general practitioners (GPs).

Sexual and reproductive health literacy of culturally and linguistically diverse young people in Australia: a systematic review.

Young people from culturally and linguistically diverse backgrounds experience barriers accessing sexual and reproductive health (SRH) information and care. This systematic review, utilising a pre-determined protocol, performed according to PRISMA guidelines, explored SRH knowledge, attitudes and information sources for young (16-24 years) culturally and linguistically diverse background people living in Australia, to gain understanding of their sexual health literacy. CINAHL, Embase, MEDLINE, PubMed and Scopus were systematically searched with inclusion criteria applied to 216 articles. After title and abstract screening, backward/forward searching, and full-text review of 58 articles, 13 articles from eight studies were identified. Thematic analysis, guided by core constructs from cultural care theory, identified three themes: (1) SRH knowledge varied by topic but was generally low; (2) young people's attitudes and beliefs were influenced by family and culture; however, 'silence' was the main barrier to sexual health literacy; and (3) Access to SRH information was limited. To attain sexual health literacy and equitable access to culturally-congruent and responsive SRH information and care, there is a need for theory-informed strategies and policies that address the diverse social, cultural and structural factors affecting young culturally and linguistically diverse background people, especially the 'silence' or lack of open SRH communication they experience.

STI and HIV testing: examining factors that influence uptake among domestic Australian-born, domestic overseas-born and international tertiary students studying in Australia.

OBJECTIVES: Sexual health knowledge among international students in Australia is lower than domestic students, however, little is known about what factors affect the uptake of STI testing, nor if there are differences for overseas-born domestic students. METHODS: We included sexually active respondents from a survey of university students in Australia (N = 3,075). Multivariate regression and mediation analyses investigated associations of STI and HIV testing with STI and HIV knowledge respectively, sexual risk behaviour and demographics, including comparisons among: domestic Australian-born, domestic overseas-born, and international students. RESULTS: STI and HIV knowledge was positively associated with STI and HIV testing respectively (STI OR = 1.13, 95% CI: 1.09, 1.16; HIV OR = 1.37, 95% CI: 1.27, 1.48). STI knowledge was significantly lower for international than domestic Australian-born students (10.8 vs. 12.2 out of 16), as was STI testing (32% vs. 38%); the difference in knowledge accounted for half the difference in STI testing rates between these two groups. International students from Southern Asia, and Eastern Asia reported the lowest STI testing rates. HIV testing was highest amongst international students from Africa and North America. Higher sexual risk behaviour, younger age, and identifying as gay or bisexual were positively associated with higher STI and HIV testing rates. CONCLUSIONS: Our study supports greater investment and commitment by universities for the provision of sexual health education that can promote access to testing to improve the health of their students.

Strategies for Recruiting Migrants to Participate in a Sexual Health Survey: Methods, Results, and Lessons.

In this article, we describe the approaches taken to recruit adult migrants living in Australia for a sexual health and blood-borne virus survey (paper and online) and present data detailing the outcomes of these approaches. The purpose was to offer guidance to redress the under-representation of migrants in public health research. Methods of recruitment included directly contacting people in individual/organizational networks, social media posts/advertising, promotion on websites, and face-to-face recruitment at public events/venues. Search query strings were used to provide information about an online referral source, and project officers kept records of activities and outcomes. Descriptive statistical analyses were used to determine respondent demographic characteristics, proportions recruited to complete the paper and online surveys, and sources of referral. Logistic regression analyses were run to predict online participation according to demographic characteristics. The total sample comprised 1454 African and Asian migrants, with 59% identifying as female. Most respondents (72%) were recruited to complete the paper version of the survey. Face-to-face invitations resulted in the highest number of completions. Facebook advertising did not recruit large numbers of respondents. Same-sex attraction and age (40-49 years) were statistically significant predictors of online completion. We encourage more researchers to build the evidence base on ways to produce research that reflects the needs and perspectives of minority populations who often bear the greatest burden of disease.

Are sexual health survey items understood as intended by African and Asian migrants to Australia? Methods, results and recommendations for qualitative pretesting.

INTRODUCTION: More research and policy action are needed to improve migrant health in areas such as sexual health and blood-borne viruses (SHBBV). While Knowledge, Attitudes and Practice Surveys (KAPS) can inform planning, there are no SHBBV KAPS suitable for use across culturally and linguistically diverse contexts. This study pretests one instrument among people born in Sub-Saharan Africa, South-East and North-East Asia living in Australia. METHODS: Employees of multicultural organisations were trained to collect data over three rounds using a hybrid qualitative pretesting method. Two researchers independently coded data. Researchers made revisions to survey items after each round. Responses to feedback questions in the final survey were analysed. RESULTS: Sixty-two participants pretested the survey. Issues were identified in all three rounds of pretesting. Of the 77 final survey respondents who responded to a survey experience question, 21% agreed and 3% strongly agreed with the statement 'I found it hard to understand some questions/words'. CONCLUSION: It is essential to pretest SHBBV surveys in migrant contexts. We offer the following pretesting guidance: (1) large samples are needed in heterogeneous populations; (2) intersectionality must be considered; (3) it may be necessary to pretest English language surveys in the participants' first language; (4) bilingual/bicultural workers must be adequately trained to collect data; (5) results need to be interpreted in the context of other factors, including ethics and research aims; and (6) pretesting should occur over multiple rounds.

Translating best practice into real practice: Methods, results and lessons from a project to translate an English sexual health survey into four Asian languages.

BACKGROUND: Migrants are underrepresented in population health surveys. Offering translated survey instruments has been shown to increase migrant representation. While 'team translation' represents current best practice, there are relatively few published examples describing how it has been implemented. The purpose of this paper is to document the process, results and lessons from a project to translate an English-language sexual health and blood-borne virus survey into Khmer, Karen, Vietnamese and Traditional Chinese. METHODS: The approach to translation was based on the TRAPD (Translation, Review, Adjudication, Pretesting, and Documentation) model. The English-language survey was sent to two accredited, independent translators. At least one bilingual person was chosen to review and compare the translations and preferred translations were selected through consensus. Agreed translations were pretested with small samples of individuals fluent in the survey language and further revisions made. RESULTS: Of the 51 survey questions, only nine resulted in identical independent translations in at least one language. Material differences between the translations related to: (1) the translation of technical terms and medical terminology (e.g. HIV); (2) variations in dialect; and (3) differences in cultural understandings of survey concepts (e.g. committed relationships). CONCLUSION: Survey translation is time-consuming and costly and, as a result, deviations from TRAPD 'best practice' occurred. It is not possible to determine whether closer adherence to TRAPD 'best practice' would have improved the quality of the resulting translations. However, our study does demonstrate that even adaptations of the TRAPD method can identify issues that may not have been apparent had non-team-based or single-round translation approaches been adopted. Given the dearth of clear empirical evidence about the most accurate and feasible method of undertaking translations, we encourage future researchers to follow our example of making translation data publicly available to enhance transparency and enable critical appraisal.

STI and HIV knowledge and testing: a comparison of domestic Australian-born, domestic overseas-born and international university students in Australia.

University students usually consist of young people from culturally and linguistically diverse backgrounds, and a group recognised as being at increased risk of STI. This study found lower levels of STI knowledge and STI testing among international students and to a lesser extent, domestic overseas-born students, compared with domestic Australian-born students. International students exhibited lower risk sexual behaviour but were more likely to have had a HIV test than domestic students. This diversity in sexual health knowledge, sexual health services utilisation and sexual experience indicates the need for a variety of public health approaches to improve sexual health.

Sexual and reproductive health knowledge, attitudes and behaviours of Chinese international students studying abroad (in Australia, the UK and the US): a scoping review.

International students within Australia are disproportionately affected by adverse sexual and reproductive health (SRH) outcomes. Chinese international students represent the majority of international students in Australia, and a large proportion of students in other high-income countries such as the United States and the United Kingdom, making them an important priority group. However, the SRH issues of this priority group have received little attention from international researchers. This review provides an overview of global studies surrounding the SRH knowledge, attitudes and behaviours of Chinese international students studying abroad. Ten articles were deemed relevant and findings from both the qualitative and quantitative data synthesis were categorised into six codes: (1) knowledge; (2) sources of information; (3) attitudes; (4) behaviours; (5) barriers; and (6) recommendations. The findings provide valuable understanding to inform the development of targeted, culturally sensitive and inclusive health promotion initiatives and policies. It is recommended that further research is conducted in this field to reduce evident health disparities.

Exploring HIV risks, testing and prevention among sub-Saharan African community members in Australia.

BACKGROUND: Significant health disparities persist regarding new and late Human Immunodeficiency Virus (HIV) diagnoses among sub-Saharan African (SSA) communities in Australia. Personal/cultural beliefs and practices influence HIV (risk, prevention, testing) within Australia and during visits to home countries. METHOD: A community forum was conducted involving 23 male and female adult African community workers, members and leaders, and health workers; facilitated by cultural workers and an experienced clinician/researcher. The forum comprised small/large group discussions regarding HIV risk/prevention (responses transcribed verbatim; utilising thematic analysis). RESULTS: Stigma, denial, social norms, tradition and culture permeated perceptions/beliefs regarding HIV testing, prevention and transmission among African Australians, particularly regarding return travel to home countries. CONCLUSIONS: International travel as a risk factor for HIV acquisition requires further examination, as does the role of the doctor in HIV testing and Pre-exposure Prophylaxis (PrEP). Further assessment of PrEP as an appropriate/feasible intervention is needed, with careful attention regarding negative community perceptions and potential impacts.

[The prediction of barley grain protein content based on hyperspectral data].

The prediction of crop grain protein by hyperspectral data has the nondestructive and quick advantages. At present, there are only a few reports about the prediction of barley grain protein by remote sensing. The present research focuses on the malt barley of Northeast China. Firstly, we analyzed the sensitive band area, compared many vegetation indexes related with the plant nitrogen. According to the mechanism of nitrogen transfer, the authors built the prediction model based on the hyperspectral vegetation indexes. Finally, we validated the results. It can meet the standard. The outcome shows that (1) the sensitive band region of barley plant nitrogen is 550-590 nm and 670-710 nm. (2) GRVI was significantly correlated with plant nitrogen. The relationship between GRVI and barley plant nitrogen had a coefficient of determination of R2 = 0.665 1. The results indicated that the prediction of barley grain protein by hyperspectral data is feasible. This research will be a strong scientific support for barley purchase.

[Measurement and comparison of Zn, Fe, Cu, Mn, Cr, Pb and Cd in rabbit liver of high-adipose group and normal group].

The objective of the present paper is to explore the experimental changes in the content of Zn, Fe, Cu, Mn, Cr, Pb and Cd in white rabbit liver with atherosclerosis disease. The method is to reproduce white rabbit liver with atherosclerosis disease by a high-fat diet, and then measure the Zn, Fe, Cu, Mn, Cr, Pb and Cd content with atomic absorption spectrometry. Results show that the Zn, Fe, Cu, Mn, Cr, Pb and Cd contents in the fodders of the normal group are 137.6, 362.3, 14.39, 9.599 mg x kg(-1) and 159.3, 355.0, 290.0 microg x kg(-1), and 86.09, 277.1, 11.07, 5.366 mg x kg(-1) and 115.2, 286.0, 210.5 microg x kg(-1), in high-adipose group. It was concluded that Zn, Fe, Cu, Mn, Cr, Pb and Cd contents in white rabbit liver decline, which may have something to do with the intake of foods and the abnormalities of lipoprotein metabolism.

Hepatitis B knowledge, testing, and vaccination among Chinese and Vietnamese adults in Australia.

Hepatitis B is a significant public health challenge within some subpopulations in Australia, including Chinese and Vietnamese migrants. There has been limited research on hepatitis B knowledge and actions in these communities. The authors conducted a self-administered survey among 442 Chinese and 433 Vietnamese in Brisbane. Generally, the knowledge is best described as "moderate." One in 2 could not identify the sexual transmission risk and less than one third knew that sharing foods or drinks did not spread the disease. The majority of Vietnamese (80%) and 60% of Chinese respondents indicated prior testing. Vaccination was reported in 60% of the Vietnamese and in 52% of the Chinese. Knowledge was better among Chinese people who had been tested and vaccinated compared with those who were nontested and nonvaccinated. Only 3.5% of the Chinese, but 11.6% of the Vietnamese, indicated having a positive test result hepatitis B virus. This study helps identify strategies for programs targeting both communities and practitioners.