Vaccination coverage among people who inject drugs: A systematic review.

BACKGROUND: People who inject drugs may be at excess risk of acquiring vaccine-preventable diseases and negative associated health outcomes, but experience barriers to vaccination. We aimed to determine vaccination coverage among people who inject drugs globally. METHODOLOGY: We conducted systematic searches of the peer-reviewed and grey literature, date limited from January 2008 to August 2023, focusing on diseases for which people who inject drugs are at elevated risk for and for which an adult vaccination dose is recommended (COVID-19, hepatitis A, hepatitis B, human papillomavirus, influenza, pneumococcal disease, tetanus). To summarise available data, we conducted a narrative synthesis. RESULTS: We included 78 studies/reports comprising 117 estimates of vaccination coverage across 36 countries. Most estimates were obtained from high income countries (80%, n=94). We located estimates for hepatitis B vaccination in 33 countries, which included 18 countries with data on serological evidence of vaccine-derived hepatitis B immunity (range: 6-53%) and 22 countries with self-report data for vaccine uptake (<1-96%). Data for other vaccines were scarcer: reported hepatitis A vaccination coverage ranged 3-89% (five countries), COVID-19 ranged 4-84% (five countries), while we located estimates from fewer than five countries for influenza, tetanus, pneumococcal disease, and human papillomavirus. CONCLUSION: Estimates were sparse but where available indicative of suboptimal vaccination coverage among people who inject drugs. Improving the consistency, timeliness, and geographic coverage of vaccine uptake data among this population is essential to inform efforts to increase uptake.

A meta-analysis of the effect of new-media interventions on sexual-health behaviours.

BACKGROUND AND OBJECTIVES: Direct access to individuals in non-intrusive ways, as well as the technical abilities of new-media to provide tailored information in relatively inexpensive ways, creates a unique opportunity for the delivery of health-related information. The aim of the present research was to examine the effect that new-media-based sexual-health interventions have on sexual-health behaviours in non-clinical populations and to determine the factors that moderate the effect of technology-based sexual-health interventions on sexual--health behaviours. DATA SOURCES: A systematic literature search of the following databases was conducted: MEDLINE, psycINFO, Global health, and EMBASE, using terms that captured three subject areas-'Sexual-health', 'New Technology' and 'Intervention'. STUDY ELIGIBILITY CRITERIA: Randomised controlled trial, or a quasi-experiment; delivered exclusively via new-media; included sexual risk behaviour change as an outcome measure and delivered to non-clinical groups. RESULTS: Twelve studies tested the effect of new-media interventions on condom use, whereas nine tested the effect on sexually transmitted disease testing. Results indicated that new-media interventions led to significant increases in both outcomes; however, these effects were not homogeneous. Moderation analyses revealed that interactivity of the intervention, target population and study design influenced the efficacy of interventions on both sexual-health outcomes, whereas intervention duration influenced sexually transmitted infection testing. CONCLUSIONS AND IMPLICATIONS: Interventions aiming to improve condom use are more successful when an interactive component is used. Further research needs to be conducted to reach specific at-risk populations.

Engaging, understanding and including young people in the provision of mental health services.

Suicide continues to be one of the leading causes of death among Australians aged 15-24 years. In order to reduce the burden of mental illness it is essential that we not only improve young people's access to professionals and services but ensure that mental health professionals and young people are better equiped to work together in the treatment and management of mental health disorders. Young people have tradititionally been viewed within the health sector as clients or service recipients. As a result compliance to treatment, whether pharmacological or psychological has been less than ideal. Current evidence suggests that involving young people directly in the development and delivery of services impacts positively on the individuals experience and service uptake. This paper is based on conference presentations by Reach Out! Youth Ambassadors Rosie Swanton and Ingrid Sorensen at the Australian and New Zealand Adolescent Health Conference in Sydney. These presentations explored Reach Out! a unique Australian Internet-based mental health service for young people. Since launching in 1998 it has been accessed by over four million users and 332 young people have been directly involved in the development and delivery of the serivce. This paper describes the Reach Out! youth participation model as a case study in youth participation. It presents and suggests practical steps to engage, understand and involve young people to increase the impact of mental health professionals and services in addressing the mental health needs of young people.