Knowledge, attitudes, beliefs, intentions and behaviours of Australian Indigenous women from NSW in response to the National Cervical Screening Program changes: a qualitative study.

Background: Indigenous women in New South Wales Australia are nearly four times more likely to die from cervical cancer than non-Indigenous women due to lower screening rates. We aimed to understand Indigenous women's cervical screening awareness, behaviours, knowledge, perceptions, motivators and barriers since the December 2017 National Cervical Screening Program changed to HPV testing, new screening age and screening interval, and introduced the new self-collection test. Methods: A qualitative study was conducted with 94 Indigenous women 25 to 74 years of age across metropolitan, regional and remote New South Wales. A team of six specialist researchers conducted the fieldwork, analysis and reporting. All data were coded thematically. Findings: Participants showed limited awareness of the renewed cervical screening program and the role of cervical screening in cervical cancer prevention, with most having a strong negative attitude towards cervical screening. Several motivators and behavioural barriers to screening were identified into four audience segments based on key characteristics. Most participants eligible to self-collect were unwilling to, due to concerns they would administer it incorrectly, injure themselves or have to return for a more invasive test. Interpretation: This study demonstrates the complex and heterogenous nature of attitudes and behaviours, among Indigenous women and highlights the intrinsic negative attitudes and social norms that are currently shaping community discourse and ultimately limiting screening. Our findings support the need for enhancing positive sentiment and community advocacy. Funding: Cancer Institute NSW Cervical Screening Program.

Food security in a sample of clients attending HIV clinics in New South Wales: A cross-sectional study.

AIM: The aim of this study was to determine the prevalence, demographics and location of food insecurity (FI) among people living with HIV at six health sites in Sydney, Australia and to identify the factors relating to FI. METHODS: This was a cross-sectional study recruiting people living with HIV receiving HIV care from six sites across the Sydney metropolitan area. The United States Department of Agriculture abbreviated six-item Subset Food Insecurity Tool was used to assess FI and a demographic questionnaire was completed. Bivariate analysis was conducted to investigate differences between variables. Descriptive and frequency statistics were used to collate the demographic questionnaire and determine the prevalence of FI. All tests performed were two sided with a P-value of less than 0.05, or 95% confidence interval not overlapping, indicating a statistically significant association. RESULTS: Of the 162 participants 47% (n = 76) reported FI. The percentage of FI was found to be higher among the females (61%, n = 8 out of 13), unemployed (65%), receiving a government pension (63%), with a lower perceived health status (68%), a lower CD4 T cell count (60%), a detectable or unknown viral load (67%), and missed taking their antiretroviral therapy either in the last week or month (64%). All of the six participants who were Australian Aboriginal were food insecure. CONCLUSIONS: The study finds evidence of associations between FI, employment, lower immune function and poorer health outcomes for people living with HIV in Sydney.