International HIV and Sexual Health
HIV, hepatitis C and sexually transmissible infections affect people and communities globally and in recognition of this, in recent years our research program has expanded beyond Australia. Researchers at the NCHSR are involved in projects in developed and developing countries, in partnership with local researchers and community organisations. We also work closely with a range of international organisations, such as UNAIDS, and provide advice to government and nongovernment agencies.
Our international research program includes studies in some European countries. These studies are seeking to provide a better understanding of, and responses to, HIV and STI epidemics in gay and other men who have sex with men and migrant communities.
Another important part of the international research of the NCHSR takes place in South Africa, through the Africa Centre for Health and Population Studies. Here we work with a range of communities to better understand their vulnerability to HIV infection and develop novel prevention interventions to contribute to curbing the devastating impact of the HIV epidemic. The centre is also engaged in strengthening research and capacity building partnerships in the Asia-Pacific region.
Current projects
- The sexual attitudes and lifestyles of London’s Eastern Europeans (SALEE)
- A rapid assessment of the HIV epidemic among men who have sex with men (MSM) in South Africa
- 5-Centre HIV and AIDS research initiative (5-CHARI)
Selected past projects
- Social and economic impact of HIV in Papua New Guinea, Indonesia and Timor Leste 2005-2025 (PDF) (1 Mb)
- HIV/AIDS behavioural surveillance and capacity development in Timor Leste: 2007 – 2009
- National HIV/AIDS prevention project behavioural surveillance system (BSS), Sri Lanka
Contacts
For more information please contact:
Prof John de Wit, Director NCHSR
Current Projects
The sexual attitudes and lifestyles of London’s Eastern Europeans (SALLEE)
Since 1 May 2004, 10 new countries in central and Eastern Europe have become full members of the European Union. Contrary to UK government projections, accession of these countries has resulted in a massive influx of predominantly young, sexually active, economic migrants from the new member states. This constitutes the largest and most concentrated migration to the UK since the Second World War. The aim of this study is to survey and interview migrants from central and Eastern Europe, to measure their sexual behaviours, attitudes and lifestyles, to describe the extent of their specific sexual and reproductive health risks and to advise on appropriate health service responses. This project is funded by the UK Medical Research Council and involves a collaboration that includes the Centre for Sexual Health and HIV Research and the School of Slavonic and Eastern European Studies, University College London; the UK Health Protection Agency, London; and the London School of Hygiene and Tropical Medicine.
Rapid assessment of the HIV epidemic among men who have sex with men (MSM) in South Africa
South Africa is currently experiencing a severe maturing generalised HIV epidemic with approximately 5.5 million people infected with HIV, the largest number of HIV infections of any country in the world. In the 1980s the very much smaller HIV epidemic was concentrated in men who have sex with men (MSM). However, emergence of a generalised epidemic in South Africa eclipsed the HIV epidemic among MSM. Current information on the incidence and prevalence of HIV among MSM in South Africa, as well as on risk practices and prevention strategies to minimise risk, is extremely limited. MSM are still categorised as a ‘high-risk group’ for HIV and other sexually transmissible infections, but on the basis of a lack of evidence, prevention messages explicitly directed at MSM are conspicuously absent from national education campaign programs. The aims of this study are to establish the prevalence of HIV among MSM attending community events in Johannesburg and Durban; to describe sexual and other risk behaviours for HIV infection among MSM in these cities and to estimate their usage of HIV testing and counselling services. This study is funded by the UK Department for International Development and involves a collaboration that includes the South African Human Sciences Research Council, Pretoria; School of Community Medicine, University of the Witwatersrand, Johannesburg; the Centre for Sexual Health and HIV Research, University College London, UK; and the HIV Centre for Clinical and Behavioural Studies, Columbia University, New York, City, US.
5-Centre HIV and AIDS research initiative (5-CHARI)
A memorandum of understanding between social researchers from five universities in Sydney (UNSW), South Africa (University of Pretoria), England (University of London), Canada (University of Toronto) and Brazil (University of Sao Paulo) has been reached to facilitate the sharing of research ideas and the writing of policy papers in the following areas: masculinity in the context of HIV prevention; the impact of treatments and vaccines on behavioural prevention; stigma and disease; and varying responses to education and health promotion. In 2007 a study began at the University of Pretoria in South Africa (Kippax, UNSW, and Brouard, University of Pretoria) to examine the impact of voluntary counselling and testing on stigma and discrimination. Also in 2007 a paper written in collaboration with members of 5-CHARI is in press in Global Health (Kippax and Worth, UNSW, and Aggleton, University of London) and a journal issue of AIDS that focused on living with HIV and AIDS was edited by Susan Kippax, UNSW, and Peter Aggleton, University of London.
Past Projects
HIV/AIDS behavioural surveillance and capacity development in Timor Leste: 2007 – 2009
This project is funded by the Global Fund. The Ministry of Health in Timor-Leste is the principal recipient of the fund and NCHSR is the sub-recipient. Jason Lee is coordinating the study in Timor-Leste.
The project has two major objectives:
- Establish and implement a behavioural surveillance system to monitor HIV/AIDS risk behaviours in Timor Leste in line with international standards established by the WHO/UNAIDS;
- Provide a framework to build the capacity of the Ministry of Health (MOH) in Timor Leste to help undertake future rounds of BSS and to oversee the implementation of HIV social research.
While the prevalence of HIV in Timor-Leste is currently in the low-level range, the Ministry of Health as well as donors such as the Global Fund see the importance of establishing surveillance systems, including second generation behavioural surveillance in Timor-Leste. HIV is concentrated in sub-populations, particularly female sex workers (FSW) and men who have sex with men (MSM). These two sub-populations, as well as uniformed personnel who are one of the major clients of FSW, are the groups targeted in the first round of the BSS. In subsequent rounds, other groups such as youth may also be included.
By July 2008, the project had successfully completed a mapping exercise to ascertain the size, whereabouts and feasibility of sampling FSW, MSM, and uniformed personnel. Mapping activities were focussed in seven districts: Dili, Baucau, Lautem, Viqueque, Ermera, Suai and Maliana. The mapping activities have helped inform a sampling strategy for the main study.
Due to the relatively ‘hidden’ nature of FSW and MSM, these two sub-populations are being sampled using respondent driven sampling (RDS) methods. Since it is possible to obtain a list of the number and whereabouts of uniformed personnel, this sub-population will be sampled using probability methods. Recruitment, which commenced in late May 2008, is progressing steadily though it is somewhat hampered for FSW by the previous Police raids on bars where FSW had been visible. Some FSW, particularly the women who are not citizens of Timor-Leste, are reticent to take part in the study out of fear of being deported.
Data collection for round 1 is scheduled for completion in mid August after which NCHSR will be conducting the first of two capacity building short courses in HIV social research. In 2009, the project is scheduled to conduct a second round of data collection, another capacity building short course and will organise a national seminar on HIV research in Timor-Leste.
National HIV/AIDS prevention project behavioural surveillance system, Sri Lanka
While the current prevalence of HIV/AIDS in Sri Lanka is low, the Government of Sri Lanka has committed to a program to prevent the spread of the epidemic, including establishing and implementing a behavioural surveillance system in Sri Lanka and providing geographical and other relevant information regarding at-risk and vulnerable populations. This is to give logistical support to the National STD AIDS Control Program for on-going HIV serosurveillance work.
This project is funded by the World Bank to the Ministry of Health in Sri Lanka and carried out by NCHSR in collaboration with NewSouth Global at the University of New South Wales, together with sociologists from the University of Sri Jayawardenepura in Colombo.
By March 2007 the first round of Sri Lanka's behavioural surveillance survey was successfully completed. In all, over 7000 interviews were conducted among six groups: factory workers (both men and women), three-wheel drivers, female sex workers, men who have sex with men, beach boys and drug users. The overall response rate of 92.1% was a very pleasing. Feedback to the National STD and AIDS Control Program (NSACP), Ministry of Health, Sri Lanka, and discussion of the main results occurred in Colombo in May 2007. Further dissemination took place at a specially designated satellite session at the 8th International Congress on AIDS in Asia and the Pacific (ICAAP) in Colombo in August 2007. A report of the first-round methodology and results was written and will be officially launched in Colombo in 2008. Capacity building workshops on sampling and SPSS data analysis for behavioural surveillance were delivered to the NSACP in May 2007. The following capacity building workshops are scheduled for 2008: ‘Multivariate analysis of behavioural surveillance data’ and ‘Respondent Driven Sampling (RDS): methodology and analysis’.
Due to the richness of the data from Round 1 and the unlikelihood that changes in behaviour and attitudes would occur in the absence of health promotion campaigns, it has been decided not to pursue a second round of the survey at this stage. The project is scheduled to conclude in 2008.
