International HIV and sexual health
The aim of the NCHSR International Research Program is to:
- conduct exemplary HIV social research in Asia and the Pacific region in partnership with local researchers and institutions and
- build research capacity to ensure an indigenous, long-term, sustainable social research response to the HIV epidemic in the region.
We believe that good social research relies on local understandings of social settings and cultures – the contexts in which HIV infection occurs and in which the impact of HIV is felt. Like all other aspects of the response to HIV there must be a country-led, country-owned social research response. Our projects demonstrate that social science evidence can be used in every part of a country’s response to HIV, including:
- Providing baseline behavioural data before setting up HIV prevention programs
- Providing long-term behavioural monitoring of progress
- Providing in-depth social data to enhance understandings of why people are at risk
- Providing evidence of stigma and discrimination
- Assessing the social impacts of the roll-out of new treatment and support programs
- Undertaking social assessments of policies and laws related to HIV
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| Current projects |
- Strengthening HIV-related social research capacity in Papua New Guinea
- Strengthening HIV-related social research capacity in Timor Leste
- Strengthening HIV-related social research capacity in Indonesia
- HIV/AIDS behavioural surveillance and capacity development in Timor Leste: 2007 – 2009
- Asia-Pacific Network of HIV Social Researchers
- Pacific Institute for HIV and STI Research
- Targeted HIV Social Research in Indonesia, PNG and the Pacific
- Australian Leadership Awards (ALA) Fellowships for “Strengthening HIV Social Research Capacity amongst Chinese HIV Social Research Leaders”
- National HIV/AIDS prevention project behavioural surveillance system (BSS), Sri Lanka
- The ART of Living: Rolling out antiretroviral therapy in Papua New Guinea
- Condom access and usage amongst young people in Vanuatu and Tonga
- 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)
- AusAID Consortium
| Selected past projects |
| Contacts |
For more information please contact:
Associate Professor Heather Worth, Head, International Program
Louisa Minney, International Program Development Manager
Project descriptions
Strengthening HIV-related social research capacity in Papua New Guinea |
Worth and Kelly
In 2007 the 10 research cadets in the Strengthening HIV Social Research project based at the Papua New Guinea Institute of Medical Research in Goroka, Eastern Highlands Province, achieved an enormous amount. While becoming proficient in both qualitative and quantitative research, the cadets engaged in a qualitative research project on young people's attitudes towards sex and HIV and were all awarded scholarships to attend the 8th International Congress on AIDS in Asia and the Pacific (ICAAP), where three presented oral papers. All of the cadets underwent training in HIV monitoring and evaluation and together the team were successful in their application for a grant to study the social impacts of antiretroviral therapy for people living with HIV/AIDS in Papua New Guinea. This project will begin in 2008.
The cadets have been invited to high-profile meetings such as those to develop PNG-specific UNGASS, HIV (UN General Assembly Special Session on HIV) indicators, national sexual health meetings and the Papua/PNG meeting held in conjunction with the International AIDS Society Conference in Sydney. They have also been involved in the evaluations of programs such as Tokaut AIDS and best practices in addressing violence against women and girls in Melanesia and East Timor. Within PNG, the research cadets and the program as a whole are being viewed as an important achievement in the national response to HIV and were profiled as such in the PNG UNGASS report.
Strengthening HIV-related social research capacity in Timor Leste |
The overall objective of this project is to develop the capacity of researchers and research institutions in Timor-Leste (T-L) to develop and maintain a local evidence base on HIV and effective responses, including thorough social, behavioural, economic, epidemiological and clinical research. The aims of the project are to:
- Train two graduates in HIV social research methods over a one year period
- Successfully apply for funding for an HIV social research project in T-L that will employ the trained social researchers on a full-time basis for a further year
- Obtain long-term institutional support for researchers from the Institute for Health Services
- Increase the use of HIV social research in T-L by workshops with stakeholders, MOH and communities
- Increase HIV social research by twinning with the universities in funding applications for social research projects.
Strengthening HIV-related social research capacity in Indonesia |
This is a collaboration between ARCSHS and NCHSR through the AusAID-funded HIV Consortium. The project will work with three distinct groups to build a Social Research base across Indonesia which will inform the national response to HIV. These are:
- The National AIDS Commission (NAC) Research Working Group and other key stakeholders
- University-based social researchers
- Community-based organisations
Attention for the first year will be directed towards capacity development with the NAC Research Working Group and other key stakeholders, identifying social researchers and conducting training with those social researchers and also training with Community Based Organisations. Work with NAC and other key stakeholders will be contained to year one. Work with university based social researchers will be conducted for all three years. It is our intent that over the three years our level of engagement with the university based social researchers will progressively increase. Work with community based organisations will occur in years one and two.
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.
This project is a collaboration between NCHSR and ARCSHS the AusAID-funded HIV Consortium. The objective of this project is to establish and maintain sustainable capacity building partnerships across the region to support improved HIV social research responses by developing a Network of HIV Social Researchers in Asia and the Pacific. This Network will:
- Assist in strengthening research institutions in the region
- Assist in developing individual HIV social research skills in the region
- Act as a support for HIV social researchers in the region
- Engender a sense of solidarity through pooling expertise and experience
- Encourage discussion of research and research methods amongst Network members
- Assist researchers in finding out about and applying for research funding - single country, multi-country and regional research
- Assist in research dissemination and knowledge transfer among members
- Assist with publishing
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This project is a collaboration between NCHSR and ARCSHS. Our aim in this project is to collaborate with the Fiji School of Medicine, The University of the South Pacific, the Oceania Society for Sexual Health and HIV Medicine, the Secretariat of the Pacific Commission and other partners to build a Pacific Institute for HIV and STI Research. While this will be based at the Fiji School of Medicine it will be a Pacific-wide institute where researchers from the region, as well as FSM staff and students, will have their capacity built in order to carry out HIV social and behavioural research in the region to build an evidence base for country and regional policy and programs. The following key areas have been identified for development and capacity building/strengthening:
- Institutional strengthening
- Pacific–wide research training
- FSM Staff and student training
- Distance learning
Targeted HIV social research in Indonesia, PNG and the Pacific |
This project aims to build on the HIV social research component of the HIV/AIDS Capacity-Building Consortium through a program of research in Indonesia, Papua New Guinea and the Pacific. The program of research will be undertaken specifically in marginalised and hard-to-reach groups and communities in those countries. It will partner in-country researchers in research projects in order to train researchers through research projects and will involve vulnerable communities in all aspects of the research. The program of research will:
- Encourage critical assessment of the social aspects of the HIV epidemic in each country and region
- Harness the new skills of HIV social researchers
- Build evidence of the social impact of HIV on marginalised and hard-to-reach populations
- Encourage the uptake of findings from research into groups vulnerable to HIV in policy and practice
Australian Leadership Awards (ALA) Fellowships for “Strengthening HIV social research capacity amongst Chinese HIV social research leaders” |
The goal of the ALA Fellowships program is to foster and strengthen links between a wide range of Australian organisations and their counterparts within the Asia-Pacific region and to develop appropriately trained current and aspiring leaders in the Asia-Pacific region who, in the short-to-medium term, will be in a position to advance key regional policy priorities. In this one-month training program we will:
- Build the capacity of Fellows in leadership positions in the field of HIV social research to better develop policy and programs in China
- Promote a collaborative research partnership between NCHSR and the AIDS Policy Research Centre at Tsinghua University in China; and
- Increase research links, quality, scope and dissemination of HIV social research across China and the Asia-Pacific region.
| 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.
| The ART of Living: Rolling out antiretroviral therapy in Papua New Guinea |
This project is being carried out in Papua New Guinea by the PNG research cadets based at the PNG Institute for Medical Research. The research will use both qualitative and quantitative research methods to examine the lived experiences, including impacts, of the roll-out of antiretroviral therapies (ART) on people with HIV who are receiving treatment in PNG.
The objectives of the project are to understand the lived experiences of PLWHA on ART such as:
- Explore the relationship between stigma and the uptake of ART
- To determine the barriers and facilitators for PLWHA's ability to adhere to ART
- To understand PLWHA’s beliefs and knowledge about ART
- Explore the impacts of ART on the lives of PLWHA, including their social and sexual lives
- Explore the gender differences in the impact of ART on PLWHA
- Understand the role of health care workers and families in the experience of ART
| Condom access and usage amongst young people in Vanuatu and Tonga |
NCHSR is managing this project with interviews being undertaken by the PNG research cadets. Through qualitative case studies, the project aims to increase the understanding of why young people in Vanuatu and Tonga are not using condoms for sex. Thirty in-depth interviews have been undertaken in each country. The themes of the interviews are:
- Condom use
- Last sex and condom use
- Reasons for not using condoms
- Access to condoms
- Religious beliefs
- Men’s and women’s roles
- Vulnerability to HIV and STIs
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.
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.
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