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Background   The NSW STI Strategy 2006-2010 acknowledges the finite capacity ofNSW STI Strategy 2006-2010 Publicly Funded Sexual Health Clinics and.

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Presentation on theme: "Background   The NSW STI Strategy 2006-2010 acknowledges the finite capacity ofNSW STI Strategy 2006-2010 Publicly Funded Sexual Health Clinics and."— Presentation transcript:

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3 Background   The NSW STI Strategy 2006-2010 acknowledges the finite capacity ofNSW STI Strategy 2006-2010 Publicly Funded Sexual Health Clinics and the need for services to be directed where most needed. The Strategy requires that Sexual Health Clinics establish goals and targets in relation to priority populations to assist with prioritising access.  Estimating the size and locations of priority populations within Area Health Service boundaries is an important step in establishing goals and targets and in planning outreach activities in relation to access by priority populations.

4 Background (continued)Background (continued)   Some approaches to doing this are described as well as limitations in estimating the size and location of some priority populations groups.  In addition to providing guidance on how to estimate the size of priority populations, a range of other information sources are identified which can be used in decision making when setting targets. Background (continued)Background (continued)   Some approaches to doing this are described as well as limitations in estimating the size and location of some priority populations groups.  In addition to providing guidance on how to estimate the size of priority populations, a range of other information sources are identified which can be used in decision making when setting targets.

5 Aboriginal PeopleAboriginal People  ABS census data now interfaces with Google maps and it is now easier to obtain numbers and percentages of Aboriginal people within a selected local government area by entering the location or postcode into the search field and clicking on the ABS census data ABS census data button. button.  Example: Entering Broken Hill into the search field and clicking on quick stats will inform you there are 1206 indigenous people in Broken hill who make up 6.2% of the total population.  A screen shot of the results is shown in the next slide.

6 Aboriginal PeopleAboriginal People

7  The Social Atlas of Australia 2010 also has a navigable Geographic Information System (GIS) where the Aboriginal populations between different suburbs can be compared. Sorting and age stratification are also possible. The Social Atlas of Australia navigable Geographic Information System (GIS) The Social Atlas of Australia navigable Geographic Information System (GIS)  A screen shot of the GIS is presented on the next page. Clicking on it will take you to the actual online GIS hosted by the Population Health Information Development Unit (University of Adelaide). Population Health Information Development Unit Population Health Information Development Unit Aboriginal PeopleAboriginal People

8 Click on ‘select data’ to select the required demographic filter when using the live application

9 Point for considerationPoint for consideration It is particularly important to identify those at risk within the population. This could mean increasing the range of broad screening programs that in other populations might be confined to “under 25” to, for instance, “under 30” in an Aboriginal population. The differences in reported incidence rates of STIs between local government areas may also need to be considered when planning outreach activities. Point for considerationPoint for consideration It is particularly important to identify those at risk within the population. This could mean increasing the range of broad screening programs that in other populations might be confined to “under 25” to, for instance, “under 30” in an Aboriginal population. The differences in reported incidence rates of STIs between local government areas may also need to be considered when planning outreach activities. Aboriginal PeopleAboriginal People

10 Gay and other MSM   ABS census data provides male populations and population by age groups searchable by local government area. Estimated population growth rates over time are also provided.ABS census datapopulation growth rates  The Social Atlas of Australia 2010’s Geographic Information System (GIS) provides populations and percentages of males by age group. Projected population numbers until 2025 are also provided.The Social Atlas of Australia Geographic Information System (GIS)   ABS census data provides male populations and population by age groups searchable by local government area. Estimated population growth rates over time are also provided.ABS census datapopulation growth rates  The Social Atlas of Australia 2010’s Geographic Information System (GIS) provides populations and percentages of males by age group. Projected population numbers until 2025 are also provided.The Social Atlas of Australia Geographic Information System (GIS)

11   The Australian Study of Health and Relationships reported that 2.5% of the male populations between ages 16 to 59 years identified as gay or bisexual.The Australian Study of Health and Relationships  Same sex experience was reported by 5.9% of men surveyed (Grulich et al 2007).(Grulich et al 2007).  Analysis of data from the Sydney Gay Community Periodic Survey suggests that the proportion of men who identify as gay or bisexual may be as high as 48% in certain inner city locations where gay communities cluster. (Madeddu et al, 2006).Sydney Gay Community Periodic Survey(Madeddu et al, 2006).  Prestage et al (2008) estimated there were 74,000 homosexual and bisexual men in NSW in 2001.Prestage et al   The Australian Study of Health and Relationships reported that 2.5% of the male populations between ages 16 to 59 years identified as gay or bisexual.The Australian Study of Health and Relationships  Same sex experience was reported by 5.9% of men surveyed (Grulich et al 2007).(Grulich et al 2007).  Analysis of data from the Sydney Gay Community Periodic Survey suggests that the proportion of men who identify as gay or bisexual may be as high as 48% in certain inner city locations where gay communities cluster. (Madeddu et al, 2006).Sydney Gay Community Periodic Survey(Madeddu et al, 2006).  Prestage et al (2008) estimated there were 74,000 homosexual and bisexual men in NSW in 2001.Prestage et al Gay and other MSM

12 Example 1: The 2006 census report there are 74,282 male residents in Parramatta LGA. Excluding children (<14 yrs) there are 59,699 males. Assume 2.5% of these males are gay or bisexual and another 5.9% have same sex experience would indicate there may be between 1492 and 3522 MSM in Parramatta and 1.9% or 1,134 males have had a same sex experience in the previous year. Parramatta LGA. Gay and other MSM

13 Example 2: Sydney (C) – east (SLA) highlighted on the right was reported to have a total male population of 28520. Excluding 5.4% of the population under age 14 would result in 26979 males. As the area is known to have a significant clustering of MSM, if we assume 48% of males are MSM the population of MSM in the area (excluding transient visitors) could be as high as 12949. Gay and other MSM

14 Recent developments in mobile technology have also made it easier to locate MSM within your area Grindr is a social-networking application that uses a global positioning system. It allows the user to contact gay and bisexual men who are nearby via a smart phone. Through a simple user interface, pictures of men, arranged from nearest to farthest away are displayed. There are options to chat, send pictures, and share one's location. Over 1000,000 men in 180 countries are part of the ‘Grindr’ network. Sexual health services can potentially link into this network and remind those within the vicinity to drop-in for a sexual health check up. It is also possible to estimate the number of MSN who frequent specific locations by measuring the number of Grindr profiles that appear over different time periods as the distance from the measuring point is also provided by the Grindr.networking Gay and other MSM

15 The number of young people ages between 15 to 24 years within a selected region can be obtained from ABS census data and from the navigable interface provided by the Social Health Atlas of Australia Geographic Information System (GIS).ABS census dataSocial Health Atlas of Australia Geographic Information System (GIS). The total number of young people in an area health service can be calculated by adding the number of young people in each local government area. Young People

16 It is particularly important to identify those at risk within the population. The highest notifications for Chlamydia from 01.04.09 to 31.03.10 in NSW were from Females age 20-24. Notification rates from post codes or LGA where STIs are notified from should also be taken into account when planning outreach activities. It is also possible to identify areas of relative socio- economic disadvantage via the Social Health Atlas of Australia GIS where outreach activities should be targeted. highest notifications for Chlamydia from 01.04.09 to 31.03.10 in NSW were from Females age 20-24.socio- economic disadvantage Young People

17 The Australian Study of Health and Relationships found that 0.9% of men and 0.5% of women had been paid for sex. In the past year it found that fewer than 0.1% of men and women had been paid for sex with men.Australian Study of Health and Relationships Councils will have access to information about legal brothels and possibly some private sex workers if they have put in a development application. Street sex work is more limited but highly visible. Sex Workers

18 Personal ads in the newspapers and other sources such as SWOP would be useful to access within LGAs in order to estimate the number of workers who could potentially attend a service. Police also have data on street workers in relation to complaints. It can be useful to develop a relationship with Local Area Commands to develop collaborative approaches to managing issues concerning the sex industry although any constraints and barriers to developing working partnerships with Local Area Commands may need to be considered first. Sex Workers

19 For example, approximately 50 licensed brothels are registered with the City of Sydney Council (average 4 sex workers per licensed brothel) sites, and 15 massage parlours. It is estimated there are around 150 to 200 home-based sex workers in the City of Sydney. Sex Worker Organisations such as the Scarlet Alliance estimate street based sex workers comprises around 1 to 2 percent of all sex workers. Sex workers work part time and there may be about 200 sex workers working at any one night in the City of Sydney.City of Sydney Council Scarlet Alliance Sex Workers

20 HIV notifications can be obtained from the Area Health Service Public Health Units Residential postcodes are reported at notification. HARP units also receive quarterly reports on Bacterial STI Notification Data from the NSW Health Communicable Diseases Branch grouped by the former 18 Area Health Services.Area Health Service Public Health Units The public health unit can provide total AIDS death notifications (check with the unit regarding reliability of the data). People with HIV/AIDS

21 Estimate the number of people with HIV in the area by deducting the number of AIDS deaths from HIV notifications (Please note: this does not take migratory factors into account). migratory factors In some AHS there will be multiple service providers and GPs in high case load areas may be contacted for an estimate of their patient numbers. Patients are entitled to choose where to go for services and may often travel across AHS boundaries especially in Sydney. Other sources of information would include support services such as ACON, Positive Life and the Bobby Goldsmith Foundation as they access clients separately.ACONPositive Life Bobby Goldsmith Foundation People with HIV/AIDS

22 Estimates of the number of people living with HIV infection are provided on page 122 of the National Centre for HIV Epidemiology and Clinical Research’s Annual Surveillance Report. 9261 people were estimated to be living with HIV infection in 2008 in NSW. Annual Surveillance Report The HIV Surveillance quarterly reports provides quarterly updates on cumulative and 2 yearly interval of new diagnosis of HIV infection. Number of deaths are also reported (Example: 1 Apr 08 to 31 Mar 09 = 20 deaths).HIV Surveillance quarterly reports Projected changed in HIV notifications over time has been estimated by the National Centre of HIV Epidemiology and Clinical Research and reported in the following document: Mathematical models to investigate recent trends in HIV notifications among men who have sex with men in Australia. People with HIV/AIDS

23 The National Drug Strategy Household Survey 2007The National Drug Strategy Household Survey 2007 reported that in 2007 it was estimated that 1.9% of the population of Australia over age 14, (328,100) had ever injected drugs and 0.5% of Australians over 14 82 400 had injected drugs within the past 12 months. Alternatively, the Hepatitis C Virus Projections Working Group (Pg. 18) has estimated that in Australia there are 80,000 regular and 120,000 occasional injecting drug users (IDU). As 33% of the Australian population lives in NSW, it could be assumed there are 26,4000 regular and 39,600 occasional injecting drug users in NSW.Hepatitis C Virus Projections Working Group The number of IDUs can be estimated by applying the formula to the findings from the National Drug Strategy Household Survey or Hepatitis C Virus Projection Working Group Estimates.

24 Many IDUs access Needle and Syringe Programs (NSP). Primary NSPs would be able to calculate IDU numbers from needles provided more readily than secondary NSPs as they survey their clients and often have some idea of whether the equipment is being used by the person collecting or a group. Certain ages groups also report higher injecting rates than others. Example those ages 30 to 39 report the higher rates of recent IDU. Males are also more likely to inject than females (2.5% vs 1.3%) (National Drug Strategy Household Survey 2007). National Drug Strategy Household Survey 2007National Drug Strategy Household Survey 2007

25 The Australian Needle and Syringe Program Survey (ANSPS) is a cross- sectional study that has been conducted over a one to two week period each year since 1995. The survey forms the basis of Australia’s human immunodeficiency virus (HIV) and hepatitis C surveillance among injecting drug users, and monitors behavioural indices of risk in addition to prevalence of infection. Demographic data collected include age group, Aboriginality, sexual identity and history of sex work. Therefore it is possible to ascertain the proportion of injecting drug users who are also members of other priority groups.Australian Needle and Syringe Program Survey (ANSPS)

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27 The number of adults within a selected region can be obtained via 2006 Census data’s interface with Google maps or from the Social Atlas of Australia’s Geographical Information System.2006 Census data’s interface with Google maps Social Atlas of Australia’s Geographical Information System According to the Australian Study of Health and Relationships 15.1% of men and 8.5% of women reported multiple sexual partners in the past year. Reporting multiple opposite-sex partners was significantly associated with being younger, identifying as bisexual, living in major cities, having a lower income, having a blue-collar occupation, and not being married.Australian Study of Health and Relationships Filters that relate to some of the above demographics can be applied to ABS data and may be helpful in strategically locating outreach programs targeting this particular priority group in the areas most needed.

28 Example: Through the interactive interface provide by the ABS website it is possible to ascertain that 46% of the population of Liverpool are not in a marriage compared with 61% in Leichhardt and 49% in Fairfield. The Social Health atlas GIS system also indicates that Fairfield East has the largest percentage (32%) of blue collar (unskilled or semi skilled) workers in NSW. This compares with 4.6% in Leichhardt and 21% in Liverpool.ABS website Social Health atlas GIS While Leichhardt has a higher percentage of single people, the Index of relative socio-economic disadvantage indicates that Fairfield is the most socio- economically disadvantaged among the local government areas mentioned, and may therefore be a preferred location for outreach activity targeting this priority group. (Leichhardt =1083; Liverpool = 933 & Fairfield =831).Index of relative socio-economic disadvantage

29 While CALD populations are not listed as a priority group within the NSW STI Strategy, the Strategy’s Environmental Scan states on pg.27 that the needs of CALD people should be considered where applicable to local population demographics and patterns of immigration settlement.Environmental Scan As country of birth and language spoken at home is also collected in the Australian Census it is possible to extract CALD demographic data from the ABS website and also via the Social Atlas of Australia’s GIS. Identification of a priority CALD group should be made in conjunction with relevant multicultural agencies (NSW Sexually Transmissible Infections Strategy Environmental Scan 2006-2010). ABS websiteSocial Atlas of Australia’s GIS

30 Example: Applying the demographic filter for ‘people born in China’ using the interface provided by the Social Atlas of Australia’s GIS and using the sort function shows that in NSW, Burwood has the largest percentage and Canterbury, the largest number of people who were born in China.Social Atlas of Australia’s GIS

31 While an estimation of the size of a priority populations will assist services in identifying targets, additional information provided in Part 2 is also required to inform decision making.

32 Embedded PDF file, please click to view references


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