1. Access to HIV information and services: are we doing enough for MSM who recently immigrated?
Horas Wong, Tim Chen, David Lewis, Brent Mackie, Azizul Haque, Andrew Stone, Ashley Ubrihien, Gabrielle Stackpool, Jeffrey Dabbhadatta, Marty Janssen, Shih-Chi Kao, Limin Mao
Culturally and Linguistically Diverse (CALD) Gay Men Action Group
Presenting Author: Horas Wong
PhD Candidate, Centre for Social Research in Health, UNSW

2. CALD Gay Men Action Group
Form in 2006
HIV health promotion interagency working group
ACON
Multicultural HIV and Hepatitis Service (MHAHS)
Centre for Social Research in Health (CSRH), UNSW
Sydney LHD HARP Unit
South Eastern Sydney LHD HARP Unit
Sydney South Western LHD HARP Unit
Western Sydney LHD HARP Unit
Northern Sydney LHD HARP Unit
The Action Group aims to address CALD gay men’s HIV and health promotion needs by developing, implementing and coordinating social research, health promotion and social marketing activities, consistent with NSW HIV and STIs Strategic Plans
The group members plan, implement and evaluate HIV and STI initiatives targeting gay men and MSM of CALD backgrounds through partnerships between member organisations.
The Action Group comprises community organisations, Multicultural HIV and Hepatitis Service , social research institute, HIV and related program units from 5 Sydney local health districts. and community representatives.

3. Study background
In Australia, nearly 30% of the nation's population were born overseas. Many of those are from Asian countries.
It is well-documented that immigrants’ and migrants’ access to quality health care is often impeded by a variety of linguistic, socio-economic and even environmental obstacles. 
Few data on the access to information and the health needs of gay men and other MSM who are new to Australia.
In NSW, HIV notification among CALD gay men and other MSM has risen over the past few years. Most of these newly diagnosed men were of South East or East Asian background.
A study was conducted to understand the health needs of CALD gay men and other MSM living in Sydney, to provide useful data for developing more effective HIV responses
In Australia, around 28 % of the nation's population, or  6.6 million people, were born overseas. Many of those are from Asian countries.

4. Study Design Design Cross-sectional study Eligibility
Adult MSM of Asian background in Sydney
Recruitment
SOPV, gay events, ACON, sexual health clinics, massage parlours, the internet
Questionnaire
English and Thai languages
Demographics
Risky sexual behaviours,
HIV/STIs testing behaviours,
Knowledge on PrEP/PEP,
Community attachment
Study period
Since Dec 2015 (pilot: Sep 2015)
Expected to be completed by June 2016

5. Characteristics of participants (n=317)
By April 2016,
Mean age 32.7= (SD 8.8)
Top races/ethnicities:
Chinese: 40%
Filipino: 12%
Thai: 12%
Vietnamese: 8%
Top countries of birth:
China (including HK and Macau): 21%,
Australia: 14%,
Philippines: 12%,
Thailand: 12%
Occupation:
Employed full time: 49.5%
Student: 25.2%
Year of residence in Australia:
Below 5 years (recent immigrants): 38%
Countries of birth of participants (n=317)

6. Sexual practices and HIV testing (n=317)
About a quarter of all participants had ever had unsafe sex with a casual and/or a regular partner in the past 6 months

7. Characteristics of recent immigrants (n=120)
Top races/ethnicities:
Chinese (42%),
Thai (17%),
Filipino (15%)
33.3% had stayed in Australia for less than 1 year
26.7% do not use English for routine communication in Australia

8. Univariate analysis of recent immigrants and non-recent immigrants on PEP/PrEP knowledge and HIV testing
p-value<0.001
p-value<0.001

9. Multivariate comparison of RI and non-RI
Odds ratios from logistic regression comparing recent immigrants and other participants*
n.s.
n.s.
The odds of recent immigrants that being age below 30, being a student, and using other languages for routine communication are more than 2 times greater than the odds of non-recent immigrants.
The odds of recent immigrants that having HIV test in the last 12m, and having heard of PEP/PrEP are aroudn 2 times smaller than the odds of non-recent immigrants.
0.461 =2.2 times less likely
0.359 =2.7 times less likely
More likely
Less likely
*Ratios are graphically presented on a logarithmic scale

10. Main messages
Compared with those who have been living in Australia for a longer time, Asian MSM who are newer to this country :
1) have a similar practice of unsafe sex
2) are disadvantaged in their access to HIV information and services
They are significantly less likely to have an HIV test in the past year and to have ever heard of PEP/PrEP.

11. Recommendations What can be done?
There is a need for health service providers to convey information in a manner that is accessible by those who are new in Australia
Continue evaluation of immigrant/migrant MSM’s barriers to access quality health care
Whom to target?
Younger people (including overseas students)
People with limited English proficiency
What messages?
Strengthen messages on HIV testing services in Australia and updates of HIV information (esp. treatment as prevention)

12. Limitations Only focused on Asian men
Questionnaires were only prepared in English and Thai
Sampling bias
Data from Chinese, Filipino and Thai participants could be over-represented

13. Thank you
Presenting Author: Horas Wong