16,17 ✉ and The International AIDS Society (IAS) Global Scientific Strategy working group*Despite the success of antiretroviral therapy (ART) for people living with HIV, lifelong treatment is required and there is no cure. HIV can integrate in the host genome and persist for the life span of the infected cell. These latently infected cells are not recognized as foreign because they are largely transcriptionally silent, but contain replication-competent virus that drives resurgence of the infection once ART is stopped. With a combination of immune activators, neutralizing antibodies, and therapeutic vaccines, some nonhuman primate models have been cured, providing optimism for these approaches now being evaluated in human clinical trials. In vivo delivery of gene-editing tools to either target the virus, boost immunity or protect cells from infection, also holds promise for future HIV cure strategies. In this Review, we discuss advances related to HIV cure in the last 5 years, highlight remaining knowledge gaps and identify priority areas for research for the next 5 years.
Despite recent evidence demonstrating that lesbian and bisexual women are at risk of sexually transmitted infections (STIs), there is a common perception that STIs cannot be transmitted between women. This paper reports on a study in which a self-report questionnaire, completed by over 300 lesbian and bisexual women and a comparison group of heterosexual women, was undertaken to determine lesbian and bisexual women's levels of knowledge about the human papillomavirus (HPV) and their attitudes toward the HPV vaccine and cervical smear testing. Alongside this, a series of in-depth interviews with lesbian and bisexual women explored how they perceive their level of HPV risk, the reasons why they do or do not feel at risk and how they manage their sexual health in relation to their lesbian or bisexual identity. The study concludes that lesbians generally feel at low risk for STIs because they are excluded from dominant sexual scripts that inform the negotiation of safer sex practice. Lesbians are unlikely to engage with sexual health promotion targeted toward gay men or heterosexual women, yet lesbian-specific sexual health promotion does not adequately construct an alternate discourse on safer sex that lesbians can relate to their own sexual practice.
This paper reports on a qualitative study exploring the ways in which transgender adults imagine a place for parenthood in their lives, and/or the ways they have negotiated parenthood with their transgender identity. A total of 13 transgender adults (including parents and non-parents) were interviewed with respect to their thoughts and experiences about family, relationships and parenting. The study sought to understand the possibilities for parenthood that transgender people create, despite barriers imposed by restrictive laws, medical practices and cultural attitudes. Interview data showed how normative assumptions about gender and parenthood shape the way people imagined and desired parenthood. It also showed how participants re-appropriated and resisted normative cultural scripts by either re-imagining parenthood in different terms (such as step-parenthood) or by creating different family forms, such as co-parented families. Participants reported a variety of experiences with healthcare providers when it came to conversations about fertility preservation and family building.
BackgroundIt has been suggested that children with same-sex attracted parents score well in psychosocial aspects of their health, however questions remain about the impact of stigma on these children. Research to date has focused on lesbian parents and has been limited by small sample sizes. This study aims to describe the physical, mental and social wellbeing of Australian children with same-sex attracted parents, and the impact that stigma has on them.MethodsA cross-sectional survey, the Australian Study of Child Health in Same-Sex Families, was distributed in 2012 to a convenience sample of 390 parents from Australia who self-identified as same-sex attracted and had children aged 0-17 years. Parent-reported, multidimensional measures of child health and wellbeing and the relationship to perceived stigma were measured.Results315 parents completed the survey (completion rate = 81%) representing 500 children. 80% of children had a female index parent while 18% had a male index parent. Children in same-sex parent families had higher scores on measures of general behavior, general health and family cohesion compared to population normative data (β = 2.93, 95% CI = 0.35 to 5.52, P = .03; β = 5.60, 95% CI = 2.69 to 8.52, P = <.001; and β = 6.01, 95% CI = 2.84 to 9.17, P = <.001 respectively). There were no significant differences between the two groups for all other scale scores. Physical activity, mental health, and family cohesion were all negatively associated with increased stigma (β = -3.03, 95% CI = -5.86 to -0.21, P = .04; β = -10.45, 95% CI = -18.48 to -2.42, P = .01; and β = -9.82, 95% CI = -17.86 to -1.78, P = .02 respectively) and the presence of emotional symptoms was positively associated with increased stigma (β =0.94, 95% CI = 0.08 to 1.81, P = .03).ConclusionsAustralian children with same-sex attracted parents score higher than population samples on a number of parent-reported measures of child health. Perceived stigma is negatively associated with mental health. Through improved awareness of stigma these findings play an important role in health policy, improving child health outcomes.
Evidence indicates that smoking cessation strategies targeted at individuals, such as NRT and/ or counselling, may be effective smoking cessation aids for Indigenous Australians. However, there is no evidence regarding interventions likely to be effective in encouraging more Indigenous Australians to access these quit support strategies.
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