Queensland Sexual Health Research Fund – Previous Successful Applications

Last Updated:

February 13, 2024

Previous Successful Applications

Project title: Increasing capacity and capability of GPs to provide hepatitis B testing and follow-up management for Chinese and Vietnamese community members.

Lead investigator: Amy Mullens

Project description: This project aims to assess current practices, clinical pathways, and resources available for hepatitis B testing and follow-up; as well as develop frameworks for a culturally responsive pilot program to ensure that patients and doctors are aware of, and uptake, these best practices.

Project timeline: March 2019 – June 2023

Project Outputs:

Conference Poster Presentations:

  • European Health Psychology Conference (Dubrovnik) 2019
  • ICBM (Glasgow) 2019
  • ASHM HIV & AIDS Sexual Health Conference (Virtual) 2020
  • ASHM Australasian SRH Conference (Sydney) 2023

Publications in preparation:

  • Qualitative paper regarding project formative assessment.  To be submitted in last quarter 2023/first quarter 2024.
  • Mixed methods evaluation paper of pilot project.  To be submitted in last quarter 2023/first quarter 2024.

All publicly accessible IP generated for this project can be found at: Queensland Health

Final project findings:

Patients with Hepatitis B virus (Hepatitis B) face many difficulties in therapy access and treatment adherence. With respect to Australia’s Chinese/Vietnamese communities, low treatment uptake may be caused by stigma associated with the disease; limited health seeking behaviour; lack of availability of, access to, or familiarity with health services; privacy and confidentiality concerns; and barriers associated with language, migration status, and cultural and gender issues (Australian Government, 2018). This study aimed to increase access to culturally appropriate and timely community-based Hepatitis B testing and prevention strategies for these communities. This project met with key stakeholders and community (including health professionals, GPs and nurses; community members; and bilingual community workers) to identify key concerns. The intervention was developed and piloted at a site in Brisbane with the help of a nurse research champion, with the results indicating positive changes and engagement to Hepatitis B testing and care. 

Key results/findings:

  • Interviewed community members, health practitioners (GPs and nurses), and bilingual community health workers to identify knowledge, attitudes and practices impacting Hepatis screening, immunisation and treatment among Chinese and Vietnamese communities and to develop a culturally responsive pilot project in primary care
  • Developed intervention pilot and mixed methods evaluation that was utilised in a GP clinic which identified many community members who would benefit from immunisation or engagement/re-engagement with Hepatitis B treatment.
    • The pilot project also led to many new and sustainable clinical governance initiatives, including new patient screening processes with a nurse to obtain more detailed history, ethnicity and determine existing chronic diseases, recording of key demographic information, as well as other clinical changes and enhanced knowledge and practice changes for the GPs involved. The project was deemed to be acceptable, feasible, and culturally responsive; with further resources needed to allow for sustainability and scale up.

Project title: Syphilis in pregnant women and their newborn infants in South-East Queensland 2016-2021: a retrospective audit of management and outcomes and assessment of barriers to care

Lead investigator: Clare Nourse

Project description: This project aims to identify gaps and potential barriers to optimise management of syphilis and will use this information to make recommendations to improve practice and optimise prevention of congenital syphilis.

Project timeline: November 2019 – June 2023

Project Outputs:

Final project findings: Recommendations for improved management of syphilis in pregnancy based on study findings include earlier maternal testing and treatment, improved monitoring after treatment, better documentation of partner screening and treatment, improved communication of maternal and infant management pathways and more frequent infant follow-up serology.

Healthcare worker interviews revealed that aspects of the healthcare electronic systems, communication between health care providers and with pregnant people, and healthcare worker knowledge are key barriers to optimal management. Multilevel and multidisciplinary strategies are needed to overcome the complex inter-connected personnel and system level barriers identified.

With regard to syphilis in pregnancy testing, barriers include time constraints, communication across disciplines and patient engagement, individual Healthcare professionals knowledge and awareness of epidemiological changes, and the ability to speak about sexual health and conduct risk assessments.

Project title: Investigating sexual health trajectories of gender variant/sexually diverse young people to inform and enhance clinical pathways and care.

Lead investigator: Lisa Fitzgerald

Project description: This project investigates the sexual health experiences and needs of gender variant, sexually diverse young people (GVSDYP) as well as their health trajectories to examine the role of personal communities in GVSDYP’s health and wellbeing.

Project timeline: August 2019 – June 2023

Project Outputs:

  • ‘SHYQQ rural and regional study – Co-design forum’ held in June 2023 which focussed on project findings and the generation of recommendations. 

Three qualitative papers in progress:

  • ‘Experiences and practices of belonging among young Queer people in rural Queensland’
  • ‘A qualitative exploration of where young Queer Australians find their sexual health information online’
  • ‘Understanding access for LGBTQIA+ young people in Queensland’ – a follow on paper to a literature review of access to services for young LGBTQIA+ young people 

Final Projects Findings:  The study explored the (sexual) health trajectories of gender and sexuality diverse young people (GSDYP), aged 16-24 years, living in rural and regional Queensland. It provides important insights and understandings of the experiences and barriers for GSDYP in accessing health, mental health and gender affirming care in regional/ rural localities. The study highlights how these barriers are compounded by the many complex challenges that GSDYP are facing post COVID-19 and in the midst of a cost-of-living and accommodation shortage crisis. Importantly, it identified the critical advocacy and support role provided by ‘Community Allies’ (often parents, community leaders and other support people) in localities where there may be an absence of formal support options, and/ or where there is initial hesitance from GSDYP to access existing support options in the community

Project title: Reducing disparities for Australian culturally and linguistically diverse overseas-born people in relation to sexual health and blood-borne viruses: Queensland sub-study.

Lead investigator: Joanne Durham

Project description: This project aims to develop recommendations for health promotion and public health initiatives that seek to improve STI and BBV outcomes for Queensland CaLD overseas-born

Project timeline: August 2019 – October 2021

Project Outputs: The survey instrument was developed by our Curtin University partners as part of a multi-jurisdictional ARC Linkage Project, with the IP owned by Curtin University.

Vujcich, D., Roberts, M., Brown, G., Durham, J., Gu, Z, et al. (2021) Are sexual health survey items understood as intended by African and Asian migrants to Australia? Methods, results, and recommendations for qualitative pretesting. BMJ Open, 11: e049010. https://doi.org/10.1136/bmjopen-2021-049010.

Final project findings: The project has provided the first state-wide baseline of migrant populations in Queensland knowledge and practices related to blood borne viruses and STIs. As the same survey was administered in New South Wales, Western Australia, South Australia and Victoria results can be compared across states other states.

Access the full report here: Full Report

Project title: Precision public health for enhanced syphilis management in Queensland.

Lead investigator: David Whiley

Project description: This project aims to understand social and sexual networks driving infections, allowing for optimisation of precision and timeliness of interventions.

Project timeline: August 2019 – December 2022

Project Outputs: Sweeney EL, Lowry K, Seel M, Rahimi F, Langton-Lockton J, Bletchly C, Nimmo GR, Whiley DM. Two Treponema pallidum strains account for the majority of syphilis infections, including among females, in Queensland, Australia. Commun Dis Intell (2018). 2022 May 19;46. https://doi.org/10.33321/cdi.2022.46.26

Final project findings: In this SHRF-funded project, we investigated the diversity of syphilis sequence types circulating in Queensland, from the start of the outbreak in 2011, through to July 2020. We identified that there were key sequence types that comprised the majority of syphilis samples in Queensland. Notably, ST1 was the dominant strain present at the start of the outbreak in 2011 and remained the most common strain in Northern Queensland, while other STs have become the dominant strain in South East Queensland. Looking specifically at key populations that are disproportionately affected by syphilis, we also identified for the first time that ST1 was particularly common in First Nations heterosexual women. Targeting dominant syphilis sequence types, such as ST1, via precision public health interventions may be a key to controlling syphilis in at-risk populations.

Project title: Enhancing pathways, workforce and capacity for HAND (HIV-Associated Neurocognitive Disorders) assessment for people living with HIV (PLHIV) throughout Qld-including regional.

Lead investigator: Amy Mullens (formerly Adina Piovesana)

Project description: This project aims to develop and improve referral pathways (including through the development of workforce development resources) and capacity for HAND-screening assessments.

Project timeline: September 2021 – June 2023

Project Outputs:

Conference poster presentations:

  • International AIDS Conference 2022 (Montreal, Canada)
  • Australasian Sexual and Reproductive Health Conference 2023 (Sydney, Australia) Award recipient – ‘ARTY Prize’

Forum presentations:

  • AAPTC Clinic Directors Forum
  • Community Research Forum (June, 2023)

Publications under review (AIDS Care):

  • HIV Associated Neurocognitive Disorder Screening and Diagnosis Pathways in Australia: A scoping review

Publications in preparation:

  • Qualitative paper regarding barriers/facilitators and recommendations for enhancing HAND screening/assessment from the perspectives of people living with HIV, community organizations, clinicians, and other key stakeholders (to submit last quarter 2023/first quarter 2024)
  • Mixed methods evaluation paper of the pilot project (e.g., ‘proof of concept’, acceptability, feasibility, sustainability) (to submit last quarter 2023/first quarter 2024)

Final project findings: HIV associated neurocognitive disorder (HAND) is a possible complication of HIV characterised by mild cognitive deficits when on treatment. If detected early, interventions can prevent any rapid cognitive decline and help develop coping skills. However, there is uncertainty surrounding accessing pathways for HAND assessments, as well as additional support. This project aimed to evaluate existing pathways, and enhance pathways, workforce and capacity for providing HAND assessment and support throughout QLD (urban and regional areas). This study included engagement with key stakeholders, as well as the development and utilisation of HAND assessment in university clinics across QLD. A resource toolkit was also developed to support neuro/psychologists and other health care professionals in their assessment of HAND, including professional development videos and documents, clinic documents, templates of reports, and other resources).

Key results/findings:

  • Scoping review findings: No specific government guidelines identified, most existing resources were based in Sydney/NSW.
  • Interviews with stakeholders, practitioners and community substantiated lack of referral pathways and assisted with development of the pilot project.
  • Relationships during the pilot were formed with Qld Positive People, University of Southern Queensland and Central Queensland University to establish referral pathways and deliver HAND assessments.
  • Several key resources were developed (e.g., professional presentations including by neurologists and neuropsychologists, assessment battery list, clinical templates, HAND information).
  • HAND assessments were delivered throughout Qld with confirmation of ‘proof of concept’ via mixed methods evaluation.

Project title: GoLoCypro: Titrating lowest effective dose of cyproterone acetate for treatment of transgender and gender diverse people who request feminising hormones.

Lead investigator: Judith Dean

Project description: This project aims to determine minimum effective dose (and identify a dose response gradient) to suppress testosterone production, leading to reduced side effects for people transitioning using androgen blockers.

Project timeline: August 2019 – December 2022

Project Outputs: Fowler, J. A., Warzywoda, S., Franks, N., Mendis, M., Lazarou, M., Bisshop, F., Wood, P., & Dean, J. A. (2023). Highs, Lows, and Hormones: A Qualitative Metasynthesis of Transgender Individuals’ Experiences Undergoing Gender-Affirming Hormone Therapy. Journal of Homosexuality, 1-32. https://doi.org/10.1080/00918369.2023.2186759

A second paper is currently under review and two are in final preparation for submission

Final project findings: This study aimed to determine the lowest possible dosing of cyproterone acetate (CPA) that could be used to reduce dose-related side effects while still achieving the patient centred goals.  Outcomes of this study provide clinical evidence that lower and alternate-day dosing CPA can achieve adequate testosterone suppression and improve the outcomes and experiences of individuals undergoing feminising gender affirming hormone therapy (GAHT).

Participants in this study describe the GAHT journey as a personal and contextual experience unique to the individual and while it can elicit a myriad of changes and challenges, the positive psychological, physical, and social changes it brings are life-changing. Our study highlights the importance of providing affirming and responsive support to peoples seeking GAHT and the key role that community plays in linking trans folk to affirming information and providers of GAHT.

Project title: Exploring the relationship between HIV literacy, risks, and networks of newly arrived Asian-born gay, bisexual, and men who have sex with men (MSM).

Lead investigator: Lisa Fitzgerald

Project description: This project seeks to outline the role that social and sexual networks play in the development of sexual health literacy among newly arrived Asian-born gay and bisexual men in QLD, and how community-based providers can navigate these networks to develop interventions to improve HIV literacy and reduce HIV risks.

Project timeline: January 2021 – June 2023

Project Outputs:

  • Monash Migration and Inclusion Centre Next Generation Network Symposium 2021. Presentation title – “Exploring sexual health literacy as social practices within migrant networks of newly arrived Asian-born GBM in Queensland: a temporally informed approach”
  • University of Queensland School of Public Health Higher Degree Research Conference 2021. Presentation title – “Exploring sexual health literacy as social practices within migrant networks of newly arrived Asian-born GBM in Queensland: a temporally informed approach”
  • The Migration, Refugees and Statelessness Conference 2022, University of Melbourne. Presentation title – “Yellow Skin, White Mask, and the Habitus of Low Self-Esteem: When Bourdieu Meets Fanon in the Sexual Environment of Newly Arrived Asian Gay Men in Australia”.
  • IMISCOE (International Migration Research Network) Annual Conference is Oslo, Norway, June 2022. Paper title – “Exploring Sexual Health Literacy as Social Practices within Sexual, Social, and Virtual Networks of Newly Arrived Asian-born Gay, Bisexual, and Men who Have Sex with Men: A Qualitative Protocol”
  • HIV Education Queensland training, January 2023. Presentation title – “The intersection of Sexual Health Literacy in HIV, migration and public health”
  • Listening to all voices? The politics of ‘lived experience’: concerns, contradictions, and challenges – Postgraduate research conference 2023, Durham University. Presentation title – “Why do you make it about race? Epistemic disobedience in public health doctoral training”
  • IMISCOE Conference, Warsaw, July 2023 – Presentation Title – “Aspiration and capital in the intersections of migration and sexual health: a qualitative study of migrant networks among Asian gay migrants in Australia”
  • Qualitative journal paper (in progress)

Final Project Findings: The study explored social relationships of eleven newly arrived Asian-born gay men in Queensland and how these relationships influenced their sexual health literacy. Our findings suggest our participants tend to be selective about who they engaged with in their diaspora communities in Australia which is influenced by the stereotype that Asian cultures are homophobic. Instead, most were eager to engage with white gay men socially, sexually, and intimately in order to be viewed as ‘open-minded’ and ‘progressive’ as these men. Consequently, they tend to assimilate and mimic the ways white gay men manage their sexual health, resulting in increased confidence about their sexuality and sexual health while simultaneously leaving them vulnerable to racial power imbalance and sexual violence. We recommend that steps to address antiracism must be included in HIV action plans and sufficiently funded to end racial inequalities affecting sexual health of newly arrived Asian-born gay men and other migrant groups.

Project title: Sexual and Reproductive Health Literacy of Young Culturally and Linguistically Diverse Queenslanders.

Lead investigator: Judith Dean

Project description: This project explores sexual health and reproductive health literacy (SRHL), attitudes, beliefs, and practices of culturally and linguistically diverse young people (CALDYP) with the aim to use findings to develop a health promotion strategy to improve and promote healthy sex-positive sexual and reproductive health conversations.

Project timeline: December 2020 – June 2023

Project Outputs: Lirios, A., Mullens, A. B., Daken, K., Moran, C., Gu, Z., Assefa, Y., & Dean, J. A. (2023). Sexual and reproductive health literacy of culturally and linguistically diverse young people in Australia: a systematic review. Culture, Health & Sexuality, Published online: 27 Sep 2023, 1-18. https://doi.org/10.1080/13691058.2023.2256376

A further 3 papers are in final preparation for submission.

Final project findings: Young Culturally and Linguistically Diverse Queenslanders continue to experience barriers to accessing culturally safe and responsive ‘sex positive’ sexual and reproductive health (SRH) information. The main barrier to achieving SRH literacy identified in our study was the ongoing ‘silence’. This silence was described as a lack of open communication about SRH matters both with parents/carers and health care providers and a lack of youth friendly and culturally responsive resources and SRH services. Our study highlighted an urgent need for theory-informed SRH strategies and services that address this ‘silence’.

The young people in our study highlighted the need for these strategies to take into consideration the diversity of cultures, languages and experiences of young people living in Queensland and for SRH information to be communicated in ways that improve their understanding and ability to act on health information they receive/access and provided actionable solutions/suggestions to overcoming linguistic cultural and systems barriers they experience.

Project title: Enhancing harm reduction services (BBV and STI) for Aboriginal and Torres Strait Islander people who inject drugs through improved engagement.

Lead investigator: Andrew Smirnov

Project description: This project seeks to support development of accessible, culturally appropriate and responsive harm reduction services for Aboriginal and Torres Strait Islander people who inject drugs (PWID), to reduce HIV, hepatitis B, hepatitis C, and syphilis infection and transmission in these population groups.

Project timeline: January 2021 – June 2023

Project Outputs: Conference presentation: World Indigenous People’s Conference On Viral Hepatitis. Access at: https://wipcvh.org/program/ Poster presentation: International HIV Coinfection + Viral Hepatitis Elimination Conference. Access at: https://ihcvhec.com.au/poster-listing-2023/#toggle-id-3

Final project findings: Data from our surveys and research interviews, conducted in regional locations with Aboriginal and Torres Strait Islander people who have injected drugs, support previous research showing that social and structural factors, including incarceration, are drivers of the disproportionately high rates of exposure to blood borne viruses and sexually transmissible infections for these groups. Stigma, racism, and discrimination, including discrimination in health care settings, were experienced by about half of the participants and were associated with poorer outcomes including sharing of needles and syringes and not receiving the health care needed.

Study participants wanted extended needle and syringe program hours, more staff with lived experience of injecting drug use, and more Aboriginal and Torres Strait Islander staff who could develop trust with program clients. Service providers believed that greater interagency collaboration, including knowledge sharing and coordinating service activities across a range of modalities (e.g. outreach), would be instrumental for improving service quality and accessibility. The project team (including the UQ School of Public Health, QAIHC, QuIHN, and Youth Link) plans to use the research findings and recommendations to create guidelines for the development of harm reduction programs for Aboriginal and Torres Strait Islander people who inject drugs.

Project title: Co-design of a Health Literacy Framework (CALD): Supporting sexual health providers to meet the needs of CALD young people.

Lead investigator: Joanne Durham

Project description: Seeks to establish the first baseline of culturally and linguistically diverse (CALD) young peoples’ sexual health literacy and co-design an acceptable Health Literacy Framework to implement across Queensland to strengthen engagement with CALD youth, support their health literacy, e-health
literacy, and sexual health literacy, and enable them to have sex-positive conversations.

Project timeline: March 2022 – February 2023

Project Outputs: No IP generated as part of project.

Final project findings: This study explored the health literacy, including sexual health literacy, of young people (aged 16-26 years old) from Pacific Islander, Northeast Asian and Southeast Asian backgrounds living in Queensland. The study demonstrated most young people have good multidimensional health literacy. Young peoples’ health literacy can be viewed as a social practice. Much of what young people (do/do not) learn and discuss about their health is with and/or influenced by their social support networks (i.e., parents, siblings, aunts/uncles, cousins, friends, church groups, communities) family doctors and at school. Stigma related to sexual and mental health, and feeling health workers are often not culturally aware or responsive to their needs, however makes it challenging for young people to develop their sexual and mental health literacy.

The codesigned framework recognises developing young people’s sexual (and mental) health literacy

  1. A stronger focus on building community health literacy (including supporting intergenerational conversations about sexual wellbeing, mental health, promotion of sexual health services) and breaking down stigma around sexual and reproductive health.
  2. Developing a culturally diverse workforce at all levels of the health care system services, particularly within the public health system (due to cost barriers of private services being raised by young people).
  3. Increasing health workers cultural awareness and capacity to establish trust and rapport in all health interactions that help young people feel safe, engaged and empowered during healthcare visits.
  4. Strengthening health workers communication skills (e.g., using plain language, additional explanations or using other aids (visual/resources) to enhance young peoples’ understanding, and practical skills for how to approach conversations/interactions, using strength-based language).
  5. Co-designing culturally tailored and accessible resources (i.e., in-language, simple English, easy to understand) with and for culturally diverse community members.

Project title: HIV prevention knowledge, attitudes, and practices among young Queenslanders: Informing PrEP Access for ‘at risk’ youth

Lead investigator: Judith Dean

Project description: To identify and explore the knowledge, attitudes, and practices of Queensland young people (16-24 years) in relation to their knowledge, access, and usage of PrEP. It will also explore their preferences for newly emerging PrEP delivery modalities, including long acting injectables and implants, with a particular focus on those under the age of 18.

Project timeline: December 2022 – June 2024

Project Outputs: No IP currently generated as part of project.

Project findings: Currently there are no published findings from this study.

Project title: Tackling the rise: Expanded gonorrhoea screening to inform guidelines for asymptomatic heterosexual women and m.

Lead investigator: Ella Trembizki

Project description: This study will provide new evidence to recommend additional NG testing for asymptomatic heterosexuals. The enhanced testing proposed in this study will have immediate positive implications for patients as it will allow early intervention; timely diagnosis and treatment of an otherwise undiagnosed infections which will in turn reduce onward transmission.

Project timeline: December 2022 – December 2024

Project Outputs: No IP generated as part of project.

[Current] project findings: Currently there are no published findings from this study.

Project title: Breaking the Stigma: Let’s talk about sex

Lead investigator: Joanne Durham

Project description: To shift the community norms that drive stigma and taboos around SRH to enable positive PCSC in CaLD families, leading ultimately to improved knowledge and sexual health outcomes.

Project timeline: December 2022 – October 2024

Project Outputs: No outputs generated as part of project.

Project findings: Currently there are no published findings from this study.

Project title: Perception/ Acceptability of Presumptive Treatment for STIs in High-Risk Groups and Physicians to Assess Chances of Uptake and Clinical Adoption.

Lead investigator: Julie-Anne Carroll

Project description: To understand acceptability of population-based presumptive treatment approaches for bacterial STIs using antibiotic treatment to determine h the applicability and transferability to public health services in Queensland

Project timeline: December 2022 – June 2024

Project Outputs: No outputs generated as part of project.

Project findings: Currently there are no published findings from this study.

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