"Nowhere Line" - Voices from Manus Island, Where Australia Deports Asylum Seekers - Video

Nowhere Line: Voices from Manus Island from Lukas Schrank on Vimeo.

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ASPIRE: A Multi-Site Community-Based Participatory Research Project to Increase Understanding of the Dynamics of Violence Against Immigrant & Refugee Women in Australia

Background

One in three women around the world are or have been subjected to violence. This includes in Australia, where violence against women is an urgent public health and human rights issue. Immigrant and refugee women who have resettled in Australia are known to face barriers accessing services aimed at preventing and responding to family violence. However there is little evidence about the contexts, nature and dynamics of violence against immigrant and refugee women to inform appropriate responses to enhance their safety and well-being. The ASPIRE project will address this gap by identifying opportunities for the development of responsive local and community-based interventions for family violence against immigrant and refugee women, contributing to the currently limited Australian research in this area.

Methods/Design

This participatory research project will work with communities in eight geographic locations (two inner-city, three outer-suburban, and three regional) across two states (Victoria and Tasmania), to generate evidence about immigrant and refugee women’s experiences in a range of settings. The project will engage stakeholders and communities through extensive consultation prior to data collection and by facilitating community members’ participation in generating and analysing data. A mix of qualitative methods will be used to generate rich data about the family, cultural and place-based contexts that shape the prevalence and dynamics of violence against immigrant and refugee women; women’s prevention and help-seeking efforts; and community attitudes about and responses to violence across a range of cultural groups. Methods include in-depth interviews with women who have experienced family violence, key informant interviews with local community service providers, focus group discussions with men and women from predominant cultural groups that have migrated to areas covered by the research sites, and Photovoice with community leaders. Bilingual health educators will contribute to development of the research approach, the collection and analysis of data, and the dissemination of findings.

Discussion

Findings from this two-year study will be disseminated to communities, service providers and policy-makers, providing evidence to inform culturally-appropriate prevention and support interventions, and building local communities’ awareness and capacity to respond to violence against immigrant and refugee women.

Full article at:   http://goo.gl/lzky4f

By:   Cathy Vaughan, Adele Murdolo, Linda Murray, Erin Davis, Jasmin Chen, Karen Block, Regina Quiazon, and Deb Warr

Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010 Australia

Multicultural Centre for Women’s Health, Suite 207, Level 2, 134 Cambridge St, Collingwood, VIC 3066 Australia

School of Medicine, Faculty of Health, University of Tasmania, Hobart, Tasmania, 7005 Australia

Cathy Vaughan, Email: ua.ude.bleminu@nahguav.c.

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Audit of Antenatal Screening for Syphilis & HIV in Migrant & Refugee Women on the Thai-Myanmar Border: A Descriptive Study

OBJECTIVE:

The antenatal prevalence of syphilis and HIV/AIDS in migrants and refugees is poorly documented. The aim of this study was to audit the first year of routine syphilis screening in the same population and reassess the trends in HIV rates.

METHODS:

From August 2012 to July 2013, 3600 pregnant women were screened for HIV (ELISA) and syphilis (VDRL with TPHA confirmation) at clinics along the Thai-Myanmar border.

RESULTS:

Seroprevalence for HIV 0.47% (95% CI 0.30-0.76) (17/3,599), and syphilis 0.39% (95% CI 0.23-0.65) (14/3,592), were low. Syphilis was significantly lower in refugees (0.07% 95% CI 0.01-0.38) (1/1,469), than in migrants (0.61% 95% CI 0.36-1.04) (13/2,123). The three active (VDRL≥1:8 and TPHA reactive) syphilis cases with VDRL titres of 1:32 were easy to counsel and treat. Women with low VDRL titres (>75% were < 1:8) and TPHA reactive results, in the absence of symptoms and both the woman and her husband having only one sexual partner in their lifetime, and the inability to determine the true cause of the positive results presented ethical difficulties for counsellors.

CONCLUSION:

As HIV and syphilis testing becomes available in more and more settings, the potential impact of false positive results should be considered, especially in populations with low prevalence for these diseases. This uncertainty must be considered in order to counsel patients and partners accurately and safely about the results of these tests, without exposing women to increased risk for abuse or abandonment. Our findings highlight the complexities of counselling patients about these tests and the global need for more conclusive syphilis testing strategies.

Table 2.

Trends in antenatal HIV and syphilis prevalence (95% CI) in migrant and refugee women at SMRU from surrounding areas of Thailand and Myanmar.

	Population	1997 Cross-sectional	2005 Cross-sectional	Aug-2012–Jul-2013 Population cohort
Syphilis	Refugee a, b	0 (0–0.9)% (0/404)	0.40 (0.1–1.2)% (3/741)	0.07 (0.01–0.38)% (1/1,469)
	Migrant a, b	n.a	0 (0–1.6) (0/234)	0.61 (0.36–1.04)% (13/2,123)
	Thailand c	n.a	0.13%	0.1%
	Myanmar c	n.a.	2.0%	0.32 (0.24–0.43)% (45/13,995)
	Myawaddy c			0.50 (0.14–0.18)% (2/400)
HIV	Refugee b	0.2 (0–1.1)% (0/500)	0.40 (0.1–1.4)% (2/500)	0.27 (0.11–0.70)% (4/1,474)
	Migrant b	n.a	n.a.	0.61 (0.36–1.04)% (13/2,125)
	Thailand c	1.75%	0.86%	0.59%
	Myanmar c	1.5%	1.3%	0.80 (0.67–0.96)% (112/13995)
	Myawaddy c			1.5 (0.39–2.54)% (4/400)

aSerological syphilis positive using the same criteria, and the same hospital for confirmatory testing at each survey time point; n.a. not available

bData from refugee and migrant populations in 1997 and 2005; published in reference 7

cData for Thailand from reference 21 and Myanmar from reference 22

Full article at:   http://goo.gl/3Vgteu

By:   McGready R1, Kang J2, Watts I2, Tyrosvoutis ME2, Torchinsky MB2, Htut AM2, Tun NW2, Keereecharoen L2, Wangsing C2, Hanboonkunupakarn B3, Nosten FH1.

• 1Shoklo Malaria Research Unit, 63110, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, 63110, Thailand ; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand ; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK.
• 2Shoklo Malaria Research Unit, 63110, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, 63110, Thailand.
• 3Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand. 

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Contribution of HIV to Maternal Morbidity among Refugee Women in Canada

We compared severe maternal morbidity (SMM) and SMM subtypes, including HIV, of refugee women with those of nonrefugee immigrant and nonimmigrant women.

We linked 1 154 421 Ontario hospital deliveries (2002-2011) to immigration records (1985-2010) to determine the incidence of an SMM composite indicator and its subtypes. We determined SMM incidence according to immigration periods, which were characterized by lifting restrictions for all HIV-positive immigrants (in 1991) and refugees who may place "excessive demand" on government services (in 2002).

Refugees had a higher risk of SMM (17.1 per 1000 deliveries) than did immigrants (12.1 per 1000) and nonimmigrants (12.4 per 1000). Among SMM subtypes, refugees had a much higher risk of HIV than did immigrants and nonimmigrants. SMM disparities were greatest after the 2002 policy came into effect. After exclusion of HIV cases, SMM disparities disappeared.

An apparent higher risk of SMM among refugee women in Ontario, Canada is explained by their high prevalence of HIV, which increased over time parallel to admission policy changes favoring humanitarian protection.

Purchase full article at: http://goo.gl/XXuvZH

By: Wanigaratne S1, Cole DC1, Bassil K1, Hyman I1, Moineddin R1, Urquia ML1.

• 1At the time of the study, Susitha Wanigaratne was a doctoral student at the Dalla Lana School of Public Health, University of Toronto, Ontario, Canada at the time of this study. Donald C. Cole and Ilene Hyman are with the Dalla Lana School of Public Health. Kate Bassil is with Toronto Public Health, Toronto, Ontario, Canada. Rahim Moineddin is with the Department of Family and Community Medicine, University of Toronto. Marcelo L. Urquia is with the Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada.  

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