Introduction: People who engage in transactional sex have a unique set of health risks that could be reduced through preventive health programs. These include stigma, reduced mental health, and sexually transmitted infections (STIs) such as blood borne viruses (BBVs). These risks overlap and interact with health risks experienced by clients of Alcohol and Other Drug (AOD) services. People experiencing drug dependency are more likely to engage in transactional sex than the general population. If appropriately resourced, AOD services would be well-positioned to help clients manage their risks from transactional sex.

Methods: A scoping review was conducted on treatment or harm reduction of people who use AOD and engage in transactional sex. The review was conducted in line with the JBI scoping framework and included PubMed, Scopus and Proquest. Included manuscripts were published in English from 1 January 1990 to 1 April 2024. A qualitative aggregation approach of the studies was applied to synthesise common findings across the studies identified.

Results: Screening included 495 articles in total, with 17 articles included in the review. Most research was conducted in America and may not reflect other countries. Demographic factors associated with AOD service clients engaging in transactional sex included being female, gay, non-Caucasian and of low socio-economic status. Other associated factors include homelessness, limited social networks, low educational attainment and unemployment. Identified health needs include mental health issues associated with trauma, and STIs including BBVs. The risk of experiencing violence was elevated.

Discussion: AOD services could play an important role in providing health care to clients engaging in transactional sex, including through stigma reduction, mental health support, and STI and BBV harm reduction. The literature provides limited guidance on best practice for screening, harm reduction or treatment of health issues experienced by this priority cohort which receives little political or academic attention.

As one of nine Victorian Local Public Health Units (LPHUs), the North Eastern Public Health Unit (NEPHU) plays a key role in supporting the Victorian Department of Health’s vision of a healthier population.

A needs assessment demonstrated that there is an inequitable distribution of primary care providers offering abortion healthcare services. Additionally, existing services are struggling to meet the high demands in Melbourne’s north eastern corridor and its growing population.

To address this, NEPHU was able to collaborate with Sexual Health Victoria to develop and fund a Scholarship Program that was offered to healthcare professionals (general practitioners, nurses and/or midwives) who work in the local government areas (LGAs) of Hume, Whittlesea, and the Yarra Ranges. This Scholarship Program is providing healthcare professionals the opportunity to participate in training facilitated by Sexual Health Victoria that aims to build capacity on how to best consult and deliver services to address the sexual and reproductive needs of community members. By increasing access to specialised education and training, it will empower primary care providers to offer best-practice care, ultimately leading to measurable sexual and reproductive health outcomes for the community, particularly in the targeted LGAs.

A total of nine scholarships were awarded to five general practitioners, two nurses, and two midwives. The successful applicants are a representation of the three targeted LGAs and work with a range of diverse population groups.

Preliminary findings suggest that the Scholarship has enabled healthcare professionals the opportunity to participate in much needed training that otherwise they would be unable to seek due to associated costs. The Scholarship Program will also enable valuable networking and mentoring between practitioners and further strengthen access to appropriate SRH healthcare for the community.

Introduction
The Aboriginal population of Central Australia has the highest prevalence of the human T cell leukaemia virus 1 (HTLV-1) in the world (39%). HTLV-1 is a blood-borne retrovirus and sexually transmissible infection that causes fatal leukaemia and myelopathy and is associated with diseases that shorten the lifespan. Transmission pathways, being via blood, sex and breastfeeding, cast HTLV-1 prevention as a task necessarily governed by affected women. Responding to a preceding study where one community requested a camp to further discuss prevention, we report on the co-design and execution of the first HTLV-1 ‘wellbeing camp’, implemented in the current absence of public health programs to address HTLV-1 in this remote setting.

Methods
Two co-design workshops and a two-day camp was implemented with 15 Aboriginal women and 5 adolescents on their traditional homelands in 2022. The primary ambition of the project was to understand what mitigation strategies were envisioned by women when provided with basic biomedical information about HTLV-1. HTLV-1 education was delivered by the researchers, and participants took responsibility for cultural activities, art-making and interpreter support. Data consisted of workshop sketches, audio recordings, direct observation, photos and paintings. A reflective discussion held with senior women after the camp provided additional insights and conclusions.

Results
Diverse preferences for HTLV-1 prevention were documented, with a focus on sensitive areas including contraception, early weaning and disclosure of status in partnerships and families. Significantly, the camp itself was viewed as a method for HTLV-1 prevention, equipping the women with knowledges that could be further dispersed within their community.

Conclusion
The project prioritised HTLV-1 prevention within a small cohort that would otherwise not have ready access to HTLV-1 information. Participatory methods and findings introduce an evidence base for community-oriented HTLV-1 prevention in Central Australia, and beckon policy reform in this neglected area of public health.

Permission to publicise findings was given by all women through a rights-based process of continuous informed consent. Publication was discussed both in instances of corporate consent and agreement (workshops before, during and after the camp) and in individual contracts with each participating woman, where written consent for publication was obtained.

Introduction: Social deprivation is recognised to be related to cardiovascular risk, but the prevalence of cardiometabolic risk factors according to both social deprivation and sex has been less explored. We addressed this question in a large international cohort.
Methods: UK Biobank participants with at least 1 cardiometabolic risk factor measured at baseline were eligible for inclusion (n=501,389, 54.4% women). We examined differences in established and emerging cardiometabolic risk factors.by socioeconomic status (quantified by a neighbourhood deprivation index) and sex.
Results: Total cholesterol, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol were lower with greater deprivation (difference between most and least deprived fifths: -0.19 mmol/L, -0.12 mmol/L, and -0.07 mmol/L, respectively), while C-reactive protein was higher (0.41 mg/L). Body mass index, waist circumference, and triglycerides were also higher with greater deprivation, but differences were larger in women (+1.8 kg/m², +4.8 cm and +0.08 mmol/L respectively) than men (+0.70 kg/m², +1.9 cm and +0.04 mmol/L). Corresponding social differences in glycated haemoglobin and glucose were higher in men (+1.9 mmol/mol and +0.16 mmol/L, respectively) than in women (+1.3 mmol/mol and +0.09 mmol/L), whilst estimated glomerular filtration rate was higher in men (+0.77 mL/min/1.73m²) but not women (-0.41 mL/min/1.73m²). The prevalences of hypertension and chronic kidney disease were higher with greater social deprivation (difference between least and most deprived: +8.5% and +1.9%, respectively). The prevalence of other risk factors across extreme deprivation groups varied by sex: smoking (+11.9% vs +15.3% in women vs men, respectively), obesity (+13.6% vs +8.2%), and diabetes (+2.8% vs +3.7%).
Conclusion: Apart from LDL-C, higher social deprivation relates to worse cardiometabolic risk factors. The social difference varies by sex for several risk factors, with particularly higher rates of smoking among men and obesity among women. Public health strategies that consider both social deprivation and sex are warranted.

Introduction: Australia's long history of employing seasonal workers from Pacific Island Countries and Territories has recently evolved into a structured, government-run program of temporary migration, known as the Pacific Australia Labour Mobility (PALM) scheme. Despite PALM workers' critical contributions to the Australian economy and communities, they face significant barriers to accessing essential health services. Temporary migrant status, social determinants of health and restrictive immigration policies can all limit healthcare access. This project examines the healthcare experiences of seasonal workers and healthcare providers, highlighting an urgent need for equitable access to testing and preventative services, particularly in the areas of sexually transmitted infections, blood-borne viruses, and reproductive health.
Methods: This project utilised a sequential mixed methods design, whereby we interviewed and surveyed seasonal workers and healthcare and service providers in regional Queensland. The data were analysed thematically.
Results: Significant challenges exist for PALM workers accessing preventative health services for blood-borne viruses and sexual and reproductive health care. These challenges are particularly driven by Commonwealth-level policy and system gaps such as Medicare ineligibility and mandatory private health insurance, inequitable healthcare resource distribution, and a lack of inclusion in national and state public health policy. Health service-level gaps exist including inconsistencies in policies and procedures for providing care for PALM workers. Individual-level barriers include health and health system literacy and cultural, language, and behavioural factors.
Conclusion: This study highlights the need for targeted interventions such as pre-departure testing and vaccination programs, outreach clinics in areas of high PALM worker population in Australia, and in-language resources including translation services. To achieve a more equitable healthcare status, policy changes to include Medicare access and culturally appropriate preventative health services are required for the prevention of sexually transmissible infections, blood-borne viruses and unwanted pregnancies in PALM workers living and working in Australia.

• Problem
Relationships and Sexuality Education (RSE) has the potential to prevent gender-based violence, enable the achievement of sexual rights and increase uptake of sexual health services.

However, young people in Juvenile Justice’s often miss this, due transient accommodation, fractured school attendance, family dysfunction, violence, sexual violence, and other complex factors.

• What you did

Since 2021, Sexual Health Quarters has been delivering RSE programs with young people in Banksia Hill Juvenile Detention Centre (BHDC). Following an initial 6-week pilot with girls, staff and participants requested ongoing weekly programs, expanded to include girls, boys, and boys in Unit 18 Casuarina (men’s maximum-security prison).

Content is founded in best practise and codesigned with young people using a strengths-based, culturally-centred and trauma-informed approach. Experienced educators tailor the sessions to the individual needs of each group, including those with low literacy and neuroglobal developmental delay (e.g. foetal alcohol spectrum disorder).


• Results

For most participants it was their first opportunity to learn about puberty, consent, relationships, bodies and sexuality. Knowledge, confidence and skills in RSE has increased, with reduced stigma and shame. Participants are eager to educate peers during sessions and proudly share how upon release, they attended SHQ for contraception or STI testing.

BHDC have reported an increase in clinic attendance, with increased knowledge, autonomy and confidence of young people requesting STI tests and contraception.

The program has been recognised interstate as the only one of its kind, and SHQ has provided training to Justice staff in QLD.

• Lessons
A multisectoral approach is needed to address the unique needs of young people in detention in Australia if the government is truly committed to ending the cycle of violence in Australia.

Tailored RSE delivered by experienced educators is crucial to empower young people to make informed decisions around sexual health.

Introduction: Clinical guidelines recommend that preventable health risks are addressed routinely throughout pregnancy. Antenatal providers are ideally placed to implement these guidelines; however, they find it difficult to provide comprehensive support within time-limited face-to-face visits. A digital platform that enables pregnant people to receive complementary preventive care outside of antenatal visits provides a potential and sustainable solution to increase access, however pregnant people’s perceptions are unknown. This study aimed to explore pregnant people’s accessibility, acceptability, preferences, and barriers to a digital platform.
Methods: Between May 2023 and September 2024 surveys (telephone and online) were conducted with pregnant people attending antenatal care at maternity services in Hunter New England Local Health District, NSW. Data were analysed using descriptive statistics.
Results: A total of 2464 surveys were completed. Almost all participants (99%) reported access to a personal digital device with internet. There was high acceptability for receiving care for preventable health risks via a digital platform, including risk assessment (82%-88%), receiving personalised information and advice (74%-83%), and linkage to referral services (86%-88%). Most participants (93%) said they would use the digital platform. Almost two-thirds (62%) wanted to have their assessment results delivered directly on the platform and provided to their antenatal provider for follow up. There were differences in participants’ preferences for information mode (written: 52%, videos: 29%, interactive activities: 13%, audio: 8%); and usage (week before appointment: 46%, day before appointment: 21%, in waiting room: 22%). Almost two-thirds of participants (65%) reported no barriers to using the platform, with time (14%) and forgetting (11%) the most common.
Conclusion: Most pregnant people have the potential to access preventive care via a digital platform and would use one to complement face-to-face antenatal care. An effective and sustainable platform would need to include features to suit varying preferences for use and address identified barriers.