The role of explanatory models of chronic hepatitis B on illness experience: a qualitative study of Vietnamese participants in Australia.

ABSTRACTObjective: This study utilises Kleinman's theory of explanatory models of health and illness to explore the experience of chronic hepatitis B (CHB) among Vietnamese people living in Australia. It examines how these explanatory models are formed and shaped by the broader community, and the extent to which this influences understandings and responses to CHB.Design: This study is based on semi-structured interviews with 22 Vietnamese people with CHB in Melbourne, Australia. The individual interviews ranged from 30 minutes to 1.5 hours in length, and were electronically recorded, translated where necessary and transcribed verbatim. Transcripts were thematically coded using NVivo 10, with coding themes guided by categories identified in Kleinman's explanatory models framework.Results: Fundamental to most participants' narratives was the profound impact of cultural, social and economic environments on their understandings and responses to CHB. Regardless of socio-demographic background, most participants juxtaposed biomedical elements of CHB with their own existing humoral-based health belief system. In the context of a chronic asymptomatic condition that, for the most part, does not require pharmaceutical treatment, a humoral-based health belief system provided a familiar conceptual framework from which participants could immediately respond and take control of their infection. This was observed through changes in diet and lifestyle, and the use of traditional herbal medicine in an attempt to 'cure' or halt the progression of their infection.Conclusions: By speaking to people living with CHB directly, it became clear that there is a disjuncture between what is commonly assumed by the biomedical model of CHB and what is understood by individuals with the infection. The public health burden of CHB will continue unless the healthcare system, including public health policies, deliver a hepatitis B model of care that is responsive to the needs and expectations of priority populations.

The personal and social impact of chronic hepatitis B: A qualitative study of Vietnamese and Chinese participants in Australia.

This study explores the lived experiences of chronic hepatitis B (CHB) among Vietnamese and Chinese-born people living in Melbourne, Australia. The aims of this study were to investigate the personal and social implications of CHB, and the extent to which these implications, including experiences of stigma and marginalisation, affect individuals' overall quality of life. This study is based on individual semi-structured interviews with 37 Vietnamese and Chinese people with CHB in Australia (n = 22 and n = 15 respectively). The interviews were conducted between February 2015 and November 2016. Electronically recorded interviews of up to 1.5 hr were conducted, translated where necessary and transcribed verbatim. Transcripts were coded using NVivo, with coding themes guided by the principles of thematic analysis. Fundamental to most participants' accounts was the experience of living in constant fear of stigma and marginalisation, which participants unanimously attributed to prevailing misconceptions about hepatitis B-related transmission routes and disease outcomes. The accompanying experiences of social isolation-whether imposed upon themselves or by others-brought on additional feelings of shame and emotional pain, which had a profound impact on participants' overall quality of life. By exploring participants' lived experiences of hepatitis B, it became clear that concerns about the clinical implications related to hepatitis B as a biomedical infection make up only a small part of their experiences. Of particular significance were personal and social concerns around transmission, disclosure as well as the impact of stigma and marginalisation on participants and their families. Adopting a comprehensive multi-pronged response to tackle the multitude of complexities surrounding this infection among key affected communities will be more effective than just recognising the physical experience of the infection.

Low education levels are associated with early age of sexual debut, drug use and risky sexual behaviours among young Indigenous Australians.

Background Earlier age at sexual debut is associated with drug and alcohol use, risky sexual behaviours and sexually transmissible infections (STI). METHODS: In the present study, 2320 young Indigenous Australians were surveyed. RESULTS: Most study participants had sex for the first time when they were 14 years or younger (79% and 67% for males and females respectively). More than 80% of participants were categorised as being in the high-risk category for the combined sexual risk factors (i.e. not using condoms, drunk or high at last sexual act, or three or more sexual partners in the past year). There was a linear decreasing trend between the proportion of males and females who had less than high school education and age at first sex (Ptrend<0.001). Compared with the highest quintile of age at first sexual debut (≥18 years), those in the bottom quintile (<15 years) were less likely to have completed high school (63% vs 32% respectively for males; 68% vs 26% respectively for females; Ptrend<0.001 for both). CONCLUSIONS: The findings of the present study suggest that sex education and STI prevention should start early when targeting Indigenous young people, with age-appropriate messages. Sex education should be comprehensive and address individual risk behaviours, sexual agency and societal vulnerability to not only delay sexual debut, but also to emphasise the importance of STI prevention through condom use, which clearly already works to a certain extent with this group.

Development of a Risk Algorithm to Better Target STI Testing and Treatment Among Australian Aboriginal and Torres Strait Islander People.

Identifying and targeting those at greatest risk will likely play a significant role in developing the most efficient and cost-effective sexually transmissible infections (STI) prevention programs. We aimed to develop a risk prediction algorithm to identify those who are at increased risk of STI. A cohort (N = 2320) of young sexually active Aboriginal and Torres Strait Islander people (hereafter referred to as Aboriginal people) were included in this study. The primary outcomes were self-reported high-risk sexual behaviors and past STI diagnosis. In developing a risk algorithm, our study population was randomly assigned to either a development (67%) or an internal validation data set (33%). Logistic regression models were used to create a risk prediction algorithm from the development data set for males and females separately. In the risk prediction models, older age, methamphetamine, ecstasy, and cannabis use, and frequent alcohol intake were all consistently associated with high-risk sexual behaviors as well as with a past STI diagnosis; identifying as gay/bisexual was one of the strongest factors among males. Those who had never tested for STIs, 52% (males) and 66% (females), had a risk score >15, and prevalence of undiagnosed STI was estimated between 30 and 40%. Since universal STI screening is not cost-effective, nor practical in many settings, targeted screening strategies remain a crucial and effective approach to managing STIs among young Aboriginal people. Risk prediction tools such as the one developed in this study may help in prioritizing screening for STIs among those most at risk.

Happiness, rather than depression, is associated with sexual behaviour in partnered older adults.

Background: The relation between positive psychological well-being (PPWB) and sexual behaviour is understudied in older adult groups. Objective: To examine the relation between PPWB (positive affect and life satisfaction) and sexual behaviour (sexual activity and physical tenderness) in older adults, and whether it is independent from depressive symptoms and uniform across older age groups. Design: Cross-sectional. Setting: Community-dwelling adults aged 65 years or older, Rotterdam, The Netherlands. Methods: Sexual behaviour, the Cantril Self-Anchoring Striving Scale, the Center for Epidemiological Studies Depression (CES-D) scale and partner status were assessed in 2,373 dementia-free older adults from the Rotterdam Study. Results: For partnered participants, greater positive affect and life satisfaction was associated with more sexual activity and physical tenderness. Although CES-D was negatively associated with sexual behaviour within partnered older adults, there was no association between the negative affect sub-scale and sexual behaviour. The relations were independent of depressive symptoms, physical health and chronic disease status and were observed for both sexes at all older ages. For unpartnered participants, greater life satisfaction and was associated with more physical tenderness. There was low prevalence of sexual behaviour in unpartnered participants, limiting further stratification. Conclusion: Greater PPWB was associated with more sexual behaviour in partnered, community-dwelling older adults. We are the first to demonstrate that sexual behaviour is associated with PPWB, rather than lack of depressive symptoms; and that the association was present at all ages for partnered older adults. Limited conclusions can be drawn for unpartnered older adults as their sexual behaviour was infrequent.

Genetic and Environmental Factors in Invasive Cervical Cancer: Design and Methods of a Classical Twin Study.

BACKGROUND: Persistent high-risk human papillomavirus (HPV) infection is a necessary prerequisite for development of cervical cancer and its precursor lesion, high-grade squamous intraepithelial lesion (HSIL). However, HPV infection is not sufficient to drive this process, and genetic and environmental factors may also play a role. METHODS/DESIGN: The Cervical Cancer, Genetics and Environment Twin Study was established to investigate the environmental and genetic influences on variation in susceptibility to cervical pre-cancer in 25- to 69-year-old monozygotic (MZ) and dizygotic (DZ) twins recruited through the Australian Twin Registry. Reviews of Papanicolaou (Pap) screening histories were undertaken to identify individual women with a history of an abnormal Pap test. This was followed by detection of HPV in archival Pap smears of selected twin pairs to determine HPV persistence. Selected twin pairs also completed a detailed questionnaire on socio-demographic characteristics, sexual behavior, and HPV knowledge. In future analyses, under the assumptions of the classical twin design, case-wise concordance for persistent HPV infection and HSIL will be calculated for MZ and DZ twin pairs, and twin pairs (both MZ and DZ) who are discordant for the above outcomes will be used to assess the contributions of measured environmental risk factors. DISCUSSION: The study examines factors related to HPV persistence and development of HSIL among female MZ and DZ twins. The results will contribute to our understanding of the natural history of cervical HPV infection and the relative contributions of genetic and environmental factors in disease progression.

Employment conditions and work-related stressors are associated with menopausal symptom reporting among perimenopausal and postmenopausal women.

OBJECTIVE: While many women undergo menopausal transition while they are in paid employment, the effect of poor working conditions on women's experience of the menopause has received scant empirical attention. We examined associations between employment conditions, work-related stressors, and menopausal symptom reporting among perimenopausal and postmenopausal working women. METHODS: Data were drawn from an online survey conducted between 2013 and 2014 involving 476 perimenopausal and postmenopausal women working in the higher education sector in Australia. Survey questions assessed demographics; health-related variables; menopausal symptom reporting; employment status; presence of flexible working hours; presence of temperature control; job autonomy; and supervisor support. RESULTS: A forced entry multivariable regression analysis revealed that high supervisor support (ß = -0.10, P = 0.04), being employed on a full-time basis (ß = -0.11, P = 0.02), and having control over workplace temperature (ß = -0.11, P = 0.02) were independently associated with lower menopausal symptom reporting. CONCLUSIONS: These findings may help inform the development of tailored occupational health policies and programs that cater for the needs of older women as they transition through menopause in the workplace.

Fertility knowledge and intentions to have children in a national study of Australian secondary school students.

OBJECTIVE: This paper reports on fertility knowledge and intentions to have children among a national sample of students in years 10-12. METHOD: Data were from the Fifth National Survey of Australian Secondary Students and Sexual Health. Students identified factors that could affect fertility, if they wanted children and at what age. RESULTS: Most students wanted to have children (77%). Of those who wanted children or were unsure (n=1,780), 54% were able to identify six of eight factors that could affect fertility. Male students had poorer knowledge than females. Poorer knowledge was also reported by male students who were born overseas or used marijuana and by female students who were sexually active or religious. More than half the students (59%) wanted their first child aged 25-29, while 19% wanted their first child after 30. Intentions to have children at an earlier age were associated with being religious, sexually active (females), and using marijuana (males). Students not exclusively attracted to the opposite sex were more likely to want children at an older age. CONCLUSIONS AND IMPLICATIONS: Most students typically want children in their late 20s. Many were unaware of factors that could affect their fertility and there was a mismatch between intentions and likely behaviour. These factors could be addressed as part of relationship education.

Individual and population level impacts of illicit drug use, sexual risk behaviours on sexually transmitted infections among young Aboriginal and Torres Strait Islander people: results from the GOANNA survey.

BACKGROUND: Sexually transmitted infections (STIs) have been increasing among Australian Indigenous young people for over two decades. Little is known about the association between alcohol and other drug use and sexual risk behaviours and diagnosis of STIs among this population. METHODS: A cross-sectional, community based self-administered survey was conducted among young Aboriginal people aged 16-29 years of age. Questionnaires included socio-demographic characteristics, knowledge, sexual risk behaviours alcohol and other drug use and health service access including self-reported history of diagnosis with a STI. Logistic regression models and population attributable risks were used to assess individual and population level impacts of illicit drug use on high risk sexual behaviours and ever reported diagnosis of an STI. RESULTS: Of the 2877 participants, 2320 (81 %) identified as sexually active and were included in this study. More than 50 % of the study population reported that they had used at least one illicit drug in past year. Cannabis, ecstasy and methamphetamines were the three most commonly used illicit drugs in the past year. The prevalence of self-reported STI diagnosis was 25 %. Compared with people who did not report using illicit drugs, risky alcohol use and sexual behaviours including inconsistent condom use, multiple sexual partners in the past year and sex with casual partners were all significantly higher among illicit drug users. In adjusted analysis, participants who reported using illicit drugs were significantly more likely to engage in sexual risk behaviours and to ever have been diagnosed with an STI. Adjusted Odds Ratios ranged from 1.86 to 3.00 (males) and from 1.43 to 2.46 (females). At the population level, more than 70 % of the STI diagnoses were attributed to illicit drug-use and sexual risk behaviours for males and females. CONCLUSION: Illicit drug use in this population is relatively high compared to other similar aged populations in Australia. Illicit drug use was associated with risky sexual behaviours and STI diagnoses among this study population. Developing and implementing effective STI prevention strategies should include not only safe sex messages but also include drug and alcohol harm reduction messages.

Menopause in the workplace: What employers should be doing.

Large numbers of women transition through menopause whilst in paid employment. Symptoms associated with menopause may cause difficulties for working women, especially if untreated, yet employers are practically silent on this potentially costly issue. This review summarises existing research on the underexplored topic of menopause in the workplace, and synthesises recommendations for employers. Longstanding scholarly interest in the relationship between employment status and symptom reporting typically (but not consistently) shows that women in paid employment (and in specific occupations) report fewer and less severe symptoms than those who are unemployed. Recent studies more systematically focused on the effects of menopausal symptoms on work are typically cross-sectional self-report surveys, with a small number of qualitative studies. Though several papers established that vasomotor (and associated) symptoms have a negative impact on women's productivity, capacity to work and work experience, this is not a uniform finding. Psychological and other somatic symptoms associated with menopause can have a relatively greater negative influence. Physical (e.g., workplace temperature and design) and psychosocial (e.g., work stress, perceptions of control/autonomy) workplace factors have been found to influence the relationship between symptoms and work. Principal recommendations for employers to best support menopausal women as part of a holistic approach to employee health and well-being include risk assessments to make suitable adjustments to the physical and psychosocial work environment, provision of information and support, and training for line managers. Limitations of prior studies, and directions for future research are presented.

Prevalence and Correlates of a Diagnosis of Sexually Transmitted Infection Among Young Aboriginal and Torres Strait Islander People: A National Survey.

BACKGROUND: Young Aboriginal and Torres Strait Islander (Aboriginal) people are recognized as a priority population for the control of sexually transmissible infections (STIs) in Australia. This article reports the prevalence of self-reported STI diagnoses and their correlates among Aboriginal people aged 16 to 29 years. METHODS: Results were analyzed from a survey conducted between 2011 and 2013 at regular community events. Univariate and multivariate logistic regression models were used to identify the correlates of a history of STI diagnosis among participants who reported being sexually active and ever having been tested for STIs. All analyses were stratified by sex. RESULTS: Of the 2877 participants in this study, 2320, comprising 60% females, self-reported ever having had vaginal or anal sex, and a further subset of 1589 (68%) reported ever being tested for any of the following STIs: chlamydia, gonorrhea, syphilis, or trichomonas. Within this latter group, the proportion who reported that they had had a positive STI diagnosis was 25%. In multivariate analysis, women who reported sexual debut before the age of 16 years (prevalence ratio [PR], 1.53; 95% confidence interval, 1.16-2.81; P < 0.05), ever having had oral sex (PR, 2.66; 1.47-4.82; P < 0.001), inconsistent condom use in the past 12 months (PR, 1.71; 1.13-2.58; P < 0.012), having had sex with someone they had just met (adjusted odds ratio, 1.74; 1.21-2.50; P < 0.003), and using ecstasy (PR, 1.81; 1.16-2.81; P < 0.009) were significantly associated with a self-reported history of an STI diagnosis. For men, being older (25-29 years; PR, 2.10; 1.10-3.96; P < 0.023), being gay or bisexual (PR, 2.22; 1.16-4.27; P < 0.016), not using a condom during last sex, (PR, 1.74; 1.10-2.76; P < 0.019), past ecstasy use (PR, 1.88; 1.11-3.20; P < 0.019), and injecting drug use (PR, 2.81; 1.35-5.88); P < 0.006) were independent predictors of ever reporting being diagnosed as having an STI. DISCUSSION: In the first community-based survey of this population, a self-reported history of ever being diagnosed as having prevalent STIs was common in sexually active young Aboriginal people who reported STI testing in the past. This population requires targeted education and health service interventions to address the high burden of STIs.

Illicit and injecting drug use among Indigenous young people in urban, regional and remote Australia.

INTRODUCTION AND AIMS: To examine patterns of illicit drug use among Australian Indigenous young people, identify correlates of frequent use separately in urban, regional and remote settings and characterise those who inject. DESIGN AND METHOD: Cross-sectional design at 40 Indigenous events. Self-complete surveys were administered to Indigenous people aged 16-29 years using mobile devices. RESULTS: 2,877 participants completed the survey. One in five reported using cannabis at least weekly in the previous year, but the use of other drugs was less prevalent. Patterns of drug use were largely similar across regions, although more participants in urban and regional areas reported using ecstasy (12% vs 11% vs 5%) and cocaine (6% vs 3% vs 1%) and more reported weekly cannabis use (18% vs 22% vs 14%). Injecting was rare (3%) but those who did inject reported a high incidence of needle sharing (37%). Methamphetamine (37%), heroin (36%) and methadone (26%) were the most commonly injected drugs, and injecting was related to prison experience (AOR 5.3 95% CI 2.8-10.0). DISCUSSION AND CONCLUSION: Attention is needed in relation to cannabis use, particularly among those Indigenous young people living in regional and urban settings. Also, although injecting is uncommon, it is associated with prison involvement. Priority must be given to reducing the numbers of Indigenous youth entering justice settings, delaying the age at first entry to justice settings, and reducing the risk of BBV acquisition while in custody through, for example, prison-based NSP, BBV education, and Indigenous-specific treatment that emphasises connection to country and culture. [Bryant J, Ward J, Wand H, Byron K, Bamblett A, Waples-Crowe P, Betts S, Coburn T, Delaney-Thiele D, Worth H, Kaldor J, Pitts M. Illicit and injecting drug use among Indigenous young people in urban, regional and remote Australia. Drug Alcohol Rev 2016;35:447-455].

Essential components in developing public policy to control viral hepatitis: lessons from Taiwan.

BACKGROUND: Over 500 million people are estimated to be infected with chronic viral hepatitis with an increasing burden resulting from the infections. In 2010, the World Health Organization recommended national governments develop effective strategies to reduce the global impact of viral hepatitis. Taiwan, to support the implementation of the world's first national vaccination program, developed the first of a series of 5-year national strategies in 1982. Our study sought to identify the essential constituents of the strategic response to chronic viral hepatitis in Taiwan, which could then be used by other governments to inform best practice in strategy development. METHODS: Semistructured qualitative interviews were conducted with key participants involved in the national response to viral hepatitis in Taiwan (n = 26) and a review of the literature. RESULTS: The development of a national strategic response is one of several factors in reducing the burden of viral hepatitis in Taiwan. Other critical factors are effective health services, a prioritization of disease prevention, government funding of science and technology, and sustained advocacy informed by a rigorous evidence base. While there has been significant policy, structural and financial commitment to reduce the burden of related to viral hepatitis, essential challenges remain. CONCLUSIONS: Taiwan's viral hepatitis policy response focuses on clinical interventions and would be strengthened by a broader involvement of interdisciplinary stakeholders, including people with viral hepatitis, and stronger coordination between the policy and government agencies responsible for their implementation.

Chronic Disease Self-Management by People With HIV.

As HIV has transitioned into a chronic disease, reappraisal of clinical management has occurred with chronic disease self-management (CDSM) as one possibility. However, despite extensive work on CDSM across a range of diseases, little attention has focused on psychosocial contexts of the lives of people for whom programs are intended. This article reports semi-structured interviews used to explore health practices and motivations of 33 people with HIV (PWHIV) in Australia. Within participants' accounts, different forms of subjectivity and agency emerged with implications for how they understood and valued health-related behaviors. Four themes arose: health support and disclosure, social support and stigma, employment/structure, and health decisions beyond HIV. The experience of stigma and its intersection with CDSM remains relatively un-chartered. This study found stigma shapes agency and engagement with health. Decisions concerning health behaviors are often driven by perceived social and emotional benefit embedded in concerns of disclosure and stigma.

"Dude, I'm Seventeen It's Okay Not to Have Sex by This Age": Feelings, Reasons, Pressures, and Intentions Reported by Adolescents Who Have Not Had Sexual Intercourse.

This study investigated feelings, reasons, pressures, and previous sexual experiences reported by students who have not had sexual intercourse and how these factors are associated with self-rated likelihood of having sex during the next year. Using data from the Fifth National Survey of Australian Secondary Students and Sexual Health (n = 783), this study found, in general, students had positive feelings about not having sex. Reasons for not having sex such as being proud to say no and not being ready were rated higher in importance than fear of potential outcomes or religious/cultural beliefs. Students reported limited pressure from parents and friends and, despite not having sexual intercourse, more than half of the sample had experienced some form of sexual activity. Stronger likelihoods of having sex during the next year were reported by students who had previously engaged in other sexual practices, reported more pressure from friends to have sex, and had negative feelings about not having sex. Sexuality educators can use these findings to guide approaches to sex education, emphasizing feelings, intentions, and reasoning over fear tactics. Discussion of a range of sexual practices will address more closely the experiences of young students as they begin their sexual lives.

Building healthcare workers' confidence to work with same-sex parented families.

This article reports on a qualitative study of barriers and access to healthcare for same-sex attracted parents and their children. Focus groups were held with same-sex attracted parents to explore their experiences with healthcare providers and identify barriers and facilitators to access. Parents reported experiencing uncomfortable or anxiety-provoking encounters with healthcare workers who struggled to adopt inclusive or appropriate language to engage their family. Parents valued healthcare workers who were able to be open and honest and comfortably ask questions about their relationships and family. A separate set of focus groups were held with mainstream healthcare workers to identity their experiences and concerns about delivering equitable and quality care for same-sex parented families. Healthcare workers reported lacking confidence to actively engage with same-sex attracted parents and their children. This lack of confidence related to workers' unfamiliarity with same-sex parents, or lesbian, gay and bisexual culture, and limited opportunities to gain information or training in this area. Workers were seeking training and resources that offered information about appropriate language and terminology as well as concrete strategies for engaging with same-sex parented families. For instance, workers suggested they would find it useful to have a set of 'door opening' questions they could utilize to ask clients about their sexuality, relationship status or family make-up. This article outlines a set of guidelines for healthcare providers for working with same-sex parented families which was a key outcome of this study.

Methods of a national survey of young Aboriginal and Torres Strait Islander people regarding sexually transmissible infections and bloodborne viruses.

OBJECTIVE: To describe the methods and basic demographics of participants in a national survey of Aboriginal and Torres Strait Islander (Aboriginal) people specific to sexually transmissible infections and bloodborne viruses. METHODS: A national cross-sectional survey of Aboriginal people aged 16-29 years in all Australian jurisdictions between 2011 and 2013 conducted at Aboriginal community events. Questions comprised demographic information, knowledge, risk behaviours and health service utilisation. Questionnaires were completed on personal digital assistants (PDAs). RESULTS: A total of 2,877 people at 21 unique community events completed the questionnaire. A total of 59% of participants were female, median age was 21 years and more than 60% were single at the time of the survey. Just over half the participants were resident in an urban area (53%) and 38% were from a regional area. Aboriginal health organisations played an important role in implementing the research. PDAs were found to be an acceptable method for collecting health information. CONCLUSION: This survey has recruited a large representative sample of Aboriginal people aged 16-29 years using a methodology that is feasible, acceptable and repeatable. IMPLICATIONS: The methodology provides a model for ongoing monitoring of this population as programs and policies are implemented to address young Aboriginal people's STI and BBV risks.

Demographic and Psychosocial Factors Associated With Psychological Distress and Resilience Among Transgender Individuals.

OBJECTIVES: We examined the independent demographic and psychosocial factors associated with psychological distress and resilience among transgender men and women. METHODS: Our data came from an online survey involving a national Australian sample of 169 transgender men and women in 2011. Survey questions assessed demographics; sources of support; contact with lesbian, gay, bisexual, and transgender peers; and experiences of victimization. We assessed the outcomes with the Kessler Psychological Distress Scale and the Brief Resilience Scale. RESULTS: In all, 46.0% of the sample reported high or very high levels of psychological distress. Multivariable regression analyses identified considerably different independent factors for psychological distress and resilience. Younger age, feeling unable to turn to family for support, and victimization experiences were associated with greater psychological distress, whereas higher income, identifying as heterosexual, and having frequent contact with lesbian, gay, bisexual, and transgender peers were associated with greater resilience. CONCLUSIONS: With different factors identified for psychological distress and resilience, these findings may help inform the development of tailored mental health interventions and resilience-building programs for this vulnerable population.

Demographic and behavioural correlates of six sexting behaviours among Australian secondary school students.

UNLABELLED: Background There has been increasing attention on assessing rates of sexting in adolescents and of the potential negative effects of the behaviour. Our aim was to assess rates and correlates of sexting in Australian students in years10, 11 and 12. METHODS: The current study was part of The Fifth National Survey of Australian Secondary Students and Sexual Health and reports on responses of 2114 students (811 male, 1303 female). Sexting was assessed using six items: sending a sexually explicit written text message; receiving a sexually explicit text message; sending a sexually explicit nude or nearly nude photo or video of themselves; sending a sexually explicit nude or nearly nude photo or video of someone else; receiving a sexually explicit nude or nearly nude photo or video of someone else; and using a social media site for sexual reasons. RESULTS: Approximately half of the students had received (54%, 1139/2097) or sent (43%, 904/2107) a sexually explicit written text message. Sexually explicit images had been received by 42% (880/2098) of students, one in four students had sent a sexually explicit image of themselves (26%, 545/2102) and one in 10 had sent a sexually explicit image of someone else (9%, 180/2095). Finally, 22% (454/2103) of students had used social media for sexual reasons. Sexting was associated with several correlates. CONCLUSIONS: Sexting was relatively common in this sample of year 10, 11 and 12 Australian students, particularly among older students, those who are sexually active, and those who use recreational substances.