The "work" of women when considering and using interventions to reduce mother-to-child transmission (MTCT) of HIV.

This paper explores HIV-infected women's experiences of considering and using recommended interventions during pregnancy and postpartum to reduce mother-to-child transmission of HIV. Data were collected from 45 HIV-infected women aged 18-44 years living in Melbourne, Australia. A semi-structured interview was used to collect qualitative information on women's reproductive experience and intentions. The 15 women who had their children after their HIV diagnosis engaged in significant work including surveillance and safety work to minimise stigma and infection, information work to inform decisions and actions, accounting work to calculate risk and benefit, hope and worry work concerning a child's infection status and impact of interventions, work to redefine an acceptable maternal identity, work to prepare an alternative story to counter the disclosure effect of the intervention and emotional work to reconcile guilt when considering these interventions. This study provides a framework to help clinicians understand the real and on-going "work" that women engage in when they are considering interventions recommended by their physicians to reduce transmission of HIV. Even in circumstances where access to and acceptance of interventions are high, women continue to engage in this work even after they have a made a decision about a particular intervention.

Australian lesbian and bisexual women's health and social experiences of living with hepatitis C.

We recruited women in two Australian locations to complete a questionnaire on their health and social experiences of living with the hepatitis C virus (HCV). Among 462 respondents 9% identified themselves as lesbian and 14% as bisexual. Bisexuals were more disadvantaged than lesbians or heterosexuals on income, work status, home ownership, and level of education. Lesbians and bisexuals were less likely to be referred for HCV treatment and were more likely to report being treated negatively by any health professional. Lesbians and bisexuals experience HCV differently from one another and from heterosexuals. Their needs are not being met by women's health and HCV-specific services.

Australian men's experiences of living with hepatitis C virus: results from a cross-sectional survey.

BACKGROUND AND AIM: Of the estimated 160,000 Australians currently infected with hepatitis C virus (HCV), two-thirds are men. Little is known about their social and health needs. The present study presents results from a comprehensive survey of Australian men living with HCV. METHODS: In 2002, a self-administered questionnaire was completed by a largely non-clinical sample of men living in the State of Victoria who had tested positive for HCV antibodies (n = 308). The return rate was 54%. The mean age was 38 years (standard deviation [SD] = 9.8; range 19-90 years), and 86% were 'current' or 'past' injecting drug users. The mean number of years since diagnosis was 6.6 years (SD = 5.0) and the mean self-reported number of years since infection was 12.6 years (SD = 9.2). RESULTS: Fifty percent of men reported experiencing HCV-related symptoms, most commonly tiredness (61%) and nausea (30%). Of the sample, 43% currently saw a doctor for HCV and although 30% had ever been referred to a specialist, few had received treatment (6% interferon; 14% combination therapy). Forty percent of men reported that they believed they received less favorable treatment from health care professionals than those without HCV. Self-assessed health status was significantly lower than Australian norms, as were SF-12 physical and mental health scores. Scores were moderately correlated, indicating an association between the physical and mental health burden of HCV. CONCLUSION: The social, physical and mental health needs of men living with HCV are considerable. Few men in the present study had accessed specialist treatment; those who were current injecting drug users were particularly disadvantaged. Reduction of barriers to primary and specialist health care is essential to improve treatment, support and care for men with HCV.

Australian women's experiences of living with hepatitis C virus: results from a cross-sectional survey.

BACKGROUND: Of the estimated 160000 Australians currently infected with the hepatitis C virus (HCV), over one-third are women and very few have received clinical treatment, with most managing their illness in non-specialist settings. Little is known about the experiences of women living with HCV in the general community. The present study provides the results from the first comprehensive social survey of Australian women's experiences of living with HCV. METHODS: In 2000, a questionnaire was administered to a largely non-clinical sample of women with HCV (n = 462) living in the state of Victoria and the Australian Capital Territory, Australia. The questionnaire was self-administered with a return rate of 75%. The mean age was 35 years and 83% were 'current' or 'past' injecting drug users. The mean time since diagnosis was 4.6 years (SD = 4.0) and the mean time since infection was 10.5 years (SD = 8.2). RESULTS: Fifty-eight percent of women reported experiencing symptoms related to their HCV, the most common being tiredness (78%) and nausea (44%). Of the sample, 56% currently saw a doctor for their HCV, and while 52% had ever been referred to a specialist, only 17% of the total sample had ever begun interferon-based combination or monotherapy. Forty-eight percent of women reported experiencing less favorable treatment by a health professional because of their HCV. Age-related self-assessed health status was significantly lower than Australian norms, as were SF-12 physical and mental health scores. The SF-12 physical and mental health scores were highly correlated, indicating a significant physical and mental health burden associated with HCV. CONCLUSION: The social, physical and mental health needs of women living with HCV are considerable. Most women had not accessed specialist treatment and the response of the primary health care system to HCV-related women's health issues requires improvement.