Physicians' inadequate involvement in sexual risk assessment has the potential to miss many asymptomatic cases. The present study was conducted to explore sexual risk assessment by physicians in clinical practice and to identify barriers in eliciting sexual histories from patients. Methods: A stratified random sample of 15% of general practitioners (GP) from New South Wales was surveyed to assess their management of sexually transmissible infections (STI). In total, 409 GP participated in the survey with a response rate of 45.4%. Results: Although nearly 70% of GP regularly elicited a sexual history from commercial sex workers whose presenting complaint was not an STI, this history taking was much lower (<10%) among GP for patients who were young or heterosexual. About 23% never took a sexual history from Indigenous patients and 19% never elicited this history from lesbian patients. Lack of time was the most commonly cited barrier in sexual history taking (55%), followed by a concern that patients might feel uncomfortable if a sexual history was taken (49%). Other constraints were the presence of another person (39%) and physician's embarrassment (15%). About 19% of GP indicated that further training in sexual history taking could improve their practice. Conclusions: The present study identifies inconsistent involvement by GP in taking sexual histories, which can result in missed opportunities for early detection of many STI. Options for overcoming barriers to taking sexual histories by GP are discussed.

This qualitative study describes the experience of music and focuses on the emotional, social, intellectual and spiritual well-being roles that music plays in the lives of older people. In-depth interviews were used to explore the meaning, importance and function of music for 52 older Australians living in the community aged 60 years and older. The findings revealed that music provides people with ways of understanding and developing their self-identity; connecting with others; maintaining well-being; and experiencing and expressing spirituality. The results show how music contributes to positive ageing by providing ways for people to maintain positive self-esteem, feel competent, independent, and avoid feelings of isolation or loneliness. The study highlights the need to be better informed about how music can facilitate and sustain older people's well-being.

Background: Primary care providers are well placed to control the spread of sexually transmitted infections (STI); however, care is likely to be influenced by their attitudes and beliefs. The present study investigates the relationship between general practitioner’s (GP) self-reported level of comfort in dealing with patients with STI and the care they deliver. Methods: A postal survey was conducted using a stratified random sample of 15% of GPs practising in New South Wales, Australia, to assess practitioners’ management of STI. A total of 409 GPs participated in the study yielding a response rate of 45.4%. Results: Although over two-thirds (69–72%) of GPs were comfortable in managing STI in heterosexual or young patients, fewer than half (40–46%) felt comfortable caring for patients who were sex workers, indigenous, people who inject drugs, gay or lesbian. Practitioners who were comfortable were more likely to offer sexual risk assessment, safe-sex counselling, and were less likely to report limited ability to influence patients’ risk behaviours. Practitioner discomfort was positively associated with reporting constraints in sexual history-taking and the need for training in sexual health. Conclusions: Practitioners' care and support for patients with STI are influenced by their inexperience, lack of skills and/or attitudes. The reasons for GP discomfort in managing STI patients need further exploration as does its impact on patient care.

Can the mining boom be blamed for the rising rates of sexually transmitted infections (STIs) in some states? The Australian Medical Association thinks so, with its Queensland president Dr Richard Kidd attributing rising rates of gonorrhoea, syphilis and chlamydia in Queensland and Western Australia to bored and cashed-up miners. Kidd is not an isolated voice. Queensland Health Minister Lawrence Springborg recently blamed sex workers operating in mining regions for the doubling of HIV diagnoses in Queensland - from 2.7 per 100,000 population in 2001 to 5.4 in 2010. These claims have been disputed by sex industry advocates who say commentators have got it wrong. Fly in fly out (FIFO) sex workers aren't contributing to the problem - they're part of the solution. So who should you believe: the medical professionals and politicians or the sex worker advocates?

Injecting drug use plays a critical role in the transmission of HIV in Vietnam. This paper provides a comprehensive review of studies on risks of HIV infection among injecting drug users (IDUs) in Vietnam. Current research evidence shows that the age at which drug initiation starts is becoming younger and the transition time between non-injecting to injecting drug use becoming shorter. The practice of needle sharing and unprotected sex was quite common among the IDUs. Although most of the IDUs generally had good knowledge of HIV transmission routes, most IDUs were not aware of their infection status. Data from a national surveillance programme shows that a third of the IDUs were HIV positive. Amongst all HIV positive cases, almost two-thirds had a history of intravenous drug use. A number of studies have identified a range of risk factors and barriers to minimize the risk of HIV infection in IDUs. This paper discusses these issues and makes recommendations for changes to HIV/AIDS policies, programme interventions as well as future research on the topic.

Recently scholars have examined more closely the topic of female sexual self-concept as an aspect of sexual well-being. Few studies have focused on migrated women's life experiences cross-culturally, and how that informs a woman's view of herself as a sexual being. This is particularly true about most middle-eastern cultures, including Iranian-American women. Four case studies draw on qualitative data from interviews with first generation Iranian-American women in the USA to describe the sexual self-concepts evolving as a result of life in both cultures. Applying narrative methodology and feminist theoretical perspectives two themes were revealed. These are i) the influence of family power, and ii) patriarchal social practices. The analysis introduces a multidimensional aspect and process associated with each woman's view of her sexual self-concept, which takes into account their behaviours, cognitions, and emotions developed in each life stage, and inform her sexual subjectivity (view of herself as a sexual being). Implications of these findings for clinicians and policy makers involved in sexual health care for women are briefly discussed.

The aims of the present study were to explore aspects of sexually transmissible infections (STI) prevention in general practice and to examine general practitioners' (GPs) perceived barriers to sexual-health promotion. The data from a postal survey of 409 GPs practising in New South Wales, Australia (response rate 45.4%) are analysed to explore the prevention of STI in general practice and to examine practitioners' perceived barriers to sexual-health promotion. About 49% of GPs reported having STI leaflets/pamphlets for patients in their clinic, while 21% had posters on STI displayed in their waiting room. Two-third (67%) of GPs provided STI-specific printed materials/leaflets to patients with STI. Female GPs were more likely to be proactive in STI prevention. Time and funding appear to be the major barriers to sexual-health promotion, followed by inadequate access to counselling. One-fifth (22%) of GPs felt that they had little influence in changing patients' risk behaviour, while about 28% emphasized the need for further preventive care training. The present study identifies inconsistencies in STI-prevention activities in general practice along with barriers to undertake sexual-health promotion. This area warrants further attention if GPs are to contribute fully to the control of STI.

Background: Over the last 50 years an increasing number of migrants have settled in Australia. These immigrants now constitute a large proportion of the Australian population, and some research suggests that they may be at high-risk for oral diseases. Methods: This paper presents data on the oral health status of a convenience sample of 721 ambulant Greek- (n=367) and Italian-born (n=354) adults aged 55 years or older. The volunteer participants were recruited through ethnic social clubs located in Melbourne, Australia. Results: The sample was largely a dentate one (83.6 per cent); with a mean DMFS score of 67.5 (s.d. 37.4). Dentate participants had 13 per cent of their restorative care unmet, and 57.3 per cent needed oral hygiene instruction plus removal of stain and hard deposits on their teeth. Almost 8 per cent required complex periodontal therapy and 30 per cent of those fully edentulous were in need of full dentures. Conclusions: Comparing these findings with existing data on oral health of older adults in Australia, the participants in this study appear to have lower DMFS scores and a higher prevalence of gingivitis, but less need for complex periodontal treatment. Inequalities were apparent in the proportion of unmet restorative and prosthetics needs.

Objective: This paper reports the impact of oral health on the quality of life (QOL) of Southern European, dentate older adults, living independently in Melbourne, Australia. Participants were recruited through ethnic social clubs and interviewed about oral health, general health, sociodemographics, and QOL using the Medical Outcomes Study Short-Form 12 (SF-12). The SF-12's physical and mental health component summary scores (PCS and MCS, respectively) were computed. The Oral Health Impact Profile (OHIP-14) assessed the specific impact of oral health on QOL. Participants were also given a clinical oral examination. Results: A total of 603 eligible older adults volunteered; 308 were from Greek background and 295 were from Italian background. Mean age was 67.7 years (SD 6.2), with 63.7% being female. The PCS score had a mean value of 45.8 (SD 11.8), and MCS had a mean of 47.8(SD 5.7). PCS was associated with, periodontal status, chronic health condition, self-perceived oral health needs, self-assessed oral health status, oral health impact score and the interaction between gender and level of education [F(11 552) ¼ 10.57; P < 0.0001]. These independent variables accounted for 16% of the variance in PCS. The multivariate model predicting MCS had only one significant variable (self-reported gingival bleeding), explaining 1.5% of the variance. The OHIP-14 ranged from 0 to 48 with a mean score of 5.6 (SD 9.3). The model predicting OHIP-14 contained four significant variables: perceived oral health treatment needs, number of missing natural teeth, reports of having to sip liquid to help swallow food, and gender [F(4576) ¼ 33.39; P < 0.0001], and explained 18% of the variance. The results demonstrated a negative association between oral health indicators and both the oral health related QOL and the physical component of the SF-12. Conclusion: The present findings support a growing recognition of the importance of oral health as a mediator of QOL. However, the self-selected sample and modest predictive power of the multivariate models suggest that further research is needed to expand this explanatory model.

Background: E-health has become a burgeoning field in which health professionals and health consumers create and seek information. E-health refers to internet-based health care and information delivery and seeks to improve health service locally, regionally and worldwide. E-sexual health presents new opportunities to provide online sexual health services irrespective of gender, age, sexual orientation and location. Discussion: The paper used the dimensions of the RE-AIM model (reach, efficacy, adoption, implementation and maintenance) as a guiding principle to discuss potentials of E-health in providing and accessing sexual health services. There are important issues in relation to utilising and providing online sexual health services. For healthcare providers, e-health can act as an opportunity to enhance their clients' sexual health care by facilitating communication with full privacy and confidentiality, reducing administrative costs and improving efficiency and flexibility as well as market sexual health services and products. Sexual health is one of the common health topics which both younger and older people explore on the internet and they increasingly prefer sexual health education to be interactive, non-discriminate and anonymous. This commentary presents and discusses the benefits of e-sexual health and provides recommendations towards addressing some of the emerging challenges. Future directions: The provision of sexual health services can be enhanced through E-health technology. Doing this can empower consumers to engage with information technology to enhance their sexual health knowledge and quality of life and address some of the stigma associated with diversity in sexualities and sexual health experiences. In addition, e-sexual health may better support and enhance the relationship between consumers and their health care providers across different locations. However, a systematic and focused approach to research and the application of findings in policy and practice is required to ensure that E-health benefits all population groups and the information is current and clinically valid and effective, including preventative approaches for various client groups with diverse needs.