Paul Byron

General practice intervention to increase opportunistic screening for chlamydia

We describe an 18-month intervention that was designed to improve opportunistic screening for chlamydia in General Practice. Key strategies included engaging and informing general practitioners, adopting a simplified screening protocol, providing feedback on practice testing performance and developing resources for use with patients. This uncontrolled before and after study found that the overall impact on testing was modest and largely transient, and was insufficient to impact on the current chlamydia epidemic. Major additional measures would be required to further substantially increase testing levels. These could include financial incentives linked to screening performance and increased community awareness to increase patient demand for testing.

“Fitness for duty”: Social, organisational and structural influences on the design and conduct of candidate hepatitis C vaccine trials involving people who inject drugs

Several candidate vaccines for hepatitis C are currently in preclinical development or the early stages of clinical trials. Implementing trials of these vaccines among people who inject drugs will be challenging. Previous research, particularly willingness to participate studies in relation to HIV vaccines in marginalized groups, has focused on the modifiable characteristics of individual participants. This qualitative research with people who inject drugs, health staff and clinicians focuses on social, organisational and structural elements of vaccine trial designs which may exclude or reduce the participation of people who inject drugs.

Safe on My Phone? Same-Sex Attracted Young People’s Negotiations of Intimacy, Visibility, and Risk on Digital Hook-Up Apps

This article draws on focus group interviews with same-sex attracted Australian men and women aged 18-29, to reflect on their accounts of the perceived risks and opportunities offered by hook-up apps such as Grindr, Blendr, and Hornet. Until recently, scholarly accounts of same-sex attracted men hooking up online have primarily focused on measuring the safety of sexual encounters in relation to HIV and “risky” sexual practices. This article extends previous health-related studies by considering the ways that the exchange of sexually explicit digital self-portraits (or selfies) feature within digital sexual negotiations and also exploring same-sex attracted women’s perceptions of safety and risk in relation to dating and hook-up apps and websites. It draws on recent scholarship on Grindr and other geo-locative hook-up apps to explore the material role that mobile phones and apps play in establishing a sense of safety, intimacy, and/or risk within flirtations and sexual interactions and the ways that young people’s “off-label” (or non-sexual) uses of hook-up apps might facilitate (and diminish) their sense of queer identity and visibility.

That Happened to Me Too: Young People's Informal Knowledge of Diverse Genders and Sexualities.

Abstract This paper explores how young people of diverse genders and sexualities share information about sex, sexualities and genders. Formal approaches to education often fail to consider young people’s communication and information exchange practices, including the circulation of peer knowledge through social media. In the wake of recent Australian backlash against the Safe Schools Coalition, we can observe how homophobia and queerphobia in the broader community can impact upon young peoples’ ability to learn about themselves and their bodies through formal education. Yet young people of diverse genders and sexualities can be observed to support each other in peer spaces, utilising their knowledge networks. This paper explores young people’s informal learning practices, the capacity of peer networks to support and educate young people, and the challenges of recognising such networks in a culture in which health and education discourses present them as ‘risk subjects’ rather than ‘health agents’. These issues are discussed in relation to our own experiences in research and health promotion, including one author’s role as a youth peer educator. Drawing on our workplace experiences, we provide a number of anecdotal examples which highlight the complexities of informal knowledge practice and information circulation, and the ways these can challenge and reform professional health, education, and research approaches.

Troubling expertise: social media and young people’s sexual health

Social media are integral to young people’s everyday lives, and sexual health promotion strategies seek to capitalise on this. Drawing from recent health promotion research and digital media ethnographies, this article considers research discourses of social media use by young people and health professionals. While health promotion commonly engages with social media as a ‘setting’ for the dissemination of static information, this neglects the participatory aspects of social media and overlooks young people’s digital media competencies. Focus groups with young people further highlight these competencies, the centrality of friendship in social media, and the stigma of sharing formal sexual health information. Considering these literature and data, this article draws from post-structural theories of knowledge to consider how formal ‘expertise’ is leveraged through the subjugation of young people’s knowledge, and how this is problematic for sexual health promotion seeking to engage with young people through social media.

Queering Sexting and Sexualisation

Recent Australian research on ‘sexting’ (the production and exchange of naked and semi-naked digital pictures) has observed that formal legal and educational discourses have failed to fully account for young peoples understandings and experiences. While there is a proliferation of scholarly and popular texts focusing on the risks that sexting might pose to young (heterosexual) women, there is a relative absence of academic, educational or popular discourse acknowledging same sex-attracted young peoples participation in cultures of creating and sharing pictures via dating and hook-up apps. This article draws on focus-group interviews with young people in Sydney (aged 18–26) to present alternative accounts of sexting, and reflect on same sex-attracted men and womens strategies for negotiating safety and risk within online and offline sexual cultures.

Friendship, sexual intimacy and young people’s negotiations of sexual health

Abstract This paper examines how young people’s friendships influence safer sexual practices. Through a thematic discourse analysis, interviews with Sydney-based young people (aged 18–25 years) and Australian-based sexual health websites for young people are considered. Interview data illustrate how friendships can support young peoples sexual experiences, concerns and safeties beyond the practice of ‘safe sex’ (condom use). This is evident in friends’ practices of sex and relationship advice, open dialogue, trust and sharing experiential knowledge, as well as friend-based sex. Meanwhile, friendship discourse from selected Australian sexual health websites fails to engage with the support offered by friendship, or its value to a sexual health agenda. Foucault’s account of friendship as a space of self-invention is considered in light of these data, along with his argument that friendship poses a threat to formal systems of knowing and regulating sex. Whether sexual or not, many close friendships are sexually intimate given the knowledge, support and influence these offer to one’s sexual practices and relations. This paper argues that greater attention to friendship among sexual health promoters and researchers would improve professional engagements with young people’s contemporary sexual cultures, and better inform their attempts to engage young people through social media.

The intimacies of young people’s sexual health and pleasure

ABSTRACT This paper considers the discourse of intimacy in young people’s accounts of sexual health. In interviews with people from Sydney aged 18–25 years, diverse understandings of sexual safeties are offered, reflecting a range of sex partner intimacies. This is seen in participants’ accounts of having a range of different partners, having different experiences with a particular partner, and having sex with friends. This discourse is considered against Australian sexual health websites for young people. In the websites, connections between safeties and intimacies are not explored, and discussion of safety is limited to condom use, as per the concept of ‘safe sex’. How condom use is supported and/or challenged by sexual and friendship intimacies is overlooked. In considering research claims about the missing discourse of pleasure in formal approaches to young people’s sexual health, I extend this to a missing discourse of intimacy. Connections between pleasure, intimacy, safety, and friendship are explored throughout this paper, and theorisations of intimacy as cultural, public, and intersubjective are considered, drawing upon the works of Lauren Berlant and Eva Illouz. It is argued that sexual health research and promotion that engages with young people’s conceptualisations of intimacy will better engage with young people’s sexual cultures, and hence be more relevant and useful to this population.