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RESEARCH ARTICLE

Prevalence of HIV among Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis

Simon Graham A G , Catherine C. O’Connor B C D , Stephen Morgan E , Catherine Chamberlain F and Jane Hocking A

A Centre for Epidemiology and Biostatistics, School of Population and Global Health, 207 Bouverie Street, The University of Melbourne, Melbourne, Vic. 3052, Australia.

B Sexual Health Service, Community Health, Sydney Local Health District, 16 Marsden Street, Camperdown, NSW 2050, Australia.

C Kirby Institute, Wallace Wurth Building, UNSW Australia, High Street, Kensington, Sydney, NSW 2052, Australia.

D Central Clinical School, Sydney Medical School, Missenden Road, University of Sydney, NSW 2050, Australia.

E Positive Life NSW, 414 Elizabeth Street, Surry Hills, NSW 2010, Australia.

F Baker IDI Heart and Diabetes Institute, 75 Commerical Road, Melbourne, Vic. 3004, Australia.

G Corresponding author. Email: simon.graham@unimelb.edu.au

Sexual Health - http://dx.doi.org/10.1071/SH16013
Submitted: 21 January 2016  Accepted: 1 December 2016   Published online: 6 February 2017

Abstract

Background: Aboriginal and Torres Strait Islanders (Aboriginal) are Australia’s first peoples. Between 2006 and 2015, HIV notifications increased among Aboriginal people; however, among non-Aboriginal people, notifications remained relatively stable. This systematic review and meta-analysis aims to examine the prevalence of HIV among Aboriginal people overall and by subgroups. Methods: In November 2015, a search of PubMed and Web of Science, grey literature and abstracts from conferences was conducted. A study was included if it reported the number of Aboriginal people tested and those who tested positive for HIV. The following variables were extracted: gender; Aboriginal status; population group (men who have sex with men, people who inject drugs, adults, youth in detention and pregnant females) and geographical location. An assessment of between study heterogeneity (I2 test) and within study bias (selection, measurement and sample size) was also conducted. Results: Seven studies were included; all were cross-sectional study designs. The overall sample size was 3772 and the prevalence of HIV was 0.1% (I2 = 38.3%, P = 0.136). Five studies included convenient samples of people attending Australian Needle and Syringe Program Centres, clinics, hospitals and a youth detention centre, increasing the potential of selection bias. Four studies had a sample size, thus decreasing the ability to report pooled estimates. Conclusions: The prevalence of HIV among Aboriginal people in Australia is low. Community-based programs that include both prevention messages for those at risk of infection and culturally appropriate clinical management and support for Aboriginal people living with HIV are needed to prevent HIV increasing among Aboriginal people.

Additional keywords: human immunodeficiency virus, Indigenous, sexual health, sexually transmissible infections.


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