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NEXUS: Investigating Australian male expatriate and long term traveller social networks in SOUTHEAST ASIA to determine their potential to influence HIV and other STI risk behaviour

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Year: 2010 - present.

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Funding details: WA Department of Health Sexual Health and Blood Borne Virus Program, NT Health and Department of Health, Northern Territory.

 

Project team: Dr Gemma Crawford (main contact, Curtin University), Prof Bruce Maycock (Curtin University), Dr Roanna Lobo (Curtin University), A/Prof Graham Brown (UNSW), Corie Gray (Curtin University), members of the CoPAHM network.

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The context: Population mobility is a factor in the increasing incidence of overseas acquired HIV in Western Australia (WA). Southeast Asia (SEA) is a common place of acquisition, with a number of infections identified amongst Australian male expatriates, longer-term and frequent travellers (ELoFTs). Research has indicated that strong Australian ELoFT culture and networks exist outside Australia but there is little information regarding the local relationships formed by ELoFTs and the effects that culture and social networks have on their health.

 

The project: The characteristics of those acquiring HIV overseas and the settings of these acquisitions warrant further exploration to develop effective interventions to reduce HIV and STI risk in these contexts. This grounded theory study seeks to understand social network processes of Australian male expatriates, longer-term or frequent travellers (ELoFTs) to SEA. The research also seeks to explore how ELoFT social networks may be harnessed for public health intervention to address HIV and more broadly, other STIs, particularly via peer education and social influence; a cornerstone of Australia’s historical HIV response. Symbolic interaction provided the theoretical lens for this study.

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Objectives:​

  • To build a deeper contextual understanding of culture and personal behaviour amongst Australian expatriates in Thailand.

  • To describe the socialisation process and pathways experienced by Australians (potential new expatriates) interacting with Australian expatriates in Thailand.

  • To investigate the roles of Australian expatriates as mentors and potential change agents within expatriate social networks in Thailand.

  • To construct a theory explaining the development of social networks amongst Australian expatriates and frequent/longer term travellers, and their capacity to support peer education and social influence interventions to reduce sexual health harms including HIV and other STIs.

  • To make recommendations for further research and intervention research targeting expatriates and frequent or longer term travelers, including the application of group and social network analysis research.

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Project impacts: This research provides the opportunity to develop novel ways of thinking about the application of grounded theory and symbolic interactionism and sense-making about changes to the HIV epidemic and those at risk. Thus far data has been collected via a systematic literature review; in-depth interviews with ELoFTs; observations of users of an online ELoFT forum and analysis of posts; fieldwork visits to Thailand including setting and venue observations and informal conversations with stakeholders. An explanatory conceptual model has been developed to support the grounded theory. This study is developing recommendations regarding intervention methods and a better contextual understanding of the target group and their attitudes, knowledge and behaviours that may make them vulnerable for HIV and other STI risk. Project findings have been used to contribute to the development of a more cohesive and national response to the issue of HIV and population mobility as it relates to ELoFTs.

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Publications:​

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Presentations and Posters:​

  • Gray C, Crawford G, Lobo R. 2017. Using a community of practice to facilitate collaborative work in HIV and mobility. Curtin University School of Public Health Seminar. Perth, Australia. (Presentation)

  • Gray C, Crawford G, Lobo R. 2017. Using online communities of practice to facilitate collaborative work in HIV and mobility. 15th World Congress on Public Health. Melbourne (Presentation)

  • Crawford G. 2016. Making the healthy choice the easy choice: not that easy. WA Health Translation Networks Public Health and Health Promotion Workshop. Perth, Australia (Invited Presentation)

  • Crawford G, Lobo R, Gray C, Brown G. 2016. HIV and Mobility in Australia: Road Map for Action update. SiREN Symposium. Perth, Australia (Presentation) https://www.youtube.com/watch?v=PeFgrd_fEm0

  • Gray C, Brown, Crawford G, Lobo R. 2016. HIV & Mobility in Australia. AFAO HIV & Mobility Forum. Sydney, Australia (Invited speaker).

  • Lobo R, Brown, Crawford G, Gray C. 2015. HIV and Mobility in Australia: Launch of the Interim Report Card. Australasian HIV and AIDS Conference. Brisbane, Australia (Oral session and posters).

  • Brown G, Crawford G, Lobo R. 2015. HIV and Mobility in Australia: A Roadmap for Action. Inaugural International Conference on Migration Social Disadvantage and Health. Melbourne, Australia (Presentation)

  • Crawford G, Lobo R, Brown G, Maycock B, McCausland K. 2014. Australian Travellers, Relationships & Risk: exploring the nexus. HIV & Mobility Satellite. Perth, Australia (Presentation)

  • Langdon P, Lobo R, Crawford G, Brown G.  2014. HIV & Mobility Discussion Paper. HIV & Mobility Satellite. Perth, Australia (Presentation)

  • Crawford G, Lobo R, Brown G, Maycock B, Tobin R, McCausland K. Rites & Responsibilities: exploring digital discourse of Australian expats/travellers. 2014. PHAA 43rd Annual Conference: The future of public health: big challenges, big opportunities. Perth, Australia (Presentation)

  • Crawford G, Langdon P, Lobo R. Fast & Cheap’: travel, HIV and public health responses. 2014. PHAA 43rd Annual Conference: The future of public health: big challenges, big opportunities. Perth, Australia (Poster)

  • Langdon P, Lobo R, Crawford G. Beyond border control? HIV, migration and public health policy. 2014. PHAA 43rd Annual Conference: The future of public health: big challenges, big opportunities. Perth, Australia (Poster)

  • Crawford G, Lobo R, Brown G, Maycock B, Tobin R. 2014. Risk, Rites and Responsibilities: Digital discourse among Australian expats and travellers in South East Asia. SiREN Symposium. Perth, Australia (Presentation)

  • Langdon P, Lobo R, Crawford G. Globalisation, Mobility and HIV: Implications for HIV prevention and care in WA. 2014. SiREN Symposium. Perth, Australia (Presentation)

  • Crawford G, Langdon T. 2009. Responding to Increases in Overseas Acquired HIV Diagnoses in WA Go West: Australian Health Promotion Association 18th National Conference. Perth, Australia (Presentation)

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