Christopher M. Fisher

Victoria University Melbourne | VU

Background: There is widespread recognition of the need to achieve equitable outcomes for all cancer survivors. This requires understanding of the experiences and outcomes of vulnerable groups. People who identify as sexually or gender diverse are known to be at risk of inferior cancer and survivorship outcomes, however, the posttreatment survivor...

Around the world trans and gender diverse people are marginalized and discriminated against in medical, psychological, and nursing care. This anthology is the first to address the current situation of this population in various global healthcare settings. The perspectives from 11 different countries give insight into the difficult experiences of th...

Background: Previous studies have tried to determine the relationship between sexting and risky behaviour to discover whether sexting fits into a deviance or normalcy discourse. This study investigated the relationship between sexting and sexual risk behaviours, contraception use and gender. Methods: The design was a cross-sectional analysis of...

Around the world trans and gender diverse people are marginalized and discriminated against in medical, psychological, and nursing care. This anthology is the first to address the current situation of this population in various global healthcare settings. The perspectives from 11 different countries give insight into the difficult experiences of th...

People who identify as lesbian, gay, bisexual, or transgender (LGBT) may experience differences in outcomes or experiences across the cancer pathway compared to the general population. This chapter describes the cancer trajectory of people who identify as LGBT in Australia and New Zealand, drawing on available evidence regarding cancer risk factors...

Literature widely acknowledges that women who experience Child Sex Abuse (CSA) have a higher risk of experiencing sexual revictimisation later in life, yet less is known about experiences of revictimisation in non-urban areas. The aim of this review is to examine what is known internationally regarding revictimisation of non-urban women, and to pro...

Introduction Teachers need training to provide high-quality sexuality education to adolescents. The recent release of a new Australian health curriculum provides a timely opportunity to examine the experiences of Australian sexuality education teachers since the release of this curriculum. Methods Australian teachers who had taught sexuality educa...

Introduction With new diagnostic technologies and treatment modalities available, more people than ever are living as cancer survivors in the USA, a large percentage of whom are breast cancer survivors. These new technologies and treatments have side effects that impact women’s sexual health during treatment and throughout long-term survivorship fr...

IntroductionLittle is known about the relationship between sexual health information-seeking practices of adolescents, knowledge and behaviour.The aim of this analysis was to characterise types of sexual health information-seeking adolescents in Australia and examine the relationship between those types and sexual health outcomes.Methods The cross-...

Introduction Relationships and sexuality education (RSE) for young people in Australia and elsewhere is a contentious topic. While focus has been on sexting practices, curriculum and policy and teachers and schools, few studies have examined how discourses of silencing are reflected in what young people want from their RSE. Methods Using thematic...

The original version of this article unfortunately contained an incorrect order of the authors.

The social construct of masculinity evolves in response to changes in society and culture. Orthodox masculinity is mostly considered to be hegemonic and is evidenced by the dominance of men over women and other, less powerful men. Contemporary shifts in masculinity have seen an emergence of new masculinities that challenge traditional male stereoty...

Objectives This study sought to explore perspectives of trans and gender diverse (TGD) people of ways to alleviate gender dysphoria in service provision and to develop a framework for application in health and other areas that can be used by researchers and service providers to design study protocols, assess organisations and enhance everyday pract...

Objectives To overcome key knowledge gaps in relation to justice involved and vulnerable young people and their sexual health and to compare this group with their peers from other youth health surveys in Australia to determine the extent of the issues. Methods Young people, aged between 14 and 17 years, who had ever been or were currently involved...

Purpose South Sudanese people form the largest number of resettled refugees in Australia between 2003 and 2004. This study aims to explore how this community understands and responds to health and illness. No study has specifically examined the concept of health and illness in the broader socio-cultural context of the South Sudanese people in Austr...

Background: Trans and gender-diverse people with a cervix experience difficulties accessing cervical cancer screening because of structural, interpersonal, and individual barriers. Objective: The aim of this study was to explore issues with cervical cancer screening participation, awareness, and healthcare provider recommendation for trans and g...

Relationships and sexuality education for young people in Australia and elsewhere is a controversial topic. Numerous studies in Australia have focused on curriculum, policy, teachers, schools, sexting and other behaviours, and knowledge regarding sexually transmitted infection (STI)/human immunodeficiency virus (HIV) and pregnancy prevention. Few l...

Background: The development of effective health promotion practices and education programs to reduce rates of sexually transmitted infections and unintended pregnancy requires accurate, up-to-date information about young people's sexual behaviors. Aims: To provide prevalence rates on sexual behaviors and condom and contraceptive use for Australi...

Background: There is little research that addresses the needs of trans and gender diverse people with cancer. Emerging evidence shows unique concerns, particularly in relation to gendered cancers such as breast and gynecological. Objective: The aim of this study was to explore the intersubjective experiences in cancer care of trans and gender-di...

Introduction: Chronic hepatitis B presents significant issues to public health and clinical practices. The infection requires lifelong clinical management and is a leading risk factor for liver cancer and liver cirrhosis. Limited studies currently exist on the social impacts of living with chronic hepatitis B, especially for people from Sub-Saharan...

Parent–child communication about gender and sexuality has received increasing attention since the late 1990s, in response to growing awareness that open dialogue plays a vital role in sex and relationships education, and improving sexual health outcomes for families and young people. However, the insights gained from this literature have been under...

Effective school-based relationship and sexuality education (RSE) can improve youth sexual outcomes, including knowledge and behaviour. National pedagogical guidance in the form of the Australian Curriculum: Health and Physical Education (AC: HPE), which includes RSE, was released in 2015. This study sought to determine the sexual health knowledge...

The aim was to explore issues in relation to accessing cancer care for the Australian trans and gender diverse community through key informant interviews to inform a larger study on the topic. Semi-structured interviews were conducted with key informants who either had clinical and/or research experience with trans and gender diverse populations or...

The Trans Health and Cancer Care Study was conducted in 2018-19 and involved 537 trans and gender diverse (TGD) people from across Australia over the age of 18. Results of the study highlight ongoing challenges faced by TGD persons in Australia in their experiences of gender affirmation, accessing healthcare and their awareness and participation in...

Introduction: Since 1992 the Australian Government has funded a periodic national survey of HIV and Sexually Transmissible Infection (STI) knowledge and sexual risk behaviour among secondary school students. Adolescents continue to be a priority population in public health efforts to reduce rates of STIs in Australia. The purpose of the survey is t...

This inquiry examines health-seeking practices and challenges among South Sudanese people from refugee backgrounds with chronic hepatitis B in Australia. Fifteen semi-structured interviews were conducted. Using interpretative thematic analysis, the results revealed four themes, consisting of barriers and facilitators to clinical follow up, treatmen...

This report presents the findings of the National Survey of Australian Secondary Students and Sexual Health 2018 , the 6th iteration of the survey. The findings highlight the knowledge, behaviours, and education young people in Australia have about their sexual health and sexual health practices.

Sex education both in and beyond the classroom has been shown to have the potential to ameliorate negative sexual health outcomes for adolescents. School-based sex education and sexual health services targeting young people should be informed, in part, by teenagers themselves. Semi-structured interviews were conducted with 41 young people aged 13–2...

Sexuality education is a trusted source of information and guidance for adolescents and young people on sexual health, sexuality and relationships, and it can improve the sexual health of this population. Such education is most effective when informed by the views of young people themselves; however, there is limited research that investigates youn...

This article examines the sexuality education component of the national Australian Curriculum: Health and Physical Education (AC: HPE) with a focus on sexuality education discourses. A critical discourse analysis explored official AC:HPE documents in relation to sexuality education; the sexuality education discourses present within these documents;...

Introduction: Support of others is a key factor for mothers who choose to breastfeed their infants, including those who balance work outside the home and breastfeeding. However, little research has been done to understand how maternal support during the postpartum period impacts mothers' ability to later balance work and breastfeeding, in particul...

Purpose: This study assessed within a Midwestern LGBT population whether, and the extent to which, transgender identity was associated with elevated odds of reported discrimination, depression symptoms, and suicide attempts. Methods: Based on survey data collected online from respondents who self-identified as lesbian, gay, bisexual, and/or transge...

Background: Youth development professionals (YDPs) working at community-based organizations (CBOs) can promote adolescent sexual health through programs. This study explored the programs and resources that youth access at CBOs and training YDPs receive. Methods: Twenty-one semi-structured interviews were conducted with YDPs. Qualitative content...

Youth development professionals (YDPs) working at community-based organizations are in a unique position to interact with the adolescents because they are neither parents/guardians nor teachers. The objectives of this study were to explore qualitatively what sexual health issues adolescents discuss with YDPs and to describe those issues using the f...

Purpose: Researchers have documented that lesbian, gay, bisexual, and transgender (LGBT) people have a higher proportion of tobacco use as compared to general population smoking rates. This study examined the relationships between tobacco use and social determinants of health in a sample of self-identifying LGBT people who spend time in Nebraska....

A community's readiness for change is a precursor to the effective application of evidence-based practices for health promotion. Research is lacking regarding potential strategies to improve readiness to address obesity-related health issues in underserved communities. This case study describes SaludABLEOmaha, an initiative to increase readiness of...

Purpose: Previous research has documented that lesbian, gay, bisexual, and transgender (LGBT) people have a higher proportion of tobacco use when compared to their non-LGBT counterpart. The purpose of this study was to examine the relationship between tobacco use and the social determinants of health in a sample of self-identifying LGBT people who...

Background: HIV testing is an important tool for addressing the HIV epidemic. Social engagement, outness, and experiences with violence have been identified as predictors of HIV test-seeking in metropolitan US populations. In rural contexts, further research is needed to describe the determinants of HIV test-seeking behavior. Methods: An online c...

Background: What happens at the intersection of sexuality and cancer survivorship is important to cancer survivors and co-survivors. Survivors of breast and gynecological cancers often experience disruptions to body image, sexual function, and hormonal levels that are common after surgery, during treatment, and years into survivorship. These fluctu...

Background. U.S. adolescent sexual health remains suboptimal. Research suggests community-based organizations (CBOs) and youth development professionals (YDP) represent an important and willing channel for addressing this problem; however, they frequently lack the education and support resources to do so effectively. Objective. To evaluate web-de...

Issues: Men who have sex with men (MSM) continue to have the highest rates of HIV in the US. The National HIV/AIDS Strategy calls for scalable community-level interventions to reduce new infections. To that end, a social marketing intervention for HIV prevention among MSM was developed in a Midwestern city using community-based participatory resear...

Previous studies demonstrated the utility of the minority stress model in understanding health disparities for lesbian, gay, bisexual, and transgender (LGBT) populations. Since most research has considered large metropolitan areas, predominantly in coastal regions of the United States, this research focuses on a midwestern state, Nebraska. This stu...

Abstract The aim of this investigation is to outline correlates of suicide ideation among LGBT individuals living in Nebraska. A community-based participatory research approach was utilized to develop a 30-minute, online anonymous survey. Almost half of the sample had seriously considered suicide at some point in their lives. Significant correlates...

Abstract Research into the health and well-being of rural lesbian, gay, bisexual, and transgender (LGBT) populations is limited. A CBPR approach was used to develop an online survey for LGBT Nebraskans. The 770 participants replied to an array of questions on social determinants of health and basic health outcomes. Only significant differences in h...

Disproportionately high rates of sexually transmitted infection and unplanned pregnancy among adolescents suggest the continuing need for evidence-based sexuality education. Community-based organizations (CBOs) and their youth development professionals (YDP) have significant potential to promote adolescent sexual health; however, recent research in...

Background: Research into the provision of sexual health information for youth has demonstrated inadequate school support and little to no information exchange between parents and their children. Community leaders have suggested and research has demonstrated that youth-serving community-based organizations (CBOs) and the youth development professio...

Objectives: Emerging data suggest that HIV disease and its treatment affect the aging process. Accurate and reliable measures of functional status are needed to investigate this further. Design: A pilot study in groups of younger and older HIV-infected adults using objective measures of function. Methods: Evaluations included neuropsychologica...

Background: Many Midwestern states and municipalities do not have employment non-discrimination protections for lesbian, gay, bisexual, and/or transgender (LGBT) persons. In February 2012, an ordinance to create job discrimination protections for LGBT persons was re-introduced to a Midwestern city council in the largest city in the state. Program...

Background: Transgender individuals remain under-studied in social science research. These individuals frequently report feelings of marginalization within LGBT and heterosexual communities, and often experience poor health outcomes. This study aims to provide an overview of the social, physical, and well-being of transgender Nebraskans. Methods:...

Objective To determine the impact of missed visits on CD4 cell count with HIV disease in a Midwest clinic. Methods This was a mixed method study consisting of a quantitative retrospective cohort study of missed clinic visits among HIV-infected patients, and a qualitative study to collect information on factors impacting appointment attendance. A d...

Background: Few studies on HIV knowledge and testing behaviors have been conducted in the Midwest with the exception of large cities (i.e., Chicago). This study sought to describe the relationships between HIV knowledge and testing behavior, depression and outness in Nebraska, a predominantly rural, low-incidence state, among self-identified Gay, B...

Background: The promotion of monogamous relationships has been recognized as a feasible strategy reducing the risk for HIV and sexually transmitted infections (STI). This strategy presents challenges for lesbian, gay, bisexual, and transgender (LGBT) couples who often lack the option of legally recognized relationships. This study examined differen...

Background: Research finds determinants of high levels of suicide behaviors in lesbian, gay, bisexual, and transgender (LGBT) populations to be similar to those for HIV risk. The aim of this investigation is to outline possible predictors of considering suicide among LGBT individuals living in a Midwestern, low-resource predominantly rural state....

Background: Sexual orientation may influence the type of specific screenings recommended by health care providers (HCP). This study examined gay men and bisexual men and women's disclosure of sexual orientation to their HCP to see if any differences could be seen in HIV and STD testing behaviors. Methods: A community-based participatory research ap...

Background: Previous research conducted in the Midwest shows that self-acceptance of sexual/gender identity (i.e. internalized homophobia) has a significant impact on the mental and physical health of Lesbian, Gay, Bisexual, and Transgender (LGBT) individuals. This research has taken place in large urban areas; little is known about how self-accept...

Background: Many public health agencies struggle with reaching populations of men who have sex with men (MSM) in HIV testing campaigns. This study of Midwest gay and bisexual men in a predominately low-resource, rural, and socially conservative state identified venues through the social engagement scale and their relationship to HIV testing behavio...

Background: Six coordinated school-based health centers (SBHCs) were launched in underserved areas of a Midwestern city to enhance health access and academic success among students. The six SBHCs serve primarily low-income, culturally diverse student populations. Purpose: To report findings from a needs assessment in SBHC catchment communities desi...

Many scholars and practitioners have advocated for a more ecological approach to sexual health promotion for adolescents, such as one that includes involvement from schools, parents, and community organizations. Although extensive research has been conducted with schools and parents, little is known about the roles community-based organizations (CB...

Background: Hunger is a staggering problem that exists in Nebraska, a primarily rural state, and across the United States. Few studies have comparatively looked at the role of food pantries in a rural/urban context. The purpose of this study is to compare characteristics of rural and urban organizations providing emergency food services and present...

Background: HIV is a documented issue for persons from Burma. While research exists for those living just outside of Burma, little is known about HIV knowledge and risk behaviors for US Burmese refugees who have begun the acculturation process. This exploratory study investigates HIV-related knowledge and risk behaviors of Burmese refugees in Fort...

Issues: Latinos, the fastest growing US demographic, are experiencing rapidly growing rates of HIV infection. In addition to the stigma MSM already face, Latino MSM are marginalized due to racism, poverty and their own cultural values. Yet to be researched is the unique socio-cultural context for Latino MSM in smaller, Midwestern cities where past...

BACKGROUND: In regions where MSM-specific resources are decentralized, community-based participatory research (CBPR) methods can build on existing community relationships to access hard-to-reach individuals. Using a CBPR approach, data on sexual compulsivity, sexual partner-seeking, and sexual behavior were collected from MSM to explore patterns of...

Background: Research shows that lack of support from the medical community on LGBT health needs assessment, awareness and acceptance by healthcare professionals, as well as, contribute to LGBT individuals' reluctance to seek health care. This study looked at perceived discrimination from beyond the health care setting and its effects on LGBT health...

While debates about adolescent sexuality education persist in the United States, little attention has been paid to adult sexuality education. Research suggests that teachable moments may be present in interactions between adult bookstore employees and the consumers who shop at these venues. The purpose of this study was to explore the potential for...

Adolescents in the United States continue to face sexual health issues. While community-based organizations (CBOs) have a long history of addressing the sexual health needs of those they serve, little attention has been given to CBOs focused on adolescent populations and the role youth development professionals (YDPs) might play in the advancement...

Background: There are limited resources that facilitate the provision of accurate sexual health information for adult women. Each year, millions of women attend in-home sex toy parties and research suggests these may provide opportunities to address the sexual health information needs of this population. Yet, little information exists that document...

Abstinence-only-until-marriage sexuality education has received increasing attention vis-à-vis policy, funding, and research. Despite large sums of federal money to develop, implement, and to some extent, assess abstinence-only education, virtually no studies have looked to assess the experiences of such a curriculum for gay and bisexual male youth...

BACKGROUND: Past research has focused on the availability, efficacy, and content of sexual health education curriculum at the primary, secondary, and collegiate levels. Policy debates have focused primarily on the content of curriculum. Missing from practice, research, and policy is a theoretically derived, pedagogy for sexual health education. M...

BACKGROUND: Public health professionals know the importance of organized youth groups targeting lesbian, gay, bisexual, and transgender (LGBT) individuals in increasing behavior-specific knowledge of HIV/AIDS and reducing disparities which lead to increased risk of infection. To date, no known studies have attempted to ascertain the longer-term rel...

BACKGROUND: Practitioners often associate number of sexual partners with risk of infection for STI including HIV. Little empirical evidence exists to support or refute this belief. METHODS: Data were collected from 504 MSM in a large Midwestern US city. Variables included number of sexual partners in the past 90 days, STI status within the last 2...

To assess relations between sexual compulsivity and a history of sexually transmitted infection (STI) diagnosis and testing among a community-based sample of men who have sex with men (MSM) in a mid-size urban area of the midwestern United States. Sexual health data were collected from 504 MSM in the metropolitan area of Indianapolis, Indiana, usin...

Among men who have sex with men (MSM), sexual compulsivity has been associated with higher frequencies of sexual behaviors that may increase risk for transmission of HIV and other sexually transmitted infections (STI). In a Midwestern region where social and community resources for MSM are relatively diffuse, the patterns of partner-seeking and sex...