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project overview

 

Name of Project

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

Project Status

Ongoing

Ethics approval

SPH-13-2012

Chief Investigators

Gemma Crawford, Bruce Maycock, Roanna Lobo, Graham Brown

Timeframe of Project

2010-

Brief overview

Mobility is a factor in an increase in the incidence of overseas acquired HIV in Western Australia. South-East Asia is a common place of acquisition, with a number of infections identified amongst Australian male expatriates and long-term travellers. Research has indicated that a strong expatriate culture and networks exist outside of the Australian environment. There is however, a dearth of information regarding the local relationships formed by expatriates and travellers and the effects that these social networks have on their health. 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. The aim of the research is to investigate whether Australian expatriate social networks can be used to support peer education and social influence interventions to reduce sexual health harms including HIV/STIs.

Objectives

  • To build a deeper contextual understanding of culture2 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 travellers, including the application of group and social network analysis research.

Funding

  • WA Department of Health Sexual Health and Blood Borne Virus Program
  • NT Health

SiREN’s role

SiREN has supported the project via supervision.

Project outputs and impacts

The role of expatriate and long-term traveller networks and their potential to impact health are untested. This is a new area of research which provides the opportunity to develop novel ways of thinking about the application of grounded theory and sense-making about changes to the HIV epidemic and those at risk. The chosen methodology can develop typologies to gain insight into expatriate and traveller behaviour. Further, it can illustrate how to locate and identify champions as change agents to address key health and social issues experienced by expatriates and longer term travellers. The significance of the research lies in its ability to gather contextual data that will inform the development of interventions for HIV and STI risk reduction programs which would significantly contribute to prevention strategies in WA. Exploration of the social networks of expatriates and long term travellers in Thailand including: developing an understanding the expatriate subgroups that exist and the way in which entry into the subgroups occurs; understanding the socialisation process, and perceptions of risk; understanding significant symbols, for examples those with shared meanings that may impact upon risk assessment; may provide findings that assist to develop peer based strategies which may be of use in other locations which experience high rates of overseas acquired HIV.

It will also contribute the body of knowledge regarding social networking and risk behaviour in WA and Australia. The role of social networks and the interaction within and between those networks may provide other opportunities for health promotion and public health interventions including in to mental health and alcohol and other drug use. The research may also provide a possible basis for larger studies based on social network analysis. This study will develop recommendations for government, non-government and research organisations regarding intervention methods. It is anticipated that a more cohesive and national response to the issue of HIV and mobility will be forthcoming including funding for research at a national and state level. Travellers will continue to be a key priority population for the next Australian national HIV strategy and the current study can provide context and tangible outcomes for research, policy and practice.

Publications

Crawford G, Lobo R, Brown G, Macri C, Smith H, Maycock B. 2016. HIV and STIs amongst expatriates and travellers to low and middle income countries: A systematic review. International Journal of Environmental Research and Public Health 13(12), 1249.

Crawford G, Lobo R, Brown G, Maycock B. 2016. The influence of population mobility on changing patterns of HIV acquisition: lessons for and from Australia. HPJA 27(2) 153-154

Crawford G, Bowser N, Brown G, Maycock B. 2013. Exploring the potential of expatriate social networks to reduce HIV and STI transmission: a protocol for a qualitative study. BMJ Open, epub.