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Women's health magazines emerged as a new cultural industry at the end of the twentieth century, representing a commercial application of the "will to health" developing in neoliberal societies. This paper explores recurring discourses in reader letters published between 1997 and 2000 in two Australian health magazines targeting white, middle-class women. Both GoodMedicine and Nature & Health are engaged in a similar cultural politics, tempting their audiences away from the established women's lifestyle, beauty, and fashion publications by representing health magazine content as natural, practical, and generally "good for you." Reader letters published in these magazines deploy the discourses of pragmatism, authenticity, and critical engagement as new cultural imperatives for performing the "normal, healthy woman." However, they offer little recognition of the social determinants of health, or the connections between individual practice and global biopolitics. Reader letters inscribe both the successes and failures experienced in performing the "will to health," and have considerable potential to facilitate new ways of negotiating these cultural imperatives.

The concepts of health and self have become intimately entangled in contemporary western society. Health is figured as a marker of identity, as a vehicle of self-production and self-actualisation, while the individual is also made increasingly responsible for his or her health. In this paper, we explore how "self" is constituted in discourses that shape the ways in which people understand and do health and medicine, particularly discourses of neoliberalism and of the immune system. Of interest here is how the productive and unpredictable intra-action of medicine and bodies may come to trouble these discursive selves. We situate our discussion in the context of efavirenz, an antiretroviral drug prescribed and consumed for the treatment of HIV infection. This drug, commonly described as "potent", can have a number of troubling effects on a person's everyday sense of self, including insomnia, confusion, cognitive disorders, depression, depersonalisation, psychosis, and suicidal ideation. While efavirenz may be clinically effective in its capacity to suppress the virus, these effects are at odds with the implicit aim of HIV medicine to restore and secure the self by way of immunological integrity and strength. These effects also bring into focus the predicament of choice under the contemporary political conditions of neoliberalism with its emphasis on health as an enterprise of the autonomous, rational self. In exploring first-person accounts, the paper unpacks a number of the binary concepts on which contemporary discourses of health and medicine rely, such as immunity and vulnerability, potency and fragility, rationality and madness, self and non-self, and asks whether the individual under neoliberalism is being asked the impossible.

This chapter draws on interviews with a diverse range of couples with mixed HIV status who took part in the qualitative YouMe&HIV study in Australia. A theme of 'trust in medicine' stood out across the twenty-five gay and straight relationships represented in the study. This concept has particular meanings in high income settings where there is an increasing attention being paid to preventing HIV transmission in serodiscordant couples through the use of new biomedical technologies. Our analysis found that trust in medicine revolved around trust in HIV pills, providers and partners. Running counter to the oft-cited phenomenon of a 'decline in public trust' in late modernity, trust emerged as a crucial element, because so much is at stake in these relationships, and because recent advances in HIV medicine open up new possibilities for these couples. We argue that itis important to take account of the lived experiences of serodiscordant couples in understanding the social dynamics of trust in advanced liberal democracies, and in developing new ways to strengthen and support trust relations among couples with mixed HIV status.

At a time when advances in biomedicine have rendered people with HIV non-infectious under certain conditions, much public discourse on HIV remains stuck in a paradigm of 'risk', which does little to lessen the divide between people with and without HIV in society or challenge the way intimate relationships across this divide are typically stigmatised as undesirable and problematic. We rarely hear the stories of couples who live with mixed HIV statuses and how they themselves perceive and manage their so called 'serodiscordance'. In this article, we examine such stories by mixed-status couples in Australia. In stark contrast to the dominant discourse, these couples invoked narratives of love, the everyday unimportance and manageability of HIV, and recent developments in HIV medicine, thereby challenging the way serodiscordant sexuality has been cast in public health research. Drawing on Ken Plummer's work on hidden sexual stories, we consider not only the content of their stories, but the broader significance of stories to the world in which they are enacted, of storytelling as a rally for social and political recognition and legitimacy. Reflecting on our own role in the co-production of research stories, we argue that by moving marginalised sexual stories out of silence, stigmatised communities and researchers can conjointly and incrementally shape a new public discourse and new forms of 'intimate citizenship'.

The community-based HIV media in Australia provide a unique arena for the negotiation of competing models of medicine between activists, clinicians, government and people living with HIV/AIDS. This article examines how these media have interpreted developments in HIV treatment strategies since the introduction of new treatments in 1996, and identifies the discursive elements employed in journalistic constructions of the temporality and character of HIV medicine. A discourse of ambivalence recurs throughout this journalism, framing the negotiated shifts in treatment strategies as evidence of the uncertainty and unpredictability of HIV medicine. Associated with this discourse are metaphors of medical ambivalence that employ provocative imagery such as fashion, rollercoaster, obstacle course and guessing game to shore up a notion of the volatility of HIV medicine. This article participates in ongoing engagements between the communities and clinicians affected by HIV/AIDS and, more broadly, in the production of knowledge around medicine and the media.

Background: The Indonesian response to HIV has been informed largely by quantitative evidence. This review examines what is known about the Indonesian HIV care cascade from published qualitative research. Methods: A 'scoping review' method was used to synthesise and interpret the findings of 17 eligible peer-reviewed publications. Results: Qualitative findings are reported in relation to two themes. Factors influencing successful engagement include a lack of HIV-related knowledge among clients, fear of stigma or lack of privacy/confidentiality at services, limited accessibility and affordability, and poor linkages between services. Factors affecting the broader response include a failure to adapt programs to specific socio-cultural settings, political issues in the distribution of donor funding, distrust and poor communication between service users and providers, the need for cultural privacy in particular community settings, and systemic experiences of gendered stigmatisation. Conclusions: Enhancing understanding of the Indonesian context would benefit from future qualitative research on HIV care in urban settings, describing the experiences of the most at-risk populations, and examining the role of clinics and providers in delivering HIV care in an increasingly decentralised health system.

Over a six week period in May-July 2005, The Sydney Morning Herald, Australia's largest-selling broadsheet newspaper, launched Campaign for Sydney to promote debate on sustainability issues in Australian cities. This was a unique project, presenting a variety of perspectives on how to "fix Sydney's water, air, land and transport", including comparative examples from cities around the world and contributions from newspaper audiences.This chapter examines the issue from the perspectives of the expert, the editor and the audience to this campaign. It briefly describes the history of sustainability in Australia, and the background and purpose of the campaign. A thematic analysis is then conducted of the seventy seven campaign pieces made available to an international audience via The Sydney Morning Herald website between 30 May and 18 June 2005. The authors conclude with reflections on key achievements and potential issues in launching an equivalent campaign in other environments.The media analysis is provided by Dr Christy Newman, with context provided by two key figures in sustainability politics in recent years. Professor Peter Newman was the Sustainability Commissioner for New South Wales from 2004 to 2006 and has a long history of actively facilitating whole-of-government commitment to sustainability benchmarks. Robert Whitehead was the architect of Campaign for Sydney and the editor of The Sydney Morning Herald from 2000 to 2005.

The social history of queer activism has always been tied to the unfolding story of queer families. From early battles with child welfare systems after a parent came out as gay or lesbian, to advocating for access to reproductive health services and comprehensive legal recognitions for same-sex parents, the rights of the LGBTIQ community to make and create families has been a focus of protest for decades. While many of those rights have now been achieved, there remain a range of persistent and emerging complexities which shape the family lives of sexually and gender diverse Australians. Drawing on both personal and professional reflections, each of our panellists will explore the question of 'who counts as a rainbow family today?' Jennifer Skattebol will firstly discuss her research on the increasing visibility of LGBTI families in early childhood services, and will also reflect on the politics and consequences of visibility she and her family experienced when they took part in the unexpectedly controversial documentary film Gayby Baby. Christy Newman will then reflect on how she hopes our representations of queer families will expand following the achievement of marriage equality, drawing on her own experiences of raising children as a bisexually-identified mum in a same-sex separated family. Cris Townley will then discuss her doctoral research on how LGBTI family identities influence participation in community playgroups, and will also reflect on her own experiences in navigating the tensions between identifying as a lesbian parent and raising a gender-diverse child. Finally, Alison Eaton will discuss some of the work that Rainbow Families is currently engaged in to support LGBTIQ families, including a highly anticipated crowd-funded resource to support Trans and Gender Diverse Parents. She and the rest of the panellists will discuss the challenges of remaining responsive to appreciating and supporting the full diversity of rainbow families, as their story continues to unfold.

Community-based health services which provide HIV care in Australia are typically known as 'gay-friendly', but little is known about what this might mean for engaging the broader diversity of people with HIV, particularly heterosexual men. We conducted a secondary analysis of qualitative interviews with key informants and clinicians to capture the meanings attributed to gay-friendly HIV clinics and to explore what these also reveal about the dynamics between sexual identity and HIV care today. Described as safe and welcoming for gay men, and promoting a politics of inclusion, the 'branding' of HIV health services as gay-friendly was also believed to have unintended effects, including the misconception that others are not welcome and that heterosexual men will stay away for fear of being misidentified as gay. Countering this were stories about heterosexual men who had challenged their own assumptions about HIV health services and clinicians who viewed the changing demographics of their patient population as both a challenge and an opportunity. Taking account of the shifting meanings ascribed to HIV health services is essential in responding to the changing needs of the positive community and in understanding the new cultural politics of the waiting room.

Summary: Interprofessional practice has been broadly endorsed as a strategy which supports the delivery of high-quality health services. Few studies have addressed the dynamics inherent to interprofessional mental health practice in an era in which client empowerment is prioritised and valued. Social work perspectives are also underexplored in the studies which have been published on interprofessional health care, despite the increasingly important role of this discipline in community mental health contexts. Through a thematic analysis of 26 semi-structured interviews, this study explored the perspectives of mental health social workers located in two geographically and culturally distinctive sites (Hong Kong and Sydney), and identified a strong theme encompassing their concerns about the facilitation of client empowerment in interprofessional settings. Findings: Participant accounts direct attention to the strategies required to co-constitute the shared territories of the different mental health professions. Findings also highlight the frustration with recent mental health reforms which aim to challenge power differentials in interprofessional decision-making. Strategies were proposed for supporting the construction of shared language among different professions, revealing the creativity and insight of practitioners in managing the conflicts arising from interactions between different professional knowledge systems. The comparison of Hong Kong and Sydney accounts highlights the importance of structural, political and cultural influences in supporting not only interprofessional collaboration but also the independence and effectiveness of distinct professional roles. Application: This article provides unique insights which aim to strengthen the contribution of social work to interprofessional practice in the promotion of empowerment-oriented interprofessional practice and education.

Objectives: This paper examines factors that enabled successful integration of testing for sexually transmissible infections into routine care in Aboriginal Community Controlled Health Services. Methods: This paper reports analysis of qualitative interview data recorded with 19 purposively sampled key informants in New South Wales, Australia, representing six Aboriginal Community Controlled Health Services and five government health bodies supporting those services. The analysis explicitly adopted a strengths-based approach. Results: Participants reported a strong belief that routine screening overcomes shame and increases engagement with sexual health screening. Incorporating sexual health screening into general medical consultations increases the capture of asymptomatic cases. The Medicare Benefits Schedule 715 Adult Health Check was highlighted as an ideal lever for effective integration into routine care. Conclusion: Integration of testing for sexually transmissible infections into routine care is widely perceived as best practice by senior stakeholders in Aboriginal healthcare in NSW. Findings support continued work to optimise the MBS 715 as a lever to increase testing. Implications for public health: Identifying accessible strategies to increase testing for sexually transmissible infections in Aboriginal Community Controlled Health Services can reduce disparities in notifications affecting Aboriginal young people.

Generational change is believed to be transforming the educational and employment preferences of medical trainees. In this article, we examine generational tensions in interviews with policy leaders and clinicians on workforce issues within one subset of the Australian medical profession: general practitioners who provide care to people with HIV in community settings. Integrating the accounts of policy leaders (n = 24) and clinicians representing the 'first generation' (n = 21) and 'next generation' (n = 23) of clinicians to do this work, shared and divergent perspectives on the role of generational change in shaping professional engagement were revealed. While those engaged in the early response to HIV believed younger clinicians to be less interested in the scientific and political dimensions of HIV care and more concerned about financial security and life balance, the next generation both countered and integrated these beliefs into new ways of conceptualising the value and appeal of this field of medicine. Critical appraisal of the assumptions that underpin generational discourse is essential in appreciating the changing views of providers over time, particularly in fields of medicine which have featured significant historical turning points.

Objectives HIV care is provided in a range of settings in Australia, but advances in HIV treatment and demographic and geographic changes in the affected population and general practitioner (GP) workforce are testing the sustainability of the special role for GPs. This paper explores how a group of 'key informants' described the role of the GP in the Australian approach to HIV care, and conceptualised the challenges currently inspiring debate around future models of care. Methods A thematic analysis was conducted of semistructured interviews carried out in 2010 with 24 professionals holding senior roles in government, non-government and professional organisations that influence Australian HIV care policy. Results The strengths of the role of the GP were described as their community setting, collaborative partnership with other medical and health professions, and focus on patient needs. A number of associated challenges were also identified including the different needs of GPs with high and low HIV caseloads, the changing expectations of professional roles in general practice, and barriers to service accessibility for people living with HIV. Conclusions While there are many advantages to delivering HIV services in primary care, GPs need flexible models of training and accreditation, support in strengthening relationships with other health and medical professionals, and assistance in achieving service accessibility. Consideration of how to support the GP workforce so that care can be made available in the broadest range of geographical and service settings is also critical if systems of HIV care delivery are to be realistic and cost-effective and meet consumer needs.

The population of people living with HIV in Australia is increasing, requiring an expert primary care workforce to provide HIV clinical care into the future. Yet the numbers of family doctors or general practitioners (GPs) training as community-based HIV medication prescribers may be insufficient to replace those retiring, reducing hours or changing roles. We conducted semi-structured interviews between February and April, 2010, with 24 key informants holding senior roles in organisations that shape HIV-care policy to explore their perceptions of contemporary issues facing the HIV general practice workforce in Australia. Informed by interpretive description, our analysis explores how these key informants characterised GPs as being 'moved' by the clinical, professional and political dimensions of the role of the HIV general practice doctor. Each of these dimensions was represented as essential to the engagement of GPs in HIV as an area of special interest, although the political dimensions were often described as the most distinctive compared to other areas of general practice medicine. Our analysis explores how each of these dimensions contributes to shaping the contemporary culture of HIV medicine and suggests that such an approach could be useful for understanding how health professionals become engaged in other under-served areas of medical work.

Research shows that some heterosexually identified men engage in sex with men; however, they remain largely hidden and little understood. Despite long-standing scholarly recognition that sexual identity and orientation do not always neatly coincide, the culturally normative heterosexual/homosexual binary tends to shape mainstream perceptions of such men as well as render them invisible in sexual health systems reliant on stable sexual identity categories. This invisibility, in turn, perpetuates the fiction of the binary. We explore perspectives on heterosexually identified men who have sex with men, drawing on recent research literature and on qualitative interviews with "key informants" in the Australian sexual health field who have frontline knowledge of these men. We consider the limitations of inventing a label to "encapsulate" these diverse men but also the significance of finding a language that meaningfully acknowledges their sexual realities and highlights heterosexuality as more varied and fluid than social attitudes and traditional sexual identity categories permit.