Background: Youth peer-led interventions have become a popular way of sharing health information with young people and appear well suited to Indigenous community contexts. However, no systematic reviews focusing on Indigenous youth have been published. We conducted a systematic review to understand the range and characteristics of Indigenous youth-led health promotion projects implemented and their effectiveness. Methods: A systematic search of Medline, Embase, and ProQuest Social Sciences databases was conducted, supplemented by gray literature searches. Included studies focused on interventions where young Indigenous people delivered health information to age-matched peers. Results: Twenty-four studies were identified for inclusion, based on 20 interventions (9 Australian, 4 Canadian, and 7 from the United States of America). Only one intervention was evaluated using a randomized controlled study design. The majority of evaluations took the form of pre–post studies. Methodological limitations were identified in a majority of studies. Study outcomes included improved knowledge, attitude, and behaviors. Conclusion: Currently, there is limited high quality evidence for the effectiveness of peer-led health interventions with Indigenous young people, and the literature is dominated by Australian-based sexual health interventions. More systematic research investigating the effectiveness of peer-led inventions is required, specifically with Indigenous populations. To improve health outcomes for Indigenous youth, greater knowledge of the mechanisms and context under which peer-delivered health promotion is effective in comparison to other methods of health promotion is needed.

Background: Migrants are underrepresented in population health surveys. Offering translated survey instruments has been shown to increase migrant representation. While ‘team translation’ represents current best practice, there are relatively few published examples describing how it has been implemented. The purpose of this paper is to document the process, results and lessons from a project to translate an English-language sexual health and blood-borne virus survey into Khmer, Karen, Vietnamese and Traditional Chinese. Methods: The approach to translation was based on the TRAPD (Translation, Review, Adjudication, Pretesting, and Documentation) model. The English-language survey was sent to two accredited, independent translators. At least one bilingual person was chosen to review and compare the translations and preferred translations were selected through consensus. Agreed translations were pretested with small samples of individuals fluent in the survey language and further revisions made. Results: Of the 51 survey questions, only nine resulted in identical independent translations in at least one language. Material differences between the translations related to: (1) the translation of technical terms and medical terminology (e.g. HIV); (2) variations in dialect; and (3) differences in cultural understandings of survey concepts (e.g. committed relationships). Conclusion: Survey translation is time-consuming and costly and, as a result, deviations from TRAPD ‘best practice’ occurred. It is not possible to determine whether closer adherence to TRAPD ‘best practice’ would have improved the quality of the resulting translations. However, our study does demonstrate that even adaptations of the TRAPD method can identify issues that may not have been apparent had non-team-based or single-round translation approaches been adopted. Given the dearth of clear empirical evidence about the most accurate and feasible method of undertaking translations, we encourage future researchers to follow our example of making translation data publicly available to enhance transparency and enable critical appraisal.

The World Health Organization estimates that almost half of all premature deaths among 15- to 19-year olds can be attributed to injuries with most (95%) fatal injuries occurring in low- and middle-income countries. Yet the evidence base for adolescent injuries in low-income countries is poor. This article uses a mixed method approach to gain an understanding of patterns, causes and consequences of unintentional injuries among adolescents aged between 14 and 16 years in four low-income country settings. Survey data collected in 2009 in Ethiopia, India (Andhra Pradesh), Peru and Vietnam (from ∼900 adolescents in each country) were integrated with qualitative research (conducted between 2007 and 2011) with a nested sample of older cohort children in Ethiopia (n = 25) and India (n = 25) using an iterative process. Logistic regression models were fitted to examine potential risk factors for injuries. Injuries were a concern for adolescents in all countries and occurred during work, recreation and sports or transportation. Being male was associated with an increased risk for all types of injuries, whereas being poor was only significantly associated with work injuries. Area of residence (urban vs rural) made a difference in some countries and for some kinds of injuries as did perceived health status. Qualitative findings highlight the consequences of injuries not only for the adolescents but also for the social and economic status of the entire household. Injury prevention programmes need to be specific to cultural and environmental settings, expectations of adolescent’s responsibilities and responsive to the context of poverty.

Australian HIV notification rates are higher for people born in Northeast Asia, Southeast Asia and sub-Saharan Africa compared to Australian-born people. The Migrant Blood-Borne Virus and Sexual Health Survey represents the first attempt to build the national evidence base regarding HIV knowledge, risk behaviors and testing among migrants in Australia. To inform survey development, preliminary qualitative research was conducted with a convenience sample of n = 23 migrants. A survey was developed with reference to the qualitative data and existing survey instruments. Non-probability sampling of adults born in Northeast Asia, Southeast Asia and sub-Saharan Africa was undertaken (n = 1489), and descriptive and bivariate analyses of data were conducted. Knowledge of pre-exposure prophylaxis was low (15.59%), and condom use at last sexual encounter was reported by 56.63% of respondents engaging in casual sex, and 51.80% of respondents reported multiple sexual partners. Less than one-third (31.33%) of respondents reported testing for any sexually transmitted infection or blood-borne virus in the previous two years and, of these, less than half (45.95%) tested for HIV. Confusion surrounding HIV testing practices was reported. These findings identify policy interventions and service improvements critically needed to reduce widening disparities regarding HIV in Australia.

In Australia, surveillance data establish that there are higher rates of late HIV diagnoses among heterosexual migrants from Sub-Saharan Africa and new HIV diagnoses among gay and bisexual men (GBM) from Southeast and Northeast Asia and Latin America. Together, these groups are identified as priority migrant communities in current efforts to eliminate HIV transmissions. HIV health literacy is recognised as a key means of improving access to services and health outcomes. This qualitative paper explores critical HIV health literacy among priority migrant communities in Queensland, Australia. To foreground community voices, peer researchers from priority migrant communities participated in the project design, data collection and analysis, with 20 interviews completed. The findings demonstrate how participants' engagement with HIV health information and services is highly relational and situated within the framework of sexual health and wellbeing. Participants strategically selected where to seek information and who they trusted to help them appraise this information. They further demonstrated reflective capacities in identifying the contextual barriers that inhibit the development of their HIV health literacy. The findings highlight the need for HIV health promotion strategies that embrace a sex positive approach, promote cultural change, and involve collaboration with general practitioners (GPs).