The Interaction Between Sexually Transmissible Infections And Human Immunodeficiency Virus Infection In Homosexual Men
Funder
National Health and Medical Research Council
Funding Amount
$635,931.00
Summary
This project examines the inter-relationship between HIV infection and sexually transmitted infections (STIs) in homosexual men. The overall goal of the projet is to inform the development of STI prevention and treatment strategies which may be important in reducing HIV incidence in this population. Homosexual men comprise over 80% of people diagnosed with HIV infecton in Australia, and in many developed nations are one of the largest groups affected by HIV. Rates of other STIs are also increase ....This project examines the inter-relationship between HIV infection and sexually transmitted infections (STIs) in homosexual men. The overall goal of the projet is to inform the development of STI prevention and treatment strategies which may be important in reducing HIV incidence in this population. Homosexual men comprise over 80% of people diagnosed with HIV infecton in Australia, and in many developed nations are one of the largest groups affected by HIV. Rates of other STIs are also increased in homosexual men. Currently, HIV rates are increasing in Australia and in many developed countries. We are in need of new and effective methods of HIV prevention. Data in heterosexuals suggest that where STIs are common, the early detection and treatment of these infections may help reduce HIV incidence. There are few data on this relationship in homosexual men. We propose to utilise an existing Sydney cohort of homosexual men to collect data on biologic tests for STIs, history of recent diagnosis of STIs, and symptoms, to allow a comprehensive description of the epidemiology of STIs and their overlap with HIV. The quality of data on the interaction between HIV and STIs in this cohort will be superior to any previously collected in homosexual men, as it will include data on self-reported doctor diagnosed illness, state of the art biologic testing, and symptom data, for the full spectrum of important STIs. The results of this study will be helpful in determining strategies for HIV and STI screening, education and control in the population which comprises the great majority of cases of HIV infection in Australia, and one of the largest risk groups for HIV infection in the developed world. Screening coupled with treatment of asymptomatic STIs may be an effective new approach to HIV prevention in this population.Read moreRead less
I am a sexual health and public health physician developing large population-based trials aimed at minimising the impact of sexually transmissible infections on the Australian population.
False Positives In The Diagnosis Of Sexually Transmitted Chlamydia Trachomatis Infection In Children
Funder
National Health and Medical Research Council
Funding Amount
$724,313.00
Summary
Chlamydia trachomatis causes sexually transmitted infections, and also the eye disease trachoma. The detection of Chlamydia in urine sample from a child can be seen as evidence for sexual abuse. We will assess the potential impacts of three mechanisms that could conceivably lead to urogenital Chlamydia diagnosis in a child in the absence of sexual abuse: contamination of the urogenital site with ocula Chlamydia, contamination of urine samples after collection, and diagnostic test malfunction.
Genital Chlamydia infections have increased over 4-fold in the last decade. Untreated infections lead to pelvic inflammatory disease, ectopic pregnancy and infertility. These conditions are due to the inflammatory immune response elicited by infections that cause scarring and oviduct blockage. The proposed studies will determine how the immune system causes tissue damage and how this damage can be avoided to enable the development a vaccine that protects women against infection and infertility.
The Epidemiology Of Bacterial Vaginosis In Young Australian Women.
Funder
National Health and Medical Research Council
Funding Amount
$87,567.00
Summary
Bacterial vaginosis (BV) is one of the commonest genital infections in women of reproductive age. It is associated with miscarriage, premature birth and increases the risk of catching HIV and sexually transmitted infections (STIs). However, the cause of BV and whether it is sexually transmitted remains unknown. Our research aims to determine how common BV is in young women commencing university and also aims to establish what risk behaviours may contribute to its development.
Regulatory Networks Controlling Virulence In Neisseria Gonorrhoeae And Neisseria Meningitidis.
Funder
National Health and Medical Research Council
Funding Amount
$300,773.00
Summary
Bacteria that cause disease produce substances called virulence determinants, often on their cell surface. These virulence determinants are either directly involved in allowing infection to take place, or cause the damage that we recognize as an infectious disease. Some virulence determinants are produced all the time, while others are only made in particular conditions - their expression is regulated. To target efforts in the development of new vaccines and treatments, it is important to identi ....Bacteria that cause disease produce substances called virulence determinants, often on their cell surface. These virulence determinants are either directly involved in allowing infection to take place, or cause the damage that we recognize as an infectious disease. Some virulence determinants are produced all the time, while others are only made in particular conditions - their expression is regulated. To target efforts in the development of new vaccines and treatments, it is important to identify all the virulence determinants produced by a particular bacterial species, but also to know which are regulated, and the environmental signals that determine their expression. It can be just as important to know whether a virulence determinant is constantly expressed, and therefore represents an invariant target. Neisseria gonorrhoeae and Neisseria meningitidis are two important disease-causing bacteria that exclusively infect humans and cause gonorrhoea, and meningitis. The complete DNA sequence of both of these bacteria is currently being determined. From computer analysis of these data, it appears that these bacteria have few of the specific regulatory systems that are present in other bacteria. The availability of DNA sequencing data enables an alternative and much more systematic approach to the identification and study of the regulation of virulence determinants. Because of the limited repertoire of regulatory systems still present in N. gonorrhoeae and N. meningitidis, it is feasible to mutate each and determine which are involved in regulation of virulence determinants. We will also be able to identify genes regulated by each system, determine how regulation is achieved, and use this information to identify any presently unknown virulence genes controlled by the same system. Such an analysis has never been previously achieved for any bacterial species, because of the number and complexity of the regulatory systems usually present.Read moreRead less
DEVELOPING AND EVALUATING NOVEL STRATEGIES FOR THE CONTROL OF SYPHILIS IN PRIORITY POPULATIONS
Funder
National Health and Medical Research Council
Funding Amount
$390,921.00
Summary
My Post Doctoral studies will assess the natural history of human papillomavirus (HPV) in men who have sex with men (MSM) and novel strategies aimed at increasing testing and early detection of HIV and other sexually transmitted infection (STIs). These studies will be conducted at the Kirby Institute (KI), the Chinese National Center for AIDS/STD Control and Prevention, Beijing (NCAIDS) and the Wuxi Center for Disease Control and Prevention (CDC), Wuxi, China, and potentially other institutions.
Adolescent Males' Beliefs And Feelings About The Consequences Of A Partner's Pregnancy: A Survey And Intervention Study
Funder
National Health and Medical Research Council
Funding Amount
$170,095.00
Summary
Each year, in Australia, approximately 28,000 adolescents become pregnant. The psychological, social and financial cost of adolescent pregnancy in Australia is substantial, in both the long and short term. An unexpected finding in North American studies is that a substantial number of adolescent pregnancies occur by design. Prevention programs in Australia and elsewhere assume adolescents do not wish to become pregnant and focus on educating adolescents about causes rather than consequences. Res ....Each year, in Australia, approximately 28,000 adolescents become pregnant. The psychological, social and financial cost of adolescent pregnancy in Australia is substantial, in both the long and short term. An unexpected finding in North American studies is that a substantial number of adolescent pregnancies occur by design. Prevention programs in Australia and elsewhere assume adolescents do not wish to become pregnant and focus on educating adolescents about causes rather than consequences. Research conducted by one of us (JAQ) found that over 75% of pregnant teenagers said they had deliberately become pregnant. Another of us (JTC) studied 1,500 Australian adolescents attitudes and beliefs about pregnancy and parenthood. The findings showed high levels of idealisation, especially in males. Males have been largely neglected in adolescent pregnancy research. The first component of this study is a survey of 500 adolescents to investigate their attitudes and beliefs about pregnancy occurring in a sexual partner, and the consequences of that event for them both. The assessment tool is a computer role-play simulation with its starting point the announcement of a pregnancy. The intervention study involves 300 adolescents and comprises viewing and discussing a video in which 4 adolescent males talk about their experiences of the consequences of pregnancy in a sexual partner. The use of 4 groups with different sequences of assessment and intervention will enable us to ascertain the effectiveness of the intervention. Of particular interest is whether the video or the role-play makes any impact on idealised attitudes and beliefs. This research is the first undertaken on adolescent male attitudes and beliefs using a computer role-play. It will provide essential information for the development of effective, male-oriented prevention programs which focus on consequences as well as causes of adolescent pregnancy.Read moreRead less
Antibiotic Treatment Of Male Partners To Reduce Recurrence Of Bacterial Vaginosis In Women: A Randomised Double-blind Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$636,674.00
Summary
Bacterial vaginosis (BV) is the most common vaginal infection in women. Healthy bacteria are lost and replaced by bacteria that cause unpleasant discharge and odour. BV puts women at increased risk of sexually transmitted infections, HIV, miscarriage and preterm delivery. Over 50% of women given antibiotics get BV back again. Studies suggest these bacteria are being sexually transmitted. We are conducting a trial of antibiotic treatment of women and their male partners to improve BV cure.
Systematic Investigation Of Conceivable Mechanisms That Could Lead To False Positive Diagnoses Of Sexually Transmitted Infections In Young Children.
Funder
National Health and Medical Research Council
Funding Amount
$1,008,839.00
Summary
Diagnosis of a sexually transmitted infection (STI) in a young child has serious social and legal consequences, because it is usually regarded as indicative of sexual abuse. It is therefore critical to understand the probability of such a diagnosis in the absence of sexual abuse. We will investigate false positives that arise by contamination of the urogenital site by STI agents that also infect the eye, and the transfer of contaminants from fingers to diagnostic specimens.