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Publisher: BMJ
Date: 14-11-2013
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/SH17050
Abstract: Transgender women across a range of different populations and settings have a high prevalence of HIV infection. There are fewer and often poorer quality studies of sexually transmissible infection (STI) prevalence. There are fewer studies in transgender men and, in general, the prevalence of HIV and STIs is lower than that of transgender women. Susceptibility to HIV and STI infection is inextricably linked to the increased vulnerability of transgender populations, a consequence of a lack of legal and social recognition that results in reduced access to educational and employment opportunities, which can result in high rates of transactional sex. Other measures of disadvantage, such as substance abuse and mental health problems, also increase the risk of HIV and STIs and have an effect on access to health care, highlighting the need for transgender-friendly multidisciplinary services offering in idualised risk assessment, prevention advice and testing for STI and HIV.
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/SH19032
Abstract: We aimed to estimate HIV pre-exposure prophylaxis (PrEP) uptake and missed opportunities for PrEP through a retrospective review of medical records of clients at high risk of HIV attending the Sydney Sexual Health Centre. Most clients (69%) were taking PrEP, and 7% of those eligible for PrEP were classified as a missed opportunity for PrEP. Although missed opportunities were uncommon, PrEP discussions should be a standard component of care for all clients at risk of HIV acquisition.
Publisher: Wiley
Date: 19-02-2009
DOI: 10.1111/J.1741-6612.2008.00336.X
Abstract: To investigate the sexual health and behaviour of older Australians attending a sexual health clinic. A retrospective patient record of people aged 50 years and over attending the clinic. 2438 people aged 50 years and over attending. The main reasons for attending were assessment of genital symptoms (40%), testing for sexually transmitted infections (STIs) (23%), and HIV testing/care (13%) more than 50% of the clients had a previous sexual health problem and more than 50% had not been tested for HIV. Men reported more lifetime sexual partners than women and were significantly more likely to report using condoms (P < 0.05), although condom use was variable. Genital herpes (10% women, 6% men) and non-gonococcal urethritis (9% men) were the most commonly diagnosed STIs. High levels of unsafe sex and many important sexual health problems were identified which provide direction for public health interventions for older sexually active Australians.
Publisher: The Royal Australian College of General Practitioners
Date: 02-2021
Publisher: BMJ
Date: 04-02-2011
Abstract: To evaluate the impact of a short message service (SMS) reminder system on HIV/sexually transmitted infection (STI) re-testing rates among men who have sex with men (MSM). The SMS reminder programme started in late 2008 at a large Australian sexual health clinic. SMS reminders were recommended 3-6 monthly for MSM considered high-risk based on self-reported sexual behaviour. The evaluation compared HIV negative MSM who had a HIV/STI test between 1 January and 31 August 2010 and received a SMS reminder (SMS group) with those tested in the same time period (comparison group) and pre-SMS period (pre-SMS group, 1 January 2008 and 31 August 2008) who did not receive the SMS. HIV/STI re-testing rates were measured within 9 months for each group. Baseline characteristics were compared between study groups and multivariate logistic regression used to assess the association between SMS and re-testing and control for any imbalances in the study groups. There were 714 HIV negative MSM in the SMS group, 1084 in the comparison group and 1753 in the pre-SMS group. In the SMS group, 64% were re-tested within 9 months compared to 30% in the comparison group (p<0.001) and 31% in the pre-SMS group (p<0.001). After adjusting for baseline differences, re-testing was 4.4 times more likely (95% CI 3.5 to 5.5) in the SMS group than the comparison group and 3.1 times more likely (95% CI 2.5 to 3.8) than the pre-SMS group. SMS reminders increased HIV/STI re-testing among HIV negative MSM. SMS offers a cheap, efficient system to increase HIV/STI re-testing in a busy clinical setting.
Publisher: Elsevier BV
Date: 12-2006
DOI: 10.1111/J.1467-842X.2006.TB00781.X
Abstract: To report the results of a 2001-04 enhanced syphilis surveillance program in south-eastern Sydney and a subset of cases from the Sydney Sexual Health Centre (SSHC). For all laboratory syphilis notifications, a questionnaire was sent to the referring doctor requesting demographic data, clinical information about disease classification and the presence of symptoms. Sex of partner/s and HIV status were collected from a subset of cases seen at SSHC. During 2001-04, 1,275 syphilis notifications were received and 1,112 (87%) were able to be classified as 361 (28%) cases of infectious syphilis, 221 (17%) non-infectious syphilis and 530 (42%) treated syphilis. From mid 2002, an increase in the number of infectious syphilis notifications was noted. Of the 361 cases of infectious syphilis, most were in men (348, 97%). From a subset of 47 cases of infectious syphilis from SSHC, 43 (91%) were in gay men and nine (21%) had concurrent HIV infection. Inner Sydney has recently experienced a rapid increase in infectious syphilis affecting a defined population: men, aged 30-39, English speaking and Australian born. These results support recent reports of outbreaks among men who have sex with men, but without routine collection of additional risk factors control programs may be misguided. In light of the review of the NSW Public Health Act 1991, it is recommended that reducing barriers to the collection of HIV status and sex of sexual partners in de-identified syphilis notifications be explored as a matter of urgency.
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/SH20024
Abstract: Abstract Background Patient-delivered partner therapy (PDPT) is a method for an index patient to give treatment for genital chlamydia to their sexual partner(s) directly. In Australia, PDPT is considered suitable for heterosexual partners of men and women, but is not uniformly endorsed. We explored the policy environment for PDPT in Australia and considered how PDPT might become a routine option. Methods: Structured interviews were conducted with 10 key informants (KIs) representing six of eight Australian jurisdictions and documents relevant to PDPT were appraised. Interview transcripts and documents were analysed together, drawing on KIs’ understanding of their jurisdiction to explore our research topics, namely the current context for PDPT, challenges, and actions needed for PDPT to become routine. Results: PDPT was allowable in three jurisdictions (Victoria, New South Wales, Northern Territory) where State governments have formally supported PDPT. In three jurisdictions (Western Australia, Australian Capital Territory, Tasmania), KIs viewed PDPT as potentially allowable under relevant prescribing regulations however, no guidance was available. Concern about antimicrobial stewardship precluded PDPT inclusion in the South Australian strategy. For Queensland, KIs viewed PDPT as not allowable under current prescribing regulations and, although a Medicine and Poisons Act was passed in 2019, it is unclear if PDPT will be possible under new regulations. Clarifying the doctor–partner treating relationship and clinical guidance within a care standard were viewed as crucial for PDPT uptake, irrespective of regulatory contexts. Conclusion: Endorsement and guidance are essential so doctors can confidently and routinely offer PDPT in respect to professional standards and regulatory requirements.
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/SH19091
Abstract: Background Previous guidelines at the Sydney Sexual Health Centre (SSHC) recommended empirical antibiotic treatment for asymptomatic contacts of Neisseria gonorrhoeae at the time of testing. With increasing concerns around gonorrhoea antibiotic resistance, it has been suggested that asymptomatic contacts should only be treated based on test results. Methods: This retrospective study of data from the SSHC electronic medical record included a total of 295 gonorrhoea contacts from 1 January 2018 to 30 June 2018. The primary outcome was the proportion of asymptomatic gonorrhoea contacts with a positive gonorrhoea result from any anatomical site. Statistically significant differences in gonorrhoea positivity according to gender, sexual preference, use of PrEP, sex worker status, country of birth, preferred language and number of partners, were calculated using Fisher’s exact test. Results: The overall proportion of asymptomatic gonorrhoea contacts with a positive gonorrhoea result was 27.1% (95% CI: 22.1–32.6%). The proportion of gonorrhoea positivity was significantly higher in females compared to males (52.0% vs 25.7%, P & 0.01), gay and bisexual men compared to heterosexual men (28.7% vs 0%, P & 0.01) and non-users of PrEP compared to PrEP users (31.2% vs 12.5%, P & 0.05). No statistically significant differences in gonorrhoea positivity were found in subgroups ided by sex worker status, country of birth, preferred language and number of partners. Conclusion: The relatively low gonorrhoea positivity rate (27.1%) in asymptomatic gonorrhoea contacts at the SSHC between January and June 2018 supports guideline changes to no longer provide empirical antibiotic treatment to asymptomatic contacts.
Publisher: The Sax Institute
Date: 2009
DOI: 10.1071/NB09004
Publisher: CSIRO Publishing
Date: 2007
DOI: 10.1071/SH07020
Abstract: Background: Previous studies have concluded that transgender people are a marginalised and stigmatised group, with high rates of sexually transmissible infections (STI), sex work, injecting drug use and multiple sexual partners. To our knowledge, this is the first study in Australia to focus on the sexual behaviour and sexual health needs of transgender people attending an urban sexual health clinic. Methods: A retrospective case note review was undertaken of the transgender attendees of the Sydney Sexual Health Centre between 1990 and 2006. Demographics, gender characteristics, risk behaviours, sexual health morbidity, psychosocial information and other significant features of the transgender population were assessed. Results: Forty clients were identified as transgender, of whom 36 (90%) were male-to-female and four (10%) were female-to-male. Seventeen (43%) had a history of sex work, 16 (40%) had injected drugs, 14 (35%) had had unprotected anal or vaginal sex in the past 3 months. Twenty (50%) clients had histories of a STI, including three (7.5%) that were HIV positive, and two were co-infected with hepatitis C. Genital warts and chlamydia were the most common diagnoses made during the study period. Physical examination was inadequately documented in 53% of first visits. Psychosocial morbidity was common. Conclusions: Transgender clients presented infrequently at this clinic. Although half reported few risks, the other half reported multiple risk behaviours and had most STI. These findings suggest that there needs to be improved sexual health service for transgender clients at our clinic.
Publisher: CSIRO Publishing
Date: 2012
DOI: 10.1071/SH11132
Abstract: Background In 2006, two new innovative features were added to a website called WhyTest which provided HIV/sexually transmissable infection (STI) information for gay men. The features were the ‘Tell them’ service allowing visitors to forward anonymous e-postcard or short message services (SMS) to sexual partners who may have been exposed to an STI, and the ‘Remind me’ service allowing visitors to register for a 3-, 6- or 12-monthly SMS reminder for a sexual health check. We describe the uptake of the new website functionality, and recognition of a health promotion c aign conducted in January–June 2007 to promote these new features. Methods: We used Poisson regression to assess trends in monthly partner notification messages and STI testing reminders sent in August 2007–June 2010. We also analysed 2007 Sydney Gay Community Periodic Survey data to measure recall of the c aign. Results: A total of 7923 partner notification messages were sent in the period August 2007–June 2010, with a significant increasing trend in monthly messages sent (P 0001). Of the total messages sent, 7581 (96%) were by SMS and 342 (4%) by e-postcards. A total of 1023 STI testing reminders were sent in the same period, with a significant increasing trend in monthly reminders sent (P 0.001) 516 reminders were by SMS (50.4%) and 507 by email (49.6%). The 2007 Sydney Gay Community Periodic Survey showed that 55% of the 2342 participants recognised the WhyTest image in the c aign. Conclusion: There was high awareness of WhyTest c aign images and the SMS partner notification service was more popular than the e-postcard feature.
Publisher: JMIR Publications Inc.
Date: 17-04-2018
Abstract: ay and bisexual men are disproportionately affected by HIV and other sexually transmissible infections (STIs), yet opportunities for sexual health testing of this population are often missed or incomplete in general practice settings. Strategies are needed for improving the uptake and completeness of sexual health testing in this setting. he goal of the research was to evaluate the impact of an intervention centered around integrated decision support software and routine data feedback on the collection of sexual orientation data and sexual health testing among gay and bisexual men attending general practice. study using before/after and intervention/comparison methods was undertaken to assess the intervention’s impact in 7 purposively s led Australian general practice clinics located near the urban centers of Sydney and Melbourne. The software was introduced at staggered points between April and August 2012 it used patient records to prompt clinicians to record sexual orientation and accessed pathology testing history to generate prompts when sexual health testing was overdue or incomplete. The software also had a function for querying patient management system databases in order to generate de-identified data extracts, which were used to report regularly to participating clinicians. We calculated summary rate ratios (SRRs) based on quarterly trends and used Poisson regression analyses to assess differences between the 12-month preintervention and 24-month intervention periods as well as between the intervention sites and 4 similar comparison sites that did not receive the intervention. mong 32,276 male patients attending intervention clinics, sexual orientation recording increased 19% (from 3213/6909 [46.50%] to 5136/9110 [56.38%]) during the intervention period (SRR 1.10, 95% CI 1.04-1.11, P .001) while comprehensive sexual health testing increased by 89% (305/1159 [26.32%] to 690/1413 [48.83%] SRR 1.38, 95% CI 1.28-1.46, P .001). Comprehensive testing increased slightly among the 7290 gay and bisexual men attending comparison sites, but the increase was comparatively greater in clinics that received the intervention (SRR 1.12, 95% CI 1.10-1.14, P .001). In clinics that received the intervention, there was also an increase in detection of chlamydia and gonorrhea that was not observed in the comparison sites. ntegrated decision support software and data feedback were associated with modest increases in sexual orientation recording, comprehensive testing among gay and bisexual men, and the detection of STIs. Tests for and detection of chlamydia and gonorrhea were the most dramatically impacted. Decision support software can be used to enhance the delivery of sexual health care in general practice.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2012
Publisher: Springer Science and Business Media LLC
Date: 26-02-2014
DOI: 10.1007/S10461-014-0733-Z
Abstract: Human immunodeficiency virus (HIV) and sexually transmitted infections (STI) testing rates are amongst the highest in the world among men who have sex with men (MSM) in Australia. However, notable minorities have never tested and many MSM have not tested recently. To examine testing routines and assess covariates of testing, an online survey was conducted among MSM in New South Wales. Five hundred and eighty non-HIV positive MSM (Mean age: 29.33 years) were randomized to answer questions on barriers to testing for HIV or STI. One in five (20.9 %) non-HIV-positive participants had never tested for HIV, 27.2 % had no HIV testing routines, 22.8 % had a moderate HIV testing routines, and 29.1 % had strong HIV testing routines. Similar patterning was observed for STI testing. In multivariate analyses participants' knowledge, beliefs, attitudes, subjective norms and perceived behavioral control were moderately related to HIV and/or STI testing routines and some associations were specific to either HIV or STI testing or to particular routines. Findings highlight that multiple social-cognitive factors each play a role in explaining HIV and STI testing among MSM. To effectively promote regular testing in MSM, programs face the challenge of having to address a range of hurdles, rather than a few major obstacles.
Publisher: Oxford University Press (OUP)
Date: 16-10-2015
DOI: 10.1093/CID/CIU813
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/SH14003
Abstract: Men who have sex with men (MSM) in Australia and overseas are disproportionately affected by sexually transmissible infections (STIs), including HIV. Many STIs are asymptomatic, so regular testing and management of asymptomatic MSM remains an important component of effective control. We reviewed articles from January 2009–May 2013 to inform the 2014 update of the 2010 Australian testing guidelines for asymptomatic MSM. Key changes include: a recommendation for pharyngeal chlamydia (Chlamydia trachomatis) testing, use of nucleic acid lification tests alone for gonorrhoea (Neisseria gonorrhoeae) testing (without gonococcal culture), more frequent (up to four times a year) gonorrhoea and chlamydia testing in sexually active HIV-positive MSM, time required since last void for chlamydia first-void urine collection specified at 20 min, urethral meatal swab as an alternative to first-void urine for urethral chlamydia testing, and the use of electronic reminders to increase STI and HIV retesting rates among MSM.
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/SH12142
Abstract: Background The resurgence of infectious syphilis in men who have sex with men (MSM) has been documented worldwide however, HIV coinfection and syphilis reinfections in MSM in inner Sydney have not been published. Methods: For all laboratory syphilis notifications assessed as a newly notified case or reinfection, a questionnaire was sent to the requesting physician seeking demographic data and disease classification. Sex of partner and HIV status were collected for all infectious syphilis notifications in men received from 1 April 2006 to March 2011. Results: From April 2001 to March 2011, 3664 new notifications were received, 2278 (62%) were classified as infectious syphilis. Infectious syphilis notifications increased 12-fold from 25 to 303 in the first and last year respectively, and almost all notifications were in men (2220, 97.5%). During April 2006 to March 2011, 1562 infectious syphilis notifications in males were received and 765 (49%) of these men were HIV-positive and 1351 (86%) reported a male sex partner. Reinfections increased over time from 17 (9%) to 56 (19%) in the last year of the study and were significantly more likely to be in HIV-positive in iduals (χ2 = 140.92, degrees of freedom= 1, P = .001). Conclusion: Inner Sydney is experiencing an epidemic of infectious syphilis in MSM and about half of these cases are in HIV-positive patients. Reinfections are increasing and occur predominantly in HIV-positive men. Accurate surveillance information is needed to inform effective prevention programs, and community and clinician education needs to continue until a sustained reduction is achieved.
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/SH13012
Abstract: Objectives Increased testing frequency is a key strategy in syphilis control, but achieving regular testing is difficult. The objective of this study is to describe a sexually transmissible infection (STI) testing outreach program (the Testing Tent) at a gay community event. Methods: Gay men attending the testing tent in 2010–11 completed a computer-assisted self-interview and were screened for STIs. Clinical, demographic, behavioural and diagnostic data were compared with gay men attending a clinic-based service during 2009. The Testing Tent was marketed on social media sites and data were extracted on the number of times the advertisements were viewed. Staffing, laboratory, marketing and venue hire expenses were calculated to estimate the cost of delivering the service. Results: Ninety-eight men attended the Testing Tent. They were older (median age: 42 years v. 30 years P 0.001), had more sex partners (median: five in 3 months v. two P 0.001) and more likely to inject drugs (9% v. 4% P = 0.034) than the 1006 clinic attendees, but were more likely to have previously tested for STIs (81% v. 69% P = 0.028) and to always use condoms for anal sex (59% v. 43% P = 0.005). Five cases of STIs were detected the diagnostic yield was not significantly different from that of the clinic. The cost of the Testing Tent was A$28 440. Conclusion: Nonclinical testing facilities are an acceptable option and are accessed by gay men requiring regular testing, and may be an important addition to traditional testing environments.
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/SH15134
Abstract: Background We aimed to determine the impact of a chlamydia (Chlamydia trachomatis) education program on the knowledge of and attitudes towards chlamydia testing of practice nurses (PNs). Methods: A cross-sectional survey was conducted at baseline and 6–12 months following recruitment with PNs in the Australian Chlamydia Control Effectiveness Pilot. Likert scales were analysed as continuous variables (scores), and t-tests were used to assess changes in mean scores between survey rounds and groups. Results: Of the 72 PNs who completed both surveys, 42 received education. Epidemiology knowledge scores increased significantly between surveys in the education group (P 0.01), with change in knowledge being greater in the education group compared with the non-education group (P 0.01). Knowledge of recommended testing scenarios (P = 0.01) and retesting following treatment (P 0.01) increased in the education group. Attitudes to testing scores improved over time in the education group (P = 0.03), with PNs more likely to want increased involvement in chlamydia testing (P 0.01). Change in overall attitude scores towards testing between surveys was higher in the education group (P = 0.05). Barriers to chlamydia testing scores also increased in the education group (P = 0.03), with change in barriers greater in the education vs the non-education group (P = 0.03). Conclusion: The education program led to improved knowledge and attitudes to chlamydia, and could be made available to PNs working in general practice. Future analyses will determine if the education program plus other initiatives can increase testing rates.
Publisher: SAGE Publications
Date: 11-2008
Abstract: In order to be effective, sexually transmitted infection (STI) testing should be comprehensive based on the clients' sexuality and risk practices. Using data from the Sydney Gay Community Periodic Survey, we explored trends in and factors associated with STI testing among gay men during 2003–2007. Among men who were not HIV-positive, 68% were tested for HIV in 2007. HIV testing was more common than STI testing and remained stable during 2003–2007. Use of swabs and urine s les increased significantly ( P-trend 0.001 for each). However, until 2007, 33% of men were not tested. Sexual behaviours (higher number of partners, having casual partners and engaging in unprotected anal intercourse with them) were associated with STI testing. HIV-negative men were tested for STI less often than HIV-positive men (prevalence ratio = 0.56 95% CI: 0.47–0.68). STI testing among HIV-negative men has improved significantly but remains inadequate for STI control and HIV prevention. It should not be assumed that appropriate and comprehensive STI screening is always provided to clients.
Publisher: Microbiology Society
Date: 05-2009
Abstract: Diagnostic, genotypic and antibiotic-resistance determinants of Neisseria gonorrhoeae were analysed by molecular methods to verify the failure of ceftriaxone treatment in two cases of pharyngeal gonorrhoea. Monoplex assays were needed to define competitive inhibition of a positive Chlamydia PCR in a duplex assay. Different penA changes were detected in the N. gonorrhoeae isolated from the two cases. These were associated with raised ceftriaxone MICs of 0.03 and 0.016 mg l −1 , which may have contributed to the treatment failures in these cases.
Publisher: CSIRO Publishing
Date: 2010
DOI: 10.1071/SH09100
Abstract: We determined the prevalence of symptomatic and asymptomatic urethral gonorrhoea among men who have sex with men (MSM) at our Australian sexual health clinic. Asymptomatic MSM are screened using the Roche Amplicor® PCR, whereas culture is used for symptomatic MSM. We analysed data from all MSM tested for urethral gonorrhoea from March 2006 to July 2008. Among the 4453 asymptomatic MSM, there were two (0.04%) diagnoses of urethral gonorrhoea, compared with 38 (3.13%) among 1213 symptomatic MSM. Despite a high prevalence of symptomatic infection, asymptomatic urethral gonococcal infection was extremely uncommon among MSM seen in our sexual health clinic.
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/SH12020
Abstract: Background: In New South Wales (NSW), publicly funded sexual health services (PFSHSs) target the populations at greatest risk for important sexually transmissible infections (STIs) and so may make a large contribution to the diagnosis of notifiable STIs. We aimed to determine the proportions of STIs diagnosed in PFSHSs and notified to the NSW Ministry of Health in 2009, and describe geographical variations. Methods: The number of notifiable STIs (infectious syphilis, gonorrhoea, HIV and chlamydia) diagnosed in 2009 was obtained for each Area Health Service (AHS) and each PFSHS. The proportion of diagnoses made by PFSHSs was calculated at the state and AHS level according to five geographical regions: inner and outer metropolitan, regional, rural and remote. Results: The overall proportions of diagnoses made by NSW PFSHSs were syphilis, 25% gonorrhoea, 25% HIV, 21% and chlamydia, 14%. Within each zone, the proportions of these STIs were (respectively): (i) inner metropolitan: 32%, 26%, 21% and 13% (ii) outer metropolitan: 41%, 24%, 43% and 9% (iii) regional: 62%, 15%, 23% and 10% (iv) rural: 8%, 29%, % and 20% and (v) remote: %, 43%, % and 29%. There was considerable variation in proportions of STIs between and within AHSs ( –100%). Conclusions: NSW PFSHSs contribute a large proportion of diagnoses for syphilis, gonorrhoea and HIV, but less so for chlamydia. Across AHSs and zones, there was considerable variation in the proportions. These data support the role of PFSHS in identifying and managing important STIs in high-risk populations.
Publisher: Public Library of Science (PLoS)
Date: 23-08-2013
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/SH17113
Abstract: The Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men were updated in 2014. An evaluation study targeting Sydney-based general practitioners was conducted among 85 clinicians. Respondents with knowledge of guideline recommendations were significantly more likely to feel comfortable asking men who have sex with men about their sexual history (98.1% vs 81.3%, P = 0.039), and to recommend at least annual testing (94.0% vs 68.8%, P = 0.015), 3-month retesting after chlamydia or gonorrhoea treatment (96.2% vs 73.3%, P = 0.017) and syphilis testing with routine HIV monitoring bloods (90.2% vs 57.1%, P = 0.037). Familiarity with the guidelines was associated with a range of positive outcomes on general practitioners’ clinical practice. Novel approaches are required to ensure more widespread distribution of future guidelines.
Publisher: Elsevier BV
Date: 12-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2012
Publisher: JMIR Publications Inc.
Date: 06-11-2018
DOI: 10.2196/10808
Publisher: Springer International Publishing
Date: 2018
Publisher: BMJ
Date: 18-09-2014
DOI: 10.1136/SEXTRANS-2013-051482
Abstract: To investigate the methods used by patients diagnosed with a sexually transmissible infection (STI) to inform their partners during contact tracing. At a large Australian sexual health clinic between March and May 2010, we undertook a retrospective, cross sectional analysis of the methods used by patients diagnosed with a bacterial STI to inform their partners. Of the 172 index patients contacted 1 week after treatment, 163 (95%) chose patient referral, 3 (2%) provider referral and 6 (3%) could not contact any partners. Index patients nominated 1010 sexual partners of whom 494 (49%) were reported as contactable. A total of 447/494 (91%) of these partners were successfully informed telephone (37%) and face to face (22%) were the most used methods. After multivariate analysis, predictors of using face to face contact methods were age <30 years (AOR: 2.8 95% CI 1.4 to 5.7), fewer than 2 sexual partners (AOR 3.6 95% CI 1.7 to 7.6) and speaking a language other than English (adjusted OR (AOR) 3.1 95% CI 1.3 to 7.2). The single predictor of using interactive contact methods (face to face+telephone) was reporting fewer than 2 sexual partners (AOR 2.7 95% CI 1.3 to 5.5). People diagnosed with syphilis were significantly less likely to use an interactive contact tracing method (AOR 0.24 95% CI 0.09 to 0.67). Most patients diagnosed with a bacterial STI at our sexual health clinic report informing their contactable partners directly either face to face or by telephone. Electronic communications methods were more popular for people with more sexual partners and those with syphilis. Effective contact tracing requires access to a range of methods for patients to inform their partners.
Publisher: No publisher found
Date: 2018
DOI: 10.1071/SH17183
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/SH18097
Abstract: Background Gonorrhoea notifications continue to rise among gay and bisexual men in Australia and around the world. More information is needed on infection trends, accounting for testing and complimented by demographics and risk practices. Methods: A retrospective cohort analysis was undertaken using repeat gonorrhoea testing data among gay and bisexual men from 2010 to 2017, which was extracted from a network of 47 sexual health clinics across Australia. Poisson and Cox regression analyses were used to determine temporal trends in gonorrhoea incidence rates, as well as associated demographic and behavioural factors. Results: The present analysis included 46904 gay and bisexual men. Gonorrhoea incidence at any anatomical site increased from 14.1/100 person years (PY) in 2010 to 24.6/100 PY in 2017 (P& .001), with the greatest increase in infections of the pharynx (5.6-15.9/100 PY, P& .001) and rectum (6.6–14.8/100 PY, P& .001). After adjusting for symptomatic and contact-driven presentations, the strongest predictors of infection were having more than 20 sexual partners in a year (hazard ratio (HR)=1.9, 95% confidence interval (CI): 1.7–2.2), using injecting drugs (HR=1.7, 95%CI: 1.4–2.0), being HIV positive (HR=1.4, 95%CI: 1.2–1.6) and being aged less than 30 years old (HR=1.4, 95%CI: 1.2–1.6). Conclusions: Gonorrhoea has increased dramatically among gay and bisexual men in Australia. Enhanced prevention efforts, as well as more detailed, network-driven research are required to combat gonorrhoea among young men, those with HIV and those who use injecting drugs.
Publisher: SAGE Publications
Date: 06-2011
Abstract: Australian and New South Wales Sexually Transmissible Infections Strategies recommend sexual health clinics actively target particular populations, including men who have sex with men (MSM), who have increasing rates of sexually transmitted infections (STIs). We describe trends in MSM attendances, STI testing and diagnostic yield from 1996 to 2007 at a Sydney public sexual clinic. Aggregate data were extracted from the clinic database. There was a 76% increase in the number of in idual MSM attending, more than three-fold increase in the number of STI tests performed and the proportion of MSM tested. The increase in testing was greatest for rectal infections. The positive yield increased for rectal chlamydia and infectious syphilis remained stable for pharyngeal gonorrhoea and decreased for urethral gonorrhoea, rectal gonorrhoea and urethral chlamydia. Our results demonstrate successful service reorientation in response to a local STI epidemic. Differing trends suggest evolving transmission dynamics for different STIs in the context of increased testing of asymptomatic MSM.
Publisher: JMIR Publications Inc.
Date: 22-09-2023
DOI: 10.2196/45695
Publisher: SAGE Publications
Date: 06-2005
Abstract: Australian guidelines recommend regular screening of men who have sex with men (MSM) for sexually transmitted infections (STIs). This audit was performed to determine STI testing rates in Sydney Sexual Health Centre before and after the development of the guidelines, and to describe characteristics of those not tested. The electronic clinic database and a manual file review were used to determine testing rates and reasons for not testing for the years 2000 and 2002. Overall testing rates were high, with 61% of MSM having had all recommended tests within the past year in 2002. There was a significant increase in testing rates for most tests after the development of the guidelines. Asymptomatic men were more likely to be tested than symptomatic men, and HIV-positive men were less likely to be tested for syphilis.
Publisher: CSIRO Publishing
Date: 24-08-2021
DOI: 10.1071/SH21087
Abstract: There is a paucity of contemporary data pertaining to sexually transmitted infection test positivity of people presenting as contacts of syphilis. Over a 12 month period in 2018, within a sexual health service, we identified 191 (92% men who have sex with men) presentations, 7.8% were diagnosed with syphilis (three primary, four secondary, six early latent and two late latent infections). A total of 20.8% (38/183) were diagnosed with one or more STI including 54 non-syphilis infections: two (1.1%) new HIV 26 (14.2%) Chlamydia trachomatis and 24 (13.1%) Neisseria gonorrhoeae. Although syphilis test positivity in contacts is low, this population requires comprehensive STI screening and HIV prevention discussion.
Publisher: SAGE Publications
Date: 10-2001
Publisher: AMPCo
Date: 29-08-2019
DOI: 10.5694/MJA2.50322
Abstract: To estimate rates of HIV infection, chlamydia, gonorrhoea, and infectious syphilis in transgender men and women in Australia to compare these rates with those for cisgender people. Cross-sectional, comparative analysis of de-identified health data. We analysed data for 1260 transgender people (404 men, 492 women, 364 unrecorded gender), 78 108 cisgender gay and bisexual men, and 309 740 cisgender heterosexual people who attended 46 sexual health clinics across Australia during 2010-2017. First-visit test positivity for sexually transmitted infections (STIs), stratified by patient group and year demographic and behavioural factors associated with having STIs. 14 of 233 transgender men (6.0%) and 34 of 326 transgender women (10%) tested during first clinic visits were chlamydia-positive nine transgender men (4%) and 28 transgender women (8.6%) were gonorrhoea-positive. One of 210 tested transgender men (0.5%) and ten of 324 tested transgender women (3.1%) were diagnosed with infectious syphilis 14 transgender men (3.5%) and 28 transgender women (5.7%) were HIV-positive at their first visit. The only significant change in prevalence of an STI among transgender patients during the study period was the increased rate of gonorrhoea among transgender women (from 3.1% to 9.8%). Compared with cisgender gay and bisexual men, transgender men were less likely (adjusted odds ratio [aOR], 0.46 95% CI, 0.29-0.71 P = 0.001) and transgender women as likely (aOR, 0.98 95% CI, 0.73-1.32 P = 0.92) to be diagnosed with a bacterial STI compared with heterosexual patients, transgender men were as likely (aOR, 0.72 95% CI, 0.46-1.13 P = 0.16) and transgender women more likely (aOR, 1.56 95% CI, 1.16-2.10 P = 0.003) to receive a first-visit bacterial STI diagnosis. The epidemiology of STIs in transgender people attending Australian sexual health clinics differs from that of cisgender patients. Gender details must be captured by health data systems to facilitate appropriate delivery of sexual health care.
Publisher: Inderscience Publishers
Date: 2014
Publisher: CSIRO Publishing
Date: 2012
DOI: 10.1071/SH11183
Abstract: Background: Annual notifications of chlamydia (Chlamydia trachomatis) diagnoses have increased steadily in Australia in the last decade. To guide public health programs, we developed 10 national chlamydia prevention indicators and report on each indicator for New South Wales (NSW). Methods: Using systematic methods, we reviewed the literature to report on the 10 health and behaviour indicators for 15- to 29–year-old heterosexuals in NSW from 2000. We included data with two or more time points. Results: Chlamydia notification rates (Indicator 1) in 15- to 29–year-olds have increased by 299%, from 237 per 100 000 population in 2001 to 946 per 100 000 population in 2010 and the percent of 15- to 34-year-olds with an annual Medicare-rebated chlamydia test (Indicator 2) increased by 326%, from 1.9% in 2001 to 8.1% in 2010. Since 2004, sentinel surveillance showed a 28% increase in chlamydia prevalence (Indicator 3) in 15- to 29-year-old females tested at their first sexual health service visit (from 8.5% in 2004 to 10.9% in 2010) but no significant increase in males. No NSW-specific chlamydia incidence (Indicator 4) was available. Pelvic inflammatory disease hospitalisation separations rate decreased from 0.58 per 1000 in 2001 to 0.44 per 1000 in 2010 in 15- to 29-year-old females (Indicator 5).Secondary school surveys in 2002 and 2008 showed chlamydia knowledge increased in males. The sexual risk-taking behaviour of young people remained unchanged (Indicators 6–10). Conclusions: Although notifications have risen steeply, the modest increase in chlamydia prevalence maybe a more realistic reflection of transmission rates. Strategies are needed to increase testing and to modify sexual risk behaviour. Crucial gaps in epidemiological data were identified.
Publisher: CSIRO Publishing
Date: 2008
DOI: 10.1071/SH07092
Abstract: Since 2002, biennial production of sexually transmissible infection testing guidelines for men who have sex with men has supported sexually transmitted infection control efforts in inner Sydney, Australia.
Publisher: CSIRO Publishing
Date: 2011
DOI: 10.1071/SH10037
Publisher: Mark Allen Group
Date: 02-07-2014
DOI: 10.12968/BJHC.2014.20.7.344
Abstract: Describe how different types of resources are received and perceived by primary care clinicians to improve sexual healthcare. Cross-sectional online survey of primary care clinicians in New South Wales, Australia, to evaluate the perceived impact of nine resources to promote sexual healthcare—seven were tailored to general practitioners (GPs) and two to practice nurses (PNs). 431 primary care clinicians (GPs=214 PNs=217). Awareness, use and perceived impact of the resources. Most GPs were aware of and used the Sexually Transmitted Infections (STI) Testing Tool the Online STI Testing Tool GP training was perceived to improve GPs' ability to raise the topic of STIs with patients and order appropriate tests. Although the highest proportion of PNs were aware of the online STI PN training, most used the PN Postcard. The former helped to improve PNs' ability to identify at-risk patients and document sexual history. This study supports the need for a multimodal approach to improve the delivery of sexual healthcare in general practice. This would involve the communication of similar messages in different modes, via different channels, at different times.
Publisher: SAGE Publications
Date: 09-06-2021
DOI: 10.1177/09564624211022583
Abstract: Mycoplasma genitalium ( M.genitalium) is associated with urethritis, cervicitis, pelvic inflammatory disease, proctitis and epididymitis. Its treatment is complicated by antimicrobial resistance. To assess clinicians’ adherence to M.genitalium diagnostic testing recommendations for syndromic presentations, as well as resistance-guided management of M.genitalium at Sydney Sexual Health Centre, we reviewed patients presenting between August and December 2018. 349/372 (94%) syndromic presentations were tested for M.genitalium with 16% M.genitalium test positivity and 81% macrolide resistance. 16/27 (59%) macrolide-sensitive infections and 65/77 (84%) macrolide-resistant infections received resistance-guided treatment. Tests of cure (TOCs) were unnecessarily ordered for 82% macrolide-sensitive cases, while 88% macrolide-resistant cases were correctly ordered TOCs. Co-existing STIs at the time of macrolide-sensitive ( p = 0.30) or macrolide-resistant M.genitalium ( p = 0.94) diagnosis did not significantly affect adherence to treatment guidelines. This study confirms the expected prevalence of M.genitalium and macrolide resistance in syndromic presentations while our real-world data highlight the decision-making challenges involved with managing M.genitalium, offering insights for further research.
Publisher: Elsevier BV
Date: 06-2022
Abstract: This paper examines factors that enabled successful integration of testing for sexually transmissible infections into routine care in Aboriginal Community Controlled Health Services. This paper reports analysis of qualitative interview data recorded with 19 purposively s led 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. 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. 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. 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.
Publisher: JMIR Publications Inc.
Date: 12-01-2023
Abstract: exually transmitted infection (STI) rates continue to rise in Australia and timely access to testing and treatment is crucial to reduce transmission. Web-based services have been viewed as a way to improve access to STI/HIV testing and have proliferated in recent years. However, the regulation of these services in Australia is minimal, leading to concerns about their quality. The purpose of this review is to systematically identify and assess web-based HIV/STI testing services available in Australia. o systematically identify and assess web-based HIV/STI testing services available in Australia. Google search of Australian web-based services conducted in March 2022 and repeated in September 2022 using Boolean operators including test service terms (e.g. online/home), STI terms (e.g. chlamydia/gonorrhoea) and test-type terms (e.g. self-test). The first 10 pages were assessed, and services categorized as self-testing (test at home), self-s ling (s le at home return to laboratory) or self-navigated pathology (specimens collected at pathology centre). Service reliability was assessed against the Health on the Net Foundation Code of Conduct, and quality assessed using a score card developed based on Australian guidelines. eventeen services were identified (8 self-testing, 2 self-s ling,7 self-navigated pathology). Only 4 services offered recommended testing for all four infections (chlamydia, gonorrhoea, syphilis, HIV) including genital, anorectal and oropharyngeal sites, and 5 offered tests not recommended by guidelines. 9 services (1 self-navigated pathology, 8 self-test) had no minimum age requirements for access. Reliability scores (scale 0-8) were similar between all services (range 4.75-6.0). Quality scores (scale 0-58) were similar between self-navigated pathology and self-s ling services (average 44.89 and 44.75 respectively) but lower for self-testing services (22.66). Cost for services varied between self-navigated pathology ($0-595), self-s le ($0) and self-testing ($0-135). here was considerable variability in quality and reliability of services identified. It is imperative that Australia develops national standards to ensure the standard-of-care offered by web-based STI/HIV testing services is appropriate to protect Australian users from the impact of poorly performing and/or inappropriate tests.
No related grants have been discovered for Christopher Bourne.