ORCID Profile
0000-0002-9325-1647
Current Organisations
ACT Health
,
Australian National University
,
Royal Australasian College of Physicians
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Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2021
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/SH20094
Abstract: Partners of heterosexual cases with chlamydia, who were identified as having difficulty in attending the clinic, were offered patient-delivered partner therapy (PDPT). Medication was delivered by the index case after telephone consultation with the partner to assess symptoms and medical history. The opportunity for testing of partners for chlamydia was provided. The PDPT process was evaluated by standardised phone interview with index patients and partners. Telephone consultation enables safe medication prescribing and an opportunity for further contact tracing. Partners were unlikely to seek testing when provided with PDPT. Delivery of medication resulted in a reported rate of treatment of 100%. PDPT was an acceptable treatment option to both index and partner and should be considered if legislation permits.
Publisher: Elsevier BV
Date: 08-2021
Publisher: SAGE Publications
Date: 07-05-2016
Abstract: Chlamydia is the most commonly notified sexually transmitted infection in Australia. Australian guidelines recommend urogenital screening in asymptomatic men and women, and rectal screening in men who have sex with men or women reporting anal sex/symptoms. International studies describe a rectal chlamydia prevalence in women of 5% to 21%. We found that in women at high risk of chlamydia, 57% (32/56) tested positive for rectal chlamydia. Of these, 97% (31/32) had concurrent urogenital chlamydia. Women with urogenital chlamydia were significantly more likely to have a positive rectal result (χ 2 , p = 0.000). Neither anal symptoms nor reported anal sex were associated with a positive rectal chlamydia test. The recommended treatment of rectal chlamydia differs substantially from that of urogenital chlamydia, raising the possibility that Australian women are being regularly undertreated due to a lack of rectal testing. Untreated rectal chlamydia may increase the risk of persistent infection, reproductive tract reinfection, complications and transmission. Further work is needed to determine the optimal management of chlamydia in women.
Publisher: SAGE Publications
Date: 19-07-2022
DOI: 10.1177/09564624221116527
Abstract: Non-occupational Post-Exposure Prophylaxis (nPEP) is an effective HIV prevention strategy in gay and bisexual men (GBM) taken after possible exposure. HIV Pre-Exposure Prophylaxis (PrEP) is also a highly effective HIV prevention strategy. A retrospective audit of medical records of GBM presenting to a sexual health centre and provided with nPEP compared two periods to determine if nPEP usage changed following availability of PrEP. In the first period (P1) PrEP was available through extended trials. In the second period (P2) PrEP became more accessible through the Australian Pharmaceutical Benefits Scheme (PBS). Period comparisons were performed using a two-population test of proportions with one-tailed testing and significance set at P .05 using SPSS Statistics Version 25. There were 232 GBM provided with nPEP in P1, and 202 in P2. A two-population test of proportions demonstrated that GBM presentations for nPEP decreased significantly from 302/4779 (6.3%) of GBM visits in P1 to 221/7205 (3.1%) in P2 when PrEP was more accessible (Z=8.53, P .001). PrEP uptake after presenting for nPEP increased from 30 (12.9%) of total GBM visits in P1 to 69 (34.2%) in P2 (Z=5.26, p .001). GBM accessing nPEP decreased with statistical significance post introduction of PBS PrEP.
Publisher: SAGE Publications
Date: 12-05-2021
DOI: 10.1177/09564624211014406
Abstract: HIV pre-exposure prophylaxis (PrEP) is recommended for gay and bisexual men (GBM) with recent diagnosis of rectal chlamydia (CT), rectal gonorrhoea (NG) or infectious syphilis. A retrospective medical record audit was undertaken at Canberra Sexual Health Centre (CSHC) of all GBM who met this criterion in 2019 and were thus determined to be at higher risk of acquisition of human immunodeficiency virus (HIV). Pre-exposure prophylaxis was discussed and/or commenced in 85% of GBM at higher risk of HIV. Audit results and education were provided to the team with a post-interventional audit in 2020 showing significant improvement. This audit is easily replicated and may be applicable to other settings engaged in GBM care.
Publisher: Mary Ann Liebert Inc
Date: 23-05-2023
Publisher: AMPCo
Date: 09-2012
DOI: 10.5694/MJA12.10090
Publisher: Elsevier BV
Date: 02-2020
Publisher: CSIRO Publishing
Date: 16-06-2022
DOI: 10.1071/SH21247
Abstract: Men who have sex with men (MSM) living with HIV are at increased risk of anal cancer and annual screening via digital ano-rectal examination (DARE) is recommended. Baseline audit (Cycle 1) was undertaken of the medical records of MSM living with HIV aged ≥50 years (n = 85) from 1 January 2017 to 31 December 2018, in line with guidelines at the time. Data collection included whether DARE was discussed and offered, and whether DARE was accepted or declined. We provided staff training and altered clinic proformas aiming to increase DARE. Audit Cycle 2 (Cycle 2) was undertaken of eligible MSM (n = 86) who attended between 1 January 2019 to 31 December 2020. DARE frequency increased from 4.7% in Cycle 1 to 41.8% in Cycle 2 (P 0.001) and discussion and offer of DARE increased from 8% to 64% in Cycle 2 (P 0.001).
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/SH18070
Publisher: Frontiers Media SA
Date: 13-03-2023
DOI: 10.3389/FPUBH.2023.1018983
Abstract: The HIV epidemic in Australia is changing with higher risk for HIV among newly-arrived Asian-born men who have sex with men (MSM) compared to Australian-born MSM. We evaluated the preferences for HIV prevention strategies among 286 Asian-born MSM living in Australia for & years. A latent class analysis uncovered three classes of respondents who were defined by their preferences: “PrEP” (52%), “Consistent condoms” (31%), and “No strategy” (17%). Compared to the “No strategy” class, men in the “PrEP” class were less likely to be a student or ask their partner for their HIV status. Men in the “Consistent condoms” class were more likely to get information about HIV from online, and less likely to ask their partner for their HIV status. Overall, PrEP was the preferred HIV prevention strategy for newly arrived migrants. Removing structural barriers to access PrEP can accelerate progress toward ending HIV transmission.
Publisher: Elsevier BV
Date: 11-2018
Publisher: Informa UK Limited
Date: 12-02-2019
DOI: 10.1080/09540121.2019.1576843
Abstract: Women comprise a minority population of in iduals living with HIV in Australia, and are often poorly represented in research and clinical trials so their needs remain largely unknown. Data suggests that they are diagnosed later than men and start antiretroviral therapy at a lower CD4 cell count. This raises the question whether there are sex specific barriers to linkage and retention in care. This study analyzed 484 surveys received from clinicians collecting demographic, virological, and reproductive health data along with perceived barriers to linkage and retention in care. Most women (67%) were estimated to have been linked into care within 28 days of diagnosis. For women who were not linked into care for more than 28 days, the most commonly reason cited was fear of disclosure to others, followed by fear of disclosure to their partner. The main reasons given for non-retention in care were related to transport, carer responsibilities, financial pressure, health beliefs and concern about stigma or disclosure.
Publisher: CSIRO Publishing
Date: 2006
DOI: 10.1071/SH05050
Abstract: Background: There are few published data on the rate of chlamydia and gonorrhoea infection in men who have sex with men (MSM). Our aim was to determine the rate of positive chlamydia and gonorrhoea tests in this population in the Australian Capital Territory (ACT). Methods: Results of all chlamydia and gonorrhoea tests generated by Canberra Sexual Health Centre between June 2001 and September 2003, including those from outreach clinics, were reviewed (audit one). Between September 2003 and April 2004, Canberra Sexual Health Centre outreach program staff and a general practitioner with a high caseload of MSM offered screening of the throat, urethra and rectum to all MSM, irrespective of their reported participation in unprotected anal intercourse. Chlamydia and gonorrhoea test results generated during this period were reviewed (audit two). Results: In the first audit, 1086 specimens from 314 in iduals were tested and 30/314 (9.6%, 95% CI 6.6–13.4) men were positive for chlamydia in one or more anatomical site. A total of 306 specimens from 118 in iduals were tested for gonorrhoea. Of these, eight (6.8%, 95% CI 3.0–12.9) in iduals tested positive. In the second audit, 16 of 157 men (10.2%, 95% CI 9.5–16.0) tested positive for chlamydia and 4/155 (2.6%, 95% CI 0.7–6.5) tested positive for gonorrhoea. The rectum was the most commonly infected anatomical site for both infections. The overall proportions of positive chlamydia and gonorrhoea tests were 36/471 (7.6%, 95% CI 5.4–10.4) and 12/273 (4.4%, 95% CI 2.2–7.6) respectively. Conclusions: These data, collected in a range of settings, indicate high rates of chlamydia and gonorrhoea in MSM in the ACT and provide support for annual testing, particularly of the rectum, in this population.
Publisher: Springer Science and Business Media LLC
Date: 09-2023
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/PY12135
Abstract: In Australia and elsewhere, chlamydia screening rates for those aged between 16 and 30 years continue to be low. Innovative, age-appropriate approaches are necessary to increase chlamydia screening among this target group to prevent short- and long-term consequences of the infection such as pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy and infertility. Studies have demonstrated that offering chlamydia screening in community pharmacies may be a useful adjunct to current screening services. Approximately 90% of Australians visit a pharmacy at least once a year. Chlamydia screening and education in community pharmacies with remuneration may provide another option for opportunistic testing as part of a national chlamydia screening scheme. Compensation is an accepted practice in the field of research and has been demonstrated to improve adherence to health promotion activities. In 2011, a cross-sectional study of community pharmacy-based chlamydia screening offered in conjunction with an A$10 cash incentive to participate was conducted in the Australian Capital Territory. As part of this study young people were asked about their experience of, and views about, pharmacy-based chlamydia screening. The views of consented participants were collected using the one-page questionnaire consisting of 10 closed questions and one open-ended question. Participants completed the questionnaire when they returned their urine s le and before being given the cash incentive. Overall participants were highly satisfied with the pharmacy-based chlamydia screening service. Over 60% of questionnaire respondents felt that the payment did affect their decision to have the chlamydia test, and 23% stated that it made no difference. Young people reported that pharmacy-based screening is acceptable and convenient. Accessibility and the small cash incentive played significant roles in increasing participation.
Publisher: CSIRO Publishing
Date: 2008
DOI: 10.1071/SH07034
Abstract: Introduction: Hepatitis C virus (HCV) prevalence has been shown to be higher in some sexual health clinic attendees than the general population. Screening for HCV in sexual health clinics may be based on risk assessment or universal screening. The aim of this audit was to explore the value of routine HCV screening in a sexual health centre population. Methods: Medical records and pathology data concerning all patients tested for HCV between 2000 and 2002 at Canberra Sexual Health Centre were audited to determine whether the diagnosis of HCV was already known and which, if any, risk factors were identified at the time of testing. Results: A total of 3845 tests were conducted on 3156 in iduals over the 3-year period. HCV seropositivity was confirmed in 95 patients (3.0% 95% CI 2.4–3.7), of which 29 (30.5%) were new diagnoses. A total of 85.3% of all patients with confirmed HCV infection reported a history of injecting drug use. Tattoos and body piercings were the most common risk factor in those who denied ever injecting. Risk factor assessment correctly identified all but one positive patient. Conclusions: HCV testing based on clinician-led risk assessment is an effective approach to HCV screening.
Publisher: BMJ
Date: 12-2017
Publisher: CSIRO Publishing
Date: 2010
DOI: 10.1071/SH09023
Abstract: Background: Anogenital warts are a common initial presentation to the Canberra Sexual Health Centre. It is anticipated that the introduction of human papillomavirus vaccination will reduce the incidence of anogenital warts. The present study determines the prevalence of other sexually transmissible infections in patients newly diagnosed with warts who may not have presented for screening without the impetus of a genital lump. Methods: The prevalence of other sexually transmissible infections in new patients presenting to the Canberra Sexual Health Centre diagnosed with anogenital warts was determined from a retrospective clinical audit from 2002 to 2007. Results: A total of 1015 new patients were diagnosed with anogenital warts. Of this total cohort, 53 (5.2%) were found to be co-infected with either chlamydia and/or gonorrhoea. Only 13.2% of co-infected patients reported symptoms other than genital lumps. Of co-infected patients 11.3% reported contact with a partner with chlamydia and/or gonorrhoea. Not all patients were screened for other sexually transmissible infections: 762 (75.1%) were screened for chlamydia and 576 (56.7%) were screened for gonorrhoea. Of those tested, 6.8% of men and 6.9% of women were positive for chlamydia highlighting the importance of offering full sexually transmissible infection screening in those newly diagnosed with anogenital warts. Chlamydia was more common in younger patients who reported a higher number of sexual partners. Conclusions: It is anticipated that human papillomavirus vaccination will lead to a decline in anogenital wart incidence as well as other human papillomavirus associated disease. Although one opportunity for testing for other sexually transmissible infections may be lost in this population, the decrease in anogenital warts will leave clinicians with more time to pursue other screening programs. Education and screening c aigns should continue to focus on the asymptomatic nature of the majority of sexually transmissible infections.
Publisher: Elsevier BV
Date: 12-2021
Publisher: CSIRO Publishing
Date: 2010
DOI: 10.1071/SH08091
Abstract: Background: We hypothesise that text-messaging and financial incentives would increase tertiary student participation in chlamydia screening. Methods: A cross-sectional study was conducted over two phases on eight tertiary c uses during 2007. During Phase 1 (6 months) study activities were advertised through student organisations and media. Education and screening were offered during a range of student activities. During Phase 2 (4 days) education and screening were offered via text messages. Non-financial incentives were offered during Phase 1 and a $10 cash incentive was offered during Phase 2. Rates of specimens provided by students and the direct costs incurred during each phase were compared. Results: 2786 students attended the 31 activities conducted in Phase 1. Of these, 627 students (22.5%) provided urine specimens for chlamydia testing. During Phase 2, the dissemination of 866 text messages resulted in urine specimens from 392 students (45.3%). Costs per test were AUD $175.11 in Phase 1 and AUD $27.13 in Phase 2. Conclusions: Compared with more labour intensive (and therefore more expensive) screening activities conducted over a 6-month period, offering a small financial incentive to tertiary students through text messaging over a 4-day period significantly increased participation in on-c us chlamydia screening. This model could readily be applied to other populations to increase participation in chlamydia screening.
Publisher: SAGE Publications
Date: 04-2007
DOI: 10.1258/095646207780658863
Abstract: Ethambutol is commonly used for the treatment of tuberculous and atypical mycobacterial infection. Central nervous system (CNS) toxicity other than optic neuropathy is not widely reported. A 40-year-old man with advanced HIV infection and Mycobacterium avium complex infection experienced rapid cognitive decline after commencement of ethambutol, and symptoms fully resolved with cessation.
Publisher: Therapeutic Guidelines Limited
Date: 02-2018
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Sarah Martin.