ORCID Profile
0000-0003-3798-830X
Current Organisation
Gold Coast Hospital and Health Service
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Publisher: Springer Science and Business Media LLC
Date: 08-11-2016
DOI: 10.1007/S10461-016-1598-0
Abstract: In Australia, approximately 30% of people diagnosed with HIV are not accessing treatment and 8% of those receiving treatment fail to achieve viral suppression. Barriers limiting effective care warrant further examination. This mixed-methods systematic review accessed health and social sector research databases between November and December 2015 to identify studies that explored the perspective of people living with HIV in Australia. Articles were included for analysis if they described the experiences, knowledge, attitudes and beliefs, in relation to treatment uptake and adherence, published between January 2000 and December 2015. Quality appraisal utilised the Mixed Methods Appraisal Tool Version 2011. Seventy-two studies that met the inclusion criteria were reviewed. The interplay of lack of knowledge, fear, stigma, physical, emotional and social issues were found to negatively impact treatment uptake and adherence. Strategies targeting both the in idual and the wider community are needed to address these barriers.
Publisher: CSIRO Publishing
Date: 2009
DOI: 10.1071/SH09010
Abstract: Background: To examine the relationship between genital chlamydia testing by healthcare providers and patient demographic characteristics in Tasmania, Australia, from 2001 to 2007. Methods: Analysis of enhanced surveillance data for genital Chlamydia trachomatis infections notified to the Tasmanian Communicable Diseases Prevention Unit between 1 January 2001 and 31 December 2007. Results: General practitioners identify most cases of genital chlamydia infection, irrespective of patient age, gender, indigenous status or urban status. Tests that are performed for screening purposes identify the largest number of cases in females, particularly in very young females. In males, tests performed due to the presence of clinical symptoms identify the majority of cases. However, tests performed for the purposes of contact tracing also identify a substantial burden of genital chlamydia infection, particularly in males. Conclusions: The present study demonstrates the critical role the general practitioner has in the identification of genital chlamydia infection. Opportunistic screening for genital chlamydia, including in the context of contact tracing, is an essential clinical activity that results in the identification of substantial numbers of cases of infection. Policy makers and public health practitioners should support general practice screening initiatives and remove the barriers to genital chlamydia screening in general practice.
Publisher: Wiley
Date: 10-2003
DOI: 10.1046/J.0004-8666.2003.00096.X
Abstract: A descriptive survey of knowledge of genital herpes and attitudes to testing was conducted among antenatal clinic attendees at the Gold Coast Hospital, Australia. The study subjects showed a good knowledge of genital herpes, to a level that appears sufficient for an informed choice regarding herpes serology testing to be made. A preference for testing for genital herpes was suggested. Although serological testing is not routinely required, the results of the study indicate that discussion of genital herpes should be considered in the antenatal clinic setting.
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/SH14201
Abstract: Background Chlamydia remains Australia’s most frequently notified communicable disease however, interpretation of notification data is difficult without knowledge of testing practices. This study examined the value of reporting positivity trends. Methods: Tasmanian population-level chlamydia laboratory tests and notification data from 2001 to 2010 were compared. Results: Notifications, tests and positivity increased, most significantly in males and females aged 15–29 years. Conclusions: Analysis of chlamydia positivity trends can inform the development, monitoring and evaluation of prevention and control activities and improves the interpretation of notification trends. After allowing for testing effort, an increase in chlamydia infections in young people was found.
Publisher: Informa UK Limited
Date: 05-2011
DOI: 10.2147/RMHP.S12710
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/SH16146
Abstract: Background Clinical guidelines recommend annual chlamydia tests for all sexually active people aged 15–29 years. This study measured adherence to these guidelines and compared testing rates to the projected levels required to reduce chlamydia prevalence. Methods: All chlamydia tests conducted in Tasmania during 2012–13, for residents aged 15–29 years, were linked. Data linkage allowed in iduals who had multiple tests across different healthcare settings to be counted only once each year in analyses. Rates of testing and test positivity by age, sex, rebate status and socioeconomic indicators were measured. Results: There were 31 899 eligible tests conducted in 24 830 in iduals. Testing coverage was higher in females (21%, 19 404/92 685) than males (6%, 5426/98 123). Positivity was higher in males (16%, 862/5426) than females (10%, 1854/19 404). Most tests (81%, 25 803/31 899) were eligible for a rebate. Positivity was higher in females with non-rebatable tests (12%, 388/3116 compared with those eligible for a rebate (9%, 1466/16 285). More testing occurred in areas of middle disadvantage (10%, 9688/93 678) compared with least (8%, 1680/21 670) and most (10%, 7284/75 460) (both P 0.001) disadvantaged areas. Higher test positivity was found in areas of most-disadvantage (11%, 822/7284) compared with middle- (10%, 983/9688) and least- (8%, 139/1680) disadvantaged areas. Conclusions: Chlamydia testing rates are lower than recommended levels. Sustaining the current testing rates in females aged 20–24 years may reduce population prevalence within 10 years. This study meets key priorities of national strategies for chlamydia control by providing a method of monitoring testing coverage and evidence to evaluate prevention programs.
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/SH16137
Abstract: Background Chlamydia re-infection increases the likelihood of adverse long-term sequelae. Clinical guidelines recommend retesting at 3–12 months for in iduals with positive results, to detect re-infections. Retesting and test positivity levels were measured in young people who previously tested positive for chlamydia infection. Methods: All chlamydia tests conducted during 2012–13 in Tasmanian residents aged 15–29 years were linked. Retesting and retest positivity rates were calculated by sex, age, socioeconomic indicators and test timeframe. Results: Retesting rates were higher in females than males at 3 months (14.5%, n = 242/1673 vs 10%, n = 71/721) (P 0.01) and 12 months (27%, 265/968 vs 24%, 98/410) (P = 0.24). The retesting rate was higher in females living in areas of most disadvantage (35.5%, 154/434) compared with areas of middle and least disadvantage (26% 139/534) (P 0.01). Males were more likely than females to retest positive at 3 months (35%, 25/71 vs 23%, 55/242) (P 0.01) retest positivity at 12 months was 32% in both sexes (males 98/140 females 265/968). Retest positivity was higher in males living in areas of least disadvantage (43%, 3/7) compared with middle (24%, 16/67) (P = 0.27) and most (27%, 10/37) (P = 0.09) and higher in females living in areas of least disadvantage (39%, 7/18) compared with middle (24%, 29/121) (P 0.01) and most (31%, 48/154) (P = 0.02). Conclusions: Retesting rates are low in Tasmania and retest positivity is high, reinforcing the importance of promoting safer sex practices, partner notification and treatment, and retesting.
Publisher: Elsevier BV
Date: 08-2016
Abstract: The proportion of positive chlamydia tests in young people in Tasmania increased significantly between 2001 and 2010. While female positivity rates increased steadily, male positivity rose steeply to 2005 then stabilised. Crude positivity rates can be influenced by a variety of factors making interpretation difficult. Unique Tasmanian datasets were used to explore whether symptom status, reason for testing or sexual exposure could explain the observed positivity trends. Population-level chlamydia positivity rates in Tasmania over a 10-year period were compared with surveillance data collected on people aged 15 to 29 years notified with chlamydia. The proportion of asymptomatic chlamydia cases increased, with the largest increase in males aged 15 to 19 years (28%). Opportunistic testing of cases increased (greatest in males, range 17-32%). Sexual exposure remained consistent. After allowing for any changes in sexual exposure, symptom status and reason for testing, an increase in chlamydia positivity occurred over the 10 years. Healthcare providers have increased chlamydia testing in high-risk groups. Monitoring chlamydia testing patterns and positivity rates at a population level is a step forward in surveillance practices. Targeted surveys provide valuable information to supplement routine surveillance data.
Publisher: Elsevier BV
Date: 04-2010
DOI: 10.1111/J.1753-6405.2010.00494.X
Abstract: To investigate trends in notification rates of Chlamydia trachomatis in Tasmania, Australia, by population sub-groups, from 1 January 2001 to 31 December 2007. An enhanced surveillance dataset was used to supplement case notifications. Rates based on age group were analysed by sex, geographic region, indigenous status, sexual exposure, reason for testing and healthcare provider. In all age groups, the notification rate increased steeply. The highest rates were seen in the ages 15-24 years this age group represented 15% of the population but accounted for 74% of the chlamydial notifications. The increased rates in females aged 15-24 years and males 15-19 years in Tasmania were larger than the increases observed nationally. Rates were consistently higher in urban areas. Females were more likely to have been tested as a result of screening, and males were more likely to have been tested when presenting with symptoms or as a result of contact tracing. The majority of cases reported sexual exposure with opposite sex partners only. This study highlights the increasing significance of chlamydial infection as a public health issue, the gender differences in health-seeking behaviour, and the discrepancies in testing patterns. These findings will assist with the design of health promotion programs.
No related grants have been discovered for Maree O'Sullivan.