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We are seeking contributions for a Special Issue.. More


Sexual Health publishes contributions on sexual health from the widest perspectives including HIV/AIDS, STIs, issues of sexuality, and reproductive health. More

Editors: Christopher Fairley and Roy Chan


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Published online 10 April 2014
Testing for ‘threads’ and leucocyte esterase in first-void urine to exclude the diagnosis of non-specific urethritis in asymptomatic men 
Sanjeeva N. S. Pallawela, Christopher Sonnex, Julia Burdett, Dawn Cooper, Katrina Nethercott, Catherina M. Thomas, Peter Goon, Hayley Webb and Christopher Carne

The aim of this pilot study was to determine if testing for urinary threads, and/or leucocyte esterase (LE) or both in asymptomatic men is a good screening tool for nonspecific urethritis (NSU). Of the126 asymptomatic men, 8% met microscopic criteria for the diagnosis of NSU. The negative predictive value for threads and LE was 96% and 93% and combining both gave a negative predictive value of 96%. The absence of threads and negative LE makes urethritis highly unlikely, making urinary nucleic acid amplification testing sufficient.

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Published online 02 April 2014
Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence 
David J. Templeton, Phillip Read, Rajesh Varma and Christopher Bourne

A literature review was performed to inform the 2014 update of the Australian testing guidelines for asymptomatic men who have sex with men (MSM). Key changes include a recommendation for pharyngeal chlamydia testing, use of nucleic acid amplification tests alone for gonorrhoea testing, more frequent gonorrhoea and chlamydia testing in HIV-positive MSM, shorter time required since last void for chlamydia first-void urine collection, and the use of electronic reminders to increase STI and HIV retesting rates among MSM.

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Published online 12 March 2014
Can treatment-based HIV prevention curb the epidemic among gay and other men who have sex with men? A narrative synthesis of increasing evidence for moderating and countervailing effects 
John B. F. de Wit and Philippe C. G. Adam

As HIV epidemics among gay and other men who have sex with men (GMSM) persist, there is hope that the use of antiretroviral therapy (ART) for prevention can curb infections. However, evidence of the beneficial effects of ART-based HIV prevention for GMSM remains limited. ART-based approaches increase people’s options to protect themselves and others, but their impact depends on what has already been achieved and how they will be used.

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Published online 10 February 2014
Recently diagnosed gay men talk about HIV treatment decisions 
Ian Down, Garrett Prestage, Kathy Triffitt, Graham Brown, Jack Bradley and Jeanne Ellard

In recent years there has been increasing evidence that early initiation of antiretroviral therapy may provide health benefits for those infected with HIV while also reducing the risk of onward transmission of the virus. Recently-diagnosed gay men, interviewed as part of the HIV Seroconversion Study, were asked about their knowledge and experience of, and their decisions about whether or not to commence, HIV treatment.

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Published online 07 February 2014
Predicting the population impact of increased HIV testing and treatment in Australia 
James Jansson, Cliff C. Kerr and David P. Wilson

A model is used to simulate the expected outcomes of treatment-as-prevention strategies in Australia under assumptions of varying levels of treatment efficacy.

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Published online 20 January 2014
Transforming Australia’s HIV prevention and treatment efforts to achieve an AIDS-free generation: the United Nations Political Declaration on HIV/AIDS and the Melbourne Declaration ‘Action on HIV’ 
Bill Whittaker

Scientific advances in HIV prevention and treatment, together with the 2011 United Nations Political Declaration on HIV/AIDS, offer unique opportunities to transform the global fight against AIDS. However, progress in responding to these opportunities has been mixed, prompting Australian scientists, clinicians and community advocates to issue the Melbourne Declaration ‘Action on HIV’, which calls for Australia’s HIV response to be revitalised through several key actions. These changes can strengthen Australia’s HIV response domestically and also enhance Australia’s leadership in the global quest to achieve an ‘AIDS-free generation’.

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Published online 17 January 2014
Current status of HIV treatment in Asia and the Pacific region 
Angsana Phuphuakrat, Sasisopin Kiertiburanakul and Somnuek Sungkanuparph

Access to HIV treatment and care vary between countries in Asia and the Pacific. Differences between high-income economies and the rest of the region are remarkable. Many high-income countries provide antiretroviral therapy (ART) to their citizens; middle- and low-income countries have rapid ART scale-up and are dependent on international funding. The global goal of achieving universal access to ART requires mainly low- and middle-income countries to be targeted.

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Published online 13 December 2013
The key role of adherence for the effectiveness of antiretroviral-based prevention: state of the science and implications for the Asia-Pacific region 
K. Rivet Amico

This paper reviews the behavioural factors influencing uptake and impact of treatment-as-prevention and pre-exposure prophylaxis. The behavioural pathways to control the HIV epidemic with these biobehavioural strategies are explored, and gaps in current knowledge are identified. Implications for each strategy in the Asia-Pacific region are considered, and critical issues in moving forward are highlighted.

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Published online 11 October 2013
Acceptability of oral and topical HIV chemoprophylaxis in India: implications for at-risk women and men who have sex with men 
Nomita Chandhiok, Smita N. Joshi and Raman Gangakhedkar

The underlying determinants for acceptability of HIV chemoprophylaxis include the individual, couple dynamics and the larger social and cultural context. Overall, Indian women and men had a positive attitude towards the concept and use of microbicide products. However, the need for HIV chemoprophylaxis is greatest for high-risk groups like female sex walkers and men who have sex with men. Acceptability in these groups needs to be further explored, including demonstration projects for program introduction.

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Published online 19 July 2013
HIV pre-exposure prophylaxis and treatment as prevention: a review of awareness and acceptability among men who have sex with men in the Asia-Pacific region and the Americas 
Martin Holt

This review assesses acceptability research for HIV pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) among men who have sex with men (MSM). There has been limited research on the acceptability of PrEP outside the United States and no research to date evaluating the acceptability of TasP. PrEP appears to be reasonably acceptable to MSM, but studies of HIV treatment optimism suggest that MSM will be sceptical of TasP.

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Volume 11 Number 1 2014

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Table of Contents 
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Hepatitis B in men who have sex with men and HIV-infected individuals: missed opportunities and future challenges 
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Nicole Allard and Benjamin Cowie
pp. 1-4

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Incident hepatitis B infection subsequent to the diagnosis of HIV infection in a Melbourne cohort: missed opportunities for prevention 
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Amy Body, Jennifer F. Hoy, Allen C. Cheng and Michelle L. Giles
pp. 5-10

This study reports incident hepatitis B infection in HIV-positive individuals in the Australian context. Of 4711 HIV-infected individuals, 39 conversions to hepatitis B occurred resulting in an incidence rate of 1.81 per 1000 patient-years risk. A detailed case series and case–control study are reported. Optimal control of HIV and improved vaccination coverage continue to provide the best opportunity for prevention.


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A comparative study of brain activation patterns associated with sexual arousal between males and females using 3.0-T functional magnetic resonance imaging 
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Gwang-Won Kim and Gwang-Woo Jeong
pp. 11-16

Most functional magnetic resonance imaging (fMRI) studies focusing on the discrimination of gender differences associated with sexual arousal have been performed on a 1.5-T fMRI system. This study used a 3.0-T fMRI to provide more accurate brain activation information by enhancing detection power and spatial specificity than does a conventional 1.5 T.


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HIV service capacity: identifying current and future areas of clinical shortage 
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Kylie-Ann Mallitt, James Jansson, Handan Wand, Levinia Crooks and David P. Wilson
pp. 17-23

The ability of HIV clinical services to meet demand in Australia has not been evaluated. We use a novel methodology to identify areas of HIV clinical undersupply. We identified seven geographical clusters that are significantly undersupplied with HIV doctors relative to the number of people living with HIV. Training of clinicians in HIV case management and shared-care clinicians should be directed towards these areas, particularly locations in rural and remote areas.


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Families of choice and noncollegiate sororities and fraternities among lesbian and bisexual African-American women in a southern community: implications for sexual and reproductive health research 
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Erika L. Austin, Lisa L. Lindley, Leandro A. Mena, Richard A. Crosby and Christina A. Muzny
pp. 24-30

We conducted focus groups and individual interviews with lesbian and bisexual African-American women in Jackson, Mississippi to characterise the role of lesbian families and lesbian sororities and fraternities among the lesbian, gay, bisexual and transgender community and their influence on sexual health. Both types of organisations were found to serve positive functions. These organisations should be incorporated into community-based popular opinion leader or lay heath advisor interventions in an effort to meet the sexual and reproductive health needs of marginalised populations.


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Correlates of condom use among males in North Sudan 
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Badreldin A. Mohamed
pp. 31-36

The aim of this study was to assess factors influencing condom use in Khartoum, Sudan. A cross-sectional survey was conducted for this purpose among a random sample of 804 respondents aged 20–40 years. The study revealed that 12% of the study sample reported condom use, while 46.3% were nonusers. Knowing someone who is infected with or had died of AIDS, experiencing condom problems and type of sexual partners were the main predictors of condom use.


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An evaluation of an express testing service for sexually transmissible infections in low-risk clients without complications 
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Nimal Gamagedara, Sheranne Dobinson, Rosey Cummings, Christopher K. Fairley and David Lee
pp. 37-41

The control of sexually transmissible infections is dependent on allowing for easy access to screening, diagnosis and treatment of priority populations. In order to allow for targeted screening, more efficient clinical services need to be instigated by fast-tracking those at lower risk of acquiring/transmitting sexually transmissible infections, to avoid creating a ‘bottle neck’ and obstructing access to clinical services for those populations which are at a higher epidemiological risk.


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Gender norms and sexual behaviours among men in western Jamaica 
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Melonie M. Walcott, Ellen Funkhouser, Maung Aung, Mirjam C. Kempf, John Ehiri, Kui Zhang, Marion Bakhoya, Deborah Hickman and Pauline E. Jolly
pp. 42-51

We conducted a cross-sectional survey of 549 men aged 19–54 years in the western region of Jamaica to assess the association between gender norms and multiple sexual partners. Attitudes towards gender norms were measured using the gender equitable men and Macho scales. Men with moderate and high support of masculinity and inequitable gender norms were more likely to report multiple sex partners. These results highlight the need for behaviour-change interventions addressing gender norms targeting Jamaican men.


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Management rates of sexually transmissible infections by Australian general practitioners, 2000–2012 
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Anthony J. Santella, Allan Pollack, Christopher Harrison, Shailendra N. Sawleshwarkar, Helena C. Britt and Richard J. Hillman
pp. 52-57

In Australia, general practitioners (GPs) manage the majority of sexually transmissible infections (STIs). Data from 1 178 400 patient encounters by 11 784 GPs during April 2000–March 2012 were analysed. Herpes simplex virus and warts were the most common STIs managed, with chlamydia management rates significantly rising over time. Despite rising population rates of syphilis and gonorrhoea, no such changes in GP management rates were found. This may reflect limited access by at-risk communities.


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High prevalence and incidence of HIV, sexually transmissible infections and penile foreskin cutting among sexual health clinic attendees in Papua New Guinea 
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Andrew Vallely, Claire E. Ryan, Joyce Allen, Joyce C. Sauk, Cassey S. Simbiken, Johanna Wapling, Petronia Kaima, Zure Kombati, Greg Law, Glenda Fehler, John M. Murray, Peter Siba and John M. Kaldor
pp. 58-66

Papua New Guinea has among the highest prevalences of HIV and sexually transmissible infections (STIs) in the Asia-Pacific region but only limited clinical research in sexual and reproductive health has been conducted to date. In a longitudinal cohort study carried out at two sexual health clinics, the prevalence and incidence of STIs, HIV and penile cutting were high, and over 80% follow-up was achieved at one year, suggesting that this population may be suitable for future interventions research and clinical trials.


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Uptake, yield and resource requirements of screening for asymptomatic sexually transmissible infections among HIV-positive people attending a hospital outpatient clinic 
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Stephen Ritchie, Rebecca Henley, Jackie Hilton, Rupert Handy, Joan Ingram, Susan Mundt, Mitzi Nisbet, Mark Thomas and Simon Briggs
pp. 67-72

We initiated a screening programme for asymptomatic sexually transmissible infections among people living with HIV/AIDS in our hospital outpatient clinic. Asymptomatic infections were identified only among men who have sex with men. Almost half of the men who were diagnosed, did not consider themselves to be at risk of infection.

    | Supplementary Material (1.8 MB)

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Validity of the Premature Ejaculation Diagnostic Tool in four subgroups of premature ejaculation syndrome: data from the Korean Internet Sexuality Survey – part 1 
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Sang Hoon Song, Woo Seok Choi, Hwancheol Son and Jae-Seung Paick
pp. 73-80

This population-based cross-sectional survey assessed the ability of the premature ejaculation diagnostic tool (PEDT) to differentiate four subgroups of PE (lifelong, acquired, variable and subjective PE) and concluded that the PEDT is not appropriate for research into four subgroups of PE when used in a general male population study, unless the PEDT is combined with an additional questionnaire with specific questions on the four PE subgroups.


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Concurrent partnering and condom use among rural heterosexual African-American men 
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JaNelle M. Ricks, Angelica Geter, Richard A. Crosby and Emma Brown
pp. 81-83

Limited research has targeted HIV risk among heterosexual African-American men in rural south-eastern USA. This study explored sexual risk behaviour of African-American men by sexual concurrency status. Reported consistent condom use was significantly greater among those reporting current monogamy. Odds of consistent condom use increased in proportion to the number of recent female sex partners, which may indicate a positive response by these men to the AIDS epidemic.


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Being drunk and high during sex is not associated with condom use behaviours: a study of high-risk young Black males 
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Richard A. Crosby, Robin R. Milhausen, Stephanie Sanders, Cynthia A. Graham and William L. Yarber
pp. 84-86

This study of young Black males in the USA attending clinics that diagnose and treat sexually transmitted infections found that the occurrence of condom use errors and problems was largely unrelated to being drunk or high during sex. Findings suggest that safer sex intervention programs that focus on avoiding alcohol and drug use may not be optimally serving this population.


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Potential gender and age differences in the performance of five condom-related behaviours in the United Kingdom 
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Jude Hancock
pp. 87-88

Safer sex is important and comprises of a series of five condom-related behaviours: accessing, carrying, negotiating, using and disposing. This study explored potential gender and age differences in these condom-related behaviours. Data suggests gender differences exist for accessing, carrying and disposing behaviours. An age difference was seen in accessing behaviour. Therefore future safer sex interventions should acknowledge the potential gender and age differences in these condom-related behaviours.


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Rapid HIV testing increases the rate of HIV detection in men who have sex with men: using rapid HIV testing in a primary care clinic 
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Beng Eu, Norman Roth, Mark Stoové, Mark O'Reilly and Edward Clarke
pp. 89-90

Rapid HIV testing was approved in Australia in December 2012. Data was collected to describe the early experience of using rapid testing in Australia but as the information was collected, the authors noted that there appeared to be a high rate of HIV diagnoses amongst rapid testers. Further analysis confirmed this impression, when the rate was compared to a baseline rate of HIV diagnoses over the 32 months before the rapid testing started (4.1% vs 1.3%).


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Sexual health, vulnerabilities and risk behaviours among homeless adults 
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Verena Strehlau, Iris Torchalla, Isabelle Linden, Kathy Li and Michael Krausz
pp. 91-93

It is well known that homeless individuals are at risk for a variety of health problems, including sexually transmissible infections. Optimisation of health services for the homeless requires knowledge of their sexual health. The sexual health and sexual vulnerability factors of 500 homeless adults (196 women) were assessed in a cross-sectional survey in three Canadian cities. Our data indicate that a significant proportion of individuals and more women than men reported multiple experiences that compromise their sexual health exponentially. These findings may inform health policies related to sexuality to foster positive sexual health outcomes for all people, including marginalised populations.


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Sexually transmitted infection testing practices among ‘money boys’ and general men who have sex with men in Shanghai, China: objective versus self-reported status 
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Lavinia Lin, Eric J. Nehl, Alvin Tran, Na He, Tony Zheng and Frank Y. Wong
pp. 94-96

Little is known about sexually transmitted infection (STI) testing among Chinese men who have sex with men (MSM). This study describes the prevalence of STI testing, associated factors and the validity of STI self-reporting among Chinese MSM. Findings indicated a high prevalence of STIs and low testing rates among MSM in Shanghai. Efforts are needed to ensure that STI testing services are accessible to MSM in China. Future HIV and STI interventions should be tailored to the needs of different subsets of MSM.


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These articles have been peer reviewed and accepted for publication. They are still in production and have not been edited, so may differ from the final published form.

    SH14071  Accepted 09 April 2014
    Bringing new HIV infections to zero: opportunities and challenges offered by ARV-based prevention in Asia, the Pacific and beyond An overview of this special issue
    Iryna Zablotska, Bill Whittaker, John de Wit, Adeeba Kamarulzaman, Jintanat Ananworanich, Edwina Wright, Mary Poynten, Kenneth Mayer

    SH13159  Accepted 06 April 2014
    Condom use motivations and selected behaviors with new versus established sex partners
    Richard Crosby, Robin Milhausen, Cynthia Graham, William Yarber, Stephanie Sanders, Richard Charnigo, Lydia Shrier

    SH14025  Accepted 19 March 2014
    Adherence-enhancing interventions for active anti-retroviral therapy in sub-Saharan Africa: a systematic review and meta-analysis
    Tim Mathes, Sunya-Lee Antoine, Dawid Pieper

    SH13094  Accepted 11 March 2014
    Challenges and potential barriers to the uptake of ARV-based prevention in Asia
    Ying-Ru Lo, Masaya Kato, Nittaya Phanupak, Masami Fujita, Duong Bui Duc, Seng Sopheap, Razia Pendse, Dong-Bao Yu, Zunyou Wu, Suwat Chariyalertsak

    SH13119  Accepted 10 March 2014
    Biomedical HIV prevention research and epidemic control in Thailand: two sides of different coins
    Frits van Griensven, Nittaya Phanuphak, Kriengkrai Srivattanasriboonchai

    SH14022  Accepted 04 March 2014
    Psycho-social factors related to willingness to use pre-exposure prophylaxis for HIV prevention among Black men who have sex with men attending a community event
    Lisa Eaton, Daniel Driffin, Harlan Smith, Christopher Conway-Washington, Denise White, Chauncey Cherry

    SH14017  Accepted 27 February 2014
    Social support and depressive symptoms among money boys and general men who have sex with men in Shanghai, China
    Huamei Yan, Frank Wong, Tony Zheng, Zhen Ning, Yingying Ding, Eric Nehl, Lavinia Lin, Na He

    SH13153  Accepted 17 February 2014
    Female sexual dysfunction among the three pregnancy trimesters: An Egyptian study
    Samy Hanafy, Neveen Srour, Taymour Mostafa

The Most Read ranking is based on the number of downloads from the CSIRO PUBLISHING website of articles published in the previous 12 months. Usage statistics are updated daily.

Rank Paper Details
1. Published 11 June 2013
The origins of the condom

Ismael Maatouk and Roy Moutran

2. Published 1 August 2013
The impact of living with HIV: differences in experiences of stigma for heterosexual and homosexual people living with HIV in Australia

Loren Brener, Hannah Wilson, Sean Slavin and John de Wit

3. Published 11 June 2013
Chlamydia screening interventions from community pharmacies: a systematic review

Sajni Gudka, Folasade E. Afuwape, Bessie Wong, Xuan Li Yow, Claire Anderson and Rhonda M. Clifford

4. Published 14 October 2013
Are Australian sexual health clinics attracting priority populations?

Hammad Ali, Basil Donovan, Christopher K. Fairley, Nathan Ryder, Anna McNulty, Marcus Y. Chen, Lewis Marshall, Catherine C. O'Connor, Bridget Dickson, Andrew E. Grulich, Margaret E. Hellard, John M. Kaldor and Rebecca J. Guy

5. Published 1 August 2013
Men who have sex with men, infectious syphilis and HIV coinfection in inner Sydney: results of enhanced surveillance

Susan J. Botham, Kelly-Anne Ressler, Patrick Maywood, Kirsty G. Hope, Chris P. Bourne, Stephen J. Conaty, Mark J. Ferson and Darren J. Mayne

6. Published 12 April 2013
Increases in newly acquired HIV infections in Victoria, Australia: epidemiological evidence of successful prevention?

Anita Feigin, Carol El-Hayek, Margaret Hellard, Alisa Pedrana, Ellen Donnan, Christopher Fairley, B. K. Tee and Mark Stoové

7. Published 12 April 2013
Elevated reporting of unprotected anal intercourse and injecting drug use but no difference in HIV prevalence among Indigenous Australian men who have sex with men compared with their Anglo-Australian peers

Toby Lea, Michael Costello, Limin Mao, Garrett Prestage, Iryna Zablotska, James Ward, John Kaldor, John de Wit and Martin Holt

8. Published 11 June 2013
Anatomic distribution of Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium infections in men who have sex with men

N. Reinton, H. Moi, A. O. Olsen, N. Zarabyan, J. Bjerner, T. M. Tønseth and A. Moghaddam

9. Published 1 August 2013
The potential impact of new generation molecular point-of-care tests on gonorrhoea and chlamydia in a setting of high endemic prevalence

Ben B. Hui, David P. Wilson, James S. Ward, Rebecca J. Guy, John M. Kaldor, Matthew G. Law, Jane S. Hocking and David G. Regan

10. Published 1 August 2013
Facilitating partner notification through an online messaging service: Let Them Know

Sarah Huffam, Christopher K. Fairley, Mark Chung, Jun Kit Sze, Jade Bilardi and Marcus Y. Chen

11. Published 14 October 2013
Masculinity, condom use self-efficacy and abusive responses to condom negotiation: the case for HIV prevention for heterosexual African-American men

Jerris L. Raiford, Puja Seth, Nikia D. Braxton and Ralph J. DiClemente

12. Published 12 April 2013
What proportion of sexually transmissible infections and HIV are diagnosed in New South Wales’ public sexual health services compared with other services?

Chris Bourne, Debbie Allen, Katherine Brown, Stephen C. Davies, Anna McNulty, Don E. Smith, Catherine C. O'Connor, Deborah Couldwell, Eva Jackson, Michale Bolton, Craig Rodgers, Pam Konecny, David J. Smith and Angela Parker

13. Published 26 March 2014
Management rates of sexually transmissible infections by Australian general practitioners, 2000–2012

Anthony J. Santella, Allan Pollack, Christopher Harrison, Shailendra N. Sawleshwarkar, Helena C. Britt and Richard J. Hillman

14. Published 12 April 2013
Abacavir exposure and cardiovascular risk factors in HIV-positive patients with coronary heart disease: a retrospective case–control study

Janine M. Trevillyan, Allen C. Cheng and Jennifer Hoy

15. Published 22 November 2013
Prevention and control of sexually transmissible infections among hotel-based female sex workers in Dhaka, Bangladesh

Duncan F. McCormick, Motiur Rahman, Sabrina Zadrozny, Anadil Alam, Lutfa Ashraf, Graham A. Neilsen, Robert Kelly, Prema Menezes, William C. Miller and Irving F. Hoffman

16. Published 1 August 2013
Effective peer education in HIV: defining factors that maximise success

Steven M. Lambert, Joseph Debattista, Aleksandar Bodiroza, Jack Martin, Shaun Staunton and Rebecca Walker

17. Published 22 November 2013
Qualitative exploration of HIV-related sexual behaviours and multiple partnerships among Chinese men who have sex with men living in a rural area of Yunnan Province, China

Eric P. F. Chow, Liangmin Gao, Fung Kuen Koo, Liang Chen, Xiaoxing Fu, Jun Jing, David P. Wilson and Lei Zhang

18. Published 1 August 2013
Preconception reflections, postconception intentions: the before and after of birth control in Australian adolescent females

Jennifer Lawson Smith, S. Rachel Skinner and Jennifer Fenwick

19. HIV pre-exposure prophylaxis and treatment as prevention: a review of awareness and acceptability among men who have sex with men in the Asia-Pacific region and the Americas

Martin Holt

20. Published 14 October 2013
HIV and hepatitis C virus co-infection among men who have sex with men in Sydney, and associations with sexual and drug use practices

Toby Lea, Evelyn Lee, Limin Mao, John de Wit and Martin Holt

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