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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

AIDS 2014: We would like to express our deepest sympathies to the families, friends and colleagues of delegates lost on MH17.
Out of respect for their work we are making our HIV Special Issue freely available online for 3 months until the end of October.


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Published online 09 October 2014
Who‘s cheating? Agreements about sexual exclusivity and subsequent concurrent partnering in Australian heterosexual couples 
Juliet Richters, Wendy Heywood, Marian K. Pitts, Julia M. Shelley, Judy M. Simpson, Kent Patrick and Anthony M. A. Smith

An Australian national representative sample of people aged 16–64 years in regular relationships completed telephone interviews, including questions about sexual exclusivity (i.e. whether they would have sex with anyone else). The vast majority (96%) expected their relationship to be exclusive (monogamous). However, only 48% of men and 64% of women had discussed the matter and explicitly agreed. Only 1% reported open relationships. A year later, most respondents (93%) were still in the same relationship, among whom 4% of men and 2% of women had had sex with someone else; most of them were in relationships that were expected to be monogamous.

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Published online 15 September 2014
Association between known recent HIV infections and methamphetamine use (ASK HIM study) in Melbourne between 2011 and 2013: a case-control study 
Beng Eu and Norman Roth

There has been an increase in new HIV infections in Australia over the past 3 years mainly in men who have sex with men. The ASK HIM study looks at the association between HIV cases diagnosed in Victoria between 2011 and 2013 in men who have sex with men (MSM) and methamphetamine use by comparing usage rates in this group with usage rates in a control group.

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Published online 09 September 2014
Vaccination against oncogenic human papillomavirus infection in HIV-infected populations: review of current status and future perspectives 
Lars Toft, Martin Tolstrup, Merete Storgaard, Lars Østergaard and Ole S. Søgaard

This paper reviews the current knowledge about with human papillomavirus (HPV) vaccination in HIV-infected populations. Current knowledge is limited; however, vaccination against HPV infection may be appropriate in certain HIV-infected populations.

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Published online 09 September 2014
Tuberculosis (TB)-associated immune reconstitution inflammatory syndrome in TB-HIV co-infected patients in Malaysia: prevalence, risk factors, and treatment outcomes 
Hong Yien Tan, Yean Kong Yong, Sin How Lim, Sasheela Ponnampalavanar, Sharifah F. S. Omar, Yong Kek Pang, Adeeba Kamarulzaman, Patricia Price, Suzanne M. Crowe and Martyn A. French

This is the first reported study to examine the incidence of, risk factors for, and consequences of tuberculosis (TB)-associated immune reconstitution inflammatory syndrome (TB-IRIS) in HIV patients from Malaysia. Approximately 9% of HIV-TB patients who commenced antiretroviral therapy developed TB-IRIS. Disseminated TB was the major risk factor. Patient survival and recovery of CD4 T cell counts were similar in TB-IRIS patients and HIV/TB patients who did not develop TB-IRIS.

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Volume 11 Number 4 2014

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Table of Contents 
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High rates of sexually transmissible infections in HIV-positive patients in the Australian HIV Observational Database: a prospective cohort study 
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Brian P. Mulhall , Stephen Wright , Debbie Allen , Katherine Brown , Bridget Dickson , Miriam Grotowski , Eva Jackson , Kathy Petoumenos , Phillip Read , Timothy Read , Darren Russell , David J. Smith , David J. Templeton , Christopher K. Fairley and Matthew G. Law
pp. 291-297

Sexually transmissible infections (STI) enhance transmission of HIV, probably even in the context of viral suppression by antiretroviral drugs. This study demonstrates high incidence rates for four STI (chlamydia, gonorrhoea, warts and syphilis) in a longitudinal treatment cohort of HIV-infected individuals between 2005 and 2011.


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Sexual and reproductive health and philanthropic funding in Australia 
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Liz Gill-Atkinson , Cathy Vaughan and Hennie Williams
pp. 298-304

Australia’s philanthropic sector is often not well understood, and little is known about philanthropic funding for sexual and reproductive health (SRH) initiatives. In-depth interviews with those working for Australian philanthropic trusts and foundations, and those working to improve SRH, identified a range of barriers and facilitators to both seeking and providing philanthropic funding for SRH-focused initiatives. Addressing the barriers identified and promoting the facilitators could enhance awareness of the possible role that Australia’s philanthropic sector could play in improving the SRH of Australians.


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Attitudes towards microbicide use for bacterial vaginosis in pregnancy 
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Marina Catallozzi , Camille Y. Williams , Gregory D. Zimet , Katharine M. Hargreaves , Shari E. Gelber , Adam J. Ratner , Lawrence R. Stanberry and Susan L. Rosenthal
pp. 305-312

Microbicides could be an option for the prevention and treatment of bacterial vaginosis (BV) and other reproductive tract infections (RTIs) in pregnancy. Understanding pregnant women’s acceptability and use of these topical microbicide products will be crucial for future product development. In this qualitative study regarding hypothetical use of topical microbicides for BV, pregnant women were open to the use of a microbicide for the prevention, and particularly for the treatment, of BV for a variety of reasons, but especially if use would positively impact the baby’s health. Improved education regarding BV, its complications, overcoming practical problems in using microbicides and involving partners in decision making regarding microbicides may improve acceptability of microbicide use for BV.


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Assessment of psychosocial impact of genital warts among patients in Singapore 
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Lucinda S. Tan , Martin T. W. Chio , Priya Sen , Yong Kuei Lim , Joseph Ng , Arunachalam Ilancheran , Jeffrey J. Low , Yen Shing Yeoh , Roy K. Chan and Nan Luo
pp. 313-318

Genital warts are associated with a negative impact on quality of life. Patients experience significant psychosocial burden, with gender differences in certain aspects of their quality of life.


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Who are the sexual partners of transgender individuals? Differences in demographic characteristics and risk behaviours of San Francisco HIV testing clients with transgender sexual partners compared with overall testers 
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Erin C. Wilson , Yea-Hung Chen , Nayla Raad , H. Fisher Raymond , Teri Dowling and Willi McFarland
pp. 319-323

Multiple drivers of HIV risk among transwomen have been investigated in the literature to date, but little work has been done to examine the sexual networks of transwomen. This study utilises San Francisco city-wide data from HIV counselling and testing sites to identify characteristics of individuals who report having a transgender sexual partner and examines their HIV-related risk behaviours. We found higher rates of risk behaviours among sexual partners of transgender people yet lower HIV positivity when comparing to the overall testing sample. These findings point to the need for a rigorous examination of the sexual networks of transgender people to better understand the disproportionately higher risk for HIV.


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Epidemiology of gonorrhoea notifications in Australia, 2007–12 
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April Roberts-Witteveen , Kate Pennington , Nasra Higgins , Carolyn Lang , Monica Lahra , Russell Waddell and John Kaldor
pp. 324-331

An increase in the notification rate of gonorrhoea was observed in the Australian surveillance system. Data analysis showed that although notification rates have increased, epidemiology remained constant, with highest rates in Indigenous people in remote areas. The greatest increase in rates was for men in urban settings. Prevention efforts should be strengthened and further analysis incorporating laboratory testing data should be undertaken.


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Prevalence, correlates and attitudes towards sexting among young people in Melbourne, Australia 
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Timothy H. Yeung , Danielle R. Horyniak , Alyce M. Vella , Margaret E. Hellard and Megan S. C. Lim
pp. 332-339

‘Sexting’ is the exchange of sexually explicit material via communication technologies. We conducted a cross-sectional questionnaire with 1372 young people and focus group discussions with 39 young people to better understand this practice. We found that sexting was common (40% had ever sexted) and participants considered consensual sexting to be an acceptable and normal part of relationships.


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Declining trends in the proportion of non-viral sexually transmissible infections reported by STD clinics in the US, 2000–10 
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Kwame Owusu-Edusei , Bianca J. Sayegh , Alesia J. Harvey and Robert J. Nelson
pp. 340-344

Analyses of the proportion of non-viral sexually transmissible infections reported by STD clinics to the Centers for Disease Control from 2000 to 2010 showed significant declines for syphilis and gonorrhoea, and to a lesser extent for chlamydia.


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A novel time-limited pop-up HIV testing service for gay men in Sydney, Australia, attracts high-risk men 
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Vickie Knight , Marianne Gale , Rebecca Guy , Nicolas Parkhill , Jo Holden , Craig Leeman , Anna McNulty , Phillip Keen and Handan Wand
pp. 345-350

We compared uptake and outcomes of a novel time-limited pop-up community HIV testing service providing rapid HIV tests with those of an established fast-track screening service clinical model offering rapid and/or conventional HIV tests and tests for sexually transmissible infections (STI). This study showed that time-limited Pop-up community HIV testing is feasible and reached high-risk gay, bisexual and other men who have sex with men (GBM); however, compared with a clinic-based model, it only reached a smaller proportion of GBM who test infrequently or who have never been tested and are unaware of their HIV status. No STI testing was conducted through the Pop-up service, which allowed a higher throughput of HIV tests; however, a significant number of STIs may have been missed.


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Comparing health survey data from Internet- and paper-based convenience samples of lesbian women in Germany 
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Oliver Hirsch , Karina Löltgen and Annette Becker
pp. 351-358

A sample of lesbian women recruited via the Internet was compared with a paper-based sample. Both groups completed a questionnaire regarding demographic variables and questions regarding dealing with homosexuality, psychological burden, access to care and discrimination experience within the German healthcare system. Health survey data derived from Internet- and paper-based samples of lesbian women in Germany are not too dissimilar. Further research in additional contexts is needed to decide whether they can be merged for further analyses.


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Early age at first sex: associations with sexual health and sociodemographic factors among a sample of young music festival attendees in Melbourne 
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Alyce M. Vella , Paul A. Agius , Anna L. Bowring , Margaret E. Hellard and Megan S. C. Lim
pp. 359-365

Young age at first sex (AFS) is associated with adverse outcomes, including the acquisition of sexually transmissible infections. We explored factors and correlates of ‘early’ (<16 years) AFS among young festival attendees in Melbourne, Australia. Median AFS was 17 years; results indicated that being male, younger, having no post-high school education, multiple lifetime sex partners, reporting inconsistent condom use, living alone or with a partner and ever using drugs was associated with early AFS. Results highlight the importance of comprehensive sex education before sexual initiation


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Reattendance and chlamydia retesting rates at 12 months among young people attending Australian general practice clinics 2007–10: a longitudinal study 
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Emma R. Weaver , Anna L. Bowring , Rebecca Guy , Caroline van Gemert , Jane S. Hocking , Douglas I. Boyle , Tony Merritt , Clare Heal , Phyllis M. Lau , Basil Donovan and Margaret E. Hellard on behalf of the ACCESS Collaboration
pp. 366-369

Clinical guidelines commonly recommend annual chlamydia testing in young people. The Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Sexually Transmitted Infections and Blood-Borne Viruses system (ACCESS) extracted consultation and pathology data on 16–29-year-olds attending 25 general practice (GP) clinics in 2007–10. We calculated the proportion of individuals with an initial negative test that reattended at 12 months (±3 months) and retested at 12 months (±3 months). Although over half of young people reattended their GP clinic approximately 1 year after a negative chlamydia baseline test, retesting at this visit was low. Strategies are needed to promote regular attendance and testing to both patients and clinicians.


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Could point-of-care testing be effective for reducing the prevalence of trichomoniasis in remote Aboriginal communities? 
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Ben B. Hui , James Ward , Louise Causer , Rebecca J. Guy , Matthew G. Law and David G. Regan
pp. 370-374

A high prevalence of trichomoniasis is reported for many remote Indigenous communities despite intensive screening and treatment. In this modelling study we investigate the potential impact for point-of-care (POC) testing and treatment to reduce trichomoniasis prevalence in this population. Our results suggest that POC testing, in place of conventional testing, may improve trichomoniasis control, but emphasis should be placed on testing older women.


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Hepatitis E in Australian HIV-infected patients: an under-recognised pathogen? 
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Michelle K. Yong , Emma K. Paige , David Anderson and Jennifer F. Hoy
pp. 375-378

This cross-sectional study revealed a seroprevalence of hepatitis E virus (HEV) of 8% in a random sample of HIV-infected patients with normal liver function and 4.4% in those with biochemical hepatitis. This is greater than the seroprevalence in the Australian general population, such that HEV may be an under-recognised cause of hepatitis in the population of individuals with HIV infection and should be considered in those with unexplained hepatitis.


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Time trends in adolescent sexual behaviour in Italy 
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Claudia Marino , Alessio Vieno , Michela Lenzi and Massimo Santinello
pp. 379-380

This study describes trends in 15-year-old adolescent sexual behaviour in Italy from 2002 to 2010. The findings from this study expand the knowledge on adolescent sexual behaviour in Italy and indicate the importance of developing new strategies to improve sexual health among Italian adolescents.


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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.

    SH14182  Accepted 14 September 2014
    Introduction to the special issue on the second Australian Study of Health and Relationships
    Catherine Mercer, Marian Pitts, Martin Holt

    SH14142  Accepted 10 September 2014
    Over reporting of congenital syphilis in Guangzhou, China.
    Xingdong Ye, Shaokai Tang, Xiangnong Dai, Wanping He, Hhilan Zhu, Xibao Zhang

    SH14020  Accepted 12 September 2014
    BMI, self-esteem, and weight contentment from adolescence to young adulthood and women’s risk for sexually transmitted disease
    Michael Merten, Amanda Williams

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 14 July 2014
Predicting the population impact of increased HIV testing and treatment in Australia

James Jansson, Cliff C. Kerr and David P. Wilson

2. Published 14 July 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

3. 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

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 28 July 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

6. Published 9 September 2014
Prevalence, correlates and attitudes towards sexting among young people in Melbourne, Australia

Timothy H. Yeung, Danielle R. Horyniak, Alyce M. Vella, Margaret E. Hellard and Megan S. C. Lim

7. Published 14 July 2014
Recently diagnosed gay men talk about HIV treatment decisions

Ian Down, Garrett Prestage, Kathy Triffitt, Graham Brown, Jack Bradley and Jeanne Ellard

8. Published 9 September 2014
High rates of sexually transmissible infections in HIV-positive patients in the Australian HIV Observational Database: a prospective cohort study

Brian P. Mulhall, Stephen Wright, Debbie Allen, Katherine Brown, Bridget Dickson, Miriam Grotowski, Eva Jackson, Kathy Petoumenos, Phillip Read, Timothy Read, Darren Russell, David J. Smith, David J. Templeton, Christopher K. Fairley and Matthew G. Law

9. Published 28 July 2014
'I demand to be treated as the person I am': experiences of accessing primary health care for Australian adults who identify as gay, lesbian, bisexual, transgender or queer

Chee S. Koh, Melissa Kang and Tim Usherwood

10. Published 26 March 2014
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

Beng Eu, Norman Roth, Mark Stoové, Mark O'Reilly and Edward Clarke

11. 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

12. Published 26 March 2014
Incident hepatitis B infection subsequent to the diagnosis of HIV infection in a Melbourne cohort: missed opportunities for prevention

Amy Body, Jennifer F. Hoy, Allen C. Cheng and Michelle L. Giles

13. Published 22 November 2013
Identifying and understanding barriers to sexually transmissible infection testing among young people

Richard Oliver de Visser and Nancy O'Neill

14. 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

15. Published 26 March 2014
High prevalence and incidence of HIV, sexually transmissible infections and penile foreskin cutting among sexual health clinic attendees in Papua New Guinea

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

16. Published 14 July 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

17. Published 26 March 2014
An evaluation of an express testing service for sexually transmissible infections in low-risk clients without complications

Nimal Gamagedara, Sheranne Dobinson, Rosey Cummings, Christopher K. Fairley and David Lee

18. 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

19. Published 14 October 2013
One confirmed and one suspected case of pharyngeal gonorrhoea treatment failure following 500mg ceftriaxone in Sydney, Australia

Phillip J. Read, E. Athena Limnios, Anna McNulty, David Whiley and Monica M. Lahra

20. Published 22 November 2013
Comparative effectiveness and acceptability of home-based and clinic-based sampling methods for sexually transmissible infections screening in females aged 14–50 years: a systematic review and meta-analysis

Tolulope Y. Odesanmi, Sharada P. Wasti, Omolola S. Odesanmi, Omololu Adegbola, Olubukola O. Oguntuase and Sajid Mahmood

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