Chemsex, a type of sexualised drug use, has been associated with potential harm among gay men and it is important to understand users’ experience of related services. Parisian men practising chemsex who attended harm reduction consultations in an infectious disease unit completed a questionnaire: most were frequent users, followed by specialists, and many had attended emergency services. Most were satisfied and reported reduced risks after consultations. Easily-accessible preventive and therapeutic services in centres attended by users may be beneficial.
The Black Caribbean population have a disproportionately high burden of sexually transmitted infections (STIs). This study explored barriers to engagement with STI testing within a UK-based young adult Black Caribbean community. Engagement with STI testing in young adults from the Black Caribbean community is impacted by historically and culturally embedded practices and beliefs inherited through generations. Targeting these factors within interventions may be effective for increasing STI-testing, and thus reducing rates of STI-infection in this population.
The Black Caribbean population have a disproportionately high burden of sexually transmitted infections (STIs). This study explored barriers to engagement with STI testing within a UK-based young adult Black Caribbean community. Engagement with STI testing in young adults from the Black Caribbean community is impacted by historically and culturally embedded practices and beliefs inherited through generations. Targeting these factors within interventions may be effective for increasing STI-testing, and thus reducing rates of STI-infection in this population.
Effective client triage is essential when demand for counselling exceeds capacity. We adapted an existing counselling triage tool to better fit the sexual health setting. Psychometric scales are useful tools in patient assessment and care, however, are best applied in combination with clinical judgement and peer consultation.
This paper systematically develops recommendations to improve current and future digital partner notification interventions. It takes findings from the published international literature and then uses tools from behavioural science to generate a series of simple recommendations. The recommendations should be further operationalised locally with key stakeholders for optimal impact.
This study aimed to address risky sexual behaviour among adolescents. We tested the effectiveness of a contingency management intervention by juvenile probation officers, primarily designed to address substance use, on reducing risky sexual behaviour among 218 adolescents on probation. Findings indicated this intervention reduced risky sexual behaviour over time. Interventions focused on individual risk behaviours among adolescents on probation populations can have positive ripple effects, evidencing a possible approach for underserved communities lacking clinician access.
HIV rates in Australia disproportionately affect men who have sex with men (MSM) born overseas compared with those who are Australian-born. One explanation may be Medicare eligibility which can affect access to affordable healthcare including HIV pre-exposure prophylaxis (PrEP). This population remains under-researched as they are not captured in routinely collected prescribing data. This study demonstrates that MSM without Medicare accessing a publicly funded sexual health clinic in Sydney are less likely to be on HIV PrEP than MSM who do have Medicare.
Chlamydia remains as the most notified bacterial sexually transmissible infection in Australia and repeat infections can lead to significant reproductive complications, particularly for women. Guidelines recommended retesting at 3 months following a chlamydia diagnosis, but current retesting rates in line with guidelines are low, and re-infections are common. Increased efforts to improve timely retesting can aid in earlier identification, management and reduced risk of disease burden.
Post-COVID, there has been a notable surge in syphilis cases, with a 38% increase reported in 2021 compared to 2019, according to the US Centers for Disease Control and Prevention. Analysis of our clinic’s data over 8 years spanning from 2015 to 2023 also showed a steady rise from 2020 to 2023, particularly among males. This trend contrasts with the overall decline in clinic attendance during the pandemic. Contributing factors include an increase in online sexual activity (seeking sexual partners online) and diverted healthcare resources towards the COVID-19 pandemic. Urgent measures are reinforced surveillance and public health response, heightened awareness, and the provision of early and cost-free treatment to address this escalation of syphilis cases.
Ever present in our digital world, misinformation continues to threaten public health efforts and, in some cases, stigmatises specific groups. Our work investigated the evolving rhetoric surrounding monkeypox (mpox) during the 2022 outbreak on Instagram, discovering that perhaps early dialogue singling out men who have sex with men shifted discussions online to combat this misinformation. By understanding the way misinformation is spread, we can better protect against it and create improved communication strategies.
HIV PrEP is widely recommended as a crucial measure for HIV prevention. In a demonstration trial in China, this article highlights two cases where facial neuralgia emerged as an unexpected side effect of PrEP medication, not previously mentioned in official prescribing information. These findings deepen our understanding of the potential side effects of emitricitabine/tenofovir disoproxil fumarate use and provide empirical evidence to enhance PrEP implementation further and address the challenges that may arise during its utilisation.
Sexual health is a complex, multi-dimensional concept; however, much research on the topic is focused on sexually transmitted infections and risk reduction. Given their status as a key population for sexual health promotion, we interviewed 10 gay men living with HIV about the meaning of sexual health. While all mentioned sexual health care and safer sex (e.g. HIV management), most also addressed intimacy and relationships and well as positive sexuality as key components of sexual health.
There is more to pre-exposure prophylaxis (PrEP) other than the health benefits. Usually, the important social benefits are less considered yet they could reveal much more. As interest intensifies, the social benefits should be incorporated more to tell us what we are missing about PrEP, that could be important globally in the use of this drug. Being less worried about a drug and enjoying sex without worry means ‘confidence’ about a drug that could be vital for future uptake.
This study aimed to provide a deeper understanding of transgender women’s experiences of pre-exposure prophylaxis (PrEP) uptake and adherence, and to identify major barriers to PrEP use to inform intervention adaptation. We interviewed 20 young transgender women and 10 health care providers from two HIV clinics in Bangkok, Thailand. Our findings deepen the current understanding of barriers to PrEP use, and inform the development of effective interventions to promote PrEP use.
International travel can increase the risk of exposure to infectious diseases including sexually transmissible infections and human immunodeficiency virus. This study explored how travel medicine clinicians integrate sexual and reproductive health (SRH) services into clinical practice. Our findings highlighted gaps in the provision of pre-travel consultation and training needs for SRH among travel medicine clinicians, and the potential for improved promotion of sexual health among travellers to provide important public health benefits for individuals and the wider community.
Several large studies suggest that men who have sex with men (MSM) may experience intimate partner violence (IPV) at similar or higher rates than those documented among women. We introduced screening for IPV among MSM at a large, urban sexual health clinic and examined prevalence and associations with self report of IPV. Reported IPV among MSM was associated with significantly increased risk behaviours. Screening allows clinicians to be aware of the potential for, and impact of, IPV in this population.
Current medical curriculum covers sexual health but is highly focused on sexually transmissible infections. Medical students and clinicians feel uncomfortable managing sexual dysfunction with patients, despite its prevalence and its effect on quality of life. This study explores the sexual dysfunction-specific training of medical students in one Australian university, and the data suggests that the medical curriculum does not adequately train students to confidently and comfortably manage sexual dysfunction.
This study uncovers an often-overlooked issue: the limited research on access to sexual health services among gay Arab men in Western countries. Findings in this publication reveal significant gaps in knowledge for this population, particularly in areas where strides have been made in reducing HIV transmission. The implications are far-reaching, as addressing these disparities is essential for ensuring equitable healthcare for underrepresented communities. By shedding light on this hidden population, this study paves the way for targeted interventions and policy changes to promote inclusive and accessible sexual health services for all.
People from Black ethnic backgrounds are disproportionately affected by sexually transmitted infections. In this paper, we reviewed existing literature to understand the effectiveness of interventions designed to increase engagement with sexual healthcare among people of Black ethnicity. Our findings highlight the importance of considering sociocultural, structural and socio-economic barriers to increasing engagement with sexual healthcare. Matching the intervention facilitators’ demographics and lived experience to intervention recipients may further increase engagement and trust.
Women living with HIV are a minority in Australia. They present unique healthcare challenges, particularly relating to sexual and reproductive health. Evidence shows higher rates of unplanned pregnancy and lower rates of long-acting-reversible contraception use among women living with HIV. We highlight gaps in care at an Australian metropolitan centre and suggest contraceptive options used by women living with HIV may be changing in the era of modern HIV treatment. We suggest changes in care provision to meet demand, including use of ‘women-centred’ models of care.
Transgender women who work in the sex industry face difficulties accessing health care facilities. This population is recognised worldwide as a high-risk group for sexually transmitted infections and HIV In this paper, we describe challenges for accessing healthcare amongst transgender women sex workers in Iran.
How people acquire new sexual partners is an important determinant of sexually transmitted infections (STI) transmission, including HIV. This analysis uses a new way of measuring partner acquisition and found that this new measure was related to people’s age, sex, wealth, partnership status and HIV status. This measure could be used to help identify population groups at high risk of STIs.
Pathology results management contributes to a significant proportion of the workload at sexual health services. This study estimates the client outcomes and costs of the existing nurse-led urgent results management model at the Sydney Sexual Health Centre compared to an ordering clinician model. The nurse-led model demonstrated improved time to notification and treatment and health system savings of 33 h of staff time per week and A$121 524 annually. Nurse-led models continue to provide value and effectiveness within sexual health services.
Older adults’ sexual health is not well understood and older Australians may have unmet sexual health needs. To better address the sexual wellbeing of older adults, we need to be able to effectively recruit them for sensitive health research. This paper outlines the recruitment and sample of the SHAPE2 sexual health study of Australians aged 60 years and over. It demonstrates that sexual health matters to many older adults and that they are willing to engage in online sexual health surveys.
International research suggests that lesbians and other women-who-have-sex-with-women (WSW) are less likely to engage in cervical screening than are heterosexual women. This study explored engagement in cervical screening and reasons for engaging (or not) among WSW in New Zealand finding lower levels of engagement due to a legacy of misinformation and endemic heteronormativity in health care. Findings of the study highlight the need to ensure that publicity around cervical screening specifically addresses WSW.