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RESEARCH ARTICLE

Could sexually transmissible infections be contributing to the increase in HIV infections among men who have sex with men in Australia?

Melanie G. Middleton A D , Andrew E. Grulich A , Ann M. McDonald A , Basil Donovan A B , Jane S. Hocking C and John M. Kaldor A
+ Author Affiliations
- Author Affiliations

A National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Level 2/376 Victoria Street, Sydney, NSW 2010, Australia.

B Sydney Sexual Health Centre, Sydney Hospital, Sydney, NSW 2000, Australia.

C Key Centre for Women’s Health in Society, School of Population Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Vic. 3010, Australia.

D Corresponding author. Email: mmiddleton@nchecr.unsw.edu.au

Sexual Health 5(2) 131-140 https://doi.org/10.1071/SH07086
Submitted: 31 October 2007  Accepted: 30 April 2008   Published: 2 June 2008

Abstract

Background: To review existing data on sexually transmissible infections (STI) in men who have sex with men in Australia in order to determine the possible contribution of STI to diverging trends in HIV notifications in different states. Methods: We reviewed data from multiple sources, including routine national surveillance data, laboratory surveillance data, self-reported information on STI testing in men who have sex with men and ad hoc reports of STI prevalence. Results: We found increasing rates of gonorrhoea and infectious syphilis notifications in urban men in Australia between 1997 and 2006, and increasing rates of chlamydia notifications in men aged 30–49 years. There was little difference in these trends by state. Differences in the population groups sampled meant we were unable to gain further information on trends in men who have sex with men from these studies. Data on STI testing showed an increase in anal STI testing between 2003 and 2006, which may have increased the number of diagnoses of chlamydia and gonorrhoea for men who have sex with men during this period. Conclusions: Over the past 10 years, there has been a substantial increase in diagnoses of gonorrhoea and infectious syphilis, and probably chlamydia, in men who have sex with men in Australia. However, it is unlikely that changes in the pattern of STI transmission are responsible for the recent divergence in HIV rates between Australian states because there is little evidence that trends in STI also differ by state.

Additional keywords: homosexuality, male.


Acknowledgements

The National Centre in HIV Epidemiology and Clinical Research is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, The University of New South Wales.


References


[1] Fleming D,  Wasserheit J. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect 1999; 75 3–17.
PubMed |

[2] Guy RJ,  McDonald AM,  Bartlett MJ,  Murray JC,  Giele CM,  Davey TM, et al. HIV diagnoses in Australia: diverging epidemics within a low prevalence country. Med J Aust 2007; 187 1–4.


[3] Guy R,  McDonald AM,  Bartlett MJ,  Murray JC,  Giele CM,  Davey TM, et al. Characteristics of HIV diagnoses in Australia, 1993–2006. Sex Health 2008; 5 91–6.
CrossRef |

[4] National Centre in HIV Epidemiology and Clinical Research. HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2007. Sydney: The University of New South Wales, National Centre in HIV Epidemiology and Clinical Research; Canberra: Australian Institute of Health and Welfare; 2007.

[5] Donovan B , Minichiello V , Hart G . Australia. In: Brown T, Chan R, Mugrditchian D, Mulhall B, Plummer D, Sarda R, et al., editors. Sexually transmitted diseases in Australia and the Pacific. Armidale: Venereology Publishing; 1998. pp. 26–60.

[6] National Centre in HIV Epidemiology and Clinical Research. Bloodborne viral and sexually transmissible infections in Aboriginal and Torres Strait Islander People: Surveillance Report 2007. Sydney: The University of New South Wales, National Centre in HIV Epidemiology and Clinical Research; 2007.

[7] The Australian Gonococcal Surveillance Programme Annual report of the Australian Gonococcal Surveillance Programme, 2006. Commun Dis Intell 2007; 31 180–4.
PubMed |

[8] Imrie J , Frankland A , editors. HIV/AIDS, hepatitis and sexually transmissible infections in Australia: Annual report of trends in behaviour 2007. Monograph 1/2007. Sydney: The University of New South Wales, National Centre in HIV Social Research; 2007.

[9] National Centre in HIV Epidemiology and Clinical Research. HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2004. Sydney: The University of New South Wales, National Centre in HIV Epidemiology and Clinical Research; Canberra: Australian Institute of Health and Welfare; 2004.

[10] Jin F,  Prestage GP,  Mao L,  Kippax SC,  Pell CM,  Donovan B, et al. Incidence and risk factors for urethral and anal gonorrhoea and chlamydia in a cohort of HIV negative homosexual men: the HIM study. Sex Transm Infect 2007; 83 113–19.
CrossRef | PubMed |

[11] Jin F,  Prestage GP,  Zablotska I,  Rawstorne P,  Kippax SC,  Donovan B, et al. Higher rates of sexually transmitted infections in HIV positive homosexual men: data from two community based cohorts. Sex Transm Infect 2007; 83 397–9.
CrossRef | PubMed |

[12] Vajdic CM,  Middleton M,  Bowden FJ,  Fairley CK,  Kaldor JM. The prevalence of Chlamydia trachomatis in Australia 1997–2004: a systematic review. Sex Health 2005; 2 169–83.
CrossRef | PubMed |

[13] Miller M,  Roche PW,  Yohannes K,  Spencer J,  Bartlett M,  Brotherton J, et al. Australia’s notifiable diseases status, 2003: annual report of the National Notifiable Diseases Surveillance System. Commun Dis Intell 2005; 29 1–61.
PubMed |

[14] Bourne C,  Edwards B,  Shaw M,  Gowers A,  Rodgers C,  Ferson M. Sexually transmissible infection testing guidelines for men who have sex with men. Sex Health 2008; 5 189–91.
CrossRef |

[15] Sweeny AL , Rowling D , Heel K , Cannon F , James M , Fagan P et al Diverging trends in infectious syphilis in Queensland, Australia. In: Rayner J, editor. Proceedings of the 15th Annual Conference of the Australasian Epidemiological Association; 2006 September. Melbourne: The University of Melbourne; 2006. p. 30.

[16] Department of Health and Ageing. National Notifiable Diseases Surveillance System. Canberra: Department of Health and Ageing. Available online at: http://www9.health.gov.au/cda/source/cda-index.cfm [verified 15 September 2007].

[17] Guy RJ , Leslie DE , Simpson K , Hatch B , Leydon J , Hellard ME et al 2005 Sustained increase in infectious syphilis in Victoria. Med J Aust 183 : 218 .

[18] Jin F,  Prestage GP,  Kippax SC,  Pell CM,  Donovan B,  Kaldor JM, et al. Epidemic syphilis among homosexually active men in Sydney. Med J Aust 2005; 183 179–83.
PubMed |

[19] Botham SJ,  Ressler K-A,  Bourne C,  Ferson MJ. Epidemic infectious syphilis in inner Sydney – strengthening enhanced surveillance. Aust N Z J Public Health 2006; 30 529–33.
CrossRef | PubMed |

[20] Teague R , Mijch A , Fairley CK , Sidat M , Watson K , Boyd K , et al Testing for sexually transmitted infections among HIV infected men who have sex with men attending two different HIV services. Int J STD AIDS, in press.

[21] Donovan B,  Bodsworth NJ,  Rohrsheim R,  McNulty A,  Tapsall JW. Increasing gonorrhoea reports – not only in London. Lancet 2000; 355 1908.
CrossRef | PubMed |

[22] Guy R,  Lim MSC,  Wand Y-HJ,  Medland N,  Anderson J,  Roth N, et al. A new surveillance system for monitoring HIV infection in Victoria, Australia. Sex Health 2007; 4 195–9.
CrossRef | PubMed |

[23] Estcourt CS,  Marks C,  Rohrsheim R,  Johnson AM,  Donovan B,  Mindel A. HIV, sexually transmitted infections, and risk behaviours in male commercial sex workers in Sydney. Sex Transm Infect 2000; 76 294–8.
CrossRef | PubMed |

[24] Hamlyn E,  McAllister J,  Winston A,  Sinclair B,  Amin J,  Carr A, et al. Is screening for sexually transmitted infections in men who have sex with men who receive non-occupational HIV post-exposure prophylaxis worthwhile? Sex Transm Infect 2006; 82 21–3.
CrossRef | PubMed |

[25] Lister NA,  Smith A,  Tabrizi SN,  Hayes P,  Medland NA,  Garland SM, et al. Screening for Neisseria gonorrhoeae and Chlamydia trachomatis in men who have sex with men at male-only saunas. Sex Transm Dis 2003; 30 886–9.
CrossRef | PubMed |

[26] Lister NA,  Smith A,  Fairley CK. Introduction of screening guidelines for men who have sex with men at an STD clinic, the Melbourne Sexual Health Centre, Australia. Sex Health 2005; 2 241–4.
CrossRef | PubMed |

[27] Lister NA,  Smith A,  Tabrizi SN,  Garland SM,  Hayes P,  Fairley CK. Comprehensive clinical care on-site in men-only saunas: confidential STI/HIV screening outreach clinic. Int J STD AIDS 2005; 16 794–8.
CrossRef | PubMed |

[28] Hocking J,  Fairley CK. Do the characteristics of sexual health centre clients predict chlamydia infection sufficiently strongly to allow selective screening? Sex Health 2005; 2 185–92.
CrossRef | PubMed |

[29] Debattista J,  Dwyer J,  Orth D,  Patten J,  Delandelles J. Community screening for Neisseria gonorrhoeae and Chlamydia trachomatis among patrons of sex-on-premises venues. Venereol 1999; 12 27–30.


[30] Debattista J,  Dwyer J,  Orth D,  Lister G,  Patten J. Community screening for Neisseria gonorrhoeae and Chlamydia trachomatis among patrons of sex-on-premises venues: two years later. Venereol 2000; 13 105–9.


[31] Debattista J,  Clementson C,  Mason D,  Dwyer J,  Argent S,  Woodward C, et al. Screening for Neisseria gonorrhoeae and Chlamydia trachomatis at entertainment venues among men who have sex with men. Sex Transm Dis 2002; 29 216–21.
CrossRef | PubMed |

[32] Currie MJ,  Martin SJ,  Soo TM,  Bowden FJ. Screening for chlamydia and gonorrhoea in men who have sex with men in clinical and non-clinical settings. Sex Health 2006; 3 123–6.
CrossRef | PubMed |

[33] Lee DM,  Chen MY,  Fairley CK. The re-emergence of syphilis among homosexually active men in Melbourne. Aust N Z J Public Health 2005; 29 390–1.
CrossRef | PubMed |

[34] Debattista J,  Dwyer J,  Anderson R,  Rowling D,  Patten J,  Mortlock M. Screening for syphilis among men who have sex with men in various clinical settings. Sex Transm Infect 2004; 80 505–8.
CrossRef | PubMed |



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