Volume 10 Number 2 2013
SHv10n2_OBIn Memoriam — Anthony Smith: 1959–2012
SH12081Abacavir exposure and cardiovascular risk factors in HIV-positive patients with coronary heart disease: a retrospective case–control study
This 14-year retrospective case-control study of HIV-positive patients demonstrated an incidence of 8.5 cases of coronary heart disease per 1000 patient years of follow up and found that cases had a higher incidence of traditional cardiovascular risk factors and were more likely to be currently receiving abacavir. Protease inhibitor therapy, HIV viral load and duration of infection were not predictive of coronary heart disease in this study.
SH12057The geographic relationship between sexual health deprivation and the Index of Multiple Deprivation 2010: a comparison of two indices
An Index of Sexual Health Deprivation was constructed and used to investigate the association between the that and the Index of Multiple Deprivation 2010 and geographic variation in sexual health. Substantial geographical variation in sexual health deprivation was seen but only showed a weak association with theIndex of Multiple Deprivation 2010. The Index of Sexual Health Deprivation can be used to guide public health action to reduce the geographical gradient in sexual health inequality.
SH12067Medical male circumcision and HIV risk: perceptions of women in a higher learning institution in KwaZulu-Natal, South Africa
Perspectives on medical male circumcision (MMC) were explored with 30 South African, female tertiary students via four focus groups. Women noted that MMC affords no direct benefit to women, would increase women’s risk of contracting HIV as well as increase number of sexual partners and decrease condom use among circumcised men. These findings point to the need for sensitisation about the impact of MMC on women’s HIV risk.
SH12020What proportion of sexually transmissible infections and HIV are diagnosed in New South Wales’ public sexual health services compared with other services?
Publicly funded sexual health services diagnose a large proportion of notifiable sexually transmissible infections (STIs) in New South Wales – syphilis (25%), gonorrhoea (25%) and HIV (21%), Chlamydia (14%) – with considerable variation within regions and across NSW (<5% -100%). These data support the role of publicly funded sexual health services in identifying and managing important STIs in high-risk populations.
Using a recent survey on rapid point-of-care HIV testing in Nova Scotia, Canada, this paper assesses the feasibility and desirability of this form or testing in non-metropolitan and rural areas. The results show similar preferences for rapid point-of-care testing in Nova Scotia and other locales, and suggest particular benefits of implementation for regions located beyond North America’s HIV epicentres.
SH12053Is it really crystal clear that using methamphetamine (or other recreational drugs) causes people to engage in unsafe sex?
This paper examines the limitations, in terms of demonstrating causality, of various types of study that have been published in relation to crystal methamphetamine use and unsafe sex. Researchers who investigate relationships between recreational drug use and behaviour, including sexual behaviour, should be careful about the wording of their conclusions and recommendations, and should consider the possibly counterproductive ways in which their findings might be represented in the media.
SH12106Misperceptions regarding protective barrier method use for safer sex among African-American women who have sex with women
Barrier methods for HIV/sexually transmitted infection prevention among women who have sex with women (WSW) are available although they are infrequently used. We discovered a number of misperceptions among African-American WSW in Birmingham, Alabama regarding barrier methods which may be associated with their limited use, most notably the conflation of dental dams and female condoms. Sexual health services provided to WSW should include an accurate description of what barrier methods are and how to use them correctly.
SH12114The prevalence of sexually transmissible infections among female sex workers from countries with low and high prevalences in Melbourne
This study compared the proportion of female sex workers (FSW) with sexually transmitted infections (STI) from countries with a high prevalence (HPC) of STI and compared this to other FSW. At first test there was no statistical difference in the proportion with STI from the two groups of FSW (P > 0.14) and gonorrhoea (GC) and trichomonas vaginalis (TV) were rare (<0.7%). On return visits rates were lower still but marginally higher in HPC than other FSW for chlamydia (chlamydia (1.2% v. 0.92%, P < 0.05) and gonorrhoea (0.29% v. 0.10%, P = <0.05).
SH12097Elevated 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
Few studies have examined sexual risk practices and drug use among Indigenous Australian men who have sex with men. This study presents findings from the Gay Community Periodic Surveys from 2007 and 2011, and compares sexual risk practices, drug use, and HIV prevalence between Indigenous and Anglo-Australian men who have sex with me.
SH12132Use of incentives to encourage sexually transmissible infection testing amongst sex-on-premises venue patrons
A trial offering free entry to sex-on-premises venues (SOPVs) for venue patrons as an incentive to access sexual health checks, resulted in 10 persons accessing six clinical sites over a 6-month period. Of these, three used their free entry passes to attend an SOPV. Two persons accessed clinics for the first time, one of whom tested reactive for an sexually transmissible infection. Another regular clinic attendee also tested reactive.
This study examined the impact of sexual excitation (arousability) on sexual risk-taking behaviours in a community sample of African-American adolescent women. Results indicate that women who have a greater propensity to become sexually aroused in a variety of situations may be at a greater risk for contracting HIV or sexually transmissible infections relative to women with a lower propensity for arousal.
SH12064Increases in newly acquired HIV infections in Victoria, Australia: epidemiological evidence of successful prevention?
Newly acquired HIV notifications in Victoria, Australia (2001-2010), are examined alongside recent trends in HIV testing, incidence and risk behaviours among gay and other men who have sex with men (MSM) attending high caseload clinics in Melbourne. A significant increasing trend in newly acquired HIV was detected; MSM accounted for 85% of newly acquired HIV. HIV testing increased and incidence declined at high caseload clinics, suggesting increased rates of newly acquired HIV may be driven by increased testing among MSM.
There are few population-based data on the disease burden of cervical cancer from South Pacific islands. Through intensive data collection from hospital pathology registry books and Ministry of Health registries, this study identified high incidence and mortality, and very low Papanicolaou smear coverage in 20- to 69-year-old women in Fiji from 2004 to 2007. Greater investment in alternative screening strategies and preventive measures should be integrated into a comprehensive, strategic cervical cancer control program in Fiji.
Azithromycin is commonly used in sexual health and respiratory medicine, often when the diagnosis is presumptive. A recent article by Ray et al. reported that 1 out of 20?000 courses of low-dose azithromycin was associated with (sudden) cardiovascular death (including 1 out of 4000 courses in high-risk cardiovascular patients), ascribing these deaths to azithromycin itself. Here, we critique the actual study and examine conflicting data from randomised control trials, animal studies and observational data.
SH12078Poor uptake of community based sexually transmissible infection testing at an inner city needle and syringe program
Sydney Sexual Health Centre and the NSW Users and AIDS Association worked in partnership on an outreach STI testing model which was trialled at an inner city needle and syringe program for people who inject drugs, in order to increase STI testing uptake in this group. This article describes the methodology and promotional efforts used to make the project successful, and explains the reasons why it was not.
This project involved unsupervised screening for chlamydia and gonorrhoea at two backpacker hostels in Manly, Sydney. A new sex partner was reported by 94% of participants with only 20% consistently using condoms. Prevalence of chlamydial infection was 11.9%. Specimen collection receptacles were frequently used for rubbish and occasionally vandalised, and many test kits inexplicably disappeared. We advise caution for projects contemplating an unsupervised outreach screening model for similar populations.
SH12145Is rectal gonorrhoea a lead indicator of HIV transmission among men who have sex with men in Victoria, Australia?
This study examines whether rectal gonorrhoea (RG; Neisseria gonorrhoeae) can be used as a lead indicator of trends in HIV diagnosis in men who have sex with men. Data from a sexual health centre in Victoria from January 2006 to December 2011 were examined. Allowing RG a 12-month lead over HIV showed no concordance in proportion positive (r = 0.27; P-value = 0.28). The data do not support use of RG trends as a lead indicator of trends in HIV among have sex with men.
SH12143Prevalence and predictors of lymphogranuloma venereum among men who have sex with men at a Sydney metropolitan sexual health clinic
Seventy-five positive anal chlamydia samples identified in men who have sex with men (MSM) over an 18-month period at RPA Sexual Health were tested for lymphogranuloma venereum (LGV). All three LGV infections occurred in symptomatic individuals, whereas only 13/72 (18.1%) of those with non-LGV anal chlamydia reported anal symptoms. LGV was not identified in any of 59 episodes of asymptomatic anal chlamydia. Our findings suggest that routine LGV testing among MSM is not warranted, except among those with anal symptoms.