Volume 10 Number 4 2013
SH12142Men who have sex with men, infectious syphilis and HIV coinfection in inner Sydney: results of enhanced surveillance
During the 10-year period, April 2001 to March 2011, infectious syphilis notifications in inner Sydney increased 12-fold from 25 to 303 in the first and last year respectively and almost all were in men. Enhanced surveillance found the epidemic was in MSM and about half of these cases were HIV-positive. Reinfections increased over time and were significantly more likely to be in HIV-positive men.
SH12108Direct urine polymerase chain reaction for chlamydia and gonorrhoea: a simple means of bringing high-throughput rapid testing to remote settings?
The results of this study show that a simplified polymerase chain reaction (PCR) strategy, whereby diluted urine is added directly to a real-time PCR, may be a feasible approach for STI testing in remote settings. The approach is simple in terms of specimen processing and may be particularly suitable for high-throughput screening.
This study examines the degree and correlates of sexual age mixing among female sex workers in Karnataka, India. About half of the sexual relationships were disassortative in nature. Degree of assortativeness assessed using Newman’s assortativity coefficient suggested a minimally assortative age mixing. This indicates that STIs can transfer from members of one age group to another. Efforts are required to address the power dynamics in disassortative relationships.
SH12193Prevalence and risk factors of reproductive tract infections among a defined population of Iranian women
Reproductive tract infections are among the most prevalent gynaecological health concerns. The symptoms of vulvovaginal infections can significantly interfere with patients’ sense of wellbeing. It has also been shown that the prevalence and incidence of reproductive tract infections vary between, as well as within, countries. Therefore, the present study was conducted to determine the prevalence and risk factors of reproductive tract infections among a defined population of Iranian women.
SH12170The impact of living with HIV: differences in experiences of stigma for heterosexual and homosexual people living with HIV in Australia
Although heterosexual transmission of HIV remains low in Australia, there has been a recent increase in new HIV diagnoses attributable to heterosexual sex. This research assesses differences in the experiences of stigma between heterosexual and homosexual PLHIV. Findings illustrate that heterosexual PLHIV have more negative experiences of general HIV stigma and treatment-related stigma than gay PLHIV and are less likely to access treatment. The data suggest that addressing HIV -related stigma may be important in increasing HIV treatment uptake amongst heterosexual PLHIV.
SH13015Performance of the OSOM Trichomonas Rapid Test for diagnosis of Trichomonas vaginalis infection among women in Mysore, India
Current diagnostic tests available for detection of Trichomonas vaginalis in resource-constrained settings have poor performance. The OSOM Trichomonas Rapid Test had excellent sensitivity, specificity, positive and negative predictive value for diagnosing trichomoniasis as compared to composite reference standard. Frequent partner reinfection as a result of wrong or missed diagnosis can be reduced in settings like India where syndromic management is used.
Three international reviews of peer education targeting young people and the most at-risk populations sought to identify determinants of the strengths and weaknesses. By assessing the implementation of peer education programs across a variety of social environments, it was possible to develop a contextual understanding for peer education’s effectiveness and provide a picture of the social, cultural, political, legal and geographic enablers and disablers to effective peer education.
SH13020Preconception reflections, postconception intentions: the before and after of birth control in Australian adolescent females
Contraceptive histories of 56 teenagers with a recent experience of pregnancy were explored using semistructured interviews. Three pregnancy intention profiles emerged: 1) unplanned, unwanted, unlikely; 2) planned, wanted, likely; 3) unplanned, ambivalent, likely. Regardless of the way that pregnancy was resolved (i.e. termination or childbirth), subsequent birth control intentions were revealed through a shared discourse of pregnancy avoidance. Implications for contraceptive counselling and the development of assessment tools to identify those at risk of unplanned and unwanted pregnancies are discussed.
SH13013Measuring self-efficacy to use vaginal microbicides: the Microbicide Use Self-Efficacy instrument
This study evaluates the psychometric properties of the Microbicide Use Self-Efficacy (MUSE) instrument and examines correlates of self-efficacy to use vaginal microbicides among a sample of racially and ethnically diverse women living in the north-eastern United States. Exploratory and confirmatory factor analytic methods were used to explore and determine the dimensionality and psychometric properties of the MUSE instrument. Two dimensions of self-efficacy to use microbicides were psychometrically validated and identified as Adherence and Access and Situational Challenges. The two four-item subscales measuring Adherence and Access and Situational Challenges had reliability coefficients of 0.78 and 0.85, respectively. MUSE can be a useful tool for capturing the multidimensional nature of self-efficacy to use microbicides.
SH13026The potential impact of new generation molecular point-of-care tests on gonorrhoea and chlamydia in a setting of high endemic prevalence
Bacterial sexually transmissible infections (STIs) persist at endemic levels in many remote Indigenous communities despite intensive screening and treatment programs. We use a mathematical model to show that new generation point-of-care (POC) tests may have a greater impact in reducing the prevalence of STIs compared with conventional diagnostic methods. The use of POC tests in combination with high screening coverage has the potential to virtually eliminate gonorrhoea and chlamydia in these communities.
SH13012Community event-based outreach screening for syphilis and other sexually transmissible infections among gay men in Sydney, Australia
This study describes a sexually transmissible infection (STI) testing outreach program at a gay community event. Clinical, demographic, behavioural and diagnostic data of gay men attending the testing tent in 2010–11 were compared with gay men attending a clinic-based service during 2009. Ninety-eight men attended the Testing Tent. Five cases of STIs were detected; the diagnostic yield was not significantly different from that of the clinic. Nonclinical testing facilities are an acceptable option and are accessed by gay men requiring regular testing, and may be an important addition to traditional testing environments.
SH13017Differences in access to healthcare and utilisation of HIV and sexually transmissible infection services between men who have sex with men and men who have sex only with women: results of the 2006–10 National Survey of Family Growth in the United States
Using a nationally representative survey, our findings show no significant differences in access to healthcare between men who have sex with men (MSM) and non-MSM in the United States. MSM were more likely to receive HIV/STI-related preventive services than non-MSM. However, the low sexually transmissible infection (STI) testing rate among MSM highlights the need for interventions to increase STI testing, and HIV and STI counselling for MSM.
SH12209Leveraging changing gender norms to address concurrency: focus group findings from South African university students
This study provides a deeper understanding of South African women’s motivations for engaging in and accepting their partners’ sexual concurrency. The findings draw on data from 12 focus groups with students at the University of KwaZulu-Natal. Our findings indicate that HIV prevention interventions in populations where concurrency is common would benefit from emphasising women’s role and power in taking greater control of their sexual decision-making in consensual and nonviolent relationships.
Let Them Know (www.letthemknow.org.au) is an Australian internet based service designed to support individuals diagnosed with an STI to notify sexual partners using anonymous or personal text messages. A review of user activity and acceptability of the website was performed.
SH12199Sexual health of Indian immigrant men in Australia: an exploratory research on help-seeking attitudes
The help-seeking attitudes for sexual health of Indian men living in Australia was explored. Of all survey respondents (n = 225), many preferred to seek help from medical doctors. Young (18–25 years) Indian men were three times more likely to prefer a specialist medical doctor than older men. Ethnicity and gender of the medical doctor was ‘not important’ for the majority of men. Most men preferred to seek help from their regular general practitioner.
Analysis of a survey of sexual behaviour of Australians yields estimates of the rate of partner acquisition for the Australian population, broken down by gender and age band. The partner acquisition rate is about 0.5 per year for 16- to 19-year-olds, peaks around 0.7 for 20- to 24-year-olds, and declines with age to about 0.2.
SH12201The prevalence of Trichomonas vaginalis detected by wet mount and polymerase chain reaction in Sydney women
Seven hundred and eighty-one women in urban Sydney were tested for Trichmonas vaginalis by PCR. Only 0.38% of tests were positive. Routine screening by PCR for trichomoniasis in our population is not warranted.
SH12213Introduction of routine polymerase chain reaction testing for Neisseria gonorrhoeae in a community laboratory
We introduced polymerase chain reaction (PCR) testing for Neisseria gonorrhoeae (NG) on the Cobas 4800 CT/NG assay for all samples received with a Chlamdyia trachomatis request in March 2012. From 1 March 2012 to 30 June 2012, all PCR-positive/culture-negative specimens had additional testing at another assay. A total of 40053 tests were performed. The estimated specificity and positive predictive value were 99.9% and 97.1%, respectively; thus routine additional testing is not required.
SH12167Diagnosis of latent tuberculosis infection among HIV-infected clients in Far North Queensland: use of an interferon-gamma release assay
Latent Mycobacterium tuberculosis infection is a significant risk for those infected with HIV. We examined the use of an interferon-gamma release assay for the diagnosis of latent tuberculosis in 240 HIV-infected clients in Far North Queensland. Low CD4 count was found to be significantly associated with an indeterminate test result (P = 0.004). No significant association between test result and other client characteristics was identified (P-values = 0.2–0.9).