Volume 10 Number 5 2013
SH13044Vulnerability to sexual violence and participation in sex work among high-end entertainment centre workers in Hunan Province, China
We administered a survey among male and female employees in two high-end entertainment centres in China. Participants reported high levels of partner violence, forced sex, and transactional sex. In the multivariate regression models, ever having had a same-sex partner was associated with higher odds of having experienced partner violence and transactional sex.
SH12191The consistency of relative incidence rates of nonviral sexually transmissible infections from health insurance claims and surveillance data, 2005–10
An analysis of the absolute and relative rates of nonviral sexually transmissible infections (chlamydia, gonorrhoea and syphilis) from national surveillance versus administrative data (MarketScan) found that, except for syphilis in females, the estimated absolute rates from administrative data were lower than those from the national surveillance data. However, the relative rates from both data sources were consistent. Additionally, for gonorrhoea and syphilis, the estimated rates from administrative data were sensitive to the enrolee inclusion criteria.
SH13049Online purchases of an expanded range of condom sizes in comparison to current dimensional requirements allowable by US national standards
Previous research has found that 35–50% of men described condoms as fitting poorly, and men facing this problem reported decreased pleasure and were more likely to experience condom breakage and slippage. We report the initial 1000 online sales of an expanded range of condom sizes comprising 95 unique sizes of 14 lengths (83–238 mm) and 12 widths (41–69 mm) predominantly sold in the United Kingdom. Only 13.4% of these sizes would be available in the United States. These initial sales figure suggest that the range of condom sizes purchased by early adopters of fitted condom is not congruent with the range currently allowable by international standards organizations.
SH13079Sexual risk-taking at home and on holidays: the importance of context for the late application of condoms
This study compared the late application of condoms during vaginal intercourse at home and away from home (holidays or short breaks). Young adults reported greater sexual risk-taking at home than when they are away from home, reporting lower rates of condom use and higher rates of late application. Regardless of location, applying a condom after sex has begun is most likely when a person has a weak desire to use a condom and when they are using a condom to prevent pregnancy.
SH13006Violent crime rates as a proxy for the social determinants of sexually transmissible infection rates: the consistent state-level correlation between violent crime and reported sexually transmissible infections in the United States, 1981–2010
We assessed the strength of the association between the violent crime rate and the gonorrhea rate at the state level for each year from 1981 to 2010. The correlation between gonorrhea and violent crime at the state level was significant for every year. Primary and secondary syphilis rates were consistently correlated with violent crime rates as well.
The early unprotected sexual behaviour of young Chinese, and the consequences of these actions, have become a health concern, posing a challenge to traditional Chinese concepts. A meta-analysis was undertaken. The results indicate that sexual activity and high-risk sexual behaviour in Chinese young people have changed and increased, particularly since the mid-1990s. High-risk sexual behaviour has contributed to some adverse consequences. Efficacious intervention strategies need to be well developed.
SH13021Productivity costs of nonviral sexually transmissible infections among patients who miss work to seek medical care: evidence from claims data
Outpatient claims and absence data were analysed to identify and link persons who had a nonviral sexually transmissible infection (STI) diagnosis with their absence from work due to the STI infection. The results indicated that, in terms of lost wages and benefits, the estimated average productivity costs were: chlamydia, $262 (CI: $214–$306); gonorrhoea, $197 (CI: $178–$217); primary and secondary syphilis, $419 (CI: $324–$514); trichomoniasis, $289 (CI: $259–$318).
Non-occupational HIV post-exposure prophylaxis (NPEP) was prescribed on 319 occasions over a 4-year period at RPA Sexual Health in Sydney, mostly following unprotected receptive anal intercourse between men. Over 30% reported adverse events which were independently associated with younger age, earlier year of NPEP prescription, being prescribed a regimen other than tenofovir–emtricitabine, changing the NPEP regimen and known completion of the course. Course completion occurred in over 70% of cases and no documented NPEP failures were identified.
SH13043Factors associated with virological failure in a cohort of combination antiretroviral therapy-treated patients managed at a tertiary referral centre
The strongest predictors of treatment failure in HIV patients attending a hospital HIV clinic, were found to be missed clinic appointments in the 1 year prior to virological failure (OR13.1), multiple previous antiretroviral therapy regimens (OR4.2), hepatitis C (OR= 8.6), and poor adherence. Further elucidation of the barriers to clinic attendance may optimise linkage and retention in care. Patients at risk of treatment failure can be identified and prevention strategies implemented.
SH13042HIV and hepatitis C virus co-infection among men who have sex with men in Sydney, and associations with sexual and drug use practices
This study examined the prevalence of HIV/HCV co-infection among a community sample of gay and other homosexually active men. Data were analysed from the ongoing Sydney Gay Community Periodic Surveys. HIV/HCV co-infection was self-reported by only a small proportion of respondents (1.2%), while sexual and drug use practices associated with blood-borne viruses were more commonly reported by co-infected men compared to HIV and HCV mono-infected men.
Red scrotum syndrome (RSS) is characterised by persistent erythema of the scrotum, associated with severe a itching or burning sensation. It is often misdiagnosed or underdiagnosed. In this retrospective study we evaluated 12 patients with RSS. The average age was 45.83 years, duration of topical steroid use was 27.41 months. Psychiatric comorbidities were seen in 75% of patients. Histopathology revealed features resembling erythematotelengiectatic rosacea. All patients responded to doxycycline with amitriptyline/pregabalin. RSS appears to be a manifestation of corticosteroid misuse/rosacea-like dermatosis rather than a primary disease.
Australian sexual health clinics attract higher proportions of priority populations compared with the proportions in the general population; this is in line with the National STI Strategy which encourages a focus on priority populations.
SH13077One confirmed and one suspected case of pharyngeal gonorrhoea treatment failure following 500mg ceftriaxone in Sydney, Australia
We report the cases of two homosexual men, both treated for pharyngeal Neisseria gonorrhoeae with 500 mg intramuscular ceftriaxone, in whom a test of cure 1 week after treatment showed persisting infection. These cases underline the importance of test-of-cure and molecular investigations in identifying treatment failure, but also highlight the complexity of distinguishing treatment failure from reinfection when relying on highly variable molecular targets that may be subject to drug pressure.
This research involved comparisons of the condom use behaviours of people who are in monogamous relationships but who have engaged in extradyadic sex (i.e. committed infidelity) to those who are in consensually nonmonogamous (CNM) relationships. Consensual nonmonogamy is the practice of openly having multiple sexual or romantic partners simultaneously, with the full knowledge and consent of all participating partners. Participants in CNM relationships used condoms more correctly in their last instance of intercourse than those who were committing infidelity.
Twenty-four hour access to condoms for rural young people is problematic for many reasons. We partnered with three local councils to install condom vending machines in highly accessible places so that young people had access after business hours. We found that condom vending machines are cost-effective for councils and did not generate any complaints from residents. The machines did not suffer unrepairable damage and were used more frequently over time.
SH13011Masculinity, condom use self-efficacy and abusive responses to condom negotiation: the case for HIV prevention for heterosexual African-American men
This study explored the role of masculinity and perceived condom use skills in abusive response to female partners’ condom requests among 80 African-American men. Men’s condom use self-efficacy explained 16.5% of the variance in abusive response to condom requests. The full model accounted for 63% of the variance. Many HIV interventions with women encourage condom negotiation. Findings highlight the need to address men’s condom use skills and masculine norms.
SH13095Analysis of females with Chlamydia trachomatis infections attending a sexually transmissible infection clinic in Singapore in 2010
Chlamydia (Chlamydia trachomatis) is an increasingly common sexually transmissible infection worldwide. Few studies, however, have been conducted to assess the clinical management and sociodemographics of this infection in Singapore. The Department of Sexually Transmitted Infection Control is a government-subsidised specialist institution that allows females to attend women-only and general public clinics. Here, we present data from an audit, contributing to the epidemiology of chlamydia in our local low- to medium-risk female population.
This study of provider referral contact tracing workload at a sexual health clinic examined the number of attempts required, the contact method and, the time taken and the success of provider referral for 230 contacts referred over a three year period. The study found that in this setting, provider notification is neither as time consuming nor resource intensive as is often perceived.
SH13113How do young black men having sex with only women differ from those also having sex with men?
In the US, young Black men (YBM) disproportionately acquire sexually transmissible infections (STI), including infection with HIV. This secondary analysis compared sexual behaviours of YBM (n = 568) not reporting sex with men with those of YBM who have sex with men (YBMSM). In the present study YBMSM were generally less likely to report engagement in sexual risk behaviours, less likely to report incarceration and more likely to ever be tested for HIV. The findings suggest that elevated rates of HIV and/or STI among YBMSM may be a product of higher prevalence rates in sexual networks.