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Table of Contents
Sexual Health

Sexual Health

Volume 11 Number 1 2014

This study reports incident hepatitis B infection in HIV-positive individuals in the Australian context. Of 4711 HIV-infected individuals, 39 conversions to hepatitis B occurred resulting in an incidence rate of 1.81 per 1000 patient-years risk. A detailed case series and case–control study are reported. Optimal control of HIV and improved vaccination coverage continue to provide the best opportunity for prevention.

Most functional magnetic resonance imaging (fMRI) studies focusing on the discrimination of gender differences associated with sexual arousal have been performed on a 1.5-T fMRI system. This study used a 3.0-T fMRI to provide more accurate brain activation information by enhancing detection power and spatial specificity than does a conventional 1.5 T.

SH13151HIV service capacity: identifying current and future areas of clinical shortage

Kylie-Ann Mallitt, James Jansson, Handan Wand, Levinia Crooks and David P. Wilson
pp. 17-23

The ability of HIV clinical services to meet demand in Australia has not been evaluated. We use a novel methodology to identify areas of HIV clinical undersupply. We identified seven geographical clusters that are significantly undersupplied with HIV doctors relative to the number of people living with HIV. Training of clinicians in HIV case management and shared-care clinicians should be directed towards these areas, particularly locations in rural and remote areas.

We conducted focus groups and individual interviews with lesbian and bisexual African-American women in Jackson, Mississippi to characterise the role of lesbian families and lesbian sororities and fraternities among the lesbian, gay, bisexual and transgender community and their influence on sexual health. Both types of organisations were found to serve positive functions. These organisations should be incorporated into community-based popular opinion leader or lay heath advisor interventions in an effort to meet the sexual and reproductive health needs of marginalised populations.

The aim of this study was to assess factors influencing condom use in Khartoum, Sudan. A cross-sectional survey was conducted for this purpose among a random sample of 804 respondents aged 20–40 years. The study revealed that 12% of the study sample reported condom use, while 46.3% were nonusers. Knowing someone who is infected with or had died of AIDS, experiencing condom problems and type of sexual partners were the main predictors of condom use.

SH13156An evaluation of an express testing service for sexually transmissible infections in low-risk clients without complications

Nimal Gamagedara, Sheranne Dobinson, Rosey Cummings, Christopher K. Fairley and David Lee
pp. 37-41

The control of sexually transmissible infections is dependent on allowing for easy access to screening, diagnosis and treatment of priority populations. In order to allow for targeted screening, more efficient clinical services need to be instigated by fast-tracking those at lower risk of acquiring/transmitting sexually transmissible infections, to avoid creating a ‘bottle neck’ and obstructing access to clinical services for those populations which are at a higher epidemiological risk.

SH13099Gender norms and sexual behaviours among men in western Jamaica

Melonie M. Walcott, Ellen Funkhouser, Maung Aung, Mirjam C. Kempf, John Ehiri, Kui Zhang, Marion Bakhoya, Deborah Hickman and Pauline E. Jolly
pp. 42-51

We conducted a cross-sectional survey of 549 men aged 19–54 years in the western region of Jamaica to assess the association between gender norms and multiple sexual partners. Attitudes towards gender norms were measured using the gender equitable men and Macho scales. Men with moderate and high support of masculinity and inequitable gender norms were more likely to report multiple sex partners. These results highlight the need for behaviour-change interventions addressing gender norms targeting Jamaican men.

SH13179Management rates of sexually transmissible infections by Australian general practitioners, 2000–2012

Anthony J. Santella, Allan Pollack, Christopher Harrison, Shailendra N. Sawleshwarkar, Helena C. Britt and Richard J. Hillman
pp. 52-57

In Australia, general practitioners (GPs) manage the majority of sexually transmissible infections (STIs). Data from 1 178 400 patient encounters by 11 784 GPs during April 2000–March 2012 were analysed. Herpes simplex virus and warts were the most common STIs managed, with chlamydia management rates significantly rising over time. Despite rising population rates of syphilis and gonorrhoea, no such changes in GP management rates were found. This may reflect limited access by at-risk communities.

SH13197High prevalence and incidence of HIV, sexually transmissible infections and penile foreskin cutting among sexual health clinic attendees in Papua New Guinea

Andrew Vallely, Claire E. Ryan, Joyce Allen, Joyce C. Sauk, Cassey S. Simbiken, Johanna Wapling, Petronia Kaima, Zure Kombati, Greg Law, Glenda Fehler, John M. Murray, Peter Siba and John M. Kaldor
pp. 58-66

Papua New Guinea has among the highest prevalences of HIV and sexually transmissible infections (STIs) in the Asia-Pacific region but only limited clinical research in sexual and reproductive health has been conducted to date. In a longitudinal cohort study carried out at two sexual health clinics, the prevalence and incidence of STIs, HIV and penile cutting were high, and over 80% follow-up was achieved at one year, suggesting that this population may be suitable for future interventions research and clinical trials.

SH13167Uptake, yield and resource requirements of screening for asymptomatic sexually transmissible infections among HIV-positive people attending a hospital outpatient clinic

Stephen Ritchie, Rebecca Henley, Jackie Hilton, Rupert Handy, Joan Ingram, Susan Mundt, Mitzi Nisbet, Mark Thomas and Simon Briggs
pp. 67-72

We initiated a screening programme for asymptomatic sexually transmissible infections among people living with HIV/AIDS in our hospital outpatient clinic. Asymptomatic infections were identified only among men who have sex with men. Almost half of the men who were diagnosed, did not consider themselves to be at risk of infection.

This population-based cross-sectional survey assessed the ability of the premature ejaculation diagnostic tool (PEDT) to differentiate four subgroups of PE (lifelong, acquired, variable and subjective PE) and concluded that the PEDT is not appropriate for research into four subgroups of PE when used in a general male population study, unless the PEDT is combined with an additional questionnaire with specific questions on the four PE subgroups.

SH13135Concurrent partnering and condom use among rural heterosexual African-American men

JaNelle M. Ricks, Angelica Geter, Richard A. Crosby and Emma Brown
pp. 81-83

Limited research has targeted HIV risk among heterosexual African-American men in rural south-eastern USA. This study explored sexual risk behaviour of African-American men by sexual concurrency status. Reported consistent condom use was significantly greater among those reporting current monogamy. Odds of consistent condom use increased in proportion to the number of recent female sex partners, which may indicate a positive response by these men to the AIDS epidemic.

SH13181Being drunk and high during sex is not associated with condom use behaviours: a study of high-risk young Black males

Richard A. Crosby, Robin R. Milhausen, Stephanie Sanders, Cynthia A. Graham and William L. Yarber
pp. 84-86

This study of young Black males in the USA attending clinics that diagnose and treat sexually transmitted infections found that the occurrence of condom use errors and problems was largely unrelated to being drunk or high during sex. Findings suggest that safer sex intervention programs that focus on avoiding alcohol and drug use may not be optimally serving this population.

Safer sex is important and comprises of a series of five condom-related behaviours: accessing, carrying, negotiating, using and disposing. This study explored potential gender and age differences in these condom-related behaviours. Data suggests gender differences exist for accessing, carrying and disposing behaviours. An age difference was seen in accessing behaviour. Therefore future safer sex interventions should acknowledge the potential gender and age differences in these condom-related behaviours.

Rapid HIV testing was approved in Australia in December 2012. Data was collected to describe the early experience of using rapid testing in Australia but as the information was collected, the authors noted that there appeared to be a high rate of HIV diagnoses amongst rapid testers. Further analysis confirmed this impression, when the rate was compared to a baseline rate of HIV diagnoses over the 32 months before the rapid testing started (4.1% vs 1.3%).

SH14019Sexual health, vulnerabilities and risk behaviours among homeless adults

Verena Strehlau, Iris Torchalla, Isabelle Linden, Kathy Li and Michael Krausz
pp. 91-93

It is well known that homeless individuals are at risk for a variety of health problems, including sexually transmissible infections. Optimisation of health services for the homeless requires knowledge of their sexual health. The sexual health and sexual vulnerability factors of 500 homeless adults (196 women) were assessed in a cross-sectional survey in three Canadian cities. Our data indicate that a significant proportion of individuals and more women than men reported multiple experiences that compromise their sexual health exponentially. These findings may inform health policies related to sexuality to foster positive sexual health outcomes for all people, including marginalised populations.

Little is known about sexually transmitted infection (STI) testing among Chinese men who have sex with men (MSM). This study describes the prevalence of STI testing, associated factors and the validity of STI self-reporting among Chinese MSM. Findings indicated a high prevalence of STIs and low testing rates among MSM in Shanghai. Efforts are needed to ensure that STI testing services are accessible to MSM in China. Future HIV and STI interventions should be tailored to the needs of different subsets of MSM.

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