Volume 11 Number 3 2014
SH14003Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence
A literature review was performed to inform the 2014 update of the Australian testing guidelines for asymptomatic men who have sex with men (MSM). Key changes include a recommendation for pharyngeal chlamydia testing, use of nucleic acid amplification tests alone for gonorrhoea testing, more frequent gonorrhoea and chlamydia testing in HIV-positive MSM, shorter time required since last void for chlamydia first-void urine collection, and the use of electronic reminders to increase STI and HIV retesting rates among MSM.
SH14025Adherence-enhancing interventions for active antiretroviral therapy in sub-Saharan Africa: a systematic review and meta-analysis
In sub-Saharan Africa, an estimated 23% of HIV-infected patients are nonadherent. The aim of this systematic review was to evaluate the effectiveness of adherence-enhancing interventions for active antiretroviral therapy. Six randomised controlled trials were included in the review. The considered interventions increase adherence only slightly. The results indicate that adherence-enhancing interventions should focus on nonadherent patients.
Pregnancy is a special period in the life of women that could affect their sexuality. This cross-sectional study evaluated female sexual dysfunction among pregnancy trimesters. It is concluded that female sexual function is affected significantly during pregnancy, in all domains, especially in the first and third trimesters.
SH14022Psychosocial factors related to willingness to use pre-exposure prophylaxis for HIV prevention among Black men who have sex with men attending a community event
In the US, Black men who have sex with men are disproportionately affected by HIV/AIDS. Using antiretroviral medications for HIV prevention is a promising option, yet many barriers to accessing this form of prevention exist. It is imperative that we prioritise research into understanding these barriers better; failure to do so will impede the potential of this prevention strategy
Whether people use condoms differentially as a function of being in a new versus established relationship has never been investigated using event-level data. Applying an event-level analysis, this study found differences in motivation for condom use and actual use in a sample of males and females attending sexually transmissible infection clinics in the US. Clinic-based counselling to promote safer-sex behaviours should recognize differences between new versus established sex partners.
SH14007'I demand to be treated as the person I am': experiences of accessing primary health care for Australian adults who identify as gay, lesbian, bisexual, transgender or queer
Individuals who identify as gay, lesbian, bisexual, transgender or queer suffer higher morbidity than the general population, but may experience significant barriers to accessing primary health care. An Internet survey of these experiences reinforced the importance of communicating acknowledgement and respect for the unique identity of each individual. Primary health care providers have a key role in ensuring equitable access
SH14005Do family factors protect against sexual risk behaviour and teenage pregnancy among multiply disadvantaged young people? Findings from an English longitudinal study
It is common for policy makers to target ‘at risk’ youth and families for additional intervention, although we do not know if or how the family environment shapes sexual risk taking among disadvantaged youth. This study examined data from 1285 ‘at risk’ 13–15 year olds in England and found limited evidence of any family-related effects on sexual health or teenage pregnancy, although family structure and communication may influence young women’s sexual risk taking in deprived contexts. Targeted family-based interventions may not be appropriate for changing the sexual behaviour of disadvantaged young people, especially young men.
SH14047Parents' views on human papillomavirus vaccination for sexually transmissible infection prevention: a qualitative study
Human papillomavirus (HPV) vaccination coverage in the US remains suboptimal. The results of this qualitative study reveal that discussing sexually transmissible infection (STI) prevention in the context of HPV vaccination in addition to cancer prevention appears to be well accepted by urban low-income minority families. Communication of this comprehensive yet simple message may help raise awareness, acceptability and uptake of HPV vaccines.
We describe an unusually severe case of disseminated gonococcal infection culminating in necrotizing fasciitis. Patient progress, treatment and outcomes are discussed with reference to currently recommended Australian guidelines. To our knowledge, this is the first such case described in the literature.
SH13190Testing for ‘threads’ and leucocyte esterase in first-void urine to exclude the diagnosis of non-specific urethritis in asymptomatic men
The aim of this pilot study was to determine if testing for urinary threads, and/or leucocyte esterase (LE) or both in asymptomatic men is a good screening tool for nonspecific urethritis (NSU). Of the126 asymptomatic men, 8% met microscopic criteria for the diagnosis of NSU. The negative predictive value for threads and LE was 96% and 93% and combining both gave a negative predictive value of 96%. The absence of threads and negative LE makes urethritis highly unlikely, making urinary nucleic acid amplification testing sufficient.
SH14017Social support and depressive symptoms among 'money' boys and general men who have sex with men in Shanghai, China
Little was known about social support and depression among men who have sex with men (MSM) in China. The aim of this study was to fill this gap. The results indicate that social support is protective against depression among this population, whereas ‘Money boys’ experience more depression than general MSM. These findings underscore the need for tailored psychological programs targeting these two types of MSM.
SH14063Cervical screening uptake and abnormalities among women attending sexual health clinics for HIV care
The aim of this study was to describe cervical screening uptake and assess correlates of screen-detected abnormalities in women attending sexual health services for HIV care. Of 156 women, 115 had documentation of a Pap test at least once in 3 years and 9.6% had an annual Pap test performed. Pap abnormalities were associated with younger age, being born in Sub-Saharan Africa, more recent arrival in Australia, lower CD4 count, detectable viral load, shorter time on antiretroviral therapy and more recent HIV diagnosis. Women accessing sexual health services for HIV care, especially those from culturally and linguistically diverse backgrounds, appear to be substantially under-screened and efforts to optimise screening are needed.