Volume 12 Number 5 2015
SH14167Testing for HIV among men who have sex with men needs a paradigm shift in Australia, given the minimal increase between 2003 and 2013 in Melbourne, Australia
A retrospective study of men who have sex with men (MSM) was conducted using data from the Melbourne Sexual Health Centre. We investigated the trends in the proportion of MSM who have had an HIV test in the preceding 12 months. It was found that, despite efforts to increase testing, there has only been a minimal increase in the proportion of MSM who have had an HIV test in the preceding 12 months. We recommend that in order to increase testing, a paradigm shift is required to remove barriers to accessing HIV tests.
Sexual behaviour and HIV prevention needs of men who have sex with men (MSM) attending suburban Sex on Premises Venues (SOPVs) are understudied. A cross-sectional survey of 213 MSM over 18 years old attending a SOPV in Western Sydney found that consistent condom usage was not associated with having regular, casual or a mix of regular and casual partners during anal sex. Additionally, 59.5% obtained sexual health screening services from general practitioners and 57.7% believed that SOPVs should offer on-site and free testing services. Low cost or free on-site HIV and STI testing at SOPVs and stronger partnerships between general practitioners and sexual health services are needed.
SH14074Developmental investigation of age at sexual debut and subsequent sexual risk behaviours: a study of high-risk young black males
Early age of sexual debut may be a mediating variable rather than a causal explanation for sexual risk behaviours among young Black males residing in the Southern United States.
SH14051Condom-associated erection problems: behavioural responses and attributions in young, heterosexual men
How young men respond to condom-associated erection problems (CAEP) remains unclear. The purpose of the current study is to examine young, men’s behavioural responses and attributions to two forms of CAEP: (1) CAEP during condom application; and (2) CAEP while wearing a condom during penile-vaginal intercourse. Young men who reported CAEP responded with both STI/HIV risk-reducing and potentially risk-increasing behaviours (e.g. forgoing condom use). Providing possible strategies that address these behavioural responses to, and perceived contributing attributions for, CAEP may increase the applicability and efficacious value of condom use education programs and interventions.
SH15053It goes both ways: a cross-sectional study of buying and selling sex among young behaviourally bisexual men in Vientiane, Laos
In Laos men who have sex with men are disproportionately affected by HIV, and transactional sex may increase HIV and sexual risk. Men who have sex with men commonly also report sex with women. This paper explores the occurrence of transactional sex among behaviourally bisexual men in Vientiane, Laos. Among 88 bisexual men, 39% reported any transactional sex. The direction of payment, gender of sex partners, condom use, and implication for HIV and sexual risk are discussed.
SH14239Hepatitis C risk factors, attitudes and knowledge among HIV-positive, HIV-negative and HIV-untested gay and bisexual men in Australia
This study compared hepatitis C virus (HCV) knowledge and risk practices among HIV-positive, HIV-negative and HIV-untested gay and bisexual men in Australia. HIV-positive participants were older, reported greater engagement in sexual risk and injecting drug practices, felt they were at greater risk of acquiring HCV, were less likely to socially and sexually exclude people with HCV and had more positive attitudes towards people who inject drugs and people with HCV compared with HIV-negative and HIV-untested participants. HIV-untested participants were younger, reported fewer HCV-related serosorting practices and were more likely to socially and sexually exclude people with HCV than the other groups. Findings suggest that HCV education and prevention for gay men may be most effective if tailored according to HIV status.
SH14234Rate of repeat diagnoses in men who have sex with men for Chlamydia trachomatis and Neisseria gonorrhoeae: a retrospective cohort study
Substantial rises in sexually transmissible infections are occurring among men who have sex with men (MSM) in Australia. This retrospective cohort study of MSM attending a large, public sexual health clinic in Melbourne, Victoria, Australia was conducted to investigate: (i) rate of repeat diagnosis of chlamydia and gonorrhoea among MSM; and (ii) the rate ratio of gonorrhoea and chlamydia among re-infected MSM in comparison with the background clinic incidence of diagnoses.
Multimorbidity, or the co-occurrence of two or more health conditions in addition to HIV, was found in the majority of people with HIV accessing a regional sexual health service in NSW, Australia. The Cumulative Illness Rating Scale (CIRS) was used to measure levels of multimorbidity. Older age and having ever being diagnosed with AIDS were associated with the CIRS score in multivariate analysis.
SH14136HIV testing rate increased following recommendation of routine screening of acute medical admissions at Royal Darwin Hospital
In light of international literature and following concerns regarding the efficacy of targeted HIV testing given a higher rate of late diagnosis and evolving risk populations in the Northern Territory, Royal Darwin Hospital implemented a new HIV testing guideline in 2012.The guideline recommended that HIV testing be considered as part of routine assessment of all adult acute medical admissions. After 8 months of implementation, the uptake, point prevalence and impact on late diagnosis of HIV of routine screening was assessed.
In this study we sought to estimate the prevalence of mixed gonococcal infections using real-time PCR methods targeting the gonococcal porB gene. The methods were applied to N. gonorrhoeae NAAT-positive clinical specimens from Queensland in the year 2012. The data provide further evidence of mixed gonococcal infections at the same anatomical site, but show that such infections may be relatively infrequent (1.3%; 95% confidence interval 0.01–2.6%) in a general screening population.
SH15007Attendance patterns and chlamydia and gonorrhoea testing among young people in Aboriginal primary health centres in New South Wales, Australia
This study included four Aboriginal Community Controlled Health Services (ACCHS) in regional areas of New South Wales, Australia and is a baseline analysis which was used to inform a sexual health quality improvement program called SHIMMER. From 2009 to 2011, we examined the attendance patterns, chlamydia and gonorrhoea testing rates and positivity of 2,896 individuals aged 15–29 years. Higher testing rates of chlamydia and gonorrhoea were found among females and those who attended more frequently. Using these results, the participating ACCHS will develop sexual health testing and management strategies to increase chlamydia and gonorrhoea testing rates among young attendees and we will evaluate these testing strategies impact on testing rates.
SH15037Estimating antiretroviral treatment coverage rates and viral suppression rates for homosexual men in Australia
Gay and other men who have sex with men retain a heavy burden of the HIV population in Australia. This study combines a clinical-based cohort with a community-based surveillance system to estimate the proportion receiving antiretroviral therapy (ART) and/or with an undetectable viral load, in recent years. Between 2010 and 2012, we found small increases in ART uptake and proportions with undetectable viral load.
Sydney Sexual Health Centre (SSHC) audited hepatitis B virus (HBV) screening and vaccination rates as a quality improvement exercise. We found that the majority of SSHC clients at higher risk of HBV acquisition are screened for HBV and the majority of those found to be HBV-susceptible commence a three-dose HBV vaccination course. However, vaccine uptake drops by almost 50% between each subsequent dose and missed opportunities for vaccination were identified.
SH15016Sexually transmissible infections and characteristics of men aged 60 years and over attending a public sexually transmitted diseases (STD) clinic in South Australia
A retrospective study looking at characteristics of, and sexually transmissible infections in men visiting the only South Australian public sexually transmitted diseases clinic over a 13-year period showed older men over 60 years of age were less likely than younger men to have been tested for HIV. There is a need for increased HIV testing in older men.
SH15073Why not the GP? Client preferences for sexually transmissible infection testing in Western Sydney
This study of clients attending a publicly-funded sexual health service (PFSHS) in Western Sydney aimed to determine why people attend a PFSHS in preference to their General Practitioner (GP), whether they would be willing to see their GP for sexual health services, and what factors were important when making this decision. Results showed that when seeking sexual health care, factors relating to healthcare staff, including maintenance of confidentiality, were rated as more important than physical and operational factors of the health service. This study has identified a GP/sexual health visit ‘cascade’. The underlying factors relating to sexual health care with the GP, whether real or perceived, need to be addressed in order for PFSHS to successfully triage out attendees who are at a lower STI risk.
SH15079Reasons why gay and other bisexually active men attend different community testing services in Sydney; a cross-sectional survey
In 2013, two new community HIV testing services were implemented in Sydney, Australia, to increase testing options for gay men. A survey of men attending showed that over one-third of gay and bisexual men selected getting their HIV result at the same visit as the main reason they attended at both testing services. The convenient location of the Shopfront was also a key reason why GBM attended for testing.
Compared with men who have sex with women, some evidence suggests that men who have sex with men (MSM) have increased prevalence of body image dissatisfaction. MSM also have a higher prevalence of sexually transmissible infections (STIs) than other population groups. As part of a cross-sectional study, we examined associations between body image and prevalent STIs.