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We are seeking contributions for a Special Issue.. More


Sexual Health publishes contributions on sexual health from the widest perspectives including HIV/AIDS, STIs, issues of sexuality, and reproductive health. More

Editors: Christopher Fairley and Roy Chan

AIDS 2014: We would like to express our deepest sympathies to the families, friends and colleagues of delegates lost on MH17.
Out of respect for their work we are making our latest HIV Special Issue freely available online for 3 months.


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Published online 08 July 2014
Psychosocial factors related to willingness to use pre-exposure prophylaxis for HIV prevention among Black men who have sex with men attending a community event 
Lisa A. Eaton, Daniel D. Driffin, Harlan Smith, Christopher Conway-Washington, Denise White and Chauncey Cherry

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

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Published online 03 July 2014
Condom use motivations and selected behaviours with new versus established sex partners 
Richard A. Crosby, Robin R. Milhausen, Cynthia A. Graham, William L. Yarber, Stephanie A. Sanders, Richard Charnigo and Lydia A. Shrier

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.

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Published online 03 July 2014
Parents' views on human papillomavirus vaccination for sexually transmissible infection prevention: a qualitative study 
Linda M. Niccolai, Caitlin E. Hansen, Marisol Credle, Sheryl A. Ryan and Eugene D. Shapiro

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.

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Published online 03 July 2014
'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 
Chee S. Koh, Melissa Kang and Tim Usherwood

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

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Published online 03 July 2014
Do family factors protect against sexual risk behaviour and teenage pregnancy among multiply disadvantaged young people? Findings from an English longitudinal study 
Chris Bonell, Meg Wiggins, Adam Fletcher and Elizabeth Allen

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.

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Published online 26 June 2014
Adherence-enhancing interventions for active antiretroviral therapy in sub-Saharan Africa: a systematic review and meta-analysis 
Tim Mathes, Sunya-Lee Antoine and Dawid Pieper

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.

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Published online 12 June 2014
Female sexual dysfunction across the three pregnancy trimesters: an Egyptian study 
Samy Hanafy, Neveen E. Srour and Taymour Mostafa

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.

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Published online 12 June 2014
Social support and depressive symptoms among 'money' boys and general men who have sex with men in Shanghai, China 
Huamei Yan, Frank Y. Wong, Tony Zheng, Zhen Ning, Yingying Ding, Eric J. Nehl, Lavinia Lin and Na He

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.

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Published online 10 April 2014
Testing for ‘threads’ and leucocyte esterase in first-void urine to exclude the diagnosis of non-specific urethritis in asymptomatic men 
Sanjeeva N. S. Pallawela, Christopher Sonnex, Julia Burdett, Dawn Cooper, Katrina Nethercott, Catherina M. Thomas, Peter Goon, Hayley Webb and Christopher Carne

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.

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Published online 02 April 2014
Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence 
David J. Templeton, Phillip Read, Rajesh Varma and Christopher Bourne

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.

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Volume 11 Number 2 2014
Antiretroviral-based Prevention of HIV

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Table of Contents 
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Preface to ‘Antiretroviral-based Prevention of HIV’ 
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Iryna Zablotska , Jintanat Ananworanich , Adeeba Kamarulzaman , Ken Mayer , Mary Poynten , Bill Whittaker , John de Wit and Edwina Wright
pp. ii-iii

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Bringing new HIV infections to zero – opportunities and challenges offered by antiretroviral-based prevention in Asia, the Pacific and beyond: An overview of this special issue 
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Iryna B. Zablotska , Bill Whittaker , John de Wit , Adeeba Kamarulzaman , Jintanat Ananworanich , Edwina Wright , Isobel Mary Poynten and Kenneth Mayer
pp. 97-100

This editorial describes the contents of this special issue of Sexual Health devoted to implementing new antiretroviral-based prevention approaches in Asia, the Pacific and beyond. Recent discoveries have opened new opportunities for HIV biomedical prevention, and countries committed to deploy new interventions and scale-up responses to HIV. This issue is dedicated to presenting research and promoting debate regarding opportunities and challenges of moving prevention innovations into the community in the region


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Transforming Australia’s HIV prevention and treatment efforts to achieve an AIDS-free generation: the United Nations Political Declaration on HIV/AIDS and the Melbourne Declaration ‘Action on HIV’ 
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Bill Whittaker
pp. 101-106

Scientific advances in HIV prevention and treatment, together with the 2011 United Nations Political Declaration on HIV/AIDS, offer unique opportunities to transform the global fight against AIDS. However, progress in responding to these opportunities has been mixed, prompting Australian scientists, clinicians and community advocates to issue the Melbourne Declaration ‘Action on HIV’, which calls for Australia’s HIV response to be revitalised through several key actions. These changes can strengthen Australia’s HIV response domestically and also enhance Australia’s leadership in the global quest to achieve an ‘AIDS-free generation’.


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'Getting to zero' in Asia and the Pacific through more strategic use of antiretrovirals for HIV prevention 
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Michael M. Cassell , Timothy H. Holtz , Mitchell I. Wolfe , Michael Hahn and Dimitri Prybylski
pp. 107-118

The strategic use of antiretrovirals is critical to ending AIDS in Asia. Nevertheless, low rates of HIV testing among men who have sex with men, people who inject drugs, sex workers and other key populations evidence low treatment coverage where treatment could have the greatest prevention benefits. Enhanced collaboration is needed between clinical and community service providers to reach, test, treat and retain key populations in care.


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Current status of HIV treatment in Asia and the Pacific region 
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Angsana Phuphuakrat , Sasisopin Kiertiburanakul and Somnuek Sungkanuparph
pp. 119-125

Access to HIV treatment and care vary between countries in Asia and the Pacific. Differences between high-income economies and the rest of the region are remarkable. Many high-income countries provide antiretroviral therapy (ART) to their citizens; middle- and low-income countries have rapid ART scale-up and are dependent on international funding. The global goal of achieving universal access to ART requires mainly low- and middle-income countries to be targeted.


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Challenges and potential barriers to the uptake of antiretroviral-based prevention in Asia and the Pacific region 
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Ying-Ru Lo , Masaya Kato , Nittaya Phanuphak , Masami Fujita , Duong Bui Duc , Seng Sopheap , Razia Pendse , Dongbao Yu , Zunyou Wu and Suwat Chariyalertsak
pp. 126-136

The effectiveness of antiretroviral therapy taken by HIV-infected individuals to prevent HIV transmission to HIV-uninfected persons (TasP) and antiretroviral pre-exposure prophylaxis taken by HIV-uninfected individuals to prevent HIV acquisition (PrEP) is unknown in HIV epidemics concentrated in populations at high risk for HIV. This paper investigates the challenges and barriers of implementing TasP and PrEP in the Asian context and makes the case that implementation research in Asia can provide data on the effectiveness of such interventions in concentrated epidemics.

   |        Open Access Article

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Can treatment-based HIV prevention curb the epidemic among gay and other men who have sex with men? A narrative synthesis of increasing evidence for moderating and countervailing effects 
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John B. F. de Wit and Philippe C. G. Adam
pp. 137-145

As HIV epidemics among gay and other men who have sex with men (GMSM) persist, there is hope that the use of antiretroviral therapy (ART) for prevention can curb infections. However, evidence of the beneficial effects of ART-based HIV prevention for GMSM remains limited. ART-based approaches increase people’s options to protect themselves and others, but their impact depends on what has already been achieved and how they will be used.


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Predicting the population impact of increased HIV testing and treatment in Australia 
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James Jansson , Cliff C. Kerr and David P. Wilson
pp. 146-154

A model is used to simulate the expected outcomes of treatment-as-prevention strategies in Australia under assumptions of varying levels of treatment efficacy.


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The key role of adherence for the effectiveness of antiretroviral-based prevention: state of the science and implications for the Asia-Pacific region 
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K. Rivet Amico
pp. 155-165

This paper reviews the behavioural factors influencing uptake and impact of treatment-as-prevention and pre-exposure prophylaxis. The behavioural pathways to control the HIV epidemic with these biobehavioural strategies are explored, and gaps in current knowledge are identified. Implications for each strategy in the Asia-Pacific region are considered, and critical issues in moving forward are highlighted.


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HIV pre-exposure prophylaxis and treatment as prevention: a review of awareness and acceptability among men who have sex with men in the Asia-Pacific region and the Americas 
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Martin Holt
pp. 166-170

This review assesses acceptability research for HIV pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) among men who have sex with men (MSM). There has been limited research on the acceptability of PrEP outside the United States and no research to date evaluating the acceptability of TasP. PrEP appears to be reasonably acceptable to MSM, but studies of HIV treatment optimism suggest that MSM will be sceptical of TasP.


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Acceptability of oral and topical HIV chemoprophylaxis in India: implications for at-risk women and men who have sex with men 
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Nomita Chandhiok , Smita N. Joshi and Raman Gangakhedkar
pp. 171-179

The underlying determinants for acceptability of HIV chemoprophylaxis include the individual, couple dynamics and the larger social and cultural context. Overall, Indian women and men had a positive attitude towards the concept and use of microbicide products. However, the need for HIV chemoprophylaxis is greatest for high-risk groups like female sex walkers and men who have sex with men. Acceptability in these groups needs to be further explored, including demonstration projects for program introduction.


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Biomedical HIV prevention research and epidemic control in Thailand: two sides of the same coin 
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Frits van Griensven , Nittaya Phanuphak and Kriengkrai Srithanaviboonchai
pp. 180-199

This paper revisits Thailand’s global role model function of effective HIV/AIDS control and high-quality biomedical HIV prevention research. Results indicate that Thailand’s initial response in raising the level of the political significance of HIV/AIDS was indeed extraordinary, but its effectiveness declined over time. However, the volume and quality of the country’s biomedical HIV prevention research continued to be high. Thailand has made a huge contribution to the global management and control of the HIV/AIDS pandemic.


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Recently diagnosed gay men talk about HIV treatment decisions 
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Ian Down , Garrett Prestage , Kathy Triffitt , Graham Brown , Jack Bradley and Jeanne Ellard
pp. 200-206

In recent years there has been increasing evidence that early initiation of antiretroviral therapy may provide health benefits for those infected with HIV while also reducing the risk of onward transmission of the virus. Recently-diagnosed gay men, interviewed as part of the HIV Seroconversion Study, were asked about their knowledge and experience of, and their decisions about whether or not to commence, HIV treatment.


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Rolling out new biomedical HIV prevention tools: what can be learned from Avahan, the India AIDS initiative? 
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Gina Dallabetta , Padma Chandrasekaran , Tisha Wheeler , Anjana Das , Lakshmi Ramakrishnan , Sameer Kumta and James Moore
pp. 207-216

The promise of new biobehavioural prevention advances, namely pre-exposure propyhlaxis (PrEP) and treatment as prevention, for key populations can only be realized if they are implemented with adequate scale and coverage. Globally, coverage of key populations with classic prevention services is inadequate and they have limited access to health services in many settings. The approaches used by Avahan in India to achieve a scaled prevention intervention with high coverage and key population engagement that served as a platform for increasing service scope to expand clinical services over time services are discussed. Key elements included clear service definitions and denominator-based targets, robust and routine data systems, multilevel supervision and cross-learning, as well as a strong cadre of key population peer outreach workers who addressed structural barriers and provided mechanisms for interaction between the key populations and health services.

   |        Open Access Article

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These articles have been peer reviewed and accepted for publication. They are still in production and have not been edited, so may differ from the final published form.

    SH14035  Accepted 15 July 2014
    Could point-of-care testing be effective for reducing the prevalence of trichomoniasis in remote Aboriginal communities?
    Ben Hui, James Ward, Louise Causer, Rebecca Guy, Matthew Law, David Regan

    SH14057  Accepted 09 July 2014
    Declining trends in the proportion of non-viral sexually transmitted infections reported by STD Clinics in the United States, 2000-2010
    Kwame Owusu-Edusei, Bianca Sayegh, Alesia Harvey, Robert Nelson

    SH14032  Accepted 02 July 2014
    Prevalence, correlates, and attitudes towards sexting among young people in Melbourne, Australia
    Timothy Yeung, Danielle Horyniak, Alyce Vella, Margaret Hellard, Megan Lim

    SH14094  Accepted 24 June 2014
    Time trends in adolescent sexual behaviour in Italy
    Claudia Marino, Alessio Vieno, Michela Lenzi, Massimo Santinello

    SH13205  Accepted 19 June 2014
    Epidemiology of gonorrhoea notifications in Australia 2007 – 2012
    April Roberts-Witteveen, Kate Pennington, Nasra Higgins, Carolyn Lang, Monica Lahra, Russell Waddell, John Kaldor

    SH13202  Accepted 16 June 2014
    Who are the sexual partners of transgender individuals? Demographic characteristics and risk behaviors of San Francisco HIV testing clients with transgender sexual partners
    Erin Wilson, Nayla Raad, Yea-Hung Chen, Henry Raymond, Teri Dowling, Willi McFarland

    SH13189  Accepted 28 May 2014
    Assessment of psychosocial impact of genital warts among patients in Singapore
    Lucinda Si Yun Tan, Martin Chio, Priya Sen, Timothy Yong Kuei Lim, Joseph Soon Yau Ng, Arunachalam Ilancheran, Jeffrey Jen Hui Low, Yen Shing Yeoh, Roy Chan, Nan Luo

    SH14027  Accepted 27 May 2014
    A case of gonococcal necrotising fasciitis
    Kudzai Kanhutu, Denis Spelman, Michael Weymouth

    SH14011  Accepted 27 May 2014
    Attitudes towards microbicide use for bacterial vaginosis in pregnancy
    Marina Catalozzi, Camille Williams, Gregory Zimet, Katharine Hargreaves, Shari Gelber, Adam Ratner, Lawrence Stanberry, Susan Rosenthal

    SH14079  Accepted 25 May 2014
    Re-attendance and chlamydia re-testing rates at 12 months among young people attending Australian General Practice 2007-2010: a longitudinal study
    Emma Weaver, Anna Bowring, Rebecca Guy, Caroline van Gemert, Jane Hocking, Douglas Boyle, Tony Merritt, Clare Heal, Phyllis Lau, Basil Donovan, Margaret Hellard

    SH14063  Accepted 19 May 2014
    Cervical screening uptake and abnormalities among women attending sexual health clinics for HIV care
    Donna Tilley, Catherine OConnor, Sunil Adusumilli, Maggie Smith, Clara Marin-Zapata, Catriona Ooi, David Templeton

    SH13204  Accepted 19 May 2014
    Sexual and reproductive health and philanthropic funding in Australia
    Liz Gill-Atkinson, Catherine Vaughan, Henrietta Williams

    SH13074  Accepted 19 May 2014
    High rates of sexually transmitted infections in HIV-positive patients in the Australian HIV Observational Database - a prospective cohort study
    Brian Mulhall, Stephen Wright, Debbie Allen, Katherine Brown, Bridget Dickson, Miriam Grotowski, Eva Jackson, Kathy Petoumenos, Phillip Read, Tim Read, Darren Russell, David Smith, David Templeton, Christopher Fairley, Matthew Law

The Most Read ranking is based on the number of downloads from the CSIRO PUBLISHING website of articles published in the previous 12 months. Usage statistics are updated daily.

Rank Paper Details
1. Published 1 August 2013
The impact of living with HIV: differences in experiences of stigma for heterosexual and homosexual people living with HIV in Australia

Loren Brener, Hannah Wilson, Sean Slavin and John de Wit

2. Published 14 October 2013
Are Australian sexual health clinics attracting priority populations?

Hammad Ali, Basil Donovan, Christopher K. Fairley, Nathan Ryder, Anna McNulty, Marcus Y. Chen, Lewis Marshall, Catherine C. O'Connor, Bridget Dickson, Andrew E. Grulich, Margaret E. Hellard, John M. Kaldor and Rebecca J. Guy

3. Published 26 March 2014
Management 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

4. Published 14 July 2014
Predicting the population impact of increased HIV testing and treatment in Australia

James Jansson, Cliff C. Kerr and David P. Wilson

5. Published 1 August 2013
Men who have sex with men, infectious syphilis and HIV coinfection in inner Sydney: results of enhanced surveillance

Susan J. Botham, Kelly-Anne Ressler, Patrick Maywood, Kirsty G. Hope, Chris P. Bourne, Stephen J. Conaty, Mark J. Ferson and Darren J. Mayne

6. Published 1 August 2013
The potential impact of new generation molecular point-of-care tests on gonorrhoea and chlamydia in a setting of high endemic prevalence

Ben B. Hui, David P. Wilson, James S. Ward, Rebecca J. Guy, John M. Kaldor, Matthew G. Law, Jane S. Hocking and David G. Regan

7. Published 14 July 2014
Transforming Australia’s HIV prevention and treatment efforts to achieve an AIDS-free generation: the United Nations Political Declaration on HIV/AIDS and the Melbourne Declaration ‘Action on HIV’

Bill Whittaker

8. Published 14 July 2014
HIV pre-exposure prophylaxis and treatment as prevention: a review of awareness and acceptability among men who have sex with men in the Asia-Pacific region and the Americas

Martin Holt

9. Published 14 October 2013
Masculinity, condom use self-efficacy and abusive responses to condom negotiation: the case for HIV prevention for heterosexual African-American men

Jerris L. Raiford, Puja Seth, Nikia D. Braxton and Ralph J. DiClemente

10. Published 14 July 2014
Recently diagnosed gay men talk about HIV treatment decisions

Ian Down, Garrett Prestage, Kathy Triffitt, Graham Brown, Jack Bradley and Jeanne Ellard

11. Published 26 March 2014
Incident hepatitis B infection subsequent to the diagnosis of HIV infection in a Melbourne cohort: missed opportunities for prevention

Amy Body, Jennifer F. Hoy, Allen C. Cheng and Michelle L. Giles

12. Published 26 March 2014
Rapid HIV testing increases the rate of HIV detection in men who have sex with men: using rapid HIV testing in a primary care clinic

Beng Eu, Norman Roth, Mark Stoové, Mark O'Reilly and Edward Clarke

13. Published 1 August 2013
Effective peer education in HIV: defining factors that maximise success

Steven M. Lambert, Joseph Debattista, Aleksandar Bodiroza, Jack Martin, Shaun Staunton and Rebecca Walker

14. Published 14 October 2013
HIV and hepatitis C virus co-infection among men who have sex with men in Sydney, and associations with sexual and drug use practices

Toby Lea, Evelyn Lee, Limin Mao, John de Wit and Martin Holt

15. Published 22 November 2013
Prevention and control of sexually transmissible infections among hotel-based female sex workers in Dhaka, Bangladesh

Duncan F. McCormick, Motiur Rahman, Sabrina Zadrozny, Anadil Alam, Lutfa Ashraf, Graham A. Neilsen, Robert Kelly, Prema Menezes, William C. Miller and Irving F. Hoffman

16. Published 1 August 2013
Preconception reflections, postconception intentions: the before and after of birth control in Australian adolescent females

Jennifer Lawson Smith, S. Rachel Skinner and Jennifer Fenwick

17. Published 22 November 2013
Qualitative exploration of HIV-related sexual behaviours and multiple partnerships among Chinese men who have sex with men living in a rural area of Yunnan Province, China

Eric P. F. Chow, Liangmin Gao, Fung Kuen Koo, Liang Chen, Xiaoxing Fu, Jun Jing, David P. Wilson and Lei Zhang

18. Published 1 August 2013
Facilitating partner notification through an online messaging service: Let Them Know

Sarah Huffam, Christopher K. Fairley, Mark Chung, Jun Kit Sze, Jade Bilardi and Marcus Y. Chen

19. Published 14 October 2013
One confirmed and one suspected case of pharyngeal gonorrhoea treatment failure following 500mg ceftriaxone in Sydney, Australia

Phillip J. Read, E. Athena Limnios, Anna McNulty, David Whiley and Monica M. Lahra

20. Published 22 November 2013
Identifying and understanding barriers to sexually transmissible infection testing among young people

Richard Oliver de Visser and Nancy O'Neill

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