Volume 14 Number 4 2017
SH17037Increasing syphilis rates among men who have sex with men and screening to detect asymptomatic infection
With increasing rates of syphilis among men who have sex with men (MSM), strategies to increase syphilis screening of MSM that are tailored to particular contexts should be implemented.
SH16149Active syphilis and its association with HIV and sexual risk behaviours in a multicity sample of men who have sex with men and transgender women in Peru
Syphilis in Peru is heavily concentrated among men who have sex with men (MSM) and transgender women (TGW). A cross-sectional analysis was conducted to better understand the correlates of active syphilis infection using a multicity sample of over 5000 MSM and TGW in Peru. Findings support the need for combined HIV and syphilis screening among MSM and TGW populations and also indicate differing syphilis epidemics throughout the country and in populations of TGW.
Few studies have examined smoking and female sexual difficulties. Data for this study came from the Second Australian Study of Health and Relationships (2012–13), which includes a representative sample of 18 427 sexually active Australian men and women (aged 16–69 years). Current tobacco smoking was associated with sexual difficulties in both men and women. This was more evident among male heavy smokers. For women, even light smoking was associated with not finding sex pleasurable and being unable to come to orgasm.
SH16046Gonorrhoea testing and positivity in non-remote Aboriginal Community Controlled Health Services
In this retrospective study, routine records on gonorrhea testing at four Aboriginal community controlled health services in Australian urban and regional settings were analysed. The proportion of patients aged 15–29 who were tested each year increased over time, and results were more often positive in people who also had chlamydia. Overall positivity was 1.6%, substantially lower than in remote communities of central and northern Australia, but high enough to justify routinely duplex testing for gonorrhea and chlamydia.
SH16183Disclosure of newly diagnosed HIV infection and condom use at first sex after diagnosis: a study of young Black men who have sex with men
Among 125 HIV-infected young Black men who have sex with men, 70% disclosed their HIV status to the first male partner they had sex with following diagnosis. Men not making this same disclosure were about three times more likely to report condomless sex with that first, post-diagnosis, male partner. Not disclosing HIV serostatus was associated with perceiving a greater level of partner-related barriers to condom use.
SH16160When a relationship is imperative, will young women knowingly place their sexual health at risk? A sample of African American adolescent girls in the juvenile justice system
Detained African American adolescent girls are particularly vulnerable to contracting HIV/STIs when compared to other adolescent populations. This study examines the heightened risk for HIV/STIs when HIV/STI knowledge is high by applying the principle of least interest to understand sexual risk-taking among a detained sample of young African American women. Although some girls had a high degree of knowledge regarding the transmission of HIV/STIs, this knowledge interacted with the endorsement of a relationship imperative to increase HIV/STI risk among this group. Risk reduction interventions are needed that acknowledge the vulnerabilities for this population and increase the opportunities for appropriate HIV/STI prevention efforts.
This study describes men’s sexual difficulties and barriers to reproductive health care in the Solomon Islands. The study included qualitative inquiry and a quantitative quasi-randomised quota sample household survey. Only a few men had ever sought professional health care for reproductive health problems, while many men preferred to use kastom medicine for sexual problems. Comorbid non-communicable diseases, low health-related quality of life and dissatisfaction with sexual relationships were independently correlated with sexual difficulties. The findings strongly suggests the need for comprehensive health services that are gender-specific and sensitive to the sexual difficulties of Islander men.
SH16151Retrospective study of hepatitis C outcomes and treatment in HIV co-infected persons from the Australian HIV Observational Database
The widespread availability of direct-acting antivirals (DAAs) is expected to drastically improve the treatment uptake and cure rate of hepatitis C virus (HCV). This paper assesses rates of and factors associated with HCV treatment uptake and cure in the HIV co-infected population in Australia before access to DAAs to establish a baseline for a new treatment era.
SH16054Partnership agreements less likely among young gay and bisexual men in Australia – data from a national online survey of gay and bisexual men’s relationships
In this paper differences in partnership agreements among gay and bisexual men (GBM) were assessed. The ability to communicate with a partner about sexual agreements has important sexual health implications for GBM. Regarding the nature of their partnership with their primary regular partner, younger men were less likely to have an agreement of any sort and were less likely to have discussed it. Due to less communication with partners about sexual agreements, when young GBM engage in sexual risk behaviour they may be at an increased risk of HIV and other sexually transmissible infections.
SH16034Prevalence and correlates of condom use among sexually active men who have sex with men in the United States: findings from the National Survey of Family Growth, 2002, 2006–10 and 2011–13
This study estimated the overall prevalence of condom use at last sex and by sexual risk behaviours among sexually active men who have sex with men (MSM) in the preceding 12 months. Approximately 31% of all MSM and 30–38% of MSM who reported at least one sexual risk behavior reported condom use at last sex. Race, recent STI diagnosis, and relationship status were associated with condom use at last sex. There was no difference in temporal trends in condom use at last sex across the three NSFG cycles. Continued promotion of consistent condom use mitigates HIV and STI risk and complements the effectiveness of new HIV prevention modalities such as pre-exposure prophylaxis.
SH17026UK healthcare professionals’ uncertainties, barriers and facilitators to the introduction of targeted human papillomavirus vaccination for men who have sex with men
Healthcare professionals’ recommendation is one of the strongest predictors of the human papillomavirus (HPV) vaccine uptake. Due to concerns about the compromised effectiveness of HPV vaccination in adult sexually active men who have sex with men (MSM), some UK healthcare professionals might be hesitant to promote the vaccine to their patients. There is an urgent need to develop guidelines on HPV vaccination for MSM, raise awareness about HPV-related diseases in MSM, and enable integrated clinic procedures on vaccinations in order to achieve optimal uptake.
SH16076Association between sexually transmissible infection testing, numbers of partners and talking to partners and friends about sexual health: survey of young adults
This study investigated the influence of partner and friendship networks on young adults (aged 18–30) sexually transmissible infection (STI) testing. Recruiting from nightlife precincts, 167 young people self-completed a questionnaire. Talking to partners and friends about STI testing was associated with testing rates for young adults, and increased numbers of sexual partners may be associated with the promotion of STI testing among friends and partners. Understanding young adult partner and friendship networks and their influence on STI testing practices may enhance health promotion efforts to increase testing for this group.
SH16238Factors associated with unwanted sexual experiences of young Australian females: an observational study
Sexual abuse and paedophilia are pervasive contemporary global issues. Thus raising awareness of the associated short and long term outcomes for the abused is pertinent to making sure relevant support systems are in place. We show that sexual behaviours and mental health are associated with childhood and adolescent unwanted sexual experiences (USEs) in young Australian females, but were unable to determine the direction of these associations. Longitudinal studies should be conducted to investigate whether there are groups of individuals who are at a high risk of experiencing childhood USE, so that high quality support services can be provided to these individuals.
SH16162Prevalence of porA pseudogene deletion among Neisseria gonorrhoeae isolates referred to the UK’s Gonococcal Resistance to Antimicrobials Surveillance Program
Some laboratories use porA pseudogene targeted real-time polymerase chain reactions to confirm the Neisseria gonorrhoeae status of clinical specimens, however porA negative strains have been sporadically reported. In this UK study, less than 0.4% (2/533) of gonococcal isolates examined were determined to porA-negative isolates. Low prevalence indicates that although these isolates do not present a major public health problem, microbiologists should remain vigilant.
This case report demonstrates that vesicovaginal fistula can be caused by the consensual use of sex toys between same-sex partners. Increased information is needed on the connection between sex toy use and trauma.
SH16221Reporting pre-exposure prophylaxis use in Craigslist personal advertisements among men seeking sex with men in the United States
This study describes the self-reported use of pre-exposure prophylaxis (PrEP) in the personal advertisements of men seeking sex with men in the United Sates on the online classified advertisement site, Craigslist. Overall use of PrEP in personal advertisements was low. However, self-reported PrEP use was often in conjunction with other sexual risk behaviours. Findings underscore the need for increased public PrEP awareness, particularly among men seeking sex with men, as well as the importance emphasising sexually transmissible infection prevention behaviours (i.e. condom use) used in conjunction with PrEP.
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Cardiovascular disease has a higher incidence in patients with HIV infection. Our study sought to determine whether national guidelines were being met to address this issue. We found that while some targets were being met, current screening and management for this patient group falls short of guidelines.
SH17045Physician testing for HIV in patients treated with tenofovir disoproxil fumarate and lamivudine monotherapy for hepatitis B virus
Previously we found that local patients were often not tested for HIV prior to commencing nucleoside/nucleotide reverse transcription inhibitor (NRTI) therapy for hepatitis B virus. We performed a national cross-sectional cohort study of physician practices via an online survey. A small majority (23/44; 52%) of participants reported always testing their hepatitis B virus patients for HIV prior to NRTI therapy, and 8/44 (18%) reported testing for HIV the majority of the time. Thirteen (30%) respondents reported testing only if risk factors were present. One physician reported a patient seroconverting to HIV while on TDF monotherapy.
SH16117UriSwab: an effective transport medium for nucleic acid detection of Chlamydia trachomatis, Mycoplasma genitalium and Neisseria gonorrhoeae
Mailing of self-collected specimens for detection of sexually transmitted infections (STIs) is being used increasingly in Australia. However, postal regulations in Australia do not allow liquids such as urine to be sent in the post. The suitability of UriSwab for the detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium by polymerase chain reaction, compared with neat urine and a flocked swab dipped in urine, as well as its performance at high and prolonged temperatures to mimic potential harsh transport conditions were evaluated.
SH16164Attitudes to sexual health in the United States: results from a national survey of youth aged 15–25 years
Data from a large panel survey show that American youths’ attitudes to sexual health fit well with global sexual health definitions. Survey respondents believed dimensions of sexual health such as emotional fulfilment, pleasure, and mutual benefits in relationships were important components of overall sexual health. Increasing belief in the importance of sexual health was associated with sexual activity and also condom use and health care use.
SH16207Trends in chlamydia and gonorrhoea testing and positivity in Western Australian Aboriginal and non-Aboriginal women 2001–2013: a population-based cohort study
This large data-linkage study of Western Australian women found significant increases in both chlamydia and gonorrhoea testing using nucleic acid amplification tests between 2001 and 2013. During this same period, chlamydia positivity remained highest in young Aboriginal women, at around 15%, with little change observed between overtime and despite increases in positivity in young non-Aboriginal women. Further gonorrhoea positivity was at least 10 times greater in young Aboriginal women than their non-Aboriginal counterparts. More effective prevention strategies and continued surveillance of chlamydia and gonorrhoea testing, positivity by age and risk groups are needed to address these disparities.
SH16190Analysis of transmitted HIV drug resistance from 2005 to 2015 in Victoria, Australia: a comparison of the old and the new
This study outlines HIV-1 transmitted drug resistance to HIV-1 protease, reverse transcriptase and integrase inhibitors in Melbourne, Victoria from 2005 to 2015. During this time, there was a statistically significant decline in the prevalence of mutations at codons M41, K103 and T215 in the reverse transcriptase gene, but none for the protease. The presence of integrase inhibitor resistance mutations was assessed from 2010 to 2015 and found to be negligible.
SH17068Rates of advertised condomless sex in the online profiles of private sex workers: a cross-sectional study
This study assessed the rate of condomless sex advertised in the online profiles of private sex workers in Sydney. None advertised condomless anal or vaginal sex and 50% advertised condomless oral sex. Age less than 25 years was associated with advertised condomless oral sex.
SH16198How partnership type and HIV seroconcordance affect HIV transmission risk in regular sexual partnerships: a cross-sectional survey of Australian gay and bisexual men
Regular sexual partnerships among gay and bisexual men who practice condomless anal intercourse have not been well characterised in terms of partnership type, HIV seroconcordance and risk of HIV transmission. Primarily sexual regular partnerships (i.e. ‘fuckbuddies’) are common among gay men, but have largely been ignored in research and HIV prevention. Condomless sex is more common among regular sexual partnerships considered to be of a romantic, committed nature. However, factors associated with such romantic or committed partnerships can also protect against HIV transmission risk. Partnerships where one or both partners’ serostatus is unknown present the greatest transmission risk, especially those of a primarily sexual nature.
SH17004Abortion: findings from women and men participating in the Understanding Fertility Management in contemporary Australia national survey
This study of a population sample of women and men in Australia aged 18–50 years revealed that experience of abortion is common: one in six women and one in 10 men reported experiencing or being a partner in an abortion. Women who were socially disadvantaged, reported not being comfortable negotiating contraceptive use, and men who lived in a metropolitan area were more likely to report having experienced, or being a partner in, an abortion. Reporting past experiences of sexual coercion increased the likelihood of reporting abortion among both women and men.
SH16235Contraception – what about the men? Experience, knowledge and attitudes: a survey of 2438 heterosexual men using an online dating service
This research analysed 2438 responses from men using an online dating site on contraceptive, knowledge attitudes and beliefs. We found high contraceptive use, especially vasectomy, and a desire to be part of the decision making, especially in long term relationships. However there was low awareness of some of the more effective methods and misperceptions about method safety, especially the emergency contraceptive pill.
SH17016Effect of attitudes towards patients on sexual history taking: a survey of Iranian–American physicians in California, USA
This is the first descriptive cross-sectional survey of Iranian–American physicians, a subpopulation of physicians, as providers of sexual health care practicing in California, USA (n = 354). The experience of dual process of cultural influences (i.e. both home and the main stream cultures) are important factors affecting these physicians’ involvement in sexual history taking. This is a significant neglected area in sexual health care which highlights the need to have a greater understanding of influential factors regarding physicians who share similar conservative cultural backgrounds. These findings support the need for development of new strategies that reflect on physicians’ attitude as providers of sexual health care.
SH16146Testing for chlamydial infection: are we meeting clinical guidelines? Evidence from a state-level laboratory data linkage analysis for 15- to 29-year-olds
This data linkage study of all chlamydia tests conducted in 15-29 year olds at a state population level over a 2-year period, enables population rates of testing and test positivity to be reported. Results are compared to clinical guidelines and to the estimated testing levels required to reduce chlamydia prevalence. Chlamydia testing rates are lower than recommended levels in both males and females. This study provides a robust methodology that can meet the requirements of the Australian National Sexually Transmissible Infections Strategy by monitoring testing coverage and providing evidence to evaluate prevention and control programs.
SH16240Prospective cohort study of childhood behaviour problems and adolescent sexual risk-taking: gender matters
Externalising (delinquent, aggressive) and internalising (anxious/depressed, withdrawn) behaviour problems are common in childhood. In a population-based birth cohort (the Western Australian Pregnancy Cohort (Raine) study), this study sought to determine relationships, by gender, between childhood behaviour problems and adolescent risky sexual behaviours and substance use. Externalising behaviour problems from as early as 5 years old in boys and 8 years old in girls predict a range of risky sexual behaviours in adolescence.
Gender dysphoria is associated with significant health disparity. Although specialised interventions such as endocrine therapy and surgery are safe and effective, mortality for the transgender population remains substantially higher than the general population. Primary health care is one of the components that contribute to health discrepancy for transgender individuals, but the medical needs of transgender patients are often misunderstood. This paper addresses some of the main primary care issues for transgender populations.
SH17073Sexual risk behaviours associated with unlicensed driving among young adults in Miami’s electronic dance music nightclub scene
This study examined sexual and other risk behaviours among young adults in Miami, Florida, comparing unlicensed driving (UD) offenders and non-UD offenders. Compared with others, UD offenders were more likely to report additional sexual risk behaviours. Results suggest that locating sexual risk reduction interventions inside of the justice system would benefit UD offenders.
This article reviews problems with the Safe Schools program in Australia which seeks to protect lesbian, bisexual, gay, transgender and intersex young people from bullying. The information in this program to Principals, teachers and young people is inaccurate and misleading. The program, as presently designed, may actually cause harm because it promotes gender transitioning without expert medical advice. The great majority of children resolve gender dysphoria issues around the time of puberty.
This article discusses transgender and gender diverse (TGD) student rights in a range of Australian laws and education policies. It shows how the inclusion of TGD students, particularly in sexuality education, is reinforced in the current Australian National Curricula. Finally, it considers research on Australian TGD students’ educational attainment, experiences of transphobic abuse and violence, and experiences in contexts where they do and do not have staff (and other) support. It promotes a shift from harmful approaches of victimising TGD students, towards celebrating their resilience and social contributions.
SH16179Pregnant young women’s attitudes about microbicides: the anticipated influence of the grandmother and father of the baby on microbicide use
Pregnant young women’s attitudes about their grandmother and father-of-the-baby’s role in decision-making and involvement in microbicide use were assessed. Greater grandmother involvement in microbicide use was significantly associated with being younger, having no reproductive tract infection or contraceptive-ring-use history. Greater father involvement in use was associated with being in a relationship with him. Strategies for engaging grandmothers and fathers in microbicide use should be developed.
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.
Low education levels are associated with early age of sexual debut, drug use and risky sexual behaviours among young Indigenous Australians
Substantial increase in yield of Neisseria gonorrhoeae testing 2008-2013 at a Sydney metropolitan sexual health clinic: an observational study
Evaluation of the 2014 Australian Sexually Transmissible Infection and HIV Testing Guidelines for Asymptomatic Men Who Have Sex with Men among General Practitioners in Sydney
Comparisons of Vaginal Flora Patterns among Sexual Behavior Groups of Women – Implications for the Pathogenesis of Bacterial Vaginosis
Blood-borne virus transmission in an urban, culturally diverse neighbourhood: results from a cross-sectional bio-behavioural survey using innovative outreach methods in a hard-to-reach population.
Retaining HIV-positive patients in HIV care: A personalized approach for those at risk of lost to follow-up at an inner city sexual health service
Factors Influencing Uptake of Pre-exposure Prophylaxis: Some Qualitative Insights from An Intervention Study of Men Who Have Sex with Men in China
Stigma Associated with STI Testing in an Online Testing Environment: Examining the Perspectives of Youth in Vancouver, Canada
A multi-method study of health behaviors and perceived concerns of sexual minority females in Mumbai, India
Syndromic Management of Sexually Transmitted Infections in Resource-Poor Settings: A Systematic Review with Meta-Analysis of the Abnormal Vaginal Discharge Flowchart for Neisseria Gonorrhoea and Chlamydia Trachomatis
Kept clinical visits as scheduled in the first six months of antiretroviral treatment determine long-term treatment outcomes in people living with HIV: a large retrospective cohort study in China
Funding art for HIV-positive temporary residents in Australia prevents transmission and is inexpensive
Developing the evidence-base for gender and age-relevant school sex education; questionnaire findings from an adolescent sample using an augmented Theory of Planned Behaviour
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Enhanced use of phylogenetic data to inform public health approaches to HIV among men who have sex with menSexual Health 14 (1)Danielle German, Mary Kate Grabowski, Chris Beyrer
Dealing with pre-exposure prophylaxis-associated condom migration: changing the paradigm for men who have sex with menSexual Health 14 (1)Richard A. Crosby
As through a glass, darkly: the future of sexually transmissible infections among gay, bisexual and other men who have sex with menSexual Health 14 (1)Mark Richard Stenger, Stefan Baral, Shauna Stahlman, Dan Wohlfeiler, Jerusha E. Barton, Thomas Peterman
Human papillomavirus vaccination in men who have sex with men – what will be required by 2020 for the same dramatic changes seen in heterosexualsSexual Health 14 (1)Christopher K. Fairley, Huachun Zou, Lei Zhang, Eric P. F. Chow
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