Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective

Sexual Health

Sexual Health

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

Editors: Christopher Fairley and Roy Chan

Current Issue

Sexual Health

Volume 14 Number 2 2017

SH16075Self-reported testing and treatment histories among older Australian men and women who may be at risk of a sexually transmissible infection

Wendy Heywood, Anthony Lyons, Bianca Fileborn, Victor Minichiello, Catherine Barrett, Graham Brown, Sharron Hinchliff, Sue Malta and Pauline Crameri
pp. 139-146

Rates of sexually transmissible infections (STIs) are increasing among older adults in many countries. Little is known about the testing and treatment histories of these populations. Correlates of testing in the past 5 years among older adults who may be at risk of a STI were examined.

SH16109Daily diary study of adult men’s and women’s event-level sexual motivations and sexual behaviour

Devon J. Hensel, Fei He, Jarek Harezlak and J. Dennis Fortenberry
pp. 147-154

Understanding why people have sex has long been of public health and health promotion interest. We used daily diaries to examine how adult men’s and women’s event-specific affective sexual motivations were linked to the types and combinations of sexual behaviours chosen in a given sexual event. Both wanting to have sex, or a partner’s wanting to have sex, were associated with a wider set of behaviours chosen.

SH16143Experience of domestic violence routine screening in Family Planning NSW clinics

Tara Hunter, Jessica R. Botfield, Jane Estoesta, Pippa Markham, Sarah Robertson and Kevin McGeechan
pp. 155-163

This study reviewed implementation of the Domestic Violence Routine Screening (DVRS) program at Family Planning NSW and outcomes of screening to determine the feasibility of routine screening in a family planning setting and the suitability of this program in the context of women’s reproductive and sexual health. A retrospective review of medical records was undertaken of eligible women attending Family Planning NSW clinics in 2015.


A retrospective analysis of computerised medical records of men who have sex with men (MSM) who attended the South Australia Specialist Sexual Health (SASSH) clinic at their first visit was conducted to determine whether HIV testing had changed. The proportion of newly registered MSM who reported ever being tested for HIV declined; the proportion of MSM who returned to the clinic for HIV testing within 12 months did not change, with less than 40% of MSM returning for HIV testing. The findings suggest that HIV testing rate among MSM attending SASSH was suboptimal. New approaches are needed to increase the uptake and early detection of HIV infection among the high-priority MSM population.

SH16100HIV testing self-efficacy is associated with higher HIV testing frequency and perceived likelihood to self-test among gay and bisexual men

Muhammad S. Jamil, Rebecca J. Guy, Benjamin R. Bavinton, Christopher K. Fairley, Andrew E. Grulich, Martin Holt, Kirsty S. Smith, Marcus Chen, Anna M. McNulty, Damian P. Conway, Phillip Keen, Jack Bradley, Darren Russell, John M. Kaldor, Garrett Prestage and on behalf of the FORTH Investigator Group
pp. 170-178

An eight-item question block was used to construct a single broad measure capturing confidence in one’s perceived ability to undertake various aspects of HIV testing and self-testing (self-efficacy) among higher risk gay and bisexual men. Higher self-efficacy was independently associated greater likelihood to self-test, and higher self-efficacy, partner numbers, and optimism regarding the effects of HIV treatments on HIV transmission were independently associated with higher frequency of HIV testing in the past year. Improving self-efficacy by enhancing knowledge and experience may lead to higher testing frequency among gay and bisexual men. The self-efficacy measure used in the present study could be useful in identifying men likely to face difficulties with HIV testing and self-testing.

SH16132Comparing non-occupational post-exposure prophylaxis drug regimens for HIV: insights from a linked HIV surveillance system

Anna B. Pierce, Carol El-Hayek, Damien McCarthy, Jude Armishaw, Kerrie Watson, Anna Wilkinson, Brian Price, Edwina J. Wright, Jennifer F. Hoy and Mark A. Stoové
pp. 179-187

Data from the Victorian NPEP Service (VNPEPS) was linked with all Victorian HIV notifications to identify HIV seroconversions in NPEP users, and potential NPEP failures. Among MSM who presented to the VNPEPS following receptive anal intercourse with a source of unknown HIV serostatus (RAIU), possible NPEP failure occurred in 13 (0.7%) who were prescribed two drug NPEP and six (2.7%) who were prescribed three drug NPEP (P<0.001). This suggests that two-drug NPEP regimens do not result in excess seroconversions compared with three-drug regimens when used following RAIU.


Funded hepatitis B vaccination is provided by the Victorian Department of Health and Human Services to at-risk groups, however uptake and impact have not been measured. Analysis of administrative data indicated that approximately 5700 courses of vaccination have been provided, most commonly to household contacts of people diagnosed with hepatitis B. The findings demonstrate that gaps still exist in the provision of immunisation to those at risk of acquisition, particularly people who inject drugs and people living with hepatitis C.


This case report presents preliminary data from two men who have sex with men who reported HIV seroconversion while using non-prescribed antiretroviral medication (ARV) for pre-exposure prophylaxis (PrEP). The men reported limited knowledge of PrEP, obtaining non-prescribed ARVs from sex partners, and engaging in multiple HIV transmission risk behaviors. The informal, non-prescribed, and non-medically supervised use of ARVs for HIV prevention may leave men unprotected against HIV transmission.

SH16148Need for more research on and health interventions for transgender people

Yeimer Ortiz-Martínez and Carlos Miguel Ríos-González
pp. 196-197

This study described the distribution of transgender-related research in several databases, finding a low scientific output, especially in low-income developing countries. This is a call for more research and public health interventions for transgender people due this population is growing day by day worldwide.

SH16106Screening and management of risk factors for cardiovascular disease in HIV-positive patients attending an Australian urban sexual health clinic

Sheena Kakar, Douglas Drak, Tahiya Amin, Jason Cheung, Catherine O'Connor and David Gracey
pp. 198-200

The medical records of 188 patients attending an inner-city sexual health clinic (SHC) between August 2013 and July 2014 were retrospectively reviewed for cardiovascular risk factors and associated screening and management practices. Cardiovascular risk factors were common among attendees of the SHC, including smoking (38%), hypertension (14%) and dyslipidaemia (11%).

Online Early

The peer-reviewed and edited version of record published online before inclusion in an issue

Published online 18 May 2017

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

Lia N. Pizzicato, Panagiotis Vagenas, Pedro Gonzales, Javier R. Lama, Monica Pun, Jorge Sanchez and Frederick L. Altice
 

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.

Published online 18 May 2017

SH17005Tobacco smoking and sexual difficulties among Australian adults: a cross-sectional study

Li Ming Wen, Chris Rissel, Yan Cheng, Juliet Richters and Richard O. de Visser
 

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.

Published online 18 May 2017

SH16179Pregnant young women’s attitudes about microbicides: the anticipated influence of the grandmother and father of the baby on microbicide use

Jenny K. R. Francis, Lauren Dapena Fraiz, Marina Catallozzi, Ariel M. deRoche, Christine Mauro and Susan L. Rosenthal
 

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.

Published online 18 May 2017

SH16170Sexual difficulties faced by men in the Solomon Islands: a mixed-methods study

Paraniala Silas C. Lui, Michael P. Dunne, Philip Baker and Verzilyn Isom
 

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.

Published online 18 May 2017

SH16162Prevalence of porA pseudogene deletion among Neisseria gonorrhoeae isolates referred to the UK

Martina Toby, Pamela Saunders, Michelle Cole, Vlad Grigorjev, Sarah Alexander and Catherine Ison
 

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.

Published online 15 May 2017

SH16221Reporting pre-exposure prophylaxis use in Craigslist personal advertisements among men seeking sex with men in the United States

Brandon J. Hill, Trevor Bak, Alicia VandeVusse and Kris Rosentel
 

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.

Published online 09 May 2017

SH16151Retrospective study of hepatitis C outcomes and treatment in HIV co-infected persons from the Australian HIV Observational Database

Rainer Puhr, Stephen T. Wright, Jennifer F. Hoy, David J. Templeton, Nicolas Durier, Gail V. Matthews, Darren Russell and Matthew G. Law
 

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.

Published online 27 April 2017

SH16123Patient, staffing and health centre factors associated with annual testing for sexually transmissible infections in remote primary health centres

Belinda Hengel, Handan Wand, James Ward, Alice Rumbold, Linda Garton, Debbie Taylor-Thomson, Bronwyn Silver, Skye McGregor, Amalie Dyda, Jacqueline Mein, Janet Knox, Lisa Maher, John Kaldor, Rebecca Guy and
 

In high-incidence Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) settings, annual re-testing is an important public health strategy. Using baseline laboratory data (2009–10) from a cluster randomised trial in 67 remote Aboriginal communities, the extent of annual re-testing was determined, along with the associated patient, staffing and health centre factors.


Almost a quarter of HIV patients managed at the Alfred Hospital had an episode of detectable viral load between 20 and 200 copies/mL. Of these, half were an isolated viral blip, and only 7% of those with persistent low level viremia progressed to virological failure. Clinician management of low level viremia was generally conservative.


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.


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.

Published online 07 April 2017

SH16202Utility of risk-based chlamydia testing in primary care: analysis of retrospective surveillance data among women in Melbourne, Australia

Anna L. Wilkinson, Kathleen McNamee, Carol El-Hayek, Eric P. F. Chow, Catriona S. Bradshaw, Norm Roth, B. K. Tee, Mark Stoové and Margaret Hellard
 

The present study used retrospective surveillance data to estimate chlamydia incidence rates and identified risk factors for infection among women. Chlamydia incidence declined with age; however specific risk behaviours were associated with infection among older women. Chlamydia control remains a challenge, with uncertainty about the best approach; testing among older women at least, should be informed by risk.

Published online 07 April 2017

SH16087First four failures of cefathiamidine to treat urogenital gonorrhoea in Guangzhou, China, 2014–15

Jingyao Liang, Ridong Yang, Xiaodong Li, Chao Bi, Xingdong Ye, Xibao Zhang and Wenling Cao
 

Four patients residing in China with urogenital gonorrhoea firstly failed to treat with 1000 mg cefathiamidine intramuscular. Ceftriaxone is still an effective treatment option for gonorrhoea in China. Continued monitoring of Neisseria gonorrhoeae susceptibility to cefathiamidine as well as ceftriaxone is imperative.

Published online 30 March 2017

SH16177Ten years on: a review of medical terminations of pregnancy performed in a sexual health clinic

Sandra G. Downing, Colette Cashman and Darren B. Russell
 

Women living in regional Queensland have limited access to medical termination of pregnancy (MToP) services. Abortion also remains in the Queensland Criminal Code leading to the potential criminal prosecution for both the woman and the provider. However, Cairns Sexual Health Service has been providing MToP services for 10 years demonstrating that this service can be safely and successfully integrated into a primary health care setting. This paper documents the clinical practice, the characteristics of the women undergoing the procedure and the outcomes over the past 5-year period at Cairns Sexual Health Service.

Published online 16 March 2017

SH16191Australian gay and bisexual men’s online preferences about sex with HIV-positive partners

Garrett Prestage, Benjamin Bavinton, Denton Callander, Steven P. Philpot, Iryna Zablotska, Johann Kolstee, Phillip Keen, Jack Bradley and Fengyi Jin
 

On a large gay website, we investigated factors associated with excluding or including HIV-positive men as potential sex partners among 57 178 Australian profiles. Being younger, living outside major cities, not identifying as gay, always preferring safer sex and being of either Caucasian or Asian background were associated with excluding HIV-positive men as potential sex partners. The disinclination to include HIV-positive men as potential sex partners may be due to fear of infection, stigma or poor information about HIV.

Published online 16 March 2017

SH16181Increasing yield of pharyngeal Chlamydia trachomatis among male gay and bisexual clinic attendees in Sydney: an observational study

Sian Louise Goddard, Preethi Rajagopal and David James Templeton
 

Among 5445 Chlamydia trachomatis (CT) testing occasions during a 4-year study period, we observed a significant increase in yield of pharyngeal CT testing, although yield of anogenital CT testing remained stable. Without pharyngeal CT testing, over a quarter of pharyngeal CT infections and almost 5.0% of all CT infections would not have been treated.

Published online 06 March 2017

SH16215Sex education: findings from the Second Australian Study of Health and Relationships

Anna Yeung, Peter Aggleton, Juliet Richters, Andrew Grulich, Richard de Visser, Judy M. Simpson and Chris Rissel
 

Data from the Second Australian Study of Health and Relationships (ASHR2) was used to ascertain the associations between sex education and sexual health outcomes, including history of sexually transmissible infection (STI), early pregnancy, contraception use at first sex and level of STI knowledge. A total of 19 836 Australians provided information on sex education and these data were analysed using logistic regression. After adjusting for age, education and non-English-speaking background, the odds of using contraception at first sex and a high level of STI knowledge were increased in respondents reporting sex education that included information on condoms and contraception.

Published online 06 February 2017

SH16013Prevalence of HIV among Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis

Simon Graham, Catherine C. O'Connor, Stephen Morgan, Catherine Chamberlain and Jane Hocking
 

This is the first systematic review and meta-analysis to exame the prevalence of HIV among Australian Aboriginal and Torres Strait Islander people. Although our study suggests the prevalence of HIV is low, the potential for HIV to increase exists especially among Aboriginal gay men and Aboriginal people who inject drugs. More community-based studies that are designed and implemented by Aboriginal people are needed that include Aboriginal people at risk and Aboriginal women. These studies need to exmine effective prevention messages, promote regular testing of at risk individuals to identify new infections early and trial culturally appropriate community and clinical strategies and support programs for Aboriginal people living with HIV.

Published online 30 January 2017

SH16137Chlamydia retesting and retest positivity rates: results from a state-wide laboratory data linkage study in Tasmania, 2012–13

Nicola Stephens, David Coleman, Kelly Shaw, Maree O'Sullivan, Alistair McGregor, Louise Cooley and Alison Venn
 

In this whole-of-state, population-level data linkage study, chlamydia retesting rates and retest positivity rates were measured in individuals aged 15 to 29 years. Retesting rates were low, and retest positivity was high, reinforcing the importance of promoting safer sex practices to prevent re-infection, partner notification and treatment, and retesting to minimise the risk of long-term sequelae.

Published online 20 January 2017

SH16171Sexual health knowledge and behaviour of young Sudanese Queenslanders: a cross-sectional study

Judith Dean, Marion Mitchell, Donald Stewart and Joseph Debattista
 

This study explored the sexual health knowledge, attitudes and behaviours of young Sudanese Queenslanders (n = 229). Patterns of sexual behaviour among this predominately refugee-background group are not dissimilar to those of other young Australians. However, the self-reported patterns of risk behaviour combined with relatively low levels of sexually transmissible infection and HIV knowledge suggest this group of young people remain sexually vulnerable. These findings support the need for sexual health education and interventions that address the contextualised needs for this group of young people, particularly early within their resettlement experience.

Published online 09 January 2017

SH16036Managing two decades of visceral leishmaniasis and HIV co-infection: a case report that illustrates the urgent research needs in the field

Melissa L. Kelly, Angie N. Pinto, Dan Suan, Debbie Marriott, David A. Cooper and Sarah L. Pett
 

This case report highlights the challenges of diagnosis, monitoring and treatment in a visceral leishmaniasis and HIV co-infected patient. This patient developed multiple complications including renal and liver failure, pancytopenia with recurrent sepsis as well as anal cancer, depression and poor quality of life. Urgent research specific to this cohort is needed, with an emphasis on accessible and affordable treatment options.

Published online 09 January 2017

SH16135Sexuality-related attitudes significantly modulate demographic variation in sexual health literacy in Tasmanian university students

Steve Simpson, Christine Clifford, Michael G. Quinn, Kaz Ross, Neil Sefton, Louise Owen, Leigh Blizzard and Richard Turner
 

Previously demonstrated differences in sexual health literacy among university students by birthplace and religion were robust to adjustment for demographics and sexual education. Using factor analysis, three constructs for attitudes regarding sexual morality were generated, corresponding to sexually conservative attitude, more sexually libertine attitude, and negative attitudes toward persons with HIV. These three attitudinal constructs were able to account for much of the differences in sexual health literacy by birthplace and religion which adjustment for sexual education could not. These results indicate the potent impact of attitude and belief on sexual health literacy and support cultural framing in the design of sexual education programs.

Published online 09 January 2017

SH16077Acceptability of self-sampling in Portuguese women: the good, the bad or the ugly?

Jani Silva, Fátima Cerqueira and Rui Medeiros
 

This study assessed the acceptability of cervicovaginal self-sampling among Portuguese women. Most of the participants considered self-sampling a well-accepted method and felt no pain, no discomfort and no complexity. The willingness to repeat self-sampling was also reported by the majority of participants. Comparing self-sampling with physician-sampling experiences, women found the former less embarrassing, more comfortable or pleasant, less painful and considered it as the preferred method.

Published online 16 December 2016

SH16150Exploring the role of sex-seeking apps and websites in the social and sexual lives of gay, bisexual and other men who have sex with men: a cross-sectional study

Kiffer G. Card, Nathan J. Lachowsky, Zishan Cui, Susan Shurgold, Maya Gislason, Jamie I. Forrest, Ashleigh J. Rich, David Moore, Eric Roth and Robert S. Hogg
 

This study examined the social and sexual factors associated with online sex seeking in a sample of 774 gay and bisexual men recruited using respondent-driven sampling. Results indicate that men who used apps and websites to seek sex were not significantly less likely to participate in the gay community and, in fact, were less likely to be socially isolated from other gay men. However, these men exhibited lower emotional attachment to the gay community and differing patterns of seroadaptive risk management with their recent sexual partners.

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