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 13 Number 4 2016

Cultural and linguistic diversity in Australia is increasing, with more than one in four (26%) Australians being born overseas and an additional 20 percent were having either one or both parents born outside of Australia. Although culturally and linguistically diverse women in Australia have the opportunity to obtain necessary health services, they experience numerous barriers in accessing and utilising sexual and reproductive health care at individual, health professional and system levels. Therefore, multiple strategies are required to address the sexual and reproductive health needs of these women.

A systematic review of individual-level protective factors and sexual health outcomes among sexual minority youth was conducted to summarise the current state of science. Among young men who have sex with men, subjective peer norms and attitudes about condom use were repeatedly shown to be protective and may be a promising area of focus for intervention development. However, more longitudinal research is needed, including among sexual minority women, to examine additional protective factors such as skills and competencies, and identity-related constructs.

The New South Wales Government’s NSW HIV Strategy 20122015: A New Era represented a punctuated shift of policy direction, and was remarkable for its ground-breaking declaration that HIV transmission could be brought to an end by 2020. This significant policy shift occurred after a long period of stability and only incremental change, some of it represented by policy decline as political and public interest in HIV waned. This article uses punctuated equilibrium theory to explore the conditions that allowed for change, and the roles played by new and long-standing actors in the HIV policy subsystem. It explains the importance of challenges to the policy image and the policy venue as key mechanisms that allowed new possibilities, created by advances in the scientific understanding of HIV, to be incorporated rapidly into government policy.

SH15210Treatment durability and virological response in treatment-experienced HIV-positive patients on an integrase inhibitor-based regimen: an Australian cohort study

Nicole L. De La Mata, David A. Cooper, Darren Russell, Don Smith, Ian Woolley, Maree O. Sullivan, Stephen Wright and Matthew Law
pp. 335-344

Our study evaluated treatment durability and virological outcomes in treatment-experienced HIV-positive patients using integrase inhibitor (INSTI) based regimens. Our findings suggest that the time to viral suppression and regimen switch from INSTI initiation was similar for second-line and highly experienced patients. The estimated probability of achieving viral suppression at 6 months was 77.7% for second-line patients and 68.4% for highly experienced patients. In addition, patient treatment experience was not a significant factor for regimen switch according to multivariate analysis, adjusting for relevant covariates.

SH15143Views of HIV-negative partners in heterosexual serodiscordant relationships regarding HIV pre-exposure prophylaxis: a qualitative study

Joana R. S. P. Falcão, Catriona C. Bradshaw, Cameryn C. Garrett, Jade E. Bilardi, Marcus Y. Chen, Iryna Zablotska, Christopher K. Fairley and Henrietta Williams
pp. 345-352

Pre-exposure prophylaxis (PrEP) is an effective option for HIV prevention among heterosexual serodiscordant couples. However, there are knowledge gaps in social research about PrEP in heterosexual serodiscordant relationships, including motivations and barriers to its use. This study explores the views of HIV-negative men and women in stable serodiscordant heterosexual relationships about the possible use of PrEP.

This retrospective cross-sectional study describes the process, outcomes and examines the cost of implementing a community-based sexually transmissible infection (STI) screening model co-located in a sex-on-premises venue. The paper highlights that offering STI screening in a community-based setting was an effective and low-cost alternative to traditional testing services.

SH15243Awareness and knowledge of HIV pre-exposure prophylaxis among Australian gay and bisexual men: results of a national, online survey

Martin Holt, Toby Lea, Susan Kippax, Johann Kolstee, Jeanne Ellard, Marlene Velecky, Dean Murphy and John de Wit
pp. 359-365

Awareness and knowledge of HIV pre-exposure prophylaxis (PrEP) were assessed in a national, online survey of Australian gay and bisexual men, conducted in 2015. Among 1251 participants, 77% were aware of PrEP. Knowledge of PrEP was inconsistent, suggesting that gay and bisexual men need to be educated about current Australian prescribing guidelines.

The experience of intimate partner violence (IPV) has been shown to decrease condom negotiation efficacy among women; however, studies of this association among gay and bisexual men (GBM) are lacking. This study uses survey and multivariate regression analysis to examine the association between low condom negotiation efficacy and recent experience of IPV. GBM who reported recent IPV experience were significantly less likely to report having felt able to negotiate condom use. These findings suggest that IPV may be a significant risk factor for HIV acquisition and transmission among GBM.

This study is the latest comprehensive literature review of HIV incidence of men who have sex with men (MSM) in Mainland China. The pooled HIV incidence of Chinese MSM is 5.61/100 person years (PY), and it showed a significantly increasing trend with the change of time (3.24/100PY in 2005–2008, 5.29/100PY in 2009–2011, 5.50/100PY in 2012–2014), which reflects the severe situation of HIV incidence of Chinese MSM. HIV prevention strategies targeted at MSM should be urgently strengthened. Innovative and comprehensive intervention strategies should also be adopted, in particular for young, less educated and syphilis infected MSM subgroups.

This study indicated a high prevalence of HIV-related sexual risk behaviours (HSRB) among the sexually active youth in China. The most common HSRB was lack of condom use during the first sexual experience. Non-heterosexual youth are at a higher risk of partaking in HSRB.

SH15236Feasibility of using GrindrTM to distribute HIV self-test kits to men who have sex with men in Los Angeles, California

A. Lina Rosengren, Emily Huang, Joseph Daniels, Sean D. Young, Robert W. Marlin and Jeffrey D. Klausner
pp. 389-392

In Los Angeles, Black and Latino men who have sex with men (MSM) have the highest rate of HIV infection, and Black MSM in LA are four times more likely than white MSM to not know they are infected with HIV. In our study, we found that it was feasible to use Grindr™, a social networking mobile phone app, to distribute HIV self-test kits, and that Grindr™ users are willing to provide personal information in exchange for HIV tests. Grindr™ users also found self-tests acceptable and easy to use. We found that social networking apps has a high potential to reach untested high-risk populations

The uptake of an opt-in system for integrating the health information of HIV-infected patients of an Australian sexual health clinic into the regional shared electronic health record (EHR) is described. A medical record audit was performed to determine the number and demographic characteristics of HIV-infected patients in the study’s sexual health clinic opting in and out of inclusion in the regional shared EHR

This study explored the assortative sexual mixing by country of birth among heterosexuals in Melbourne, Australia. Results showed that about 47% of men who are living in Australia whose female partner (Australian-born and aged under 21 years) had been eligible for the human papillomavirus vaccine, suggesting these men would also have received herd protection from their female partners.

The main objective of this study is to assess human papillomavirus (HPV) prevalence in the oral cavity of men who have sex with men (MSM) from Beirut, Lebanon. Among 42 participants, HPV prevalence in the oral cavity was 10% (95% CI 0.93–19.07); there was no statistical difference according to HIV status. The HPV type was exclusively HPV-6. Our findings did not find an urgent need for routine HPV prevalence and screening for cancers in the oral cavity in MSM group in Lebanon; however, they confirm previous findings about geographic variations in HPV prevalences.

Current Issue

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

Published online 19 August 2016

SH16041Disparities of sexual orientations by sex and urban or rural residence among youth in China

Chao Guo, Lihua Pang, Lei Zhang, Gong Chen, Zhenjie Wang and Xiaoying Zheng

This study described the distribution of sexual orientations among Chinese youth. Female youth and rural youth were found with higher odds of non-heterosexual orientation than male youth and urban youth. More efforts should be made to enhance sex education and legal protection for non-heterosexual youth in China.

Published online 19 August 2016

SH16092Characteristics, sexual practices and sexually transmissible infections diagnoses of men who have sex with men and use non-occupational HIV post-exposure prophylaxis in Victoria, Australia

Jason J. Ong, Andre Landika, Christopher K. Fairley, Catriona Bradshaw, Marcus Chen, Tim R. H. Read and Eric P. F. Chow

A retrospective analysis of 40 395 consultations with men who have sex with men (MSM) attending Melbourne Sexual Health Centre showed that men who received non-occupational post-exposure prophylaxis (NPEP) were more likely to report ever having injected drugs, more than three male partners in the past 3 months and inconsistent condom use with these partners within the past 3 months, and were more likely to test positive for any sexually transmissible infection. This reinforces that MSM receiving NPEP generally had a higher risk profile than MSM not requesting NPEP. Therefore, we conclude that NPEP is currently being used by MSM at higher risk for HIV and that consultations for NPEP is an opportune time for discussing other effective biomedical interventions such as pre-exposure prophylaxis for HIV.

Published online 02 June 2016

SH15227Prevalence and risk factors of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and other sexually transmissible infections among women attending antenatal clinics in three provinces in Papua New Guinea: a cross-sectional survey

Lisa M. Vallely, Pamela Toliman, Claire Ryan, Glennis Rai, Johanna Wapling, Carolyn Tomado, Savarina Huliafi, Gloria Munnull, Patricia Rarau, Suparat Phuanukoonnon, Handan Wand, Peter Siba, Glen D. L. Mola, John M. Kaldor and Andrew J. Vallely

Through a cross-sectional bio-behavioural survey in three sites we enrolled 765 pregnant women attending their first antenatal clinic visit. We identified high rates of sexually transmissible infectionss among this study cohort; 43% had one or more of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) infection. CT was the most prevalent STI (22.9%), followed by TV (22.4%), and NG (14.2%). Prevalences were highest among primigravid women, women aged <25 years, and among those in Central Province.

Published online 29 August 2016

SH15132Opportunities to increase rates of human papillomavirus vaccination in the New South Wales school program through enhanced catch-up

Christine Staples, Michelle Butler, Jennifer Nguyen, David N. Durrheim, Patrick Cashman and Julia M. L. Brotherton

Australia’s school-based human papillomavirus (HPV) vaccination program provides an ideal opportunity to reach the traditionally ‘hard to reach’ adolescent cohort. Maximising uptake of this program is important for the health of Australian adolescents into the future. This paper identifies that logistical issues with program delivery are the main reasons why HPV vaccine courses remain incomplete.

Published online 11 August 2016

SH16027Characteristics of gay, bisexual and other men who have sex with men testing and retesting at Australia’s first shop-front rapid point-of-care HIV testing service

Kathleen E. Ryan, Anna L. Wilkinson, David Leitinger, Carol El-Hayek, Claire Ryan, Alisa Pedrana, Margaret Hellard and Mark Stoové

A summary of the first 12 months of testing at PRONTO!; Australia’s first community-based, shop-front, peer-led rapid point-of-care HIV testing service. The service attracted gay bisexual and other men who have sex with men (GBM) with no previous testing history, and GBM reporting high risk for HIV transmission. Retesting within 6 months was observed among 23% of GBM. Service refinements are needed to increase repeat testing.

Published online 23 June 2016

SH15183Characteristics of gonorrhoea cases notified in inner and south-western Sydney, Australia: results of population-based enhanced surveillance

Andrew Ingleton, Kirsty Hope, Zeina Najjar, David J. Templeton and Leena Gupta

Gonorrhoea disproportionately affects young people and men who have sex with men although characteristics of those infected are poorly described. Enhanced surveillance conducted across two urban health districts in Sydney, Australia identified differing risk factors and testing characteristics between men who have sex with men, heterosexual males and females. This surveillance highlighted the importance of obtaining accurate sexual histories to ensure appropriate testing.

Published online 11 August 2016

SH16037Is sexual content in new media linked to sexual risk behaviour in young people? A systematic review and meta-analysis

Lucy Watchirs Smith, Bette Liu, Louisa Degenhardt, Juliet Richters, George Patton, Handan Wand, Donna Cross, Jane S. Hocking, S. Rachel Skinner, Spring Cooper, Catharine Lumby, John M. Kaldor and Rebecca Guy

This is the first systematic review and meta-analysis of sexting and sexually explicit websites and young people’s sexual practices and attitudes. The meta-analysis suggests that sexual content in new media is linked to sexual risk behaviour in young people and that further longitudinal research in this area is warranted.

Published online 11 August 2016

SH16061Predisposing, enabling and need-for-care predictors of adolescents’ intention to use sexual health services

Nancy F. Berglas, Katherine Hucles, Norman A. Constantine, Petra Jerman and Louise A. Rohrbach

This study examined the influence of various factors on adolescents’ intention to use sexual health services among a sample in Los Angeles (n = 600). In hierarchical regression models, predisposing and enabling factors (e.g., knowledge and beliefs, awareness of services, perceived accessibility) predicted intention to use services, but sexual experience did not. These findings underscore the need for interventions that provide information, encourage positive beliefs about health care, and promote access to sexual health services for all adolescents.

Published online 29 July 2016

SH15189What qualities of long-acting reversible contraception do women perceive as desirable or undesirable? A systematic review

Jacqueline Coombe, Melissa L. Harris and Deborah Loxton

This study assessed the available peer-reviewed literature to ascertain what qualities of long-acting reversible contraception (LARC) are considered desirable or undesirable by women. Although there were many characteristics of LARC that women liked, particularly their convenience and longevity, there were also many characteristics that women didn’t like, including their often unpredictable impact on bleeding and other hormonal side effects. This information is crucial in the clinical setting as it provides practitioners with a greater understanding of the qualities women do and do not like about LARC methods. Discussion about these qualities, positive and negative, during consultations about contraception may increase rates of uptake.

Females who are aged ≤32 years were eligible for the free female human papillomavirus vaccination program. Unvaccinated heterosexual men who had a female partner aged ≤32 were less likely to have penile warts. This suggests men would have received herd protection from their female partners.

Published online 29 July 2016

SH16055Assortative sexual mixing patterns in male–female and male–male partnerships in Melbourne, Australia: implications for HIV and sexually transmissible infection transmission

Eric P. F. Chow, Tim R. H. Read, Matthew G. Law, Marcus Y. Chen, Catriona S. Bradshaw and Christopher K. Fairley

This retrospective cross-sectional study examined the sexual mixing patterns for age, number of partners and condom use in 1165 male–female and 610 male–male partnerships attending a sexual health service in Melbourne, Australia. Male–female and male–male partnerships have a high assortativity mixing pattern for age, number of partners and condom use. The sexual mixing pattern is not purely assortative, and hence it may lead to increased HIV and STI transmission in certain risk groups.

Published online 05 August 2016

SH16049Self-testing for Trichomonas vaginalis at home using a point-of-care test by women who request kits via the Internet

Charlotte A. Gaydos, Mary Jett-Goheen, Mathilda Barnes, Laura Dize and Yu-Hsiang Hsieh

We offered a point-of-care test for Trichomonas vaginalis to women via the Internet to determine if it was acceptable to women to perform the test at home. Most of the 102 participants felt that it was easy to collect the specimen, follow the instructions, and read and interpret the results for the trichomonas self-testing assay.

We offered a point-of-care test for Trichomonas vaginalis to women via the Internet to determine if it was acceptable to women to perform the test at home. Most of the 102 participants felt that it was easy to collect the specimen, follow the instructions, and read and interpret the results for the trichomonas self-testing assay.

Published online 05 August 2016

SH16070HIV incidence among gay men and other men who have sex with men in 2020: where is the epidemic heading?

Shauna Stahlman, Carrie Lyons, Patrick S. Sullivan, Kenneth H. Mayer, Sean Hosein, Chris Beyrer and Stefan D. Baral

This paper reviews the recent trend in HIV incidence among men who have sex with men (MSM), which is now increasing in many low- and high-income settings with young, adolescent, and racial/ethnic minority MSM being among those at highest risk. We discuss the risk factors that are potentiating the epidemic including individual-, network-, and structural-level factors such as stigma and lack of access to pre-exposure prophylaxis and antiretroviral treatment as prevention. Finally, we call for a concerted effort to integrate all evidence-based interventions to proximally decrease HIV acquisition and transmission risks, together with structural interventions to support improved coverage and retention in care.

Published online 05 August 2016

SH16089Effects of multiple types of stigma on the probability of HIV disclosure to sex partners: a systematic review

Haochu Li, Xiaoming Li, Lei Zhang and Eric Chow

This is a systematic review of empirical studies on the effects of stigma on HIV disclosure to sex partners. The review indicates that studies should use precisely defined measurements in their matching context. Particular types of stigma, types of sex partners, and demographic characteristics are factors that may influence HIV disclosure.

Published online 29 July 2016

SH15240Sexting among singles in the USA: prevalence of sending, receiving, and sharing sexual messages and images

Justin R. Garcia, Amanda N. Gesselman, Shadia A. Siliman, Brea L. Perry, Kathryn Coe and Helen E. Fisher

In a national sample of 5805 single adults in the USA, the present study examines sexting attitudes and behaviours, including sending, receiving, and sharing of sexual messages and images, across gender, age, and sexual orientation. Participants’ self-reported views on the impact of sexting on reputation, coupled with the relatively high rates of unauthorised sext sharing we report, suggest a contemporary struggle to reconcile digital eroticism with real-world consequences.

Published online 04 July 2016

SH15026A systematic analysis of the needs of people with HIV in Australia: stakeholder views of the key elements for a healthy life

Sarity Dodson, Roy Batterham, Karalyn McDonald, Julian H. Elliott, Richard H. Osborne and for the HealthMap Project Team

The HealthMap project is developing an intervention to reduce cardiovascular risk in people living with HIV. As part of the formative stages of the intervention design, we sought to understand the needs of people with HIV (PWHIV). Workshops with PWHIV and their providers, and follow-up questionnaires provided insights into what PWHIV perceive they need, to live with and manage their condition, and its impact on their life. PWHIV and HIV providers continue to report unmet needs in the areas of social justice and emerging concerns about access to aged care services.

Published online 29 August 2016

SH16072Adapting behavioural surveillance to antiretroviral-based HIV prevention: reviewing and anticipating trends in the Australian Gay Community Periodic Surveys

Martin Holt, Toby Lea, Limin Mao, Iryna Zablotska, Evelyn Lee, John B. F. de Wit and Garrett Prestage

This article describes the adaptation of a behavioural surveillance system, the Gay Community Periodic Surveys, to the introduction of HIV pre-exposure prophylaxis (PrEP) and treatment as prevention. National trends in key indicators during 2000–15 are reviewed, showing increases in HIV testing, treatment and condomless sex with casual partners. Two scenarios anticipating the effect of PrEP highlight the need to target gay and bisexual men who engage in receptive condomless sex while also sustaining condom use at a population level.

Published online 29 August 2016

SH16119Emerging models of clinical services for men who have sex with men: focused versus comprehensive approaches

Kenneth H. Mayer, Rodney Vanderwarker, Chris Grasso and Stephen L. Boswell

Over the past few decades, the recognition of infections that were specifically transmitted through male–male intimate contact (e.g. anal intercourse) led to the development of sexual health services that were tailored to gay and other men who have sex with men (MSM). With the spread of HIV among MSM, the need for these services to address other aspects of comprehensive care, including behavioural health, led to further refinements. Some programs have further evolved to become primary care centres for all sexual and gender minority people, including lesbians, bisexuals and transgender persons, while others have refined their model to provide more efficient sexual health services for otherwise healthy individuals. This paper will discuss some of the emerging models of sexual health care.

Published online 07 July 2016

SH16058Reducing the burden of sexually transmissible infections in Papua New Guinea requires strengthening of clinical services and engaging men

Jane S. Hocking, Cathy Vaughan, Andrew Lau, Dorothy A. Machelak and Simon Graham

In this edition of Sexual Health, Vallely et al. report the results of a cross-sectional prevalence survey of sexually transmissible infections (STIs) among women attending their first antenatal visit in three provinces of Papua New Guinea (PNG). This Editorial examines potential reasons for these high prevalence estimates and discusses strategies for addressing high STIs rates in PNG.

Published online 22 July 2016

SH15144Antiretroviral pre-exposure prophylaxis preferences among men who have sex with men in Vietnam: results from a nationwide cross-sectional survey

Catherine E. Oldenburg, Bao Le, Hoang Thi Huyen, Dinh Duc Thien, Nguyen Hoang Quan, Katie B. Biello, Amy Nunn, Philip A. Chan, Kenneth H. Mayer, Matthew J. Mimiaga and Donn Colby

Pre-exposure prophylaxis (PrEP) is a promising HIV prevention strategy for men who have sex with men (MSM) in Vietnam, but implementation programs will benefit from understanding preferences for PrEP delivery. We conducted a cross-sectional survey with members of online social networking websites for MSM in Vietnam. Approximately one quarter of participants had previously heard of PrEP, and most participants indicated a preference for rectal microbicides as their preferred PrEP modality.

Published online 22 July 2016

SH16026Adherence to, and acceptability of, Listerine® mouthwash as a potential preventive intervention for pharyngeal gonorrhoea among men who have sex with men in Australia: a longitudinal study

Vincent J. Cornelisse, Christopher K. Fairley, Sandra Walker, Tameka Young, David Lee, Marcus Y. Chen, Catriona S. Bradshaw and Eric P. F. Chow

Ten men who have sex with men attending the Melbourne Sexual Health Centre were recruited in this study to examine the adherence to, and acceptability of, Listerine® mouthwash as a potential preventive intervention for pharyngeal gonorrhoea. This study found high adherence and acceptability of daily mouthwash use.

Published online 22 July 2016

SH16038Sexually transmissible infection control programs for men who have sex with men – what will they look like in 2020?

Oliver N. Refugio, Chelsea Roberts, Richard West and Jeffrey D. Klausner

The resurgence of sexually transmissible infections among men who have sex with men is a concern for sexual health. Traditional strategies have relied on the promotion of condom use, regular testing, treatment, and partner management. Future sexually transmissible infection control programs must combine current prevention methods with novel approaches that target the providers, patients, and mechanisms of health care delivery.

Published online 04 July 2016

SH15176Deadly Liver Mob: opening the door – improving sexual health pathways for Aboriginal people in Western Sydney

Karen Biggs, Jennifer Walsh and Catriona Ooi

The Deadly Liver Mob project (DLM) is an incentive-based, peer-driven health promotion intervention for Aboriginal people, focusing on hepatitis C and, offering education and screening for sexually transmissible infections (STI) and blood-borne viruses (BBV). This study assessed the DLM effect on attendance and STI/BBV screening, describes BBV risk factors and reports infection rates among Aboriginal people attending Western Sydney Sexual Health Centre.

Published online 04 July 2016

SH16011An observational study of the impact of the 2014 XX Commonwealth Games on the sexual and reproductive health services in Glasgow, Scotland

Rebecca Metcalfe, Rebecca R. Acquah, Janine Simpson, Gwendolyn Allardice and Andrew Winter

The aim of this study is to investigate if the 2014 XX Commonwealth Games had an effect on the service demands of a Glasgow city-wide integrated SRH service. Electronic patient records, city-wide pharmacy data and case note review was used to assess aspects of SRH; this included overall attendance at integrated services, clinic and community emergency contraception prescriptions, victims of sexual assault, acute sexually transmissible infections (STIs), post exposure prophylaxis after sexual exposure (PEPSE) prescriptions, condom distribution and termination of pregnancy. There was a significant decrease in core sexual health attendances, total acute STIs and emergency hormonal contraception prescriptions. There was no change in PEPSE prescriptions or the number of reported sexual assaults throughout the city. This study found no evidence that the 2014 XX Commonwealth Games placed any increased demand on the local SRH services, and showed no increase in STIs, emergency hormonal contraception prescriptions or sexual assaults. These findings will help service planning in host cities hosting future large sporting events.

Published online 09 September 2016

SH16051Sexually transmissible infection and HIV prevention and treatment for young male sex workers in Vietnam: findings from the SHEATH intervention

Michael C. Clatts, Lloyd A. Goldsamt, Lê Minh Giang, Lê Quôc Báo, Gary Yu and Donn Colby

Young male sex workers (YMSW) in Vietnam have low levels of HIV and sexually transmissible infection knowledge, and limited engagement with health services. The SHEATH Intervention, derived from Harm Reduction and Sexual Health Promotion, was delivered to 919 out-of-treatment YMSW in Hanoi and Ho Chi Minh City. Results indicate that the intervention was well-received and that participants expressed high levels of intentions to visit healthcare providers in the next 6 months and disclose to these providers that they engaged in sex with other men.

Published online 09 September 2016

SH16124Neisseria gonorrhoeae isolated from an unexpected site

Stella Pendle and Timothy Barnes

Neisseria gonorrhoeae was isolated from a nipple piercing wound in a homosexual man with pharyngeal gonoccocal carriage. Transmission to the wound may have been by direct oral contact or auto-inoculation via saliva. Wounds can readily harbour gonorrhoea and should be considered for testing in high risk groups.

Published online 02 September 2016

SH16056Enhanced use of phylogenetic data to inform public health approaches to HIV among men who have sex with men

Danielle German, Mary Kate Grabowski and Chris Beyrer

Using HIV phylogenetic approaches to understand and intervene within social networks at high risk for transmission is a rapidly evolving field with strong promise for informing innovative responses to the HIV epidemic among men who have sex with men (MSM). Here, we argue that viral phylogenetics could become an invaluable tool in the public health response to HIV among MSM that adds value to ongoing HIV surveillance and other public health data sources. We also highlight promising HIV phylogenetic applications for the MSM HIV epidemic and important methodological, ethical and implementation questions for the field.

Published online 02 September 2016

SH16104As through a glass, darkly: the future of sexually transmissible infections among gay, bisexual and other men who have sex with men

Mark Richard Stenger, Stefan Baral, Shauna Stahlman, Dan Wohlfeiler, Jerusha E. Barton and Thomas Peterman

Sexually transmissible infections (STI) among men who have sex with men (MSM) appear to be increasing globally. We explore the history of STI among MSM before the emergence of HIV, how STI incidence may have decreased as a result of the HIV pandemic and discuss factors potentially contributing to recent STI increases. Looking ahead to the next decade, we conclude that STIs may continue to increase among MSM for a variety of reasons and discuss the implications for MSM sexual health.

The advent of pre-exposure prophylaxis (PrEP) necessitates attention to several issues associated with condom migration. One issue is the clear possibility of population-level increases in the incidence of sexually transmissible infections. A second issue pertains to how clinicians can best promote the dual use of PrEP and condoms such that both are used consistently and correctly. A third issue involves accounting for condom use in future efficacy trials of PrEP; a complex task that require intensified measurement protocols.

Published online 02 June 2016

SH16023Indicators of HIV-risk resilience among men who have sex with men: a content analysis of online profiles

Jaclyn M. White Hughto, Anna P. Hidalgo, Angela R. Bazzi, Sari L. Reisner and Matthew J. Mimiaga

HIV-risk resilience, or positive adaptation in the face of risk, is increasingly being recognised as an important characteristic among men who have sex with men (MSM). However, resilience in the context of online partner seeking remains underexplored among MSM. This study used content analysis methodology to identify indicators of HIV-risk resilience in the online profiles of MSM using a sexual networking website. Implications for promoting HIV-risk resilience through online interventions for MSM are discussed.

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