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Table of Contents
Sexual Health

Sexual Health

Volume 12 Number 1 2015

Featuring abstracts from the International Anal Neoplasia Society Scientific Meeting, March 13–15, 2015, Atlanta, GA, USA – The Second Interdisciplinary Forum on Anal Neoplasia

SH15010Let’s talk about sex: gender norms and sexual health in English schools

Farah Jamal, Chris Bonell, Kai Wooder and Simon Blake
pp. 1-3

The sexual health of young people in England is an urgent public health concern. While interventions to address young people’s sexual health have focussed on knowledge, skills and contraception access, amazingly none in the UK has explicitly addressed the effects of the social hierarchies of gender and gendered behavioural ideals that shape young people’s sexual expectations, attitudes and behaviour. The lack of attention to gender is a persistent gap in health research, practice and policy. A rigorous evaluation of such an intervention package would go some way to building an evidence base for challenging gender norms, which appear to be strongly associated with adverse sexual health outcomes.

SH14080Barriers and facilitators of sexually transmissible infection testing in remote Australian Aboriginal communities: results from the Sexually Transmitted Infections in Remote Communities, Improved and Enhanced Primary Health Care (STRIVE) Study

Belinda Hengel, Rebecca Guy, Linda Garton, James Ward, Alice Rumbold, Debbie Taylor-Thomson, Bronwyn Silver, Skye McGregor, Amalie Dyda, Janet Knox, John Kaldor and Lisa Maher
pp. 4-12

Remote Australian Aboriginal communities experience high rates of bacterial sexually transmissible infections (STIs). A key strategy to reduce STIs is to increase testing in primary health care centres. As part of the STI in Remote communities, Improved and Enhanced Primary Health Care (STRIVE) project; a large cluster randomised controlled trial of a sexual health quality improvement program, qualitative research was conducted to investigate health centre staff’s perceived barriers to STI testing. Participants identified cultural, structural and health system issues as barriers to offering STI testing in remote communities, some of which were overcome through the creativity and enthusiasm of individuals rather than formal systems.

SH14061Effect of improving the knowledge, attitude and practice of reproductive health among female migrant workers: a worksite-based intervention in Guangzhou, China

Xue Gao, Longchang Xu, Ciyong Lu, Jie Wu, Zhijin Wang, Peter Decat, Wei-Hong Zhang, Yimin Chen, Eileen Moyer, Shizhong Wu, Meile Minkauskiene, Dirk Van Braeckel and Marleen Temmerman
pp. 13-21

A worksite-based cluster-randomised intervention study on women’s sexual and reproductive health (SRH) was conducted in eight factories in Guangzhou, China, 2008. Factories were randomly allocated to accept the standard package of interventions (SPIs) or the intensive package of interventions (IPIs). We found that both interventions had positive influences on SRH knowledge, attitudes and behaviours, and IPIs were more effective than SPIs, indicating that comprehensive interventions may be better approaches of improving SRH status for female migrant workers.

SH14158A field evaluation of a new molecular-based point-of-care test for chlamydia and gonorrhoea in remote Aboriginal health services in Australia

Louise M. Causer, Belinda Hengel, Lisa Natoli, Annie Tangey, Steven G. Badman, Sepehr N. Tabrizi, David Whiley, James Ward, John M. Kaldor and Rebecca J. Guy
pp. 27-33

Point-of-care tests could be important public health tools in settings with treatment delays and high rates of sexually transmissible infections. We assessed a new molecular-based test for simultaneous detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) alongside traditional ICTs in remote Aboriginal health services in Australia. The accuracy and operational benefits of GeneXpert CT/NG make it very suitable in settings where delays to treatment are encountered.

SH14144Paying the price in an era of HIV treatment as prevention: a retrospective study of the cost burden of HIV treatment for people living with HIV in Victoria, Australia

Anna L. Wilkinson, James McMahon, Yik-Siang Cheah, Catriona S. Bradshaw, Carol El-Hayek and Mark Stoové
pp. 34-38

The cost of antiretroviral treatment (ART) for people living with HIV (PLWH) is potentially a barrier to the commencement and adherence to HIV treatment. We conducted a retrospective cross-sectional study of pharmacy data dispensed between January 2012 and November 2013 from a large hospital network in Victoria, Australia. The estimated costs ranged from $433.20 for patients with a concession card, collecting two medications, to $866.40 for a patient without a concession card, collecting four medications. Consideration needs to be given to the costs associated with ART for PLWH in the context of new treatment-based prevention strategies.

Male sex workers (MSW) have high rates of unprotected sex with both male and female sexual partners, including both client partners and elective partners. Condom use is low and high rates of unprotected vaginal and anal sex were found across partner types. MSWs evidence high rates of sexually transmissible infections (STIs), notably ulcerative STIs that may facilitate HIV transmission. Despite high levels of behavioural risk, rates of health services utilisation are low, symptom-driven, lacking in full disclosure of sexual risk, and often abandoned before treatment has been completed. There is an urgent need to develop targeted sexual health interventions for MSW, both to reduce behavioural risk and to increase knowledge and skills related to health services utilisation.

Duplex testing for Chlamydia trachomatis and Neisseria gonorrhoeae has become routine in most Australian laboratories, greatly increasing the number of tests performed for N. gonorrhoeae. Increasing notifications for N. gonorrhoeae should be interpreted with caution.

SH14213Chlamydia and gonorrhoea point-of-care testing in Australia: where should it be used?

Lisa Natoli, Rebecca J. Guy, Mark Shephard, Basil Donovan, Christopher K. Fairley, James Ward, David G. Regan, Belinda Hengel and Lisa Maher
pp. 51-58

With accurate molecular tests now available for diagnosis of chlamydia and gonorrhoea at the point of care (POC), we explored their potential utility in various clinical settings in Australia. Findings from in-depth interviews suggested that POC testing is likely to be of greatest benefit in remote Aboriginal communities where prevalence of sexually transmissible infections is high and treatment delays are common. Some respondents indicated that POC testing may be useful in juvenile justice services and in certain primary health care, general practice and outreach settings – although opinions were mixed, particularly in relation to urban services with easy access to pathology services.

This cross-sectional survey of 447 sexually active girls aged 10–19 in South Africa identifies factors associated with adolescent pregnancy and explores a pathway of risk by assessing whether condom use mediated the relationship between age-disparate sexual relationships and adolescent pregnancy. Consistent condom use and school enrolment were associated with lower pregnancy rates, while age-disparate sex and long-term school absences with higher pregnancy rates, controlling for age, age at sexual initiation, poverty and residence. The indirect effect of age-disparate sex on adolescent pregnancy through condom use was significant, suggesting that not using condoms in age-disparate sexual relationships may drive adolescent pregnancy.

SH14155Purchasing condoms near a college campus: environmental barriers

Annie M. Wilson and Melinda J. Ickes
pp. 67-70

This study explored the number of businesses available to purchase condoms from within 2 miles of a large college campus and investigated environmental differences between types of businesses. The average unit price of male condoms was significantly higher in drug store/pharmacies compared with convenience-type stores and grocery stores and barriers to purchasing condoms were significantly higher in convenience stores/gas stations. An understanding of environmental barriers related to purchasing condoms is necessary and must be considered when targeting sexual health promotion on college campuses.

SH14132Feasibility and acceptability of point-of-care testing for sexually transmissible infections among men and women in mobile van settings

Elizabeth A. Hesse, Lea E. Widdice, Sherine A. Patterson-Rose, Sarah St. Cyr, Laura Dize and Charlotte A. Gaydos
pp. 71-73

To demonstrate the feasibility and acceptability of mobile point-of-care and near-patient testing for sexually transmissible infections, we offered services during an annual community event and surveyed event-goers; 42 men and women were tested. When provided with options, the majority of participants chose point-of-care and near-patient testing. Participants responding to a written questionnaire reported sample self-collection and testing in a van as acceptable, although men reported self-collection in a van as less acceptable than a doctor’s office. Providing mobile point-of-care and near-patient sexually transmitted infection testing to the general population is feasible and acceptable.

SH14207Dark rooms in Brazilian nightclubs: a matter of concern for STD/HIV policymakers

Zila M. Sanchez, Claudia M. A. Carlini and Solange Andreoni
pp. 74-75

A mixed methods study in Brazil identified patterns of drug use, violence and sexual behaviours in a representative sample of nightclubs and patrons. Ethnographic observations were performed inside the nightclubs and showed the existence of “dark rooms” – areas reserved for sexual intercourse – in nightclubs targeting men who have sex with men. The letter describes characteristics of the sexual behaviour in these areas.

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