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Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
Table of Contents

Volume 20 Number 1 2023

SH22134Australian sexually transmitted infection (STI) management guidelines for use in primary care 2022 update

Jason J. Ong 0000-0001-5784-7403, Christopher Bourne, Judith A. Dean 0000-0002-2513-2013, Nathan Ryder 0000-0002-2050-0155, Vincent J. Cornelisse 0000-0003-0657-9677, Sally Murray, Penny Kenchington, Amy Moten, Courtney Gibbs, Sarah Maunsell, Tyler Davis, Jessica Michaels and Nicholas A. Medland 0000-0003-0403-8930
pp. 1-8

This major review of the ‘Australian Sexually Transmitted Infection (STI) Management Guidelines For Use In Primary Care’ highlights important aspects of the guidelines and provides the rationale for significant changes.

SH22144Barriers and facilitators to accessing sexual health services for older LGBTQIA+ adults: a global scoping review and qualitative evidence synthesis

Hayley Conyers 0000-0002-2059-0402, Dan Wu, Eneyi Kpokiri, Qihang Zhang, Sharron Hinchliff, Tom Shakespeare and Joseph Tucker 0000-0003-2804-1181
pp. 9-19

Sexual health services are often built for young, otherwise healthy individuals, framing heterosexual sex above all else, creating a paucity of services for older LGBTQIA+ adults who fall outside of scope. Older LGBTQIA+ adults have specific and unique sexual health considerations which cause them to seek care, but are stymied by stigma, inappropriate services, and insensitive providers. By addressing the barriers and facilitators of sexual health care access for older LGBTQIA+ adults, we have identified practical strategies to improve their care.

SH22073Men of refugee and migrant backgrounds in Australia: a scoping review of sexual and reproductive health research

Zelalem Mengesha 0000-0003-1599-0951, Alexandra J. Hawkey, Mazen Baroudi, Jane M. Ussher and Janette Perz
pp. 20-34

Refugee and migrant men in Australia are currently under-represented and generally marginalised in fertility and sexual and reproductive health program development, research conceptualisation and implementation. This review indicates that sexual and reproductive health literature on refugee and migrant men largely focuses on sexually transmitted infections, meaning other areas such as contraception, fertility, the impact of gender roles and psychosexual health are poorly understood. This knowledge is needed to evaluate and inform national and state policy on men’s health in Australia.

SH22081Migrant and refugee youth perspectives on sexual and reproductive health and rights in Australia: a systematic review

Sharanya Napier-Raman 0000-0001-6557-7052, Syeda Zakia Hossain, Mi-Joung Lee, Elias Mpofu, Pranee Liamputtong and Tinashe Dune
pp. 35-48

This review examines how migrant and refugee youth in Australia understand their sexual and reproductive health and rights, as well as the socioecological factors that shape these understandings. While youth responses to socioecological factors were varied, we identified certain shared experiences, particularly in education, parental and family interactions, institutional engagement, and cross-cultural navigation. This review provides crucial information on how practice and policy can be improved to deliver to this population, not just in Australia but globally.

SH22045Sexual activities and condom use among heterosexual men and women engaged in mixed-gender group sex events in Melbourne, Australia

Chen Lew, Christopher K. Fairley 0000-0001-9081-1664, Julien Tran 0000-0003-3139-7090, Tiffany R. Phillips 0000-0001-6920-7710, Jason J. Ong 0000-0001-5784-7403, Ei T. Aung 0000-0002-2560-3233, Kate Maddaford, Catriona S. Bradshaw, Marcus Y. Chen and Eric P. F. Chow 0000-0003-1766-0657
pp. 49-56

Group sex has been identified as a risk factor for HIV and STI. In this cross-sectional study of 3277 heterosexual men and women, we found that 5% had engaged in group sex in the past 3 months. Of those who had vaginal sex in the most recent group sex event, only 35% used condoms consistently and changed condoms between consecutive partners. Safe sex messages on changing condoms between partners and between sexual activities should be reinforced for sexually transmitted infections prevention.

SH22129Sexting and sexual behaviour in Australian adolescents

Tasha A. Falconer 0000-0003-4308-5772, Sylvia Kauer and Christopher M. Fisher
pp. 57-63

Is sexting deviant or a normal part of adolescence? Many reports of sexting in adolescence have noted that it is a deviant behaviour, considering it part of a grouping of risky sexual behaviour that includes unprotected sex. In a national study of Australian adolescents, there were no differences between sexters and non-sexters in STI rates and contraceptive use; indicating that sexting is not part of a group of risky sexual behaviours and is instead a normative part of adolescents exploring their sexual selves.

SH22095The effect of pre-exposure prophylaxis (PrEP) on negotiating casual sex between gay men: disclosure, assumptions, and communication

Johann Kolstee 0000-0002-2668-1823, Garrett Prestage, Steven Philpot, Benjamin Bavinton, Mohamed Hammoud, Phillip Keen 0000-0002-2678-0645 and Martin Holt
pp. 64-70

With the rapid uptake of pre-exposure prophylaxis (PrEP) in Australia, norms and expectations about discussion and disclosure of HIV status may have changed. Many participants assumed their partners would find information about their HIV status or PrEP use on their online profiles or that partners would ask, if necessary. Building a stronger, shared understanding among gay men that disclosure and discussion no longer automatically occur before sexual encounters may be useful.

SH22143Clinician views and experiences with reproductive coercion screening in a family planning service

Yan Cheng 0000-0003-2043-4335, Claire Rogers 0000-0002-9021-7443, Clare J. Boerma, Jessica R. Botfield 0000-0001-6157-9739 and Jane Estoesta 0000-0001-6112-6158
pp. 71-79

This paper explores the views and experiences of clinicians undertaking a reproductive coercion screening program at a family planning service in New South Wales, Australia. Clinicians involved in the program believed screening was an important and relevant component of their practice. They identified that ongoing education and training with relevant resources, and establishment of effective referral pathways with a multi-disciplinary collaborative response, would support clinicians in undertaking screening and responding to disclosures of reproductive coercion.

SH22147Isolated middle cerebral artery stenosis caused by syphilitic vasculitis

Ping Zhang 0000-0003-1678-675X, Lei Chen, Shiyue Chen, Tao Wu and Yongwei Zhang
pp. 80-82

We report the case of a patient with cerebral infraction and severe isolated middle cerebral artery (MCA) stenosis, who was evaluated by serial high-resolution vessel wall magnetic resonance imaging (HR-VWI). The follow-up HR-VWI showed that concentric parietal thickening and contrast enhancement of the arterial walls were found in the patient, and the complete loss of contrast enhancement with slight residual stenosis 6 months after IV penicillin G treatment. HR-VWI is an important diagnostic tool for SV and could serve as a biomarker for assessing the response to anti-syphilis treatment in the future.

SH22161Case report of a man with HIV presenting with malignant syphilis

Myong Gyu Kim 0000-0003-4282-414X, Vasanth Kamath, Marianne Martinello and Kristen Overton
pp. 83-86

Malignant syphilis is a rare manifestation of secondary syphilis and is usually associated with HIV infection. Disseminated syphilis can pose a diagnostic dilemma, often a masquerade for other conditions including fungal endophthalmitis. Syphilis remains a disease of concern and has continued to rise in prevalence in the past decade.

SH22128Sexually transmitted infection testing among transgender and non-binary persons: results of a community-based cross-sectional survey

Ashley Lacombe-Duncan 0000-0002-9023-8877, Shanna K. Kattari, Leonardo Kattari, Ayden I. Scheim and Brayden A. Misiolek
pp. 87-91

Studies demonstrate higher rates of sexually transmitted infections (STIs) among transgender (trans) and non-binary (TNB) persons, particularly trans women. We expand the literature by examining non-HIV STI testing and including trans men and non-binary persons. We found high rates of lifetime non-HIV STI testing (82.1%, 79.6%, 86.7%, and 77.1% among trans women, trans men, non-binary persons assigned male at birth, and non-binary persons assigned female at birth, respectively), with no statistically significant differences across genders, suggesting broad-based interventions are warranted.


Hepatitis B is sexually transmitted among men who have sex with men (MSM) and anti-hepatitis B core (anti-HBc) determines current or previous infection. A total of 331/3342 (10%) of MSM had a positive anti-HBc (0.3% had active hepatitis B), which was associated with being aged >30 years, previous hepatitis C, previous syphilis and being non-UK born (but not living with HIV, or having gonorrhoea or chlamydia), and the proportion testing positive reduced significantly between 2012 and 2019. Hepatitis B is endemic in MSM locally and further efforts are needed to enhance hepatitis B prevention strategies including vaccination.

SH22171Changing trends in transgender demographics and morbidity: baseline data from a Spanish cohort

Pedro González Fernández 0000-0002-3099-796X, Gema Grau Bolado, Carmen Fernández López, Susana Ponce de León Saenz de Navarrete, María Luisa Guadilla Fernández, Federico Vázquez San Miguel, Virginia Bellido and Itxaso Rica Echevarria
pp. 96-98

The number of transgender people requesting specialised treatment is rapidly increasing worldwide, especially among minors. We have studied the changes over time in the characteristics of transgender persons who have sought hormone treatment in a specialised clinic in Spain for the past 12 years, observing a progressive decrease in their age, an increase in their academic level and a better health profile. These findings probably reflect favourable changes in how the group is treated by society and public health services.

Committee on Publication Ethics