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RESEARCH ARTICLE

An alternative model of sexually transmissible infection testing in men attending a sex-on-premises venue in Sydney: a cross-sectional descriptive study

Cherie Bennett A B G , Vickie Knight B C , Douglas Knox D , James Gray E , Gemma Hartmann B and Anna McNulty B F
+ Author Affiliations
- Author Affiliations

A NSW Sexually Transmitted Infections Programs Unit, PO Box 1614, Sydney, NSW 2001, Australia.

B Sydney Sexual Health Centre, Sydney Hospital, 8 Macquarie Street, Sydney NSW 2001, Australia.

C The Kirby Institute, Wallace Wurth Building, UNSW Australia, Sydney, NSW 2052, Australia.

D HIV Related Programs Unit, South Eastern Sydney Local Health District, 301 Forbes Street, Darlinghurst, NSW 2010, Australia.

E ACON, 414 Elizabeth Street, Surry Hills, NSW 2010, Australia.

F School of Public Health and Community Medicine, UNSW Australia, Kensington, NSW 2052, Australia.

G Corresponding author. Email: Cherie.Bennett@health.nsw.gov.au

Sexual Health 13(4) 353-358 https://doi.org/10.1071/SH15174
Submitted: 3 September 2015  Accepted: 9 March 2015   Published: 23 May 2016

Abstract

Background: Sydney Sexual Health Centre (SSHC) partnered with a large sex-on-premises venue, South Eastern Sydney Local Health District HIV and Related Programs Unit and AIDS Council of NSW (ACON) to develop and implement a community-based sexually transmissible infection (STI) screening model co-located in a sex-on-premises venue. This paper describes the process, the outcomes and examines the cost of this model. Methods: A retrospective cross-sectional study of gay and bisexual men (GBM) attending a STI testing service co-located in a sex-on-premises venue in Sydney city between the 1 November 2012 and 31 May 2014. Results: A total of 402 patrons had 499 testing episodes in the study period. Testing patrons were a median of 39.5 years of age, 221 (55%) were born overseas, 85 (21%) spoke a language other than English at home and 54 (13%) had a STI at first testing. A total of 105 (26%) testing patrons had never tested for a STI before. Of the 297 (74%) who had been tested before, 83 (21%) had not been tested within the last 12 months. A total of 77 STIs were detected in 63 people over 499 testing episodes, giving a STI positivity rate of 15% in the testing episodes. The prevalence of rectal chlamydia was the highest at 8% followed by pharyngeal gonorrhoea at 3%. A total of 97% of testing patrons were successfully relayed their results via their preferred methods within a median of 7.5 days. Conclusion: This paper highlights that offering STI screening in a community-based setting was an effective and low-cost alternative to traditional testing services.

Additional keywords: chlamydia, computer-assisted self-interview, fast-track testing service, gonorrhoea.


References

[1]  Currie MJ, Martin SJ, Soo TM, Bowden FJ. Screening for chlamydia and gonorrhoea in men who have sex with men in clinical and non-clinical settings. Sex Health 2006; 3 123–6.
Screening for chlamydia and gonorrhoea in men who have sex with men in clinical and non-clinical settings.Crossref | GoogleScholarGoogle Scholar | 16800399PubMed |

[2]  Debattista J, Clementson C, Mason D, Dwyer J, Argent S, Woodward C, et al Screening for Neisseria gonorrhoeae and Chlamydia trachomatis at entertainment venues among men who have sex with men. Sex Transm Dis 2002; 29 216–21.
Screening for Neisseria gonorrhoeae and Chlamydia trachomatis at entertainment venues among men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 11912463PubMed |

[3]  The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia. Annual Surveillance Report. Sydney: UNSW; 2014.

[4]  Health Protection NSW Communicable Diseases Branch. Sexually transmitted infections notification data 4th quarterly report. Sydney: NSW Health; 2013.

[5]  Zetola NM, Bernstein KT, Wong E, Louie B, Klausner JD. Exploring the relationship between sexually transmitted diseases and HIV acquisition by using different study designs. J Acquir Immune Defic Syndr 2009; 50 546–51.
Exploring the relationship between sexually transmitted diseases and HIV acquisition by using different study designs.Crossref | GoogleScholarGoogle Scholar | 19367993PubMed |

[6]  Chesson HW, Bernstein KT, Gift TL, Marcus JL, Pipkin S, Kent CK. The cost-effectiveness of screening men who have sex with men for rectal chlamydial and gonococcal infection to prevent HIV infection. Sex Transm Dis 2013; 40 366–71.
The cost-effectiveness of screening men who have sex with men for rectal chlamydial and gonococcal infection to prevent HIV infection.Crossref | GoogleScholarGoogle Scholar | 23588125PubMed |

[7]  Kent CK, Chaw JK, Wong W, Liska S, Gibson S, Hubbard G, et al Prevalence of rectal, urethral, and pharyngeal chlamydia and gonorrhea detected in 2 clinical settings among men who have sex with men: San Francisco, California, 2003. Clin Infect Dis 2005; 41 67–74.
Prevalence of rectal, urethral, and pharyngeal chlamydia and gonorrhea detected in 2 clinical settings among men who have sex with men: San Francisco, California, 2003.Crossref | GoogleScholarGoogle Scholar | 15937765PubMed |

[8]  Templeton DJ, Read P, Varma R, Bourne C. Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence. Sex Health 2014; 11 217–29.
Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence.Crossref | GoogleScholarGoogle Scholar | 24690473PubMed |

[9]  Centres for Disease Control and Prevention. STD & HIV Screening Recommendations 2014. [updated 16th December 2014]. Available online at: http://www.cdc.gov/std/prevention/screeningReccs.htm [verified 16 September 2014].

[10]  Australian Government Department of Health. Third national sexually transmissible infections strategy 2014–2017. Available online at: http://www.health.gov.au/internet/main/publishing.nsf/Content/8DB 875B386DC5672CA257BF0001E377D/$File/STI-Strategy2014-v3.pdf [verified 10 September 2014].

[11]  Lister NA, Smith A, Tabrizi S, Hayes P, Medland NA, Garland S, et al Screening for Neisseria gonorrhoeae and Chlamydia trachomatis in men who have sex with men at male-only saunas. Sex Transm Dis 2003; 30 886–9.
Screening for Neisseria gonorrhoeae and Chlamydia trachomatis in men who have sex with men at male-only saunas.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3sngtVaqsA%3D%3D&md5=e9e2b1d1f83c35c76bd61b2423cb5353CAS | 14646635PubMed |

[12]  Bingham TA, Secura GM, Behel SK, Bunch JG, Simon PA, MacKellar DA. HIV risk factors reported by two samples of male bathhouse attendees in Los Angeles, California, 2001–2002. Sex Transm Dis 2008; 35 631–6.
HIV risk factors reported by two samples of male bathhouse attendees in Los Angeles, California, 2001–2002.Crossref | GoogleScholarGoogle Scholar | 18545142PubMed |

[13]  Huebner DM, Binson D, Pollack LM, Woods WJ. Implementing bathhouse-based voluntary counselling and testing has no adverse effect on bathhouse patronage among men who have sex with men. Int J STD AIDS 2012; 23 182–4.
Implementing bathhouse-based voluntary counselling and testing has no adverse effect on bathhouse patronage among men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC38nislyruw%3D%3D&md5=d09bd46c7dff384c279a06619777b3e5CAS | 22581871PubMed |

[14]  Debattista J, Dwyer J, Anderson R, Rowling D, Patten J, Mortlock M. Screening for syphilis among men who have sex with men in various clinical settings. Sex Transm Infect 2004; 80 505–8.
Screening for syphilis among men who have sex with men in various clinical settings.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2crpvFGrsw%3D%3D&md5=b512687255b35ab543761541b7e39375CAS | 15572624PubMed |

[15]  Prestage G, McCann RD, Hurley M, Bradley J, Down IGB. Pleasure and Sexual Health The PASH Study 2009. Sydney: National Centre in HIV Epidemiology and Clinical Research; 2009.

[16]  Bowden F, Currie M, Todkill M, Schmidt M, Webeck S, Del Rosario R, et al A pragmatic assessment of the relative efficiency of outreach chlamydia screening events conducted in non-clinical settings. BMC Public Health 2012; 12 341
A pragmatic assessment of the relative efficiency of outreach chlamydia screening events conducted in non-clinical settings.Crossref | GoogleScholarGoogle Scholar | 22571184PubMed |

[17]  Morris SR, Bauer HM, Chartier M, Howard H, Watson S, Yokotobi J, et al Relative efficiency of chlamydia screening in non-clinical settings in two California counties. Int J STD AIDS 2010; 21 52–6.
Relative efficiency of chlamydia screening in non-clinical settings in two California counties.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1MfktVektw%3D%3D&md5=62eeb435143a89fc98cc69ee46a74e81CAS | 20029065PubMed |

[18]  SouthEastern Sydney Illawarra Local Health Network. HIV and related programs unit – sex on premise venue survey. Report; 2009.

[19]  Knight V, Ryder N, Guy R, Lu H, Wand H, McNulty A. New xpress sexually transmissible infection screening clinic improves patient journey and clinic capacity at a large sexual health clinic. Sex Transm Dis 2013; 40 75–80.
New xpress sexually transmissible infection screening clinic improves patient journey and clinic capacity at a large sexual health clinic.Crossref | GoogleScholarGoogle Scholar | 23250305PubMed |

[20]  Knight V, Wand H, Gray J, McNulty A, Guy R. Convenient HIV testing service models are attracting previously untested gay and bisexual men; a cross-sectional study. J Acquir Immune Defic Syndr 2015; 69 e147–55.
Convenient HIV testing service models are attracting previously untested gay and bisexual men; a cross-sectional study.Crossref | GoogleScholarGoogle Scholar | 25970653PubMed |

[21]  Knight V, Gale M, Guy R, Parkhill N, Holden J, Leeman C, et al A novel time-limited pop-up HIV testing service for gay men in Sydney, Australia, attracts high-risk men. Sex Health 2014; 11 345–50.
A novel time-limited pop-up HIV testing service for gay men in Sydney, Australia, attracts high-risk men.Crossref | GoogleScholarGoogle Scholar | 25163573PubMed |

[22]  Hull P, Mao L, Kolstee J, Duck T, Prestage G, Zablotska I, et al. Gay community periodic survey: Sydney 2014. Sydney: Centre for Social Research in Health, UNSW Australia; 2014.

[23]  Australian Government Department of Health. Seventh national HIV strategy 2014–2017 Available online at: http://www.health.gov.au/internet/main/publishing.nsf/Content/8E87E65EEF535B02CA257BF0001A4EB6/$File/HIV-Strategy2014-v3.pdf [verified 5 September 2014].

[24]  Mullens AB, Staunton S, Debattista J, Hamernik E, Gill D. Sex-on-premises venue (SOPV) health promotion project in response to sustained increases in HIV notifications. Sex Health 2009; 6 41–4.
Sex-on-premises venue (SOPV) health promotion project in response to sustained increases in HIV notifications.Crossref | GoogleScholarGoogle Scholar | 19254490PubMed |

[25]  Bernstein KT, Marcus JL, Nieri G, Philip SS, Klausner JD. Rectal gonorrhea and chlamydia reinfection is associated with increased risk of HIV seroconversion. J Acquir Immune Defic Syndr 2010; 53 537–43.
Rectal gonorrhea and chlamydia reinfection is associated with increased risk of HIV seroconversion.Crossref | GoogleScholarGoogle Scholar | 19935075PubMed |

[26]  Stueve A, O’Donnell LN, Duran R, SanDova IA, Blome J. Time-space sampling in minority communities: results with young Latino men who have sex with men. Am J Public Health 2001; 91 922–6.
Time-space sampling in minority communities: results with young Latino men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MzhvVyrug%3D%3D&md5=6e47645c87faa75f163f6883ce502fa3CAS | 11392935PubMed |

[27]  Australian Government Department of Health. HIV testing in Australia 2015. Available online at: https://www.tga.gov.au/hiv-testing-australia (verified 30 July 2015).

[28]  Sturrock CJ, Currie MJ, Vally H, O’Keefe EJ, Primrose R, Habel P, et al Community-based sexual health care works: a review of the ACT outreach program. Sex Health 2007; 4 201–4.
Community-based sexual health care works: a review of the ACT outreach program.Crossref | GoogleScholarGoogle Scholar | 17931534PubMed |

[29]  Lister NA, Smith A, Tabrizi SN, Garland S, Hayes P, Fairley CK. Comprehensive clinical care on-site in men-only saunas: confidential STI/HIV screening outreach clinic. Int J STD AIDS 2005; 16 794–8.
Comprehensive clinical care on-site in men-only saunas: confidential STI/HIV screening outreach clinic.Crossref | GoogleScholarGoogle Scholar | 16336760PubMed |

[30]  Santella AJ, Schlub TE, Ooi C, Varma R, Holt M, Prestage G, et al Sexual behaviour and HIV prevention needs of men attending a suburban sex-on-premises venue. Sex Health 2015; 12 383–9.
Sexual behaviour and HIV prevention needs of men attending a suburban sex-on-premises venue.Crossref | GoogleScholarGoogle Scholar |

[31]  Mayer KH, Ducharme R, Zaller ND, Chan PA, Case P, Abbott D, et al Unprotected sex, underestimated risk, undiagnosed HIV and sexually transmitted diseases among men who have sex with men accessing testing services in a New England bathhouse. J Acquir Immune Defic Syndr 1999; 2012 194–8.