Access to sexual health services after the rapid roll out of the launch of pre-exposure prophylaxis for HIV in Melbourne, Australia: a retrospective cross-sectional analysis
Robert Needleman A , Eric P. F. Chow A B C , Janet M. Towns A B , Vincent J. Cornelisse A B , Tim Z. T. Yang A , Marcus Y. Chen A B , Catriona S. Bradshaw A B , Ria Fortune A and Christopher K. Fairley A BA Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, VIC 3053, Australia.
B Central Clinical School, Monash University, 99 Commercial Road, Melbourne, VIC 3004, Australia.
C Corresponding author. Email: Echow@mshc.org.au
Sexual Health 15(6) 528-532 https://doi.org/10.1071/SH17182
Submitted: 22 September 2017 Accepted: 23 January 2018 Published: 5 July 2018
Abstract
Background: On 26 July 2016, Victoria began a large study of HIV pre-exposure prophylaxis, called PrEPX, that involved the creation of around 2600 appointments over 3 months across multiple sites in Melbourne, Australia. At this time, the Melbourne Sexual Health Centre (MSHC) appeared to have a larger demand on its services. The aim of the present study was to determine whether this apparent increase in demand was substantially different from other demand fluctuations. Methods: Patients presenting to the MSHC from 2014 to 2016 were reviewed. Demographic characteristics, sexual risks and sexually transmitted infection diagnoses were extracted from the clinical database. Results: There were 115 522 walk-in presentations for care and a rise in presentations in the week following the launch of the PrEPX study, but at least six similar peaks occurred that year. The peak coinciding with the launch of PrEPX was only apparent for men who have sex with men. There was a substantial increase in the proportion of patients who could not be seen (i.e. triaged out), from 10% in the week before PrEPX to 22.2% in the second week after, but this was primarily due to staff absences. At the time of the PrEPX study, data were collected on the duration of symptoms for common conditions and found no significant (P > 0.29) change in the average duration of symptoms compared with that seen before the PrEPX launch. Conclusions: The increase in the number of medical consultations required for the PrEPX study did not result in excessive demand for public sexual health services.
Additional keyword: healthcare.
References
[1] McCormack S, Dunn D, Desai M, Dolling D, Gafos M, Gilson R, Sullivan AK, Clarke A, Reeves I, Schembri G, Mackie N, Bowman C, Lacey CJ, Apea V, Brady M, Fox J, Taylor S, Antonucci S, Khoo SH, Rooney J, Nardone A, Fisher M, McOwan A, Phillips AN, Johnson AM, Gazzard B, Gill ON. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet 2016; 387 53–60.| Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial.Crossref | GoogleScholarGoogle Scholar |
[2] Alfred Health. PrEPX. 2017. Available online at: https://www.alfredhealth.org.au/research/research-areas/infectious-diseases-research/prepx-study [verified 27 August 2017].
[3] El-Hayek C, Bartnik N, Asselin J, Roth N, Willcox J, Tee BK, Donovan B, Guy R, Stoove M, Hellard M. Is the increase in syphilis cases in Victoria due to increased testing? In: Proceedings of the Australasian Sexual Health Conference; 14–16 November 2016; Adelaide, Australia. 2016.
[4] Melbourne Sexual Health Centre annual report 2016. Melbourne: Melbourne Sexual Health Centre; 2016. Available online at: http://www.mshc.org.au/Portals/0/Documents/ClinicInfo/AnnualReport/AnnualReport2016.pdf [verified 27 August 2017].
[5] Victorian State Government. Infectious diseases surveillance in Victoria. 2017. Available online at: https://www2.health.vic.gov.au/public-health/infectious-diseases/infectious-diseases-surveillance [verified 11 September 2017].
