Patient-delivered partner therapy (PDPT) is a method for a patient to give treatment for genital chlamydia to their sexual partner(s) directly, but is not uniformly endorsed in Australia. Drawing on key informant interviews and a document appraisal, we explored the policy environment for PDPT in Australia and considered how it might become routine. A multifaceted approach is crucial and could include a mix of regulatory and policy change or advice; professional endorsement; guidance and education; and development of clear procedures and supportive resources.

Infectious syphilis is usually diagnosed and monitored using changes in rapid plasma reagin (RPR) levels. When reviewing 215 subjects with infectious syphilis, the median time to confirmed cure was 121 days post treatment, and switching from a reactive RPR to a non-reactive result was achieved in only 42.3% cases at a median of 235 days. As the number of syphilis cases continue to climb amongst men who have sex with men, better and more specific tests are urgently needed.

Female sex workers are at risk for sexually transmissible infections. However, the risk for these infections might differ according to the work location of these sex workers. We found that work location was indeed a risk factor for genital and rectal chlamydia and rectal gonorrhoea; these infections occurred more frequently among women working as escorts/homeworkers or in clubs/brothels/private houses/massage salons compared with window prostitution. These findings emphasise the need for extra attention to improve condom use and STI testing in these groups.

Transmitted human immunodeficiency virus type 1 (HIV-1) drug resistance (TDR) is an important contributor to treatment failure. Western Sydney is home to a culturally diverse population. The prevalence of non-B subtypes and TDR was 58% (95%CI = 46.9–69.3) and 19% (95%CI = 10.0 to 27.8) respectively. TDR was associated with subtype B infection (OR 3.53; 95%CI = 1.41–8.82; P = 0.007) and being born in Australia (OR 12.0; 95%CI = 2.45–58.86; P = 0.002). The prevalence of non-B HIV-1 subtypes and TDR is higher in Western Sydney than in the rest of Australia.

Failure to treat the partners of patients with chlamydia infection because it’s ‘too hard for them to get to the clinic’ limits efforts to control this infection. Patient-delivered partner medication after a phone consultation with partners was highly acceptable to index patients and partners and ensured treatment safety and an opportunity for contact tracing. Service delivery models that reduce delayed or no treatment of chlamydia contacts may reduce re-infection and improve case finding.

The availability of subsidised hepatitis C treatment through primary care since March 2016 has buoyed optimism that Australia will eliminate hepatitis C as a public health threat by 2030. We conducted two surveys of general practitioners (GPs) about hepatitis C and found that GPs’ hepatitis C knowledge and engagement in providing treatment has increased. However, with less than one-quarter having prescribed treatment, additional support for GPs is warranted to ensure all patients living with hepatitis C can be cured.

Patients newly diagnosed with HIV at a community testing site were more likely to be first-time testers than patients diagnosed at a traditional sexual health service in central Sydney. Most were born overseas and many preferred a language other than English. Innovative HIV testing models are reaching under-tested populations, but could be tailored to improve access for culturally and linguistically diverse populations.

Women attending a retail pharmacy were approached to enrol in a free sexually transmissible infection (STI) testing program. Use of self-collected vaginal swabs by women attending the pharmacy was found to be feasible and acceptable for STI screening. Future integration of public health partnerships with pharmacies may assist in removing barriers for getting more persons tested and treated.