Post-COVID, there has been a notable surge in syphilis cases, with a 38% increase reported in 2021 compared to 2019, according to the US Centers for Disease Control and Prevention. Analysis of our clinic’s data over 8 years spanning from 2015 to 2023 also showed a steady rise from 2020 to 2023, particularly among males. This trend contrasts with the overall decline in clinic attendance during the pandemic. Contributing factors include an increase in online sexual activity (seeking sexual partners online) and diverted healthcare resources towards the COVID-19 pandemic. Urgent measures are reinforced surveillance and public health response, heightened awareness, and the provision of early and cost-free treatment to address this escalation of syphilis cases.
Sexual Health
Volume 21 Number 1 2024
Ever present in our digital world, misinformation continues to threaten public health efforts and, in some cases, stigmatises specific groups. Our work investigated the evolving rhetoric surrounding monkeypox (mpox) during the 2022 outbreak on Instagram, discovering that perhaps early dialogue singling out men who have sex with men shifted discussions online to combat this misinformation. By understanding the way misinformation is spread, we can better protect against it and create improved communication strategies.
SH23158 Abstract | SH23158 Full Text | SH23158PDF (612 KB) | SH23158Supplementary Material (1 MB) Open Access Article
Sexual health is a complex, multi-dimensional concept; however, much research on the topic is focused on sexually transmitted infections and risk reduction. Given their status as a key population for sexual health promotion, we interviewed 10 gay men living with HIV about the meaning of sexual health. While all mentioned sexual health care and safer sex (e.g. HIV management), most also addressed intimacy and relationships and well as positive sexuality as key components of sexual health.
HIV PrEP is widely recommended as a crucial measure for HIV prevention. In a demonstration trial in China, this article highlights two cases where facial neuralgia emerged as an unexpected side effect of PrEP medication, not previously mentioned in official prescribing information. These findings deepen our understanding of the potential side effects of emitricitabine/tenofovir disoproxil fumarate use and provide empirical evidence to enhance PrEP implementation further and address the challenges that may arise during its utilisation.
There is more to pre-exposure prophylaxis (PrEP) other than the health benefits. Usually, the important social benefits are less considered yet they could reveal much more. As interest intensifies, the social benefits should be incorporated more to tell us what we are missing about PrEP, that could be important globally in the use of this drug. Being less worried about a drug and enjoying sex without worry means ‘confidence’ about a drug that could be vital for future uptake.
SH23056 Abstract | SH23056 Full Text | SH23056PDF (365 KB) Open Access Article
This study aimed to provide a deeper understanding of transgender women’s experiences of pre-exposure prophylaxis (PrEP) uptake and adherence, and to identify major barriers to PrEP use to inform intervention adaptation. We interviewed 20 young transgender women and 10 health care providers from two HIV clinics in Bangkok, Thailand. Our findings deepen the current understanding of barriers to PrEP use, and inform the development of effective interventions to promote PrEP use.
International travel can increase the risk of exposure to infectious diseases including sexually transmissible infections and human immunodeficiency virus. This study explored how travel medicine clinicians integrate sexual and reproductive health (SRH) services into clinical practice. Our findings highlighted gaps in the provision of pre-travel consultation and training needs for SRH among travel medicine clinicians, and the potential for improved promotion of sexual health among travellers to provide important public health benefits for individuals and the wider community.
SH23098 Abstract | SH23098 Full Text | SH23098PDF (1.6 MB) | SH23098Supplementary Material (1.2 MB) Open Access Article
Current medical curriculum covers sexual health but is highly focused on sexually transmissible infections. Medical students and clinicians feel uncomfortable managing sexual dysfunction with patients, despite its prevalence and its effect on quality of life. This study explores the sexual dysfunction-specific training of medical students in one Australian university, and the data suggests that the medical curriculum does not adequately train students to confidently and comfortably manage sexual dysfunction.
SH23172 Abstract | SH23172 Full Text | SH23172PDF (716 KB) Open Access Article
Several large studies suggest that men who have sex with men (MSM) may experience intimate partner violence (IPV) at similar or higher rates than those documented among women. We introduced screening for IPV among MSM at a large, urban sexual health clinic and examined prevalence and associations with self report of IPV. Reported IPV among MSM was associated with significantly increased risk behaviours. Screening allows clinicians to be aware of the potential for, and impact of, IPV in this population.
People from Black ethnic backgrounds are disproportionately affected by sexually transmitted infections. In this paper, we reviewed existing literature to understand the effectiveness of interventions designed to increase engagement with sexual healthcare among people of Black ethnicity. Our findings highlight the importance of considering sociocultural, structural and socio-economic barriers to increasing engagement with sexual healthcare. Matching the intervention facilitators’ demographics and lived experience to intervention recipients may further increase engagement and trust.
This study uncovers an often-overlooked issue: the limited research on access to sexual health services among gay Arab men in Western countries. Findings in this publication reveal significant gaps in knowledge for this population, particularly in areas where strides have been made in reducing HIV transmission. The implications are far-reaching, as addressing these disparities is essential for ensuring equitable healthcare for underrepresented communities. By shedding light on this hidden population, this study paves the way for targeted interventions and policy changes to promote inclusive and accessible sexual health services for all.
SH23131 Abstract | SH23131 Full Text | SH23131PDF (486 KB) | SH23131Supplementary Material (1.1 MB) Open Access Article
Women living with HIV are a minority in Australia. They present unique healthcare challenges, particularly relating to sexual and reproductive health. Evidence shows higher rates of unplanned pregnancy and lower rates of long-acting-reversible contraception use among women living with HIV. We highlight gaps in care at an Australian metropolitan centre and suggest contraceptive options used by women living with HIV may be changing in the era of modern HIV treatment. We suggest changes in care provision to meet demand, including use of ‘women-centred’ models of care.
Transgender women who work in the sex industry face difficulties accessing health care facilities. This population is recognised worldwide as a high-risk group for sexually transmitted infections and HIV In this paper, we describe challenges for accessing healthcare amongst transgender women sex workers in Iran.
How people acquire new sexual partners is an important determinant of sexually transmitted infections (STI) transmission, including HIV. This analysis uses a new way of measuring partner acquisition and found that this new measure was related to people’s age, sex, wealth, partnership status and HIV status. This measure could be used to help identify population groups at high risk of STIs.
SH23134 Abstract | SH23134 Full Text | SH23134PDF (925 KB) | SH23134Supplementary Material (2 MB) Open Access Article
Older adults’ sexual health is not well understood and older Australians may have unmet sexual health needs. To better address the sexual wellbeing of older adults, we need to be able to effectively recruit them for sensitive health research. This paper outlines the recruitment and sample of the SHAPE2 sexual health study of Australians aged 60 years and over. It demonstrates that sexual health matters to many older adults and that they are willing to engage in online sexual health surveys.
SH23116 Abstract | SH23116 Full Text | SH23116PDF (698 KB) | SH23116Supplementary Material (952 KB) Open Access Article
Pathology results management contributes to a significant proportion of the workload at sexual health services. This study estimates the client outcomes and costs of the existing nurse-led urgent results management model at the Sydney Sexual Health Centre compared to an ordering clinician model. The nurse-led model demonstrated improved time to notification and treatment and health system savings of 33 h of staff time per week and A$121 524 annually. Nurse-led models continue to provide value and effectiveness within sexual health services.
International research suggests that lesbians and other women-who-have-sex-with-women (WSW) are less likely to engage in cervical screening than are heterosexual women. This study explored engagement in cervical screening and reasons for engaging (or not) among WSW in New Zealand finding lower levels of engagement due to a legacy of misinformation and endemic heteronormativity in health care. Findings of the study highlight the need to ensure that publicity around cervical screening specifically addresses WSW.
SH23145 Abstract | SH23145 Full Text | SH23145PDF (288 KB) Open Access Article
Testing for sexually transmissible infections is challenging in rural and regional areas. Innovations, such as vending machines, are a novel approach to dispensing test kits to minimise barriers for people disadvantaged by the health system. STI-X, our STI test vending machine pilot, aims to offer an alternative to mainstream services and increase access to STI testing in regional and rural settings in northern Victoria.
We report the first cases of high-level azithromycin resistant N. gonorrhoeae emerging from South Africa. All viable isolates obtained during 2021 were susceptible to extended-spectrum cephalosporins; however, four isolates had high azithromycin MICs ranging from 32 mg/L to >256 mg/L and grouped into two distinct novel NG-MAST and NG-STAR groups. Continued antimicrobial resistance surveillance is critical to detect increasing azithromycin resistance prevalence in N. gonorrhoeae, which may justify future modifications to the STI syndromic management guidelines.
Technology has the potential to benefit relationships – it can facilitate and enhance sexual and intimate practices in a variety of ways. However, it also has the potential to be risky, with people reporting concerns about safety and privacy. This paper presents a new measure that is designed to accurately assess perceptions of the risks and benefits of sexualised technology use.
SH23034 Abstract | SH23034 Full Text | SH23034PDF (381 KB) Open Access Article
SH22185The effects of bivalent human papillomavirus (HPV) vaccination on high-risk anogenital HPV infection among sexually active female adolescents with and without perinatally acquired HIV
Women living with HIV are at high risk of anogenital infection, with high-risk human papillomavirus (HPV) and associated cervical and anal cancers. In young women with perinatally acquired HIV who have experienced immune system compromise from birth, the risk of abnormal cervical cytology is even greater. We found that not receiving a HPV vaccination and having a perinatally acquired HIV were associated with persistent HPV. Catch-up HPV vaccination should be prioritised for children and youth with HIV, regardless of their sexual history.