Sexual Health
Volume 17 Number 4 2020
SH19204Young Aboriginal people's sexual health risk reduction strategies: a qualitative study in remote Australia
Despite increasing emphasis on strengths-based approaches to Aboriginal sexual health, there are limited studies documenting how young Aboriginal people reduce sexual health risks they encounter. Drawing on in-depth interviews with 35 Aboriginal men and women aged 16–21 years in two remote Australian settings, we document many individual and collective STI and pregnancy risk reduction strategies. Findings illustrate the need for holistic, multisectoral STI prevention and sexual health programs driven by the diverse realities of young people’s sexual lives.
SH19204 Abstract | SH19204 Full Text | SH19204PDF (152 KB) Open Access Article
SH19218Factors associated with HIV and syphilis infection among female sex workers in three cities in Papua New Guinea: findings from Kauntim mi tu, a biobehavioral survey
The study shows that the factors associated with HIV and syphilis among FSW in Papua New Guinea’s three major cities are different, highlighting the value of conducting surveys in multiple locations and the importance developing locally appropriate interventions.
SH19218 Abstract | SH19218 Full Text | SH19218PDF (195 KB) Open Access Article
SH20024Patient-delivered partner therapy for chlamydia in Australia: can it become part of routine care?
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.
SH20043Utility of rapid plasmin reagin titres in assessing treatment response and re-infection for infectious syphilis
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.
Young people in Fiji experience high rates of sexually transmissible infections and early pregnancy, but little is known about young people’s perspectives on and experiences of sexual and reproductive health concerns that arise in premarital relationships. This study aimed to enhance understandings of premarital sex and condom use practices among young people in Fiji. Findings suggest the need for culturally appropriate youth-centred sexual and reproductive health programs and services.
SH20040 Abstract | SH20040 Full Text | SH20040PDF (187 KB) Open Access Article
SH20001Investigating the decline in Lymphogranuloma venereum diagnoses in men who have sex with men in the United Kingdom since 2016: an analysis of surveillance data
Following an upward trajectory in LGV diagnoses in the UK from 2004 to 2016, a decrease was seen between 2016 and 2018. Analysis of surveillance data alongside the national management guidelines issued over the course of the epidemic, which increased testing in asymptomatic patients, indicated that the fall in diagnoses was likely due to increasing earlier clinical diagnosis and treatment. In combination with changes to clinical policy and practice, this likely had a positive effect on the control of LGV infection.
SH20001 Abstract | SH20001 Full Text | SH20001PDF (529 KB) Open Access Article
In Indonesia, men who have sex with men (MSM) face high rates of HIV infection and low rates of testing. This article documents community outreach programs for MSM in Indonesia based on focus group discussions held with peer outreach workers (OW) together with healthcare workers. OW described challenges and solutions in assisting their community to access HIV services in a context where stigma is one barrier. However, relationships between OW and healthcare workers present useful insights for the development of community-based responses to HIV testing and treatment. Documenting the experiences of OW helps understand ways to adapt existing HIV programs to reduce barriers to access and increase community participation.
SH20065 Abstract | SH20065 Full Text | SH20065PDF (247 KB) Open Access Article
SH19233Peer-delivered point-of-care testing for Chlamydia trachomatis and Neisseria gonorrhoeae within an urban community setting: a cross-sectional analysis
Comprehensive STI testing is an effective prevention strategy in response to the significant effect sexually transmissible infections (STI) have on increasing the risk of HIV transmission and acquisition. Incorporating point-of-care testing (POCT) for chlamydia and gonorrhoea into an urban peer-delivered community testing service already providing HIV and syphilis POCT is feasible and acceptable to clients. This model offers an effective means of moving beyond the traditional pathology and STI testing services by establishing community-led models that increase client engagement in STI testing among people at risk, including reluctant and non-testers.
SH19233 Abstract | SH19233 Full Text | SH19233PDF (276 KB) Open Access Article
SH19153Sexually transmissible infections among female sex workers in Amsterdam between 2011 and 2016: does risk vary by work location?
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.
SH20013HIV-1 subtype variability and transmitted drug resistance in a culturally diverse population in Western Sydney, New South Wales, Australia
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.
SH20128Sex workers are returning to work and require enhanced support in the face of COVID-19: results from a longitudinal analysis of online sex work activity and a content analysis of safer sex work guidelines
Sex workers confront major challenges to their health and well-being in the face of COVID-19, which remain largely unaddressed by governments and other public health bodies. Our analysis of online data finds that, after a period of social distancing and self-isolation, many male sex workers may be returning to in-person work. Although sex worker community organisations have published ‘safer sex work’ and COVID-19 guidelines, research and funding are required to support their widespread dissemination and uptake.
SH20128 Abstract | SH20128 Full Text | SH20128PDF (302 KB) Open Access Article
SH19189A survey of Australian general practitioners’ hepatitis C knowledge and management 2 years after subsidised direct-acting antiviral therapy became available
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.