Journal articles on the topic 'HIV infections – New South Wales – Sydney'
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Richardson, Daniel, Hubert Chan, Rohan Bopage, David A. Lewis, Shailendra Sawleshwarkar, Charles Chung, and Jen Kok. "HIV-1 subtype variability and transmitted drug resistance in a culturally diverse population in Western Sydney, New South Wales, Australia." Sexual Health 17, no. 4 (2020): 377. http://dx.doi.org/10.1071/sh20013.
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Abstract Background Transmitted human immunodeficiency virus type 1 (HIV-1) drug resistance (TDR) is an important contributor to antiretroviral treatment failure, and is associated with HIV-1 transmission among men who have sex with men (MSM), non-MSM clusters and individuals diagnosed with concurrent sexually transmissible infections (STI). Western Sydney has a culturally diverse population, with a high proportion of non-Australian-born individuals. This study describes the prevalence of TDR and non-B HIV-1 subtypes in a clinic-based population. Methods: A clinic database was examined for all newly diagnosed treatment-naïve HIV-1 patients and information on their HIV-1 resistance and subtype, demographics including country of birth and diagnosis of a bacterial sexually transmissible infection was collected. Results: Data were available from 74/79 individuals (62 cis-male, 16 cis-female and 1 transgender woman). Of the 74 genotypes, the prevalence of non-B subtypes and TDR was 43/74 (58%; 95%CI = 46.9–69.3) and 14/74 (19%; 95%CI = 10.0 to 27.8). It was also found that 30/79 (38%) had a concurrent bacterial STI. 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). Conclusion: The relative prevalence of non-B HIV-1 subtypes and TDR is higher in Western Sydney than in the rest of Australia. TDR is associated with subtype B HIV-1 and being Australian born, suggesting ongoing local transmission. This highlights the diversity of the HIV epidemic locally and the need for interventions to prevent ongoing HIV transmission.
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Houghton, Rebecca, Ruthy McIver, Timmy Lockwood, Karl Johnson, and Rosalind Foster. "Characteristics of clients newly diagnosed with HIV in central Sydney in 2016–17: a retrospective audit comparing a community-based testing site and a clinical sexual health service." Sexual Health 17, no. 4 (2020): 390. http://dx.doi.org/10.1071/sh19152.
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Abstract In New South Wales (NSW), Australia, innovative community-based testing models have been implemented to increase HIV testing among populations at risk. The characteristics of patients newly diagnosed with HIV at a community-based testing site and at a traditional clinical service in Sydney, NSW, were compared. Compared with the clinical service, clients diagnosed at the community-based site were more likely to be diagnosed at their first visit and report no prior HIV test. A high proportion of clients at both sites had a preferred language other than English. Innovative HIV testing models are reaching under-tested populations, but could be further improved.
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Prestage, Garrett, Fengyi Jin, Iryna Zablotska, John Imrie, John M. Kaldor, and Andrew E. Grulich. "Trends in HIV prevalence among homosexual and bisexual men in eastern Australian states." Sexual Health 5, no. 2 (2008): 103. http://dx.doi.org/10.1071/sh07074.
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Objectives: In Australia, HIV notification rates in homosexual men, previously much higher in New South Wales, have become similar across the eastern states. We examined whether trends in HIV prevalence in community-based samples of homosexual men were consistent with the trends in HIV notifications. Methods: We examined data on self-reported HIV status from annual cross-sectional, self-completed anonymous surveys of homosexual men conducted between 1998 and 2006 in Sydney, Melbourne and Brisbane. Men were recruited at gay community venues, clinics and large gay community events. We calculated age-specific and age-standardised HIV prevalence rates. Comparisons of HIV prevalence between the three cities and across time were carried out using age-specific rates, and using logistic regression, controlling for age. Results: Men recruited from clinics had a much higher prevalence of HIV (P < 0.001) and were excluded from further analyses. Among the 50 239 completed questionnaires obtained at non-clinic sites, there was a marked decline in aged-standardised HIV prevalence in Sydney (from 14.2 to 8.98%, P < 0.001), a small decline in Brisbane (from 8.51 to 6.94%, P = 0.012) and no change in Melbourne (from 8.35 to 8.06%, P = 0.848). There were significant declines in men aged less than 50 years in Sydney, and in men aged less than 30 years in Brisbane. In Melbourne there was no significant trend in HIV at any age. Conclusion: HIV prevalence among young homosexual men has declined in Sydney, and these data suggest that HIV incidence among homosexual men is now similar in the eastern state capitals of Australia.
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Jin, Fengyi, Garrett P. Prestage, Ann McDonald, Tim Ramacciotti, John C. Imrie, Susan C. Kippax, John M. Kaldor, and Andrew E. Grulich. "Trend in HIV incidence in a cohort of homosexual men in Sydney: data from the Health in Men Study." Sexual Health 5, no. 2 (2008): 109. http://dx.doi.org/10.1071/sh07073.
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Objectives: To determine the incidence of HIV seroconversion in a community-based cohort of homosexual men in Sydney from 2002 to 2006. Methods: Participants were recruited between 2001 and 2004 from community-based events and venues. They were tested for HIV annually at follow-up interviews. Each year, the study database was matched against the national HIV register to identify additional HIV seroconversions among men lost to active follow up. The trend in HIV incidence over time was examined using Cox regression. Results: Among 1426 participants, 52 cases of HIV seroconversion were identified between 2002 and 2006, an incidence of 0.87 per 100 person-years (95% CI: 0.65–1.14). HIV incidence varied from 1.67 per 100 person-years in 2002 to 0.39 in 2006 (P trend = 0.282). The median age of HIV seroconversion was 36.9 years, ranging from 22 to 63 years. Conclusion: In this community-based cohort of highly sexually active homosexual men in Sydney, HIV incidence was close to 1% each year and declined non-significantly between 2002 and 2006. These data are consistent with surveillance data suggesting no increase in recent HIV incidence in homosexual men in New South Wales.
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Stardust, Zahra, Johann Kolstee, Stefan Joksic, James Gray, and Siobhan Hannan. "A community-led, harm-reduction approach to chemsex: case study from Australia’s largest gay city." Sexual Health 15, no. 2 (2018): 179. http://dx.doi.org/10.1071/sh17145.
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Rates of drug use remain substantially higher among gay and bisexual men (GBM) and people living with HIV (PLHIV) in Sydney, New South Wales, Australia. The use of drugs to enhance sexual pleasure within cultures of Party and Play creates opportunities to discuss sexual health, mental health, consent and wellbeing. Community organisations with a history of HIV prevention, care, treatment are well-placed to respond. ACON’s (formerly the AIDS Council of New South Wales) multi-dimensional response to ‘chemsex’ includes: direct client services support for individuals seeking to manage or reduce their use; health promotion activities that support peer education; partnerships with research institutions to better understand cultures of chemsex; and policy submissions that call for drug use to be approached as a health, rather than a criminal, issue. The approach speaks the language of Party and Play subcultures; employs culturally relevant terminology and imagery; uses content designed, created and delivered by peers; and operates within a pleasure-positive, harm-reduction and community-led framework. These interventions have led to increased service uptake, strong community engagement, robust research partnerships and the recognition of GBM as a priority population in relevant strategies.
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Couldwell, Deborah L., Dean Jalocon, Melissa Power, Neisha J. Jeoffreys, Sharon C.-A. Chen, and David A. Lewis. "Mycoplasma genitalium: high prevalence of resistance to macrolides and frequent anorectal infection in men who have sex with men in western Sydney." Sexually Transmitted Infections 94, no. 6 (March 22, 2018): 406–10. http://dx.doi.org/10.1136/sextrans-2017-053480.
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ObjectivesWe aimed to estimate the prevalence of Mycoplasma genitalium infection and of mutations linked to macrolide resistance using the ResistancePlus MG assay (SpeeDx, Sydney, New South Wales, Australia) in first-void urine (FVU), anorectal and oropharyngeal samples from men who have sex with men (MSM) attending Western Sydney Sexual Health Centre (WSSHC).MethodsConsecutive symptomatic and asymptomatic MSM attending for STI testing were prospectively enrolled. M. genitalium testing using the ResistancePlus MG assay was performed on FVU, anorectal and oropharyngeal samples routinely collected for Chlamydia trachomatis and Neisseria gonorrhoeae assays.ResultsOverall, the prevalence of M. genitalium infection in the study group was 13.4% (68/508). Most (79.4%, 54/68) M. genitalium harboured macrolide resistance mutations (87.5% of urethral and 75.6% of anorectal infections). The anorectum was the most commonly infected site (45/505, 8.9%), followed by the urethra (24/508, 4.7%). No oropharyngeal M. genitalium infections were detected (0/508). Most of the anorectal (93.3%) and urethral (79.2%) infections were asymptomatic.MSM who were taking HIV pre-exposure prophylaxis (PrEP) were twice as likely to be infected with M. genitalium compared with MSM who were not on PrEP (OR 2.1, 95% CI 1.3 to 3.6; P=0.0041). Always using condoms for anal sex in the last 3 months was protective of infection (OR 0.8, 95% CI 0.6 to 1.0; P=0.0186).ConclusionsWe demonstrated a high prevalence of M. genitalium and very high levels of macrolide resistance among MSM attending WSSHC. Our findings support the routine use of an assay to detect macrolide resistance mutations in M. genitalium infections. This will ensure, in regions or populations with high rates of macrolide resistance among M. genitalium strains, that first-line treatment with azithromycin will only be used if a macrolide-sensitive strain is identified.
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Ooi, Catriona, Basil Donovan, and David A. Lewis. "Cross-sectional study of sexual behaviour and health of gay and bisexual men in suburban Sydney, New South Wales, Australia: contrasts between sex venue and clinic attendees." Sexual Health 18, no. 3 (2021): 248. http://dx.doi.org/10.1071/sh20196.
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Abstract Background In Australia, men-who-have-sex-with-men (MSM) have higher rates of sexually transmissible infections (STIs) and HIV compared with heterosexual men. We compared demographics, behaviour and HIV/STI prevalence for MSM attending a sex-on-premises-venue (SOPV) or the local sexual health clinic (SHC) to determine key differences. Methods: Men attending a SOPV during onsite HIV/STI screening from November 2015 for 12 months were compared with MSM attending a local SHC for screening. Each group completed a self-administered questionnaire and STI/HIV testing. Data analysis was performed using SPSS. Results: Compared with SHC participants (n = 108), SOPV participants (n = 84) had a higher median age (47 years [range, 22–88] vs 33 years [range, 19–71]; P < 0.001) and less likely to report previous HIV testing (73% vs 89%; P < 0.01), STI testing (60% vs 90%; P < 0.001) or be vaccinated for hepatitis A (32% vs 65%; P < 0.001) or hepatitis B (35% vs 73%; P < 0.001). SOPV participants were more likely to be married, widowed or have a long-term female partner (39% vs 7%; P < 0.001) and have a higher prevalence of urethral and rectal chlamydia (7% vs 1%; P = 0.02 and 8% vs 2%; P = 0.03, respectively). There was no significant difference between the groups for detection of syphilis (4% vs 9%), gonorrhoea (5% vs 9%) or HIV (1% vs 0%). Conclusion: MSM attending the SOPV had higher anogenital chlamydial prevalence compared with those attending the SHC. They reported higher rates of sex with female partners, which may facilitate STI/HIV transmission to heterosexual populations. Our findings have implications for HIV/STI service provision, contact tracing and local health promotion initiatives.
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McDonald, A., and J. M. Kaldor. "37. MONITORING HIV TRANSMISSION AMONG MEN SEEN AT METROPOLITAN SEXUAL HEALTH CLINICS IN AUSTRALIA, 1996-2005." Sexual Health 4, no. 4 (2007): 299. http://dx.doi.org/10.1071/shv4n4ab37.
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National surveillance for newly diagnosed HIV infection indicates an increasing trend in Queensland, South Australia and Victoria but not in New South Wales. It was not clear if trends in newly diagnosed HIV infection were due to different patterns of HIV antibody testing. We report the pattern of HIV antibody testing among people seen through a network of sexual health clinics in Australia. Six public metropolitan sexual health clinics (Sydney Sexual Health Centre (SSHC), South West Sexual Health Centre (SSWSHC), NSW; Brisbane Sexual Health Clinic (BSHC), Gold Coast Sexual Health Clinic (GCSHC), QLD; Clinic 275, SA; Melbourne Sexual Health Centre (MSHC), VIC) provide annual tabulations of the number of people seen, the number tested for HIV antibody, and the number with newly diagnosed HIV infection, broken down by sex, exposure category and testing history. The number of men seen at the clinics ranged from 17 138 in 1996 to 19 184 in 2005. Among men seen, the percentage who were tested for HIV declined from 62% in 1996 to 50% in 2001 and increased to 56% in 2005. HIV prevalence remained stable in 1996-2005 at 0.5% and was highest at SSHC (0.7-1.1%) and among homosexually active men (1.8% in 1996 and 1.6% in 2005). The percentage of men retested within 12 months of a negative test increased from 41% in 1996 to 44% in 2005. At SSHC, retesting among homosexually active men declined from 56% in 1996 to 44% in 2001 and increased to 58% by 2005. At Clinic 275 and MSHC, 50-60% and around 50% of homosexually active men were retested in 1996 - 2005 and in 2004-2005, respectively. HIV infection was newly diagnosed in 0.4% (8) in 1996 and in 0.8% (26) in 2005. While HIV antibody testing patterns vary between the clinics, incidence of newly diagnosed HIV infection has remained low.
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Power, Melissa, Kevin Dong, Jennifer Walsh, David A. Lewis, and Daniel Richardson. "Barriers to HIV testing in hospital settings within a culturally diverse urban district of Sydney, Australia." Sexual Health 18, no. 4 (2021): 340. http://dx.doi.org/10.1071/sh20189.
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Background Eleven percent of people living with HIV in Australia remain unaware of their diagnosis, and there are missed opportunities for HIV testing in priority settings in New South Wales. HIV testing remains low outside of sexual health clinics with the exception of antenatal settings where HIV testing is routine. To understand why HIV testing rates are low, we sought to identify health worker-related barriers to HIV testing. Methods: We conducted an anonymous online survey to health workers in Western Sydney Local Health District (WSLHD) in September 2019. Tick-box, Likert scale responses were analysed using Chi-square and Kruskal–Wallis statistical tests, and free text responses were analysed with thematic analysis. Results: Three percent (n = 420) of WSLHD’s estimated 14 000 health workers responded. These included 317 clinicians (171 nurses, 65 doctors, 56 allied health professionals (AHPs), 25 midwives, and 103 health workers in non-clinical roles). Health workers were from a variety of in-patient/out-patient settings. Many health workers (291/420, 69%; 95%CI = 64.9–73.7%) were unaware that HIV testing is offered in their areas; doctors (82%) and midwives (80%) were more aware than nurses (23%) and AHPs (11%) (P < 0.0001). Doctors (Likert score = 3.62; 3.45/5) and midwives (2.84; 2.76) were significantly more comfortable discussing and confidently offering HIV testing than nurses (2.42; 1.81) or AHPs (1.83; 0.91) (P < 0.0001 for both). The top five barriers to HIV testing were (1) procedural knowledge, (2) identification of at-risk patients, (3) HIV knowledge, (4) positive result management, and (5) privacy concerns. Free text responses highlighted perceived stigma, testing/result responsibilities and resource challenges as barriers to HIV testing. Conclusions: Clinicians working in priority settings and with priority populations require more education and support to increase targeted HIV testing.
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Chan, Curtis, Prital Patel, Karl Johnson, Matthew Vaughan, Karen Price, Anna McNulty, David J. Templeton, et al. "Community-based peer-led HIV/sexually transmitted infection testing services in Sydney for gay and bisexual men captured an eighth of new HIV diagnoses in New South Wales, Australia." AIDS 35, no. 11 (September 1, 2021): 1878–80. http://dx.doi.org/10.1097/qad.0000000000002982.
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Horn, Ryan, Denton Callander, and Bridget Haire. "Perceptions of sexually transmissible infection pre-exposure prophylaxis: a qualitative study of high-risk gay and bisexual men in Sydney, New South Wales." Sexual Health 17, no. 2 (2020): 129. http://dx.doi.org/10.1071/sh19175.
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Background Novel sexually transmissible infection (STI) prevention strategies are needed to combat increasing bacterial STI incidences alongside decreasing condom use among gay and bisexual men (GBM) in Australia. Sexually transmissible infection pre-exposure prophylaxis (STI-PrEP) using regular doxycycline is one such strategy that is the subject of ongoing research. However, a lack of qualitative data regarding the conceptualisation, perceived risks, perceived benefits and preferred dosing strategies of STI-PrEP may impede future research and implementation efforts. Methods: Semistructured in-depth interviews were conducted with 13 high-risk GBM residing in Sydney, Australia. Interviews were audio recorded, transcribed verbatim and then analysed thematically. Results: STI-PrEP was largely conceptualised using pre-existing knowledge of HIV-PrEP. The perceived benefits, including a reduced incidence of STIs, destigmatisation and a ‘peace of mind’, often outweighed the perceived risks, including side effects, antibiotic resistance and stigmatisation of consumers. A daily dosing regimen was preferred unanimously by participants when compared with event-driven or episodic strategies. Conclusions: Participants of this study were cautiously optimistic regarding the concept of STI-PrEP. The findings suggest that, in addition to examining the effectiveness of STI-PrEP, future implementation studies should also focus on concerns regarding side effects and monitoring antibiotic resistance, as well as considering the acceptability and potential for stigmatisation of STI-PrEP consumers.
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Healey, Loretta M., Catherine C. O'Connor, and David J. Templeton. "HIV result giving. Is it time to change our thinking?" Sexual Health 7, no. 1 (2010): 8. http://dx.doi.org/10.1071/sh09042.
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Background: Ensuring patients receive post-test discussion when collecting HIV test results is an integral component of the HIV testing process. New South Wales Health Department (NSW Health) policy recommends that all patients be given their HIV results in person. We assessed the number of patients who returned for HIV test results to Royal Prince Alfred Sexual Health Clinic in Sydney, Australia, and predictors of return. Methods: The files of 218 patients having consecutive HIV tests from the beginning of January to the end of April 2007 were manually reviewed. Non-consenting patients and those returning to the clinic for another reason were excluded. Multivariate logistic regression was used to determine factors associated with return for HIV results in person within 4 weeks of having the test. Results: Seventy-two of 159 patients (45%) returned for their HIV result within 4 weeks of testing. Independent predictors of return were male gender (P = 0.041), attending the outreach men-only (v. base) clinic (P = 0.017), first HIV test at the clinic (P = 0.002) and sex overseas in the past year (P = 0.048). Conclusion: Over one-half of patients did not collect their HIV results in person and thus did not receive any post-test discussion. The strongest predictor of return for HIV test results was having a first HIV test at the clinic. Current NSW Health policy is failing to achieve high levels of HIV post-test discussion. For many patients, giving results by telephone may be a more appropriate strategy to ensure HIV post-test discussion.
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Murray, Danielle, Limin Mao, T. H. (Horas) Wong, Tim Chen, Brent Mackie, Shih-Chi Kao, Azizul Haque Mahee, et al. "High levels of engagement with testing for HIV and sexually transmissible infection among gay Asian men in Sydney and Melbourne: an observational study." Sexual Health 17, no. 2 (2020): 121. http://dx.doi.org/10.1071/sh18216.
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Background Gay and other men who have sex with men of Asian background (GAM) have been identified as a key population in efforts to eradicate HIV in New South Wales. The aims of the present study were to evaluate current levels of engagement with HIV and sexually transmissible infection (STI) testing services, assess knowledge of pre- and post-exposure prophylaxis and to identify factors associated with service engagement in this group. Methods: A survey of 604 GAM residing in Sydney and Melbourne was undertaken. Results: The data identified that a significant proportion of non-HIV-positive men (i.e. HIV-negative men and men whose HIV status was unknown) surveyed (n = 567; 93.9%) had engaged in frequent HIV testing and comprehensive STI testing in the 12 months prior to the survey (n = 180; 31.7%). There were significant differences (P < 0.05) in sexual practices at the bivariate level between those who reported frequent and comprehensive HIV/STI testing and those who did not. Those who tested regularly were substantially more sexually active, were more likely to have multiple partners (P = 0.001) and were more likely to engage in condomless anal intercourse with both casual (P < 0.001) and regular (P = 0.002) partners. Those who engaged with testing initiatives were more likely to discuss HIV status with both regular (P = 0.008) and casual (P < 0.001) partners, and identified more reasons to test than their counterparts (P < 0.001). The data also highlighted key service venues, with gay men most likely to have used public sexual health clinics (46.9%) as their most recent testing venue. Conclusions: The data demonstrate an association between high levels of male-to-male sexual activity and engagement in frequent and comprehensive HIV and STI testing. This likely derives from both self-perceived notions of risk and current reliance on established gay community organisations to convey information around testing. Increasing engagement with testing initiatives beyond GAM who self-identify as being at high HIV and STI risk will require the use of novel routes by which to disseminate this information.
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McIver, Ruthy, Amalie Dyda, Vickie Knight, Rebecca Guy, and Anna McNulty. "Hepatitis B screening and vaccination: how does a Sexual Health service measure up?" Sexual Health 12, no. 5 (2015): 458. http://dx.doi.org/10.1071/sh15061.
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Hepatitis B virus (HBV) is a vaccine-preventable disease. Sexual health clinics in New South Wales see a high caseload of populations at risk of HBV, and thus screening and vaccination are part of routine care. Uptake of screening and vaccination at Sydney Sexual Health Centre was assessed and it was found that among 1577 new patients with an elevated risk of HBV infection, 864 (55%) were potentially susceptible. Of those susceptible, the majority were screened (76%) and approximately one-third (35%) were found to be eligible for vaccination. The majority (83%) initiated vaccination. Of concern, however, is that incremental gaps between initiation and completion of the vaccine course resulted in an overall HBV vaccine coverage of 26% among those HBV susceptible.
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Day, Carolyn, Rohan Jayasuriya, and Graham Stone. "Hepatitis C-related discrimination in New South Wales." Australian Health Review 27, no. 2 (2004): 57. http://dx.doi.org/10.1071/ah042720057.
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Carolyn Day is with the National Drug and Alcohol Research Centre, University of New South Wales. Rohan Jayasuriya is at the Graduate School of Public Health, University of Wollongong. Graham Stone is with HIV, Program AIDS, Northern Sydney Health, Manly Hospital.Acknowledgements: The HepCare trial was funded by the Commonwealth Department of Health and Family Welfare and the NSW Health Department.Hepatitis C-related discrimination was examined. Intake interviews with 606 HepCare trial participants from New South Wales were analysed to determine the prevalence and correlates of hepatitis C related discrimination. The sample was a mean age of 37 years, 54% were males, 79% reported a history of drug injecting and 35% were current injectors. Forty percent of the sample reported experiencing hepatitis C-related discrimination. Multivariate analysis revealed that current injectors, 35-44 year olds, females, those who had recently consulted a general practitioner and those who had been referred to a specialist for their hepatitis C were more likely to report discrimination than other groups. More research is required to attain a better understanding of hepatitis C-related discrimination.
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Di Giallonardo, Francesca, Angie Pinto, Phillip Keen, Ansari Shaik, Alex Carrera, Hanan Salem, Christine Selvey, et al. "Increased HIV Subtype Diversity Reflecting Demographic Changes in the HIV Epidemic in New South Wales, Australia." Viruses 12, no. 12 (December 6, 2020): 1402. http://dx.doi.org/10.3390/v12121402.
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Changes over time in HIV-1 subtype diversity within a population reflect changes in factors influencing the development of local epidemics. Here we report on the genetic diversity of 2364 reverse transcriptase sequences from people living with HIV-1 in New South Wales (NSW) notified between 2004 and 2018. These data represent >70% of all new HIV-1 notifications in the state over this period. Phylogenetic analysis was performed to identify subtype-specific transmission clusters. Subtype B and non-B infections differed across all demographics analysed (p < 0.001). We found a strong positive association for infections among females, individuals not born in Australia or reporting heterosexual transmission being of non-B origin. Further, we found an overall increase in non-B infections among men who have sex with men from 50 to 79% in the last 10 years. However, we also found differences between non-B subtypes; heterosexual transmission was positively associated with subtype C only. In addition, the majority of subtype B infections were associated with clusters, while the majority of non-B infections were singletons. However, we found seven non-B clusters (≥5 sequences) indicative of local ongoing transmission. In conclusion, we present how the HIV-1 epidemic has changed over time in NSW, becoming more heterogeneous with distinct subtype-specific demographic associations.
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Di Giallonardo, Francesca, Angie N. Pinto, Phillip Keen, Ansari Shaik, Alex Carrera, Hanan Salem, Barbara Telfer, et al. "Limited Sustained Local Transmission of HIV-1 CRF01_AE in New South Wales, Australia." Viruses 11, no. 5 (May 27, 2019): 482. http://dx.doi.org/10.3390/v11050482.
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Australia’s response to the human immunodeficiency virus type 1 (HIV-1) pandemic led to effective control of HIV transmission and one of the world’s lowest HIV incidence rates—0.14%. Although there has been a recent decline in new HIV diagnoses in New South Wales (NSW), the most populous state in Australia, there has been a concomitant increase with non-B subtype infections, particularly for the HIV-1 circulating recombinant form CRF01_AE. This aforementioned CRF01_AE sampled in NSW, were combined with those sampled globally to identify NSW-specific viral clades. The population growth of these clades was assessed in two-year period intervals from 2009 to 2017. Overall, 109 NSW-specific clades were identified, most comprising pairs of sequences; however, five large clades comprising ≥10 sequences were also found. Forty-four clades grew over time with one or two sequences added to each in different two-year periods. Importantly, while 10 of these clades have seemingly discontinued, the remaining 34 were still active in 2016/2017. Seven such clades each comprised ≥10 sequences, and are representative of individual sub-epidemics in NSW. Thus, although the majority of new CRF01_AE infections were associated with small clades that rarely establish ongoing chains of local transmission, individual sub-epidemics are present and should be closely monitored.
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McCarthy, Melissa, Lewis J. Haddow, Virginia Furner, and Adrian Mindel. "Contact tracing for sexually transmitted infections in New South Wales, Australia." Sexual Health 4, no. 1 (2007): 21. http://dx.doi.org/10.1071/sh06019.
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Background: Contact tracing is an important strategy in the control of sexually transmitted infections (STI) because it encourages individuals who may be unaware they have been exposed to an infection to be tested and treated. The aim of this study was to review STI contact tracing procedures in NSW by sexual health clinics (SHC), public health units (PHU) and general practitioners (GP). Methods: A questionnaire study carried out in 2004–2005 of SHC, PHU and a random sample of GP in NSW. SHC and PHU participated in structured interviews and GP completed questionnaires at educational workshops or through a mail-out. Interviews and questionnaires addressed current contact tracing practice and methods of improving the service. Results: All 35 SHC, 6/18 (33%) PHU and 172/212 (81%) of the GP who responded to the survey undertook contact tracing for STI. Chlamydia was the STI most commonly traced by SHC (34/35, 97%) and GP (165/172, 96%). HIV was the STI most commonly traced by PHU (5/6, 83%). Only 23/172 (13%) GP were familiar with the ‘Australasian contact tracing manual’. The commonest barriers to tracing for SHC and GP included patient reluctance (SHC 60%, GP 71%), and the lack of contact details for partners (SHC 46%, GP 60%). GP identified the availability of information for patients (82%) and more training (55%) as necessary resources for optimal contact tracing. Conclusions: SHC and GP frequently undertook contact tracing for some STI; PHU do so less frequently. Barriers to contact tracing are similar for all health-care providers. For GP, there is a need for increased training and the development of written policies and agreed pathways for referral.
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MUSCATELLO, D. J., K. A. O'GRADY, K. NEVILLE, and J. McANULTY. "Acute poststreptococcal glomerulonephritis: public health implications of recent clusters in New South Wales and epidemiology of hospital admissions." Epidemiology and Infection 126, no. 3 (June 2000): 365–72. http://dx.doi.org/10.1017/s0950268801005568.
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Acute poststreptococcal glomerulonephritis (APSGN) is an inflammatory kidney condition that can complicate Group A streptococcal infections. Two clusters of APSGN occurred recently in New South Wales (NSW), Australia; one in a rural town in December 1999 and the other in a Sydney suburb in January 2000. We interviewed carers of the affected children but found no common exposures except three of the Sydney cases were cousins in frequent contact. To assess the probability of these clusters occurring, we analysed hospital admissions for acute glomerulonephritis, as a proxy for APSGN in younger patients. The incidence of acute glomerulonephritis in NSW during 1989/90–1997/8 in residents aged under 20 years was 2·2/100000/year (95% CI 2·0–2·5). Incidence was highest in children aged 5–9 years, boys and Aboriginal children. We found no evidence for other clusters during that period. The recent clusters highlight the continued potential for unexpected future outbreaks of APSGN.
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Butt, Daniel, and David Raftos. "Immunosuppression in Sydney rock oysters (Saccostrea glomerata) and QX disease in the Hawkesbury River, Sydney." Marine and Freshwater Research 58, no. 2 (2007): 213. http://dx.doi.org/10.1071/mf06080.
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This study assessed links between host fitness, environmental change and opportunistic parasite infections in a dynamic estuary system. The Hawkesbury River in New South Wales is the most recent Sydney rock oyster growing area to experience outbreaks of infectious QX disease. This area was used to examine a relationship between the intensity of QX disease and inhibition of the oyster immune system. Oysters were grown at various sites along the river and periodically monitored for general condition, total haemolymph protein content, antibacterial capacity and phenoloxidase activity. Phenoloxidase activity was significantly inhibited during a key period of Marteilia sydneyi infectivity in late summer 2005. The degree to which phenoloxidase was inhibited strongly correlated with the intensity of M. sydneyi infection. The data suggest that the presence of some transient environmental stressor may have affected phenoloxidase activity during a key period of infection and increased the susceptibility of oysters to disease. These results provide further evidence for a specific relationship between decreased phenoloxidase activity and susceptibility to QX infection.
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Waldron, Liette S., Belinda C. Ferrari, Cristel Cheung-Kwok-Sang, Paul J. Beggs, Nicola Stephens, and Michelle L. Power. "Molecular Epidemiology and Spatial Distribution of a Waterborne Cryptosporidiosis Outbreak in Australia." Applied and Environmental Microbiology 77, no. 21 (September 9, 2011): 7766–71. http://dx.doi.org/10.1128/aem.00616-11.
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ABSTRACTCryptosporidiosis is one of the most common waterborne diseases reported worldwide. Outbreaks of this gastrointestinal disease, which is caused by theCryptosporidiumparasite, are often attributed to public swimming pools and municipal water supplies. Between the months of January and April in 2009, New South Wales, Australia, experienced the largest waterborne cryptosporidiosis outbreak reported in Australia to date. Through the course of the contamination event, 1,141 individuals became infected withCryptosporidium. Health authorities in New South Wales indicated that public swimming pool use was a contributing factor in the outbreak. To identify theCryptosporidiumspecies responsible for the outbreak, fecal samples from infected patients were collected from hospitals and pathology companies throughout New South Wales for genetic analyses. Genetic characterization ofCryptosporidiumoocysts from the fecal samples identified the anthroponoticCryptosporidium hominisIbA10G2 subtype as the causative parasite. Equal proportions of infections were found in males and females, and an increased susceptibility was observed in the 0- to 4-year age group. Spatiotemporal analysis indicated that the outbreak was primarily confined to the densely populated coastal cities of Sydney and Newcastle.
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Mallitt, Kylie-Ann, James Jansson, Handan Wand, Levinia Crooks, and David P. Wilson. "HIV service capacity: identifying current and future areas of clinical shortage." Sexual Health 11, no. 1 (2014): 17. http://dx.doi.org/10.1071/sh13151.
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Background The capacity of HIV services to meet the clinical needs of people living with HIV (PLHIV) has not been evaluated. Similarly, whether HIV services are positioned to respond to increases in patient demand outside metropolitan centres over the next decade is unknown. Methods: A novel statistical methodology was used to estimate HIV clinical service capacity in Australia. A survey of HIV services was conducted. Geostatistical analysis was used to identify significant regions of clinical service undersupply relative to the estimated number of PLHIV in 2010 and 2020. Results: In 2010, an estimated 2074 PLHIV (9.7% of all PLHIV) resided in regions more than 15 km from a clinical service provider; 485 PLHIV (2.3% of all PLHIV) live >50 km away. By 2020, this is estimated to rise to 3419 and 807 (11.5% and 2.7% of estimated PLHIV) for 15 km and 50 km, respectively. To meet this demand, the establishment of new HIV services are required in the areas of greatest HIV clinical undersupply. In 2010, these are northern Sydney and western New South Wales, the Queensland mid-north coast and the outer suburbs of Melbourne. At the current estimated rate of increase in PLHIV, areas that will become critically undersupplied by 2020 include south-west Sydney, the outer suburbs of Brisbane and Western Australia. Conclusions: This study provides a quantitative assessment using modern statistical techniques to identify HIV clinical service gaps that is applicable in developed and nondeveloped settings. Training of new HIV clinicians should be directed towards undersupplied areas.
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Bourne, Christopher, Meeyin Lam, Christine Selvey, Rebecca Guy, and Denton Callander. "Changing pattern of sexually transmissible infections and HIV diagnosed in public sexual health services compared with other locations in New South Wales, 2010–14." Sexual Health 15, no. 4 (2018): 366. http://dx.doi.org/10.1071/sh17183.
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Background In Australia, testing and treatment for HIV and other sexually transmissible infections (STIs) is usually managed in general practice, while publicly funded sexual health clinics (PFSHC) attract people at higher risk for infection. The proportion of HIV and STI diagnoses in New South Wales (NSW) occurring in PFSHC stratified by priority population was investigated. Methods: From 2010 to 2014, NSW notification frequencies for chlamydia, gonorrhoea, infectious syphilis, and HIV were compared with the number of diagnoses in PFSHC. The annual proportion of diagnoses at PFSHC was calculated and Wilcoxon rank-sum tests assessed trends. Diagnoses from PFSHC were also organised by priority population, including gay and bisexual men (GBM), people living with HIV, Aboriginal and Torres Strait Islander people, people who use injecting drugs, sex workers and young people. Results: The annual proportion of HIV and STIs diagnosed at PFSHC increased (all P < 0.001): chlamydia from 12% to 15%, gonorrhoea 23% to 38%, infectious syphilis 21% to 40% and HIV 22% to 30%. Overall, the majority of all infections diagnosed at PFSHC were among GBM, with the proportional distribution of chlamydia increasing from 32% to 46% among GBM (P < 0.001) and decreasing among young people (50% to 40%; P < 0.001). There were no other significant changes by population or infection at PFSHC. Conclusions: Increasing proportions of STI and HIV are being diagnosed at NSW PFSHC, mostly among GBM. PFSHC reorientation to priority populations continues to make a large and increasing contribution to STI and HIV control efforts in NSW.
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Hoare, Alexander, David P. Wilson, David G. Regan, John Kaldor, and Matthew G. Law. "Using mathematical modelling to help explain the differential increase in HIV incidence in New South Wales, Victoria and Queensland: importance of other sexually transmissible infections." Sexual Health 5, no. 2 (2008): 169. http://dx.doi.org/10.1071/sh07099.
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Background: Since 1999 there has been an increase in the number of HIV diagnoses in Australia, predominantly among men who have sex with men (MSM), but the magnitude of increase differs between states: ~7% rise in New South Wales, ~96% rise in Victoria, and ~68% rise in Queensland. Methods: Epidemiological, clinical, behavioural and biological data were collated into a mechanistic mathematical model to explore possible reasons for this increase in HIV notifications in MSM. The model was then used to make projections to 2015 under various scenarios. Results: The model suggests that trends in clinical and behavioural parameters, including increases in unprotected anal intercourse, cannot explain the magnitude of the observed rise in HIV notifications, without a substantial increase in a ‘transmission-increasing’ factor. We suggest that a highly plausible biological factor is an increase in the prevalence of other sexually transmissible infections (STI). It was found that New South Wales required an ~2-fold increase in other STI to match the data, Victoria needed an ~11-fold increase, and Queensland required an ~9-fold increase. This is consistent with observed trends in Australia for some STI in recent years. Future projections also indicate that the best way to control the current rise in HIV notifications is to reduce the prevalence of other STI and to promote condom use, testing for HIV, and initiation of early treatment in MSM diagnosed during primary infection. Conclusions: Our model can explain the recent rise in HIV notifications with an increase in the prevalence of other STI. This analysis highlights that further investigation into the causes and impact of other STI is warranted in Australia, particularly in Victoria.
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Mallitt, Kylie-Ann, David P. Wilson, Ann McDonald, and Handan Wand. "HIV incidence trends vary between jurisdictions in Australia: an extended back-projection analysis of men who have sex with men." Sexual Health 9, no. 2 (2012): 138. http://dx.doi.org/10.1071/sh10141.
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Background Trends in HIV diagnoses differ across Australia and are primarily driven by men who have sex with men (MSM). We use national population surveillance data to estimate the incidence of HIV infections among MSM by jurisdiction and infer the proportion of undiagnosed infections. Methods: Annual surveillance data for AIDS diagnoses, HIV diagnoses and recently acquired HIV infections were obtained from 1980 to 2009. A modified statistical back-projection method was used to reconstruct HIV incidence by jurisdiction. Results: HIV incidence among MSM peaked for all jurisdictions in the early 1980s and then declined into the early 1990s, after which incidence increased. Trends then differ between jurisdictions. In New South Wales (NSW) and South Australia, estimated HIV incidence peaked at 371 and 50 cases respectively in 2003, and has since decreased to 258 and 24 cases respectively in 2009. HIV infections in Queensland (Qld) have more than doubled over the past decade, from 84 cases in 2000 to 192 cases in 2009. Victoria and Western Australia have seen a rise in HIV incidence from 2000 to 2006 (to a peak of 250 and 38 incident cases respectively), followed by a plateau to 2009. HIV incidence in the Northern Territory, Tasmania and Australian Capital Territory have increased since 2000; however, case numbers remain small (<20 per year). The estimated proportion of HIV infections not yet diagnosed to 2009 ranges from 10% (NSW) to 18% (Qld), with an average of 12% across Australia. Conclusions: HIV diagnosis trends among MSM in Australia reflect changes in estimated incidence to 2009, and reveal the largest increase in the past 10 years in Qld.
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Bourne, Chris, Debbie Allen, Katherine Brown, Stephen C. Davies, Anna McNulty, Don E. Smith, Catherine C. O'Connor, et al. "What proportion of sexually transmissible infections and HIV are diagnosed in New South Wales’ public sexual health services compared with other services?" Sexual Health 10, no. 2 (2013): 119. http://dx.doi.org/10.1071/sh12020.
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Background: In New South Wales (NSW), publicly funded sexual health services (PFSHSs) target the populations at greatest risk for important sexually transmissible infections (STIs) and so may make a large contribution to the diagnosis of notifiable STIs. We aimed to determine the proportions of STIs diagnosed in PFSHSs and notified to the NSW Ministry of Health in 2009, and describe geographical variations. Methods: The number of notifiable STIs (infectious syphilis, gonorrhoea, HIV and chlamydia) diagnosed in 2009 was obtained for each Area Health Service (AHS) and each PFSHS. The proportion of diagnoses made by PFSHSs was calculated at the state and AHS level according to five geographical regions: inner and outer metropolitan, regional, rural and remote. Results: The overall proportions of diagnoses made by NSW PFSHSs were syphilis, 25%; gonorrhoea, 25%; HIV, 21%; and chlamydia, 14%. Within each zone, the proportions of these STIs were (respectively): (i) inner metropolitan: 32%, 26%, 21% and 13%; (ii) outer metropolitan: 41%, 24%, 43% and 9%; (iii) regional: 62%, 15%, 23% and 10%; (iv) rural: 8%, 29%, <5% and 20%; and (v) remote: <5%, 43%, <5% and 29%. There was considerable variation in proportions of STIs between and within AHSs (<5–100%). Conclusions: NSW PFSHSs contribute a large proportion of diagnoses for syphilis, gonorrhoea and HIV, but less so for chlamydia. Across AHSs and zones, there was considerable variation in the proportions. These data support the role of PFSHS in identifying and managing important STIs in high-risk populations.
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Bourne, Chris, Debbie Allen, Katherine Brown, Stephen C. Davies, Anna McNulty, Don E. Smith, Catherine C. O'Connor, et al. "Corrigendum to: What proportion of sexually transmissible infections and HIV are diagnosed in New South Wales’ public sexual health services compared with other services?" Sexual Health 10, no. 3 (2013): 290. http://dx.doi.org/10.1071/sh12020_co.
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Background: In New South Wales (NSW), publicly funded sexual health services (PFSHSs) target the populations at greatest risk for important sexually transmissible infections (STIs) and so may make a large contribution to the diagnosis of notifiable STIs. We aimed to determine the proportions of STIs diagnosed in PFSHSs and notified to the NSW Ministry of Health in 2009, and describe geographical variations. Methods: The number of notifiable STIs (infectious syphilis, gonorrhoea, HIV and chlamydia) diagnosed in 2009 was obtained for each Area Health Service (AHS) and each PFSHS. The proportion of diagnoses made by PFSHSs was calculated at the state and AHS level according to five geographical regions: inner and outer metropolitan, regional, rural and remote. Results: The overall proportions of diagnoses made by NSW PFSHSs were syphilis, 25%; gonorrhoea, 25%; HIV, 21%; and chlamydia, 14%. Within each zone, the proportions of these STIs were (respectively): (i) inner metropolitan: 32%, 26%, 21% and 13%; (ii) outer metropolitan: 41%, 24%, 43% and 9%; (iii) regional: 62%, 15%, 23% and 10%; (iv) rural: 8%, 29%, Conclusions: NSW PFSHSs contribute a large proportion of diagnoses for syphilis, gonorrhoea and HIV, but less so for chlamydia. Across AHSs and zones, there was considerable variation in the proportions. These data support the role of PFSHS in identifying and managing important STIs in high-risk populations.
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Ward, James, Joanne Bryant, Heather Worth, Peter Hull, Sarina Solar, and Sandra Bailey. "Use of health services for sexually transmitted and blood-borne viral infections by young Aboriginal people in New South Wales." Australian Journal of Primary Health 19, no. 1 (2013): 81. http://dx.doi.org/10.1071/py11032.
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The objective of the present study was to describe use of health services for sexually transmitted infections (STI), blood borne viral infections (BBV) and drug and alcohol issues by young Aboriginal people in New South Wales (NSW). A cross-sectional survey was conducted at two Aboriginal sports and cultural events in NSW, in 2007 and 2008, among Aboriginal people aged 16–30 years to ascertain their knowledge of STI, BBV, associated risk behaviours and health service access in NSW. A total of 293 young Aboriginal people completed the survey; 58% were female, the mean age was 20 years, and almost 70% were single. Just over one-third (34%) of participants had been tested for an STI in the past 12 months, and over half (58%) reported that they had ever had an STI test (including HIV). Of respondents who had had an STI test in the past 12 months, 54.0% had done so at an Aboriginal Community Controlled Health Service (ACCHS) and 29% by a GP. Just over one-third (36%) of participants had ever had a test for hepatitis C, 45% of whom had received their test at an ACCHS. Participants were also asked about the types of services they had used for advice about STI and BBV. Of the 69% who had sought STI advice, ACCHS was the most common clinical location for doing so (36% for STI and 26% for hepatitis C). This study highlights the important role that ACCHS play in the provision of STI and BBV testing care and management for a cohort of young Aboriginal people in NSW.
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Fairley, Christopher K., Glenda Fehler, Sharon R. Lewin, Marian Pitts, Marcus Y. Chen, Catriona S. Bradshaw, and Jane S. Hocking. "Sexually transmissible infection and HIV management among men who have sex with men with and without HIV: survey of medical practitioners who are members of the Australasian Society for HIV Medicine." Sexual Health 5, no. 2 (2008): 155. http://dx.doi.org/10.1071/sh07094.
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Background: Rates of HIV in New South Wales (NSW) have been stable, but have increased significantly in other Australian states. The reasons for this are unknown and may be associated with differences in the management of sexually transmissible infections (STI) and HIV in different states in Australia. Our aim was to determine if the use of suppressive treatment for genital herpes, the treatment of HIV or STI screening practices were different between states in Australia. Methods: This study was a cross-sectional survey of medical practitioners who are S100 prescribers and members of the Australian Society for HIV Medicine. Results: In general, there were no differences between the clinical practices of practitioners in NSW and other states except that in NSW fewer practitioners tested HIV-positive men who have sex with men (MSM) for syphilis annually (NSW 78% v. others 87%, P = 0.04) or treated MSM with advanced HIV disease (CD4 < 150 × 106 cells L–1) with acicylovir in the absence of herpes simplex virus (HSV) (NSW 4% v. others 13%, P = 0.03), and more practitioners in NSW tested HIV-negative MSM for HSV type-specific serology (NSW 21% v. others 11%, P = 0.02). Conclusions: It is unlikely that the minor differences in HSV and HIV treatment or STI screening practices among practitioners in NSW and other Australian states explains the differences in HIV notifications between these two areas.
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Rajagopal, Preethi, Sian L. Goddard, and David J. Templeton. "Substantial increase in yield of Neisseria gonorrhoeae testing 2008–2013 at a Sydney metropolitan sexual health clinic: an observational study." Sexual Health 15, no. 1 (2018): 79. http://dx.doi.org/10.1071/sh17080.
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Background A substantial increase in gonorrhoea notifications in New South Wales has been observed in recent years. Methods: We assessed yield of testing and characteristics of those diagnosed with gonorrhoea from January 2008 to December 2013 at RPA Sexual Health in the inner-west of Sydney. Yield was defined as the proportion of testing occasions which were positive for gonorrhoea. Generalised estimating equations were used to calculate trends in yield over time. Results: During the 6-year study period, 6456 individuals (4308 males, 2124 females, 24 transgender individuals) were tested on 12 799 occasions; this included 2441 gay and bisexual men (GBM) who were tested on 6945 occasions. Over the study period there was a significant increase in testing at genital, anorectal and pharyngeal sites (P-trend <0.001 for all). In total, gonorrhoea was detected on 668 testing occasions among 536 individuals (5.2%). Overall, 254/12765 (2.0%) of genital tests, 251/7326 (3.4%) of anorectal tests and 342/8252 (4.1%) of pharyngeal tests were positive. There was a significant increase in overall gonorrhoea yield from 2.2% in 2008 to 7.1% in 2013 (P-trend <0.001). This temporal increase in gonorrhoea yield was observed in heterosexual males (P < 0.001), heterosexual females (P-trend = 0.008), female sex workers (P-trend = 0.006), HIV-positive GBM and HIV-negative GBM (both P < 0.001) and at all anatomical sites (P-trend <0.001 for all). Conclusions: From 2008 to 2013, we observed a greater than threefold increase in yield of gonorrhoea testing disproportionately affecting GBM, although the increase also occurred in other subpopulations and at all anatomic sites. More frequent and comprehensive testing could potentially reduce the high and increasing community prevalence of gonorrhoea.
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Stockwell, Michelle P., Deborah S. Bower, John Clulow, and Michael J. Mahony. "The role of non-declining amphibian species as alternative hosts for Batrachochytrium dendrobatidis in an amphibian community." Wildlife Research 43, no. 4 (2016): 341. http://dx.doi.org/10.1071/wr15223.
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Context Pathogens with reservoir hosts have been responsible for most disease-induced wildlife extinctions because the decline of susceptible hosts does not cause the decline of the pathogen. The existence of reservoirs for Batrachochytrium dendrobatidis limits population recovery and conservation actions for threatened amphibians. As such, the effect of reservoirs on disease risk within host community assemblages needs to be considered, but rarely is. Aims In this study we aimed to determine if amphibian species co-occurring with the green and golden bell frog Litoria aurea, a declining species susceptible to B. dendrobatidis, act as alternate hosts. Methods We quantified B. dendrobatidis infection levels, sub-lethal effects on body condition and terminal signs of disease in amphibian communities on Kooragang Island and Sydney Olympic Park in New South Wales, Australia, where two of the largest remaining L. aurea populations persist. Key results We found L. aurea carried infections at a similar prevalence (6–38%) to alternate species. Infection loads ranged widely (0.01–11 107.3 zoospore equivalents) and L. aurea differed from only one alternate host species (higher median load in Litoria fallax) at one site. There were no terminal or sub-lethal signs of disease in any species co-occurring with L. aurea. Conclusion Our results suggest that co-occurring species are acting as alternate hosts to L. aurea and whether their presence dilutes or amplifies B. dendrobatidis in the community is a priority for future research. Implications For L. aurea and many other susceptible species, confirming the existence of reservoir hosts and understanding their role in community disease dynamics will be important for optimising the outcomes of threat mitigation and habitat creation initiatives for their long-term conservation.
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Yap, Lorraine, Juliet Richters, Tony Butler, Karen Schneider, Kristie Kirkwood, and Basil Donovan. "Sexual practices and dental dam use among women prisoners - a mixed methods study." Sexual Health 7, no. 2 (2010): 170. http://dx.doi.org/10.1071/sh09138.
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Background: Dental dams have been distributed to women prisoners for protection against HIV and other sexually transmissible infections (STIs) in some Canadian and Australian prisons for over a decade. However, we do not know whether they serve any useful public health purpose. Objective: To determine how dental dams are used in women’s prisons in New South Wales (NSW), Australia. Method: Using quantitative and qualitative methods, we investigated women’s sexual practices with a focus on how dental dams are used in NSW prisons. Results: Although 71 of the 199 (36%) women reported having had sex with another inmate, with oral sex involved in most encounters, only eight (4%) had ever used a dental dam. The main sources of STI transmission risk among women prisoners were oral sex, manual sex and sharing dildos. Furthermore, sharing razors could also allow the transmission of blood-borne viruses, which could occur during sex in the presence of cuts or menstrual fluid. The high rates of hepatitis B and C among incarcerated women compound this risk. Conclusion: Dental dams are not widely used by women prisoners and we question their utility in women’s prisons. Oral sex is an important risk factor for acquisition of herpes simplex virus type 1, but most women in NSW prisons (89%) are already infected. Condoms and latex gloves may have more use. Condoms could be used as a barrier on shared dildos and sex toys, while latex gloves could be used to protect cut and grazed hands from vaginal and menstrual fluids.
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Kotevski, Damian P., Meeyin Lam, Christine Selvey, David J. Templeton, Linda G. Donovan, and Vicky Sheppeard. "Epidemiology of lymphogranuloma venereum in New South Wales, 2006–2015." Communicable Diseases Intelligence 43 (November 18, 2019). http://dx.doi.org/10.33321/cdi.2019.43.54.
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Aim To describe the epidemiology of lymphogranuloma venereum (LGV) in New South Wales (NSW) from 2006 to 2015. Methods LGV notification data between 2006 and 2015 from New South Wales were analysed to describe time trends in counts and rates by gender, age group and area of residence, as well as anatomical sites of infection. A positivity ratio was calculated using the number of LGV notifications per 100 anorectal chlamydia notifications per year. Data linkage was used to ascertain the proportion of LGV cases that were co-infected with HIV. Results There were 208 notifications of LGV in NSW from 2006 to 2015; all were among men, with a median age of 42 years, and half were residents of inner-city Sydney. Annual notifications peaked at 57 (1.6 per 100,000 males) in 2010, declined to 16 (0.4 per 100,000 males) in 2014, and then increased to 34 (0.9 per 100,000 males) in 2015. Just under half (47.4%) of LGV cases were determined to be co-infected with HIV. Conclusion The number of LGV notifications each year has not returned to the low levels seen prior to the peak in 2010. Continued public health surveillance is important for the management and control of LGV.
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Ubrihien, Ashley, Kylie Gwynne, and David A. Lewis. "Enabling culturally safe sexual health services in western Sydney: a protocol to improve STI treatment outcomes for Aboriginal young people." Pilot and Feasibility Studies 7, no. 1 (May 13, 2021). http://dx.doi.org/10.1186/s40814-021-00847-7.
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Abstract Background Aboriginal people face challenges on several fronts when it comes to the health and wellbeing of their community, compared to the rest of the Australian population. This is no different in urban areas such as Australia’s largest urban Aboriginal community located in Blacktown, NSW, where sexually transmitted infections (STIs) remain an issue of concern. Across Australia, rates of infectious syphilis, human immunodeficiency virus (HIV), and hepatitis C infection have increased by 400, 260, and 15% respectively while gonorrhoea decreased 12% in the 5-year period from 2013 to 2017. This study explores how to address the barriers that prevent young Aboriginal people under 30 years of age from accessing STI treatment through Government Sexual Health Services. Methods This qualitative study will use purposeful sampling to recruit 20 male and 20 female health consumers, 10 Aboriginal elders and 10 sexual health clinicians. This recruitment will be undertaken with the assistance of the local Government Health Services and local Aboriginal organisations. One-on-one semi-structured interviews will be undertaken by someone of the same gender in order to address cultural preferences. Data will be entered into NVivo and thematically analysed. Discussion This study will seek to add to the literature that explores why young Aboriginal people do not access sexual health services. This study seeks to understand the experience of clinicians, Aboriginal elders and Aboriginal young people to provide practical policy and clinical redesign evidence that can be used to improve the experience and cultural safety of sexual health services in urban areas of Australia. The results of the qualitative research will be disseminated with the assistance of participating local Aboriginal organisations, and the findings will be published through peer-reviewed scientific journals and conference presentations. Trial registration The study is approved by the Western Sydney Local Health District Human Research Ethics Committee (HREC/16/WMEAD/449) and the New South Wales Aboriginal Health and Medical Research Council’s Human Research Ethics Committee (1220/16).
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Fletcher, Stephanie, Graziella Caprarelli, Juan Merif, David Andresen, Sebastian Van Hal, Damien Stark, and John Ellis. "Epidemiology and geographical distribution of enteric protozoan infections in Sydney, Australia." Journal of Public Health Research 3, no. 2 (August 25, 2014). http://dx.doi.org/10.4081/jphr.2014.298.
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<em>Background</em>. Enteric protozoa are associated with diarrhoeal illnesses in humans; however there are no recent studies on their epidemiology and geographical distribution in Australia. This study describes the epidemiology of enteric protozoa in the state of New South Wales and incorporates spatial analysis to describe their distribution. <br /><em>Design and methods.</em> Laboratory and clinical records from four public hospitals in Sydney for 910 patients, who tested positive for enteric protozoa over the period January 2007-December 2010, were identified, examined and analysed. We selected 580 cases which had residence post code data available, enabling us to examine the geographic distribution of patients, and reviewed the clinical data of 252 patients to examine possible links between protozoa, demographic and clinical features. <br /><em>Results</em>. Frequently detected protozoa were <em>Blastocystis</em> spp. (57%), <em>Giardia intestinalis</em> (27%) and <em>Dientamoeba</em> <em>fragilis</em> (12%). The age distribution showed that the prevalence of protozoa decreased with age up to 24 years but increasing with age from 25 years onwards. The geographic provenance of the patients indicates that the majority of cases of <em>Blastocystis</em> (53.1%) are clustered in and around the Sydney City Business District, while pockets of giardiasis were identified in regional/rural areas. The distribution of cases suggests higher risk of protozoan infection may exist for some communities. <br /><em>Conclusions</em>. These findings provide useful information for policy makers to design and tailor interventions to target high risk communities. Follow-up investigation into the risk factors for giardiasis in regional/rural area is needed.