Journal articles on the topic 'Melbourne Sexual Health Centre'
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1
Read, Tim R. H., Marcus Y. Chen, Catriona S. Bradshaw, Sriyakantha Beneragama, and Christopher K. Fairley. "Do all women attending urban sexual health services need testing for gonorrhoea?" Sexual Health 2, no. 4 (2005): 259. http://dx.doi.org/10.1071/sh05029.
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Asymptomatic women are often screened for gonorrhoea at Australian sexual health centres. The medical records of all women diagnosed with gonorrhoea at the Melbourne Sexual Health Centre (MSHC) between January 2002 and December 2003 were audited and the database was examined for risk factors in all women tested in 2003. Fifteen cases of gonorrhoea were identified among women at MSHC, all had symptoms or an identifiable risk factor. Asymptomatic women without risk factors may not require screening for Neisseria gonorrhoeae in low prevalence populations.
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Abraham, Esha, Christopher K. Fairley, Ei T. Aung, Catriona S. Bradshaw, Marcus Y. Chen, Tiffany R. Phillips, and Eric P. F. Chow. "Trichomoniasis among men presenting to a sexual health clinic in Melbourne, Australia." Sexual Health 19, no. 1 (February 14, 2022): 70–73. http://dx.doi.org/10.1071/sh21240.
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Background This study aimed to examine the positivity of urethral Trichomonas vaginalis in men attending an urban sexual health clinic in Melbourne, Australia. Methods We conducted a retrospective analysis of men who were tested for T. vaginalis using nucleic acid amplification test at the Melbourne Sexual Health Centre between August 2018 and May 2021, and calculated the positivity. Results Of the 893 men who were tested for T. vaginalis, 12 (1.3%; 95% CI 0.7–2.3) tested positive for T. vaginalis. The positivity of T. vaginalis among men who reported sexual contact with a female partner with T. vaginalis was significantly higher than men who were not contacts (18.6% [8/43] vs 0.5% [4/850], P < 0.001). Conclusions The positivity of T. vaginalis was low at our clinic. The high positivity among contacts highlights the importance of partner notification, testing and management.
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Greaves, Kate E., Christopher K. Fairley, Jaimie L. Engel, Jason J. Ong, Elena Rodriguez, Tiffany R. Phillips, and Eric P. F. Chow. "Sexual mixing patterns among male–female partnerships in Melbourne, Australia." Sexual Health 19, no. 1 (March 8, 2022): 33–38. http://dx.doi.org/10.1071/sh21161.
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Background Individuals who have both opposite- and same-sex partners have the potential to pass sexually transmitted infections (STIs) between high- and low-risk populations. Our aim was to examine assortative sexual mixing in terms of same-sex activity among male–female partnerships. Methods This was a retrospective repeated cross-sectional study of male–female partnerships attending the Melbourne Sexual Health Centre (MSHC) from 2015 to 2019. Sex of sexual partners was collected via computer-assisted self-interview. We calculated the proportion of partnerships where at least one individual reported same-sex partners in the previous 12 months and the degree of assortativity by bisexuality. Results A total of 2112 male–female partnerships (i.e. 4224 individuals) were included, with a median age of 27 years (IQR 23–31). Overall, 89.3% (1885/2112) of male–female partnerships did not report any other same-sex partners; however, in 9.5% (201/2112) of partnerships, same-sex partners were reported by one individual and in 1.2% (26/2112) of partnerships, both individuals reported same-sex partners. Bisexuality appeared to be slightly assortative in male–female partnerships (r = 0.163, 95% CI: 0.150–0.176; P < 0.001). Conclusion One in 10 individuals in male–female partnerships had at least one same-sex partner within the previous 12 months. Individuals were minorly selective by bisexuality, suggesting the patterns of bisexual mixing in male–female partners are more variable and this may have a significant impact on STI transmission in heterosexual populations.
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Gamage, Deepa G., Candice A. Fuller, Rosey Cummings, Jane E. Tomnay, Mark Chung, Marcus Chen, Cameryn C. Garrett, Jane S. Hocking, Catriona S. Bradshaw, and Christopher K. Fairley. "Advertising sexual health services that provide sexually transmissible infection screening for rural young people - what works and what doesn't." Sexual Health 8, no. 3 (2011): 407. http://dx.doi.org/10.1071/sh10144.
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Background ‘TESTme’ is a sexually transmissible infection (STI) screening service for Victorian young people living in rural areas. We evaluated the effectiveness of advertising for this service over an 11-month pilot period. Methods: The advertising that was used included websites, a Facebook page, posters, flyers, business cards, wrist bands and professional development sessions for health nurses that occurred throughout the pilot period. We also used once-off methods including advertisements in newspapers, student diaries and short messages to mobile phones. Results: Twenty-eight clients had a consultation through TESTme. Twenty found the service through health professionals, six through the Melbourne Sexual Health Centre (MSHC) web page, one through the Facebook page and one through the student diary. The total direct costs incurred by the centre for advertising were $20 850. The advertising cost per client reached for each advertising method was $26 for health professionals, $80 for the MSHC web advertisement, $1408 for Facebook and $790 for the student diary. Other advertising methods cost $12 248 and did not attract any clients. Conclusion: Advertising STI health services for rural young people would be best to focus on referrals from other health services or health care websites.
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Zappulla, Annalisa, Christopher K. Fairley, Basil Donovan, Rebecca Guy, Catriona S. Bradshaw, Marcus Y. Chen, Tiffany R. Phillips, Kate Maddaford, and Eric P. F. Chow. "Sexual practices of female sex workers in Melbourne, Australia: an anonymous cross-sectional questionnaire study in 2017–18." Sexual Health 17, no. 1 (2020): 53. http://dx.doi.org/10.1071/sh19037.
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Background Sexually transmissible infections (STIs) are rising among female sex workers (FSW) in Australia. The rise might be explained by changes in sexual practices; however, there is limited behavioural data available. This study aimed to explore the current sexual practices among FSW in Melbourne. Methods: This cross-sectional study was conducted among FSW at Melbourne Sexual Health Centre between September 2017 and March 2018. Participants were asked about current sexual practices with male clients in an average working week. The frequency and proportion of each sexual practice was calculated. Results: There were 180 questionnaires included in the analysis. The median age of the FSW was 28 years (interquartile range [IQR]: 25–34). Most FSW (80.6%) worked in brothels. In an average working week, FSW had a median of 10 (IQR: 7–20) male clients. The most common sexual practices included: vaginal sex (98.3%), fellatio (97.2%), cunnilingus (92.2%) and tongue-kissing (83.7%). FSW had a median number of 10 (IQR: 6–18) vaginal, 10 (IQR: 5–18) fellatio, 7 (IQR: 2–10) cunnilingus and 6 (IQR: 2–10) tongue-kissing clients. Consistent condom use with all clients was highest for vaginal sex (97.1%), followed by anal sex (92.3%), then fellatio (78.9%). Only 3.1% used dental dams consistently for cunnilingus. Conclusion: Consistent condom use with all clients was high among FSWs, especially for vaginal and anal sex. However, one-fifth of FSW had condomless fellatio during an average working week. Tongue-kissing was more common than previously published. Peer-led sexual health education on safe sex practice for FSW is of high importance.
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Turek, Evelyn M., Christopher K. Fairley, Marjan Tabesh, Tiffany R. Phillips, and Eric P. F. Chow. "Group sex events among female sex workers in Melbourne, Australia." Sexual Health 17, no. 6 (2020): 534. http://dx.doi.org/10.1071/sh20136.
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Background Group sex is associated with increased risk of HIV and sexually transmissible infections (STIs), but there is limited data on group sex among female sex workers (FSW). Understanding current group sex practices among FSW may assist with understanding and addressing the rise in STIs observed among Australian FSW in the 2010s. The aim of this study was to examine the proportion of FSWs who had engaged in group sex. Methods: A cross-sectional survey was conducted among FSWs attending the Melbourne Sexual Health Centre, Australia, between March and April 2019. Females aged ≥18 years who self-reported as a sex worker were invited to participate in the survey asking whether they had had group sex in the past 3 months. Group sex was defined as sex that involved two or more sexual partners. Results: Of the 51 FSWs who completed the survey, the median age was 29 years (IQR 24–34). Almost half (49%; n = 25) reported having group sex in the past 3 months, with a median number of group sex events of two (IQR 1–4). Australian-born FSW were more likely to report group sex than overseas-born FSW (76% vs 42%; P = 0.02). Age, number of paid clients and injecting drug use were not associated with group sex. Conclusion: The present study findings show that group sex is common among FSW and should be included in peer sexual health education and interventions among FSW.
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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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Martín-Sánchez, Mario, Richard Case, Christopher Fairley, Jane S. Hocking, Catriona Bradshaw, Jason Ong, Marcus Y. Chen, and Eric P. F. Chow. "Trends and differences in sexual practices and sexually transmitted infections in men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a repeated cross-sectional study in Melbourne, Australia." BMJ Open 10, no. 11 (November 2020): e037608. http://dx.doi.org/10.1136/bmjopen-2020-037608.
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ObjectivesIn the 2010s, there has been an increase in sexually transmitted infections (STI) in men who have sex with men (MSM) in Australia, and since 2015 also in urban heterosexuals. Men who have sex with both men and women (MSMW) have characteristics that may differ from both men who have sex with men only (MSMO) and heterosexual men. We aimed to compare the sexual practices and the trends in HIV/STI positivity between MSMO and MSMW.DesignRepeated cross-sectional study.SettingA sexual health centre in Melbourne, Australia.ParticipantsMSM aged 18 years and above who attended the Melbourne Sexual Health Centre for the first time between 2011 and 2018. This includes 12 795 MSMO and 1979 MSMW.Primary outcome measuresDemographic characterics, sexual practices and HIV/STI positivity.ResultsCompared with MSMW, MSMO were more likely to practice anal sex and to have condomless receptive anal sex with casual male partners, and less likely to have a current regular relationship. Over the 8-year period, there was an increase in condomless receptive anal sex with casual male partners for both groups (MSMO: from 46.2% to 63.3%, ptrend <0.001; MSMW: from 41.3% to 57.9%, ptrend=0.011). Syphilis positivity increased in MSMO (from 5.5% to 7.9%, ptrend=0.012) and MSMW (from 0.9% to 6.4%, ptrend=0.004) and HIV remained stable. Gonorrhoea increased among MSMO from 2011 to 2014 (from 6.7% to 9.6%, ptrend=0.002), and remained stable from 2015 to 2018. MSMO had higher odds of testing positive for gonorrhoea (adjusted OR (aOR) 1.36, 95% CI 1.13 to 1.64), chlamydia (aOR 1.39, 95% CI 1.16 to 1.67), syphilis (aOR 1.74, 95% CI 1.37 to 2.22) and HIV (aOR 4.60, 95% CI 2.43 to 8.70) than MSMW.ConclusionsMSMW have overall lower condomless sex and lower HIV/STI positivity. In the last years, changes in sexual practices in MSM have affected both MSMW and MSMO leading to an increased STI risk.
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Lister, Nichole A., Anthony Smith, and Christopher K. Fairley. "Introduction of screening guidelines for men who have sex with men at an STD clinic, the Melbourne Sexual Health Centre, Australia." Sexual Health 2, no. 4 (2005): 241. http://dx.doi.org/10.1071/sh05006.
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Background: A recent audit indicated that a substantial proportion of men who have sex with men (MSM) were not screened for rectal gonorrhoea and chlamydia at the Melbourne Sexual Health Clinic, Melbourne, Australia. In response, screening guidelines for MSM were introduced at the clinic using a computer reminder. The aim of this study was to evaluate the impact of the guidelines and alert on screening MSM for gonorrhoea and chlamydia. Methods: The medical records of MSM were reviewed for gonorrhoea and chlamydia screening by site (pharyngeal, urethral and rectal), four months before the implementation of the guidelines and alert (July to October 2002), and one year thereafter (beginning November 2002). Results: After the introduction of the guidelines there was a significant increase in rectal chlamydia testing (55% to 67%, P < 0.001), and significant reduction in pharyngeal chlamydia and gonorrhoea testing (65% to 28%, P < 0.001, and 83% to 76%, P = 0.015 respectively). The proportion of tests that were positive by any site did not change (7% to 7%). Conclusions: The introduction of a computer reminder for new guidelines was temporally associated with screening that conformed more closely to clinical guidelines.
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Cleere, Eoin F., Christopher K. Fairley, Launcelot McGrath, Catriona S. Bradshaw, Marcus Y. Chen, and Eric P. F. Chow. "Sex with a transgender or gender diverse person among patients attending a sexual health centre in Melbourne, Australia." Sexually Transmitted Infections 95, no. 1 (June 27, 2018): 46–52. http://dx.doi.org/10.1136/sextrans-2018-053653.
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ObjectivesAll males and females attending the Melbourne Sexual Health Centre (MSHC) from August 2017 were asked whether they had had sex with a transgender or gender diverse (TGD) person using computer-assisted self-interviewing (CASI). We aimed to verify the self-reported responses via chart review. The secondary aim of this study was to identify whether having sex with a TGD person was associated with STI risk.MethodsThis was a retrospective chart analysis of patients visiting MSHC between August and December 2017. Chart review was performed to verify the self-reported responses. Multivariable logistic regression was performed to examine the association between having sex with a TGD person and patients’ characteristics and STI risk.ResultsOf the 10 100 male and female consultations, the proportion who reported having sex with a TGD person was 111 (1.0%) and was higher among males (1.3%) than females (0.6%) (p=0.001). After chart review, we could verify 66.9% of the responses, more for males (75.2%) than females (45.2%) (p<0.001). Of the 6822 males, men aged ≥35 years (adjusted OR=2.2; 95% CI 1.1 to 4.1) were more likely to have sex with a TGD person compared with men aged ≤24 years, after adjusting for confounding factors. Sex with a TGD person was not associated with sexual orientation in males. Of the 3278 females, gay and bisexual females had 13.7-fold (95% CI 5.1 to 37.0) higher odds of having sex with a TGD person than heterosexual females. There was no association between chlamydia positivity and sex with a TGD person in both males and females.ConclusionWhen a question on TGD partners is asked as part of routine sexual history using CASI, the majority of responses could be verified. TGD partners were most commonly reported among males. These findings underscore the value of asking patients about sex with TGD partners.
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Cornelisse, Vincent J., Christopher K. Fairley, Tiffany Phillips, Sandra Walker, and Eric PF Chow. "Fuckbuddy partnerships among men who have sex with men – a marker of sexually transmitted infection risk." International Journal of STD & AIDS 29, no. 1 (July 6, 2017): 44–50. http://dx.doi.org/10.1177/0956462417717647.
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‘Fuckbuddies’ are a type of regular sexual partner with whom men have ongoing sexual contact, generally in the absence of romantic attachment. We surveyed 989 men who have sex with men (MSM) at the Melbourne Sexual Health Centre, Australia, with the aim of determining the frequency of ‘fuckbuddy’ partnerships among sexual health clinic attendees and assessing their sexual risk. The majority (60%) of 1139 regular partnerships were described as ‘fuckbuddies’. Most MSM (63%) with a ‘fuckbuddy’ had multiple ‘fuckbuddies’. MSM with ‘fuckbuddies’ were more likely to also have casual sexual partners (odds ratio [OR] 5.7; 95% confidence interval 3.6–8.9) and had more casual sexual partners (median of 4 versus 1, p < 0.001) and more rectal chlamydia (12.4% versus 5.7%; adjusted OR 2.3; p < 0.05) than MSM without ‘fuckbuddies’, and this risk persisted after adjusting for total numbers of sexual partners. Our findings suggest that patients with ‘fuckbuddies’ are at particular risk of sexually transmitted infections. We argue that clinicians should specifically ask about ‘fuckbuddy’ partnerships as part of their risk assessment during patient interviews, as these patients may benefit from HIV prevention strategies such as pre-exposure prophylaxis (PrEP).
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Chow, Eric P. F., and Christopher K. Fairley. "Assortative sexual mixing among heterosexuals in Australia: implications for herd protection in males from a female human papillomavirus vaccination program." Sexual Health 13, no. 4 (2016): 395. http://dx.doi.org/10.1071/sh15246.
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The aim was to investigate the assortative sexual mixing by country of birth among heterosexuals in Australia. An analysis of 1060 heterosexual couples who attended the Melbourne Sexual Health Centre between 2011 and 2014 was conducted. Of the 1060 couples, 27% (n = 281) were both Australian-born men and women, and 42% (n = 445) were both overseas-born. Of the 171 couples with women aged ≤21 years, 41% (n = 70) were both born in Australia and 33% (n = 56) were both born overseas. A strong assortative mixing pattern by country of birth was observed among all 1060 couples (r = 0.361; 95% CI: 0.320–0.403), and among 171 couples with women aged ≤21 years (r = 0.481; 95% CI: 0.379–0.584).
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Lee, David M., Christopher K. Fairley, Jun Kit Sze, Tim Kuo, Rosey Cummings, Jade Bilardi, and Marcus Y. Chen. "Access to sexual health advice using an automated, internet-based risk assessment service." Sexual Health 6, no. 1 (2009): 63. http://dx.doi.org/10.1071/sh08046.
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Background: The present study aimed to determine the sexual risk profile of people using an automated, internet-based service that allows internet users to receive recommendations on sexually transmissible infection screening (‘Check your risk’ (CYR), http://www.checkyourrisk.org.au/), and to compare this with that of patients attending the Melbourne Sexual Health Centre (MSHC) for the first time over the same 6-month period: January–June 2006. Methods: The characteristics of those who used CYR and those who attended MSHC were compared using a χ2-test for categorical variables and the Mann–Whitney U-test for non-parametric data. Results: There were 2492 users who accessed CYR and 2735 who attended MSHC over the period. The age of CYR users was similar to that of MSHC patients when compared according to risk groups. The median number of recent sexual partners reported by CYR users was similar to and not significantly lower than that reported by MSHC patients. Of the 309 CYR users who provided a rating for the CYR site, 215 (70%) rated it as being ‘useful’ to ‘very useful’. Conclusions: Individuals who accessed an automated, internet-based sexual risk assessment service were at substantial risk for sexually transmitted infections, similar to those attending a sexual health service.
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Morton, Anna N., Catriona S. Bradshaw, and Christopher K. Fairley. "Changes in the diagnosis and management of bacterial vaginosis following clinical research." Sexual Health 3, no. 3 (2006): 183. http://dx.doi.org/10.1071/sh06024.
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Background: It has become common practice to offer patients attending public sexual health clinics participation in research studies. We investigated the premise that clinician involvement in research leads to improvements in clinical practice within a sexual health service in Melbourne, Australia. Methods: Retrospective case note reviews were conducted of 100 cases of bacterial vaginosis (BV) during three time periods; 2000, 2002 and 2004. The first and second reviews were conducted 2 years before and immediately prior to a cross-sectional study of BV at Melbourne Sexual Health Centre. The third review was conducted immediately after study completion. Diagnostic criteria and treatment for BV were recorded. Clinicians were divided into high and low recruiters, according to the percentage of eligible patients that they recruited into the cross-sectional study. No audited cases were enrolled in the study. Results: Significant improvements in the use of Amsel’s criteria occurred between the second and third audit periods (51 to 65%, P = 0.04) but not between the first and second audits (51% for both, P = 1.0). The improvement was seen in high-recruiting clinicians (P = 0.02) but not low-recruiting clinicians (P = 0.75). Although treatment with 7 days of metronidazole or vaginal clindamycin increased for all clinicians between the first and second audit periods (8 to 18%, P = 0.04), it was greater between the second and third audit periods (18 to 72%, P < 0.01). No difference was observed between high- and low-recruiting clinicians. Conclusion: Introduction of research was temporally associated with improved clinical practice in high-recruiting clinicians only.
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Bradford, David. "Twenty-five years." Sexual Health 2, no. 1 (2005): 39. http://dx.doi.org/10.1071/sh05003.
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Having returned to Australia from the United Kingdom in late 1979, it has been my privilege to witness first-hand the quite dramatic changes in Sexual Health Medicine which have taken place during the final 25 years of my professional life. In this article I give a snapshot of my early experiences at the Melbourne Communicable Diseases Centre, highlighting some of the deficiencies that needed urgent attention. I wish I could say that this picture was an exaggeration to make the article more interesting but unfortunately that is not the case. I also attempt to examine some of the factors that brought about the much-needed improvements, especially the effect human immunodeficiency virus had on sexual health practice. It is impossible to mention all the individuals most involved in initiating change, but I have mentioned a couple of names, only because of close personal knowledge about their contribution.
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Needleman, Robert, Eric P. F. Chow, Janet M. Towns, Vincent J. Cornelisse, Tim Z. T. Yang, Marcus Y. Chen, Catriona S. Bradshaw, Ria Fortune, and Christopher K. Fairley. "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." Sexual Health 15, no. 6 (2018): 528. http://dx.doi.org/10.1071/sh17182.
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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 115522 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.
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Chow, Eric P. F., Lenka A. Vodstrcil, and Christopher K. Fairley. "Seasonal variations in kissing and sexual activities among men who have sex with men in Melbourne, Australia: implications for seasonal sexually transmissible infection preventions and interventions." Sexual Health 17, no. 2 (2020): 149. http://dx.doi.org/10.1071/sh19046.
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Background Previous studies have shown that there is a peak in sexually transmissible infection (STI) cases and sexual activities around summer, but there has been no study examining whether kissing also follows a similar seasonal pattern. The aim of this study was to examine the seasonal patterns of kissing and sex partners among gay, bisexual and other men who have sex with men (MSM). Methods: A short cross-sectional study was conducted among MSM attending the Melbourne Sexual Health Centre between March 2016 and February 2017. Participants were asked to report the number of kissing-only, sex-only and kissing-with-sex male partners in the last 3 months. The mean number of male partners was calculated and stratified by Australia’s seasons. The seasonal trend in the number of partners was assessed by negative binomial regression models. Results: In total, 4391 MSM were included in the analysis. The number of kissing-only and sex-only partners increased significantly from autumn to summer among MSM in Melbourne (Ptrend <0.001). MSM reported the highest number of male partners for kissing-only (mean: 4.91; 95% confidence intervals (CI): 4.78–5.04) and sex-only (mean: 1.91; 95% CI: 1.83–1.99) around summer compared with other seasons. However, the number of kissing-with-sex partners remained stable across seasons. Conclusions: The study data suggest that there is a peak in kissing-only and sex-only partners among MSM around summer and holiday seasons.
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Hughes, Bernadette. "Beyond Sexual Abuse: A Project to Enhance GP's Responses to Victim/Survivors of Sexual Abuse." Australian Journal of Primary Health 4, no. 3 (1998): 197. http://dx.doi.org/10.1071/py98049.
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Research (e.g. Mazza, Dennerstein, & Ryan, 1996) has demonstrated that general practitioners (GPs) are seeing female victims of sexual abuse in their practices but that the majority of victim/survivors do not disclose their trauma history to their GP. Consistent with this, referrals from GPs to the Western Region Centre Against Sexual Abuse (WestCASA) represented a small percentage of total referrals and anecdotal evidence suggested GPs were not adequately skilled to respond confidently to victim/survivors of sexual abuse. In 1997, WestCASA embarked upon a joint project with the Western Melbourne Division of General Practice for the enhancement of GP's awareness and skills in the identification, assessment and management of victim/survivors of sexual abuse, and to improve the networking and referral between WestCASA and GPs. The project resulted in GPs being more aware, skilled and confident in the assessment and continuing care of victim/survivors of sexual abuse with a marked increase in the number of referrals and secondary consultation with GPs. This project is presented as a model of best practice and the paper details the five stages of the project, including the training and relationship building strategies employed. Key factors contributing to the project's success are outlined and it is argued that projects such as this are vital in improving the quality of care provided by GPs, enhancing collaborative work between GPs and specialist, community agencies and improving the overall health and well being of survivors of sexual abuse.
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Chow, Eric P. F., and Christopher K. Fairley. "Association between sexual mixing and genital warts in heterosexual men in Australia: the herd protection from the female human papillomavirus vaccination program." Sexual Health 13, no. 5 (2016): 489. http://dx.doi.org/10.1071/sh16053.
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Australian-born women aged ≤32 years were eligible for the free female human papillomavirus (HPV) vaccination program introduced in 2007. A total of 1165 heterosexual couples attending the Melbourne Sexual Health Centre between 2011 and 2014 were included in this analysis. Findings showed the odds of having penile warts was 0.52-fold lower among men who had a female partner aged ≤32 years compared with men who had a female partners aged >32 years. This suggests men would have received herd protection from their female partners and hence they are at lower risk of acquiring genital warts.
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Bush, Matiu R., Henrietta Williams, and Christopher K. Fairley. "HIV is rare among low-risk heterosexual men and significant potential savings could occur through phone results." Sexual Health 7, no. 4 (2010): 495. http://dx.doi.org/10.1071/sh09088.
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Background: The legislation in Victoria requires HIV-positive results to be given in person by an accredited health professional. Many sexual health clinics require all men to receive HIV results in person. Our aim was to determine the proportion of low-risk heterosexual men at a sexual health centre who tested HIV-positive. Methods: The electronic data on all HIV tests performed between 2002 and 2008 on heterosexual men at the Melbourne Sexual Health Centre (MSHC) was reviewed. The individual client files of all heterosexual men who tested HIV-positive were reviewed to determine their risks for HIV at the time that the HIV test was ordered. Results: Over the 6 years there were 33 681 HIV tests performed on men, of which 17 958 tests were for heterosexual men. From these heterosexual men, nine tested positive for the first time at MSHC (0.05%, 95% confidence interval (CI): 0.01%, 0.09%). These nine cases included six men who had had sex with a female partner from the following countries: Thailand, Cambodia, China, East Timor, Botswana and South Africa. Two men had injected drugs and one had a HIV-positive female partner. Of the 17 958 test results for heterosexual males, 14 902 (83% 95% CI: 84%, 86%) test results were for men who did not have a history of intravenous drug use or had sexual contact overseas. Of these 14 902 low-risk men, none tested positive (0%, 95% CI: 0, 0.00025). Conclusion: Asking the 83% of heterosexual men who have an extremely low risk of HIV to return in person for their results is expensive for sexual health clinics and inconvenient for clients. We have changed our policy to permit heterosexual men without risk factors to obtain their HIV-negative results by phone.
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Chow, Eric PF, Ei T. Aung, Marcus Y. Chen, Catriona S. Bradshaw, and Christopher K. Fairley. "Human papillomavirus vaccination and sexual practices among men who have sex with men in Melbourne, Australia: a cross-sectional study." International Journal of STD & AIDS 31, no. 4 (February 17, 2020): 312–17. http://dx.doi.org/10.1177/0956462419897514.
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The aim of this study was to explore the factors associated with self-reported receipt of human papillomavirus (HPV) vaccine among men who have sex with men (MSM). MSM aged 16–40 years attending the Melbourne Sexual Health Centre, Australia, for their first visit in 2016 were included in the analysis. Multivariable logistic regression analyses were performed to examine the association between self-reported HPV vaccination and sexual practices: one examining the sexual practices. A total of 1332 MSM with a mean age of 27.6 (standard error [SE] = 0.1) were included in the analysis. The mean number of reported male partners in the last 3 and 12 months was 4.0 (SE = 0.1) and 8.9 (SE = 0.4), respectively. Six percent ( n = 81) of MSM reported receiving the HPV vaccine. There was no significant association between sexual practices (the number of partners or condomless anal sex) and self-reported HPV vaccine receipt after adjusting for confounding factors such as human immunodeficiency virus (HIV) status and pre-exposure prophylaxis (PrEP). HIV-negative MSM taking PrEP were three times more likely to be vaccinated against HPV compared with HIV-negative MSM not taking PrEP in both multivariable analyses. Our findings suggest that there is no association between HPV vaccination and sexual risk practices in MSM.
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Bellhouse, Clare, Sandra Walker, Christopher K. Fairley, Eric PF Chow, and Jade E. Bilardi. "Getting the terminology right in sexual health research: the importance of accurately classifying fuck buddies among men who have sex with men." Sexually Transmitted Infections 94, no. 7 (March 29, 2017): 487–89. http://dx.doi.org/10.1136/sextrans-2016-053000.
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ObjectiveThe aim of this report was to raise the issue of the definition and classification of partner terminology in men who have sex with men (MSM) research, particularly in regards to ‘fuck buddies’. If definitions in research differ from general consensus in the MSM population, it is possible that public health strategies will be ineffective as the target population may be inaccurate.MethodsThirty semistructured interviews with MSM attending the Melbourne Sexual Health Centre were conducted, focusing on the willingness to change sexual practices to reduce the risk of pharyngeal gonorrhoea. As part of these interviews, men were also asked their views on the terminology they used to describe their relationships and sexual partners.ResultsThe degree of emotional attachment often defined the type or classification of relationships. There was a consensus among men that partners they engaged with for ‘sex only’ were classified as casual partners and partners with whom there was an emotional attachment or formalisation of the relationship were classified as ‘regular partners’. However, the classification of ‘fuck buddy’ as a regular or casual partner was less clear.ConclusionsFurther research is needed to ascertain the ways in which men conceptualise sexual relationships and define or classify partner types, particularly ‘fuck buddy’ relationships. A third category for sexual relationships should be considered to encapsulate fuck buddy relationships.
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Chow, Eric P. F., and Christopher K. Fairley. "Oro-anal sexual practice among female sex workers in Melbourne: implication for extragenital gonorrhoea and chlamydia transmission." Sexual Health 17, no. 3 (2020): 296. http://dx.doi.org/10.1071/sh19219.
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Background The prevalence of sexually transmissible infections has been low among female sex workers (FSWs) in Melbourne, Australia. However, the prevalence of gonorrhoea and chlamydia, especially at extragenital sites, has increased since the mid-2010s. Oro-anal sex (i.e. rimming) has been identified as a risk factor for extragenital gonorrhoea and chlamydia. However, rimming has rarely been studied among the FSW population. The aim of this study was to examine the proportion of FSWs who had had rimming with their male clients. Methods: A cross-sectional survey among FSWs attending the Melbourne Sexual Health Centre in Australia in March 2018 was conducted. All females aged ≥18 years and self-reported as a sex worker were eligible. The survey included questions related to the number of insertive and receptive rimming partners with their male clients in an average working week. Results: Forty-five FSWs completed the survey; five (11.1%; 95% CI: 3.7–24.1%) FSWs had had insertive rimming and 19 (42.2%; 95% CI: 27.7–57.8%) had had receptive rimming with their male clients in an average working week. The median number of insertive rimming partners was two (interquartile range (IQR) 1–5) and the median number of receptive rimming partners was one (IQR 1–3). Conclusion: Insertive rimming is more commonly practiced than receptive rimming among FSWs with their male clients in an average working week.
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Bellhouse, Clare, Sandra Walker, Christopher K. Fairley, Lenka A. Vodstrcil, Catriona S. Bradshaw, Marcus Y. Chen, and Eric P. F. Chow. "Patterns of sexual behaviour and sexual healthcare needs among transgender individuals in Melbourne, Australia, 2011–2014." Sexually Transmitted Infections 94, no. 3 (September 29, 2016): 212–15. http://dx.doi.org/10.1136/sextrans-2016-052710.
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ObjectiveLiterature surrounding the healthcare needs of transgender individuals is limited in Australia. This study aimed to investigate the demographic characteristics, risk behaviours and HIV/STI positivity among male-to-female (MTF) and female-to-male (FTM) transgender individuals attending Melbourne Sexual Health Centre (MSHC), Australia, between 2011 and 2014.MethodA retrospective cohort analysis for 133 transgender individuals was conducted based on the first visit of individuals to MSHC during the study period. Demographic characteristics, sexual behaviours and HIV/STI positivity were examined.ResultsThe majority of transgender individuals were single or never married (74%; n=99). Almost half of the individuals (47%; n=62) had ever engaged in sex work during their lifetime. The median number of male sexual partners (MSP) reported in the last 3 months was 1 (IQR: 1–2) and with female sexual partners (FSP) was 2 (IQR: 1–4). For those who reported having sexual partners in the previous 3 months, always using condoms with MSP was 31% (n=22), and that with FSP was 18% (n=2). HIV/STI positivity during the study period was 7% (n=8) for chlamydia, 5% (n=6) for gonorrhoea, 5% (n=5) for syphilis and 1% (n=1) for HIV. Hormone use for reassignment was reported by 63% (n=90) of individuals and reassignment surgery was reported by 27% (n=29+6=35).ConclusionsTransgender individuals in this study were found to be a diverse group, with a history of sex work being a common feature. These findings indicate that transgender individuals' sexual healthcare needs differ substantially from those in other countries, including the US and Canada. Attention to differences in MTF and FTM transgender persons must be considered in healthcare settings in Australia.
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Constantinou, Heidi, Christopher K. Fairley, Jane S. Hocking, Catriona S. Bradshaw, Edmond P. H. Choi, Kate Maddaford, Tiffany R. Phillips, and Eric P. F. Chow. "Associations Between Methods of Meeting Sexual Partners and Sexual Practices Among Heterosexuals: Cross-sectional Study in Melbourne, Australia." JMIR Formative Research 5, no. 7 (July 20, 2021): e26202. http://dx.doi.org/10.2196/26202.
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Background The association between meeting partners on the web and sexual practices has been understudied in heterosexuals. Objective This study aims to examine the associations between the methods of meeting partners and sexual practices and HIV and sexually transmitted infections (STIs) in heterosexuals. Methods We conducted a survey among heterosexuals attending the Melbourne Sexual Health Centre in 2019. This survey asked about the methods through which the participants engaged in meeting their sexual partners, sexual practices, and intravenous drug use (IVDU) over the past 3 months. The participants’ HIV and STI (chlamydia, gonorrhea, and syphilis) status was obtained from clinical testing. Multivariable logistic regression was used to examine the association between each method of meeting and the participants’ sexual practices, IVDU, and STI status. Results A total of 698 participants (325 men and 373 women) were included in the study. Most of the participants reported using only one method to meet partners (222/325, 68.3% men; 245/373, 65.7% women; P=.05). The men met partners most commonly at social venues (eg, bar, pub, or party; 126/325, 38.8%), whereas the women met partners most commonly through friends or family (178/373, 47.7%). Paying for sex was associated with men meeting partners at sex venues (adjusted odds ratio [AOR] 145.34, 95% CI 26.13-808.51) and on the internet (AOR 10.00, 95% CI 3.61-27.55). There was no association between IVDU and methods of meeting. Social venues were associated with condomless vaginal sex among men (AOR 3.31, 95% CI 1.94-5.71) and women (AOR 2.58, 95% CI 1.61-4.13) and testing positive for STI among men (AOR 3.04, 95% CI 1.24-7.48) and women (AOR 3.75, 95% CI 1.58-8.89). Conclusions Heterosexuals who met partners at social venues had a more than threefold risk of testing positive for STIs, indicating that heterosexuals may benefit from health promotion campaigns that are delivered through a public setting.
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Cornelisse, Vincent J., Christopher K. Fairley, Sandra Walker, Tameka Young, David Lee, Marcus Y. Chen, Catriona S. Bradshaw, and Eric P. F. Chow. "Adherence to, and acceptability of, Listerine® mouthwash as a potential preventive intervention for pharyngeal gonorrhoea among men who have sex with men in Australia: a longitudinal study." Sexual Health 13, no. 5 (2016): 494. http://dx.doi.org/10.1071/sh16026.
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We investigated whether men who have sex with men (MSM) would use mouthwash daily to prevent pharyngeal gonorrhoea. Ten MSM attending the Melbourne Sexual Health Centre were asked to use a Listerine® alcohol-containing mouthwash daily for 14 days in August 2015. Mouthwash was used at least once daily for 133 of 140 person-days (95% of days; 95% confidence interval 90–98%). All 10 men were willing to use mouthwash on a daily basis, and nine men were willing to use mouthwash after oral sex. This study showed that daily use of mouthwash is an acceptable intervention to prevent pharyngeal gonorrhoea in MSM.
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Chow, Eric PF, Vincent J. Cornelisse, Tim RH Read, Marcus Y. Chen, Catriona S. Bradshaw, and Christopher K. Fairley. "Saliva use in sex: Associations with use of smartphone dating applications in men who have sex with men." International Journal of STD & AIDS 29, no. 4 (August 23, 2017): 362–66. http://dx.doi.org/10.1177/0956462417727669.
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Smartphone dating applications have become a primary source for men who have sex with men (MSM) to meet sexual partners. It has been found that MSM who used smartphone dating applications are at higher risk of gonorrhoea, but the reasons remain unknown. This study aimed to investigate whether MSM who met their partners via smartphone dating applications are more likely to engage in sexual practices such as rimming (oro-anal sex), and use of partner’s saliva as a lubricant, that are associated with the risk of gonorrhoea. A cross-sectional study was conducted among 1672 MSM attending the Melbourne Sexual Health Centre, Australia, between 31 July 2014 and 30 June 2015. Multivariate logistic regression was conducted to examine the associations between sources of meeting partners and the two aforementioned sexual practices. MSM who used smartphone dating applications were 1.78 (95% CI: 1.38–2.28) times more likely to get rimmed, and 1.63 (95% CI: 1.27–2.09) times more likely to use partner’s saliva as a lubricant during anal sex, compared to other sources, after adjusting for age and other sources for meeting partners. These practices are highly associated with gonorrhoea.
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Kong, F., C. Kyle-Link, J. Hocking, and M. Hellard. "11. SEX AND SPORT: A COMMUNITY BASED PROJECT OF CHLAMYDIA TESTING AND TREATMENT IN RURAL AND REGIONAL VICTORIA." Sexual Health 4, no. 4 (2007): 288. http://dx.doi.org/10.1071/shv4n4ab11.
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Chlamydia is the most common notifiable infectious disease in Australia with the number of notifications increasing 92% over the past 5 years. The "Sex and Sport" Project is piloting a community based chlamydia testing and treatment program reaching young people in a specific community setting, sporting clubs. This multifaceted approach utilises health education, population screening and collection of data on risk taking behaviour as the first steps in enhancing health and shaping future service provisions. The project's primary aim is to assess the feasibility of an outreach testing and treatment program. Secondary aims are to measure the prevalence of chlamydia and assess sexual risk behaviour in this population. Strong community collaborations and integration into local health services through the Primary Care Partnerships is important in the project's sustainability; in particular key community members respected by sporting clubs needed to be identified, capacity developed to deliver effective health promotion messages and improve young people's access to sexual health services. Additionally, local knowledge has guided overall program implementation and provides opportunities for capacity building to regionally based services. For example, poor access to sexual health services is being addressed by the participants being able to access services via telephone consultation with Melbourne Sexual Health Centre. Approximately 1000 Victorians aged 16-25 years from the Loddon Mallee region of Victoria will be tested between June and September 2007. This paper will report on the feasibility, challenges and possible solutions in establishing a community based outreach testing and treatment program.
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Lee, Dooyeon, Eric P. F. Chow, Ivette Aguirre, Christopher K. Fairley, and Jason J. Ong. "Access to HIV Antiretroviral Therapy among People Living with HIV in Melbourne during the COVID-19 Pandemic." International Journal of Environmental Research and Public Health 18, no. 23 (December 3, 2021): 12765. http://dx.doi.org/10.3390/ijerph182312765.
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The social measures taken to control the COVID-19 pandemic can potentially disrupt the management of HIV. The objective of this study was to examine the impact of the Australian COVID-19 lockdown restrictions on access to antiretroviral therapy (ART) for people living with HIV in Melbourne. Using data from the Melbourne Sexual Health Centre (MSHC), we assessed the changes in rates of ART postal delivery, controlled viral load, and ART dispensing from 2018 to 2020. The percentage of ART delivered by postage from the MSHC pharmacy was calculated weekly. The percentage of people living with HIV with a controlled viral load (≤200 copies/mL) was calculated monthly. We calculated a yearly Medication Possession Ratio (MPR). The average percentage of HIV ART dispensed through postage for the years 2018, 2019, and 2020 was 3.7% (371/10,023), 3.6% (380/10,685), and 14% (1478/10,765), respectively (Ptrend < 0.0001). Of the 3115 people living with HIV, the average MPR for 2018, 2019, and 2020 was 1.05, 1.06, and 1.14, respectively (Ptrend = 0.28). The average percentage of people with an HIV viral load of <200 copies/mL for the years 2018, 2019, and 2020 was 97.6% (2271/2327), 98.0% (2390/2438), and 99.2% (2048/2064), respectively (Ptrend < 0.0001). This study found that the proportion of controlled viral load and access to ART of people living with HIV in Melbourne was largely unaffected by the COVID-19 lockdown restrictions. This suggests that some of the services provided by the MSHC during the pandemic, such as HIV ART postal delivery, may assist long-term HIV management.
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Chambers, Sarah. "Standing Together: A Cross-Cultural Approach to Working with Victim/Survivors of Sexual Assault." Australian Journal of Primary Health 4, no. 3 (1998): 192. http://dx.doi.org/10.1071/py98048.
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The Western Region Centre Against Sexual Assault (WestCASA) is located in a culturally rich and diverse Melbourne community. As a small agency, with limited resources, we wondered how we could respond to the often silent and unmet needs of victim/survivors of sexual assault from non-English speaking backgrounds (NESB) communities. The Cultural Equity Program (CEP), based on principles of respect and empowerment, strongly advocates a collaborative approach and also recognises the importance of identifying structural, organisational and individual barriers preventing NESB victim/survivors from accessing support and/or counselling. Vietnamese and Filipino workers were invited to be cultural consultants to WestCASA and met regularly during 1996/1997. These meetings enabled the exchange of cultural knowledge/expertise and an opportunity to discuss sensitive cultural issues. Together we also developed a culturally and linguistically respectful community education and training strategy. WestCASA also introduced initiatives for developing a more culturally sensitive practice. The paper presents the CEP as a model of best practice. The ideas and concepts are outlined which have guided us in the design of the developmental framework. We also reflect on our learning which has been rich and inspiring, and comment on the implications for Women's Health Policy.
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Powell, S. "20. SEXUAL HEALTH SERVICES & HIV PREVENTION: IMPROVING INTERVENTION OPPORTUNITIES." Sexual Health 4, no. 4 (2007): 292. http://dx.doi.org/10.1071/shv4n4ab20.
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Objective: This descriptive study was undertaken to determine the presence of key indicators which might alert clinicians that a Melbourne Sexual Health Centre (MSHC) client is at increased risk of HIV acquisition and, if so, lead to recommendations for changes to clinical practice. Method: We identified and reviewed the most recent medical files of clients who received an HIV positive diagnosis and who had also received a negative result at MSHC within the preceding two years (n�=�20). Quantitative epidemiological and demographic data were collected and analyzed using SPSS software. Qualitative data analysis of annotated entries both pre and post HIV diagnosis included transcription and examination for emergent themes. Results: Quantitative data analysis revealed the following; all 20 clients were male and identified MSM behaviour. Median age at diagnosis was 34.5 years (95% CI�:�28.3-37.6 years). The median number of partners in the 3 months preceding HIV diagnosis was 4 (95% CI�:�3.4-9.6; p�=�0.005) and in the preceding 12 months 23 (95% CI�:�11.4-61.4; p�<�0.05). 85% of men reported inconsistent condom use, and one reported no anal sex in the preceding 12 months. None reported a history of IDU and three men reported sex overseas in the preceding 12 months. Qualitative analysis revealed some emergent themes which included histories of mental illness, drug and alcohol use, childhood abuse, HIV serodiscordant relationships and confusion surrounding sexual orientation. Discussion: Clinicians have an obligation to assist clients, within their scope of practice, to remain HIV negative. Results from this study have implications for the method of identification of clients at risk and also for the utilization of intervention opportunities which impact on risk behaviour. The challenge for MSHC is to adapt our practice in order to maximize these opportunities.
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Phillips, Tiffany R., Heidi Constantinou, Christopher K. Fairley, Catriona S. Bradshaw, Kate Maddaford, Marcus Y. Chen, Jane S. Hocking, and Eric P. F. Chow. "Oral, Vaginal and Anal Sexual Practices among Heterosexual Males and Females Attending a Sexual Health Clinic: A Cross-Sectional Survey in Melbourne, Australia." International Journal of Environmental Research and Public Health 18, no. 23 (December 1, 2021): 12668. http://dx.doi.org/10.3390/ijerph182312668.
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Sex practices among heterosexuals are not well studied. We aimed to explore sexual practices among heterosexuals attending a sexual health clinic. This cross-sectional survey was conducted at Melbourne Sexual Health Centre between March and April 2019. Data were collected on kissing, oral sex (fellatio or cunnilingus), vaginal sex, anal sex and rimming in the previous 3 months. Univariable and multivariable logistic regression analyses were performed to examine the associations between engaging in anal sex and other sex practices. There were 709 participants (333 men; 376 women) who were eligible and completed the survey (response rate was 24.6%). In the past 3 months, most participants had had vaginal sex (n = 677; 95.5%), with a mean of 3.0 (standard deviation (SD): 3.9) vaginal sex partners, and half reported engaging in condomless vaginal sex in the past 3 months (n = 358; 50.1%). A total of 135 (19.0%) participants had had anal sex, with a mean of 1.3 (SD: 1.0) anal sex partners, with 63.5% (n = 94) engaging in any condomless anal sex in the past 3 months. Most participants (n = 637, 89.8%) had received oral sex in the past 3 months; this proportion did not differ by age group or gender. Women (n = 351, 93.4%) were more likely to perform oral sex than men (n = 275; 82.6% men) (p < 0.001) and to have received rimming (26.6% women vs. 12.6% men; p < 0.001). Men were more likely to have performed rimming (25.5% men vs. 9.3% women; p < 0.001). After adjusting for age, number of partners and sexual practice, anal sex was associated with being ≥35 years (adjusted odds ratio (aOR): 2.3; 95% CI: 1.2–4.2), receiving rimming (aOR: 3.8; 95% CI: 2.4–6.0) and performing rimming (aOR: 2.8; 95% CI: 1.8–4.6). Rimming and anal sex are practiced by one-fifth or more of heterosexuals. Older heterosexuals were more likely to engage in anal sex and to perform rimming. Future research should consider the benefits of testing extragenital sites where appropriate.
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Phillips, Tiffany R., Christopher K. Fairley, Marcus Y. Chen, Catriona S. Bradshaw, and Eric P. F. Chow. "Risk factors for urethral gonorrhoea infection among heterosexual males in Melbourne, Australia: 2007–17." Sexual Health 16, no. 5 (2019): 508. http://dx.doi.org/10.1071/sh19027.
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Background Since 2014 there has been an increase in gonorrhoea among heterosexuals in Australia. Sex with a partner from a country with high gonorrhoea prevalence has been identified as a risk factor for gonorrhoea in heterosexual females, but risk factors for heterosexual males remain unclear. This study determined risk factors for gonorrhoea among heterosexual males. Methods: Retrospective analysis was performed among heterosexual males attending Melbourne Sexual Health Centre (MSHC) between 1 January 2007 and 31 December 2017. Countries for overseas sexual partners were stratified as high-prevalence countries (HPC) or low-prevalence countries (LPC) based on the incidence of gonorrhoea. Results: The annual gonorrhoea positivity increased from 0.72% in 2007 to 1.33% in 2017 (Ptrend <0.001). Males attending MSHC as a contact of gonorrhoea had the highest odds of testing positive (adjusted odds ratio (aOR) 7.46; 95% confidence interval (CI) 4.46–12.49), followed by males identifying as Aboriginal and Torres Strait Islander (aOR 2.57; 95% CI 1.30–5.09), males who had injected drugs in the past 12 months (aOR 2.44; 95% CI 1.39–4.30) and males who had sex with a female from an HPC (aOR 2.18; 95% CI 1.77–2.68). Males aged ≥35 were at higher risk than those aged ≤24 years (aOR 1.44; 95% CI 1.14–1.82). Gonorrhoea positivity increased among males who had sex with females from an LPC (from 0.60% to 1.33%; Ptrend = 0.004) but remained the same over time among males who had sex with females from an HPC (2.14%; Ptrend = 0.143). Conclusions: There was an 80% increase in urethral gonorrhoea among heterosexual males between 2007 and 2017. Having sex with a female from an HPC is a significant risk factor for gonorrhoea. Gonorrhoea positivity among men having sex with a female from an HPC did not change over time, suggesting this risk factor has become less important.
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Chow, Eric PF, Jason J. Ong, Lenka A. Vodstrcil, and Christopher K. Fairley. "Drug use and the influence on kissing among men who have sex with men in Melbourne, Australia." International Journal of STD & AIDS 31, no. 1 (December 2, 2019): 16–21. http://dx.doi.org/10.1177/0956462419878338.
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The use of drugs is not uncommon among gay, bisexual and other men who have sex with men (MSM). Kissing has been recently identified as a risk factor for gonorrhoea. This study aimed to examine the proportion of MSM who used drugs and how specific drugs influence the likelihood of kissing. We conducted a cross-sectional survey among MSM attending the Melbourne Sexual Health Centre between March 2016 and February 2017. Participants reported their use of eleven specific drugs in the last three months and whether they felt the drug influenced them to kiss someone. Four thousand, three hundred and ninety-one MSM were included in the analysis; 63.1% ( n = 2772) used at least one drug in the last three months and 36.6% ( n = 1605) used ≥2 drugs. Poppers (44.8%), marijuana (30.8%) and ecstasy (19.1%) were the three most common drugs used among MSM in the last three months. 80.4% of ecstasy users and 74.3% of gammahydroxybutyrate users reported the drug made them much more likely to kiss someone. The majority of MSM reported that the use of heroin (63.6%) and Viagra/Cialis (60.7%) did not influence their kissing behaviour. Drug use is common among sexually active MSM in Melbourne. Most reported the use of ecstasy would increase their likelihood of kissing someone.
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Cornelisse, Vincent J., David Priest, Christopher K. Fairley, Sandra Walker, Catriona S. Bradshaw, Tiffany Phillips, and Eric PF Chow. "The frequency of kissing as part of sexual activity differs depending on how men meet their male casual sexual partners." International Journal of STD & AIDS 29, no. 6 (December 19, 2017): 598–602. http://dx.doi.org/10.1177/0956462417748717.
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Previous studies have shown that men who have sex with men (MSM) who use smartphone dating applications (apps) are at higher risk of gonorrhoea, but not HIV. We have hypothesised that kissing may be a risk factor for oropharyngeal gonorrhoea. We measured differences in kissing practices among MSM who use different methods to find male casual sexual partners (CSPs). If MSM who use apps kiss more CSPs, then this may help to explain why these men are at increased risk of gonorrhoea but not HIV. This was a cross-sectional questionnaire-based study of MSM attending Melbourne Sexual Health Centre, Australia, between March and September 2015. We measured differences in kissing practices among MSM who use different methods to find male casual sexual partners (CSPs). The questionnaire included questions about numbers of CSPs, numbers of CSPs kissed, and how men found CSPs. We surveyed 753 MSM with a median age of 29 years (interquartile range 25–36). Six hundred and one men (79.8%) reported using apps to find CSPs in the last three months. Users of apps had a higher number of CSPs than non-users (5.0 vs. 3.2; p < 0.001). Users of apps kissed a higher number (4.6 vs. 2.2; p < 0.001), and a higher proportion (90.4% vs. 71.0%; p < 0.001) of CSPs compared to non-users. We are currently investigating whether kissing is a significant mode of transmission of gonorrhoea, and if this proves correct then this study suggests that users of apps would particularly benefit from health promotion that addresses this mode of transmission.
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Charleson, Finley J., Christopher K. Fairley, Jane S. Hocking, Lenka A. Vodstrcil, Catriona S. Bradshaw, and Eric P. F. Chow. "Age, ethnic and travel-related disparities in kissing and sexual practices among heterosexual men in Melbourne, Australia." Sexual Health 17, no. 3 (2020): 279. http://dx.doi.org/10.1071/sh19230.
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Background The kissing practices of heterosexual men are not well understood, despite the potential of kissing to be a significant risk factor for gonorrhoea transmission. This study aimed to explore kissing and sex practices among heterosexual men. Methods: A cross-sectional survey among heterosexual men attending the Melbourne Sexual Health Centre in 2016–2017 was conducted. Men were asked to report their number of kissing-only (in the absence of sex), sex-only (in the absence of kissing) and kissing-with-sex partners in the last 3 months. The mean number of each partner type was calculated, and multivariable negative binomial regression was used to investigate associations between the number of different types of partners and demographic characteristics. Results: Of the 2351 heterosexual men, men reported a mean of 2.98 kissing-only, 0.54 sex-only and 2.64 kissing-with-sex partners in the last 3 months. Younger men had a mean higher number of kissing-only partners than older men (4.52 partners among men aged ≤24 years compared with 1.75 partners among men ≥35 years, P < 0.001). Men born in Europe had the most kissing-only partners (mean: 5.16 partners) and men born in Asia had the fewest kissing-only partners (mean: 1.61 partners). Men recently arrived in Australia, including travellers from overseas, had significantly more kissing-only partners (adjusted incidence rate ratio (aIRR): 1.53; 95% CI: 1.31–1.80) than local men. Conclusions: This study provides novel data about kissing practices of heterosexual men. Studies assessing oropharyngeal gonorrhoea should include measurements of kissing until studies can clarify its contribution to transmission risk.
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Chow, Eric P. F., Tim R. H. Read, Matthew G. Law, Marcus Y. Chen, Catriona S. Bradshaw, and Christopher K. Fairley. "Assortative sexual mixing patterns in male–female and male–male partnerships in Melbourne, Australia: implications for HIV and sexually transmissible infection transmission." Sexual Health 13, no. 5 (2016): 451. http://dx.doi.org/10.1071/sh16055.
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Background: Assortative mixing patterns have become a new and important focus in HIV/sexually transmissible infection (STI) research in recent years. There are very limited data on sexual mixing patterns, particularly in an Australian population. Methods: Male–female and male–male partnerships attending the Melbourne Sexual Health Centre (MSHC) between 2011 and 2014 were included. Correlation of age between two individuals within a partnership was examined by using Spearman’s rank correlation. The Newman’s assortativity coefficient was used as an aggregate quantitative measurement of sexual mixing for number of partners and condom use. Results: 1165 male–female and 610 male–male partnerships were included in the analysis. There was a strong positive correlation of age in both male–female (rho = 0.709; P < 0.001) and male–male partnerships (rho = 0.553; P < 0.001). The assortative mixing pattern for number of partners was similar in male–female (r = 0.255; 95% CI: 0.221–0.289) and male–male partnerships (r = 0.264; 95% CI: 0.218–0.309). There was a stronger assortative mixing pattern for condom use in male–male (r = 0.517, 95% CI: 0.465–0.569) compared with male–female (r = 0.382; 95% CI: 0.353–0.412) partnerships. Conclusion: Male–female and male–male partnerships have a high assortativity mixing pattern for age, number of partners and condom use. The sexual mixing pattern is not purely assortative, and hence it may lead to increased HIV and STI transmission in certain risk groups.
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McGrath, Launcelot, Christopher K. Fairley, Eoin F. Cleere, Catriona S. Bradshaw, Marcus Y. Chen, and Eric P. F. Chow. "Human papillomavirus vaccine uptake among young gay and bisexual men who have sex with men with a time-limited targeted vaccination programme through sexual health clinics in Melbourne in 2017." Sexually Transmitted Infections 95, no. 3 (November 8, 2018): 181–86. http://dx.doi.org/10.1136/sextrans-2018-053619.
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ObjectiveIn mid-2017, the Victorian Government funded a free time-limited human papillomavirus (HPV) vaccination catch-up programme for gay and bisexual men who have sex with men (MSM) aged up to 26 years through sexual health clinics or other immunisation centres. We aimed to examine the uptake of the HPV vaccine among young MSM attending the Melbourne Sexual Health Centre (MSHC).MethodsMSM aged ≤26 attending MSHC between 27 April 2017 and 31 December 2017 were included in the analysis. HPV vaccine uptake was calculated based on the first consultation of each patient during the period. Multivariable logistic regression was performed to examine the association between vaccine uptake and patient factors.ResultsThere were 2108 MSM aged ≤26 who attended MSHC over the study period, with 7.6% (n=161) reporting previous HPV vaccination. Of the 1947 eligible men, 1134 (58.2%, 95% CI 56.0% to 60.4%) were offered the vaccine by the clinicians, and 830 men received it on the day. The vaccine coverage among all eligible MSM was 42.6% (95% CI 40.4% to 44.9%; 830 of 1947) and among MSM who were offered the vaccine by the clinicians was 73.2% (95% CI 70.5% to 75.8%; 830 of 1134). Men with a history of genital warts (adjusted OR (aOR)=3.11, 95%CI 1.39 to 6.99) and those who had >4male partners in the last 12 months (aOR=1.38, 95% CI 1.04 to 1.85) were more likely to receive the HPV vaccine on the day. 304 men declined the vaccine; most men did not specify the reason (31.3%, n=95), while 27.3% (n=83) needed time to think.ConclusionAlthough vaccine uptake was 73.2% among those offered, the actual coverage of those eligible remained unsatisfactory (42.6%) in a sexual health clinic. This highlights a clinic-based targeted MSM programme may not reach sufficiently high vaccine coverage to provide MSM with the same vaccine benefits as heterosexuals.
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Constantinou, Heidi, Christopher K. Fairley, Catriona S. Bradshaw, Edmond P. H. Choi, Kate Maddaford, Tiffany R. Phillips, and Eric P. F. Chow. "Factors associated with group sex in heterosexual males and females attending a sexual health clinic in Melbourne, Australia: a cross-sectional survey." Sexual Health 19, no. 1 (March 16, 2022): 39–45. http://dx.doi.org/10.1071/sh21224.
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Background There have been limited studies of group sex among heterosexual individuals. This study aimed to explore the factors associated with group sex among heterosexual males and females to improve risk assessment guidelines and inform sexually transmitted infection (STI) screening requirements. Methods A cross-sectional survey was conducted among heterosexual males and females aged ≥16 years attending the Melbourne Sexual Health Centre between March and April 2019. The survey asked about group sex participation, methods used to meet sexual partners, number of casual and/or regular partners, and injection drug use (IDU) in the previous 3 months. HIV and STI (chlamydia, gonorrhoea, syphilis) diagnoses were extracted. A multivariable logistic regression was conducted to identify the factors associated with group sex participation. Results A total of 698 participants (325 males, 373 females) were included and 4.7% (33/698) had participated in group sex in the previous 3 months. The proportion who participated in group sex increased with age (2.1% in 16–24 years, 5.5% in 25–34 years, 7.8% in ≥35 years, ptrend = 0.010). Meeting partners at sex venues (e.g. brothels) was associated with the highest odds of participating in group sex (aOR = 5.74, 95% CI: 1.20–27.44), followed by dating apps (aOR = 2.99, 95% CI: 1.36–6.58), friends/family (aOR = 2.99, 95% CI: 1.34–6.69) and social venues (e.g. bar) (aOR = 2.73, 95% CI: 1.18–6.30). Group sex was strongly associated with STI positivity (aOR = 6.24, 95% CI: 2.41–16.13). There was no association between group sex and sex, casual and/or regular partners, HIV positivity or IDU. Conclusion Heterosexual individuals participating in group sex had a six-fold risk of testing positive for STIs. Including group sex in a sexual history is useful to determine STI risk and inform testing practices. Safe sex messages on group sex that are delivered through multiple methods (e.g. at sex venues, social venues and dating apps simultaneously) would be beneficial.
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Chow, Eric P. F., John B. Carlin, Tim R. H. Read, Marcus Y. Chen, Catriona S. Bradshaw, Jun K. Sze, and Christopher K. Fairley. "Factors associated with declining to report the number of sexual partners using computer-assisted self-interviewing: a cross-sectional study among individuals attending a sexual health centre in Melbourne, Australia." Sexual Health 15, no. 4 (2018): 350. http://dx.doi.org/10.1071/sh18024.
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Background The number of sexual partners is one of the most important risk factors for sexually transmissible infections (STIs), including HIV. The aim of the present study was to examine the association between declining to report the number of partners using computer-assisted self-interviewing (CASI) and HIV or STI positivity at a public sexual health centre in Melbourne, Australia, in 2016. Methods: Individuals were categorised into three risk populations: women, men who have sex with women only (MSW) and men who have sex with men (MSM). Logistic regression analysis was used to examine the association between declining to report the number of sexual partners in the past 12 months and HIV or STI positivity for women and MSW, with generalised estimating equations (GEE) used for estimation in MSM to address repeated-measures within individuals. Results: In all, 18085 individuals (5579 women, 6013 MSW, 6493 MSM) were included in the final analysis. There was no association between chlamydia positivity and declining to respond among women and MSW. MSM who declined to respond were more likely to be chlamydia positive (adjusted odds ratio1.21; 95% confidence interval (CI) 1.01–1.43). Known HIV-positive MSM and MSM newly diagnosed with HIV had 3.31-fold (95% CI 2.48–4.42) and 2.82-fold (95% CI 1.84–4.32) greater odds respectively of declining to respond compared with HIV-negative MSM. Gonorrhoea and syphilis positivity in MSM were not associated with declining to respond. Conclusions: There was no association between declining to report the number of partners and chlamydia positivity among women and MSW. However, MSM who declined to report the number of partners were slightly more likely to have chlamydia and substantially more likely to be HIV positive.
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Martín-Sánchez, Mario, Christopher K. Fairley, Catriona S. Bradshaw, Marcus Y. Chen, and Eric P. F. Chow. "Meningococcal vaccine uptake among men who have sex with men in response to an invasive meningococcal C disease outbreak in Melbourne, Australia." Sexually Transmitted Infections 96, no. 4 (January 9, 2020): 246–50. http://dx.doi.org/10.1136/sextrans-2019-054318.
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ObjectiveIn 2017, there was an outbreak of invasive meningococcal disease (IMD) serogroup C among men who have sex with men (MSM) in Victoria, Australia. A government-funded free meningococcal (MenACWY) vaccination programme targeting all MSM living in Victoria was launched between December 2017 and December 2018. The aim of this study was to examine the vaccine uptake among MSM attending a sexual health clinic in Melbourne.MethodsThis was a retrospective clinical audit of MSM attending the Melbourne Sexual Health Centre (MSHC) during the vaccination programme. We calculated the proportion of MSM who received the meningococcal vaccine on their first visit and at any time during the programme. We performed univariable and multivariable logistic regression to identify the factors associated with the vaccine uptake on the first visit.ResultsOf the 10 370 MSM who attended MSHC, 55.5% received the vaccine on their first visit and 67.4% at any time during the programme. MSM had higher odds of receiving the vaccine on the first visit if they were aged 16–25 years (adjusted OR (aOR) 1.21; 95% CI 1.08 to 1.35) or 26–35 years (aOR 1.17; 95% CI 1.07 to 1.29) in comparison with MSM older than 35 years; were HIV-negative and not on pre-exposure prophylaxis (aOR 1.80; 95% CI 1.56 to 2.09); had more than four male partners in the last 12 months (aOR 1.16; 95% CI 1.06 to 1.27); had male partners only (aOR 2.24; 95% CI 1.96 to 2.55); or were born overseas (aOR 1.11; 95% CI 1.03 to 1.21).ConclusionsTwo-thirds of the MSM attending a sexual health clinic received at least one dose of meningococcal vaccine. The vaccination programme coincided temporally with a dramatic reduction in the incidence of IMD. Vaccination should be further promoted among MSM and men who have sex with both men and women.
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Lin, An-Chieh, Christopher K. Fairley, Krishneel Dutt, Karen M. Klassen, Marcus Y. Chen, Glenda Fehler, Matthew Law, et al. "Testing for HIV among men who have sex with men needs a paradigm shift in Australia, given the minimal increase between 2003 and 2013 in Melbourne, Australia." Sexual Health 12, no. 5 (2015): 373. http://dx.doi.org/10.1071/sh14167.
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Background Increasing the frequency of HIV testing in men who have sex with men (MSM) will reduce the incidence of HIV. Trends in HIV testing among MSM in Melbourne, Australia over the last 11 years have been investigated. Methods: A retrospective study was conducted using electronic medical records of the first presentation of MSM who attended the Melbourne Sexual Health Centre between 2003 and 2013. Factors associated with HIV testing (year, demographic characteristics and sexual practices) were examined in multivariable logistic regression analyses. Jonckheere–Terpstra tests were used to examine the significance of trends in the mean time since the last HIV test. Results: Of 17 578 MSM seen; 13 489 attended for the first time during the study period. The proportion of first attendances who had previously tested and reported a HIV test in the last 12 months increased from 43.6% in 2003 to 56.9% in 2013 (adjusted ptrend = 0.030), with a corresponding decrease in median time since the last HIV test from 19 months [interquartile range (IQR) 6–42] in 2003 to 10 months (IQR4–24) in 2013 (ptrend <0.001). The proportion of high-risk MSM (who reported unprotected anal intercourse and/or >20 partners in 12 months) who reported an HIV test in the last 12 months was unchanged (ptrend = 0.242). Conclusions: Despite HIV testing becoming more frequent, the magnitude of change over the last decade is insufficient to substantially reduce HIV incidence. A paradigm shift is required to remove barriers to testing through strategies such as point-of-care rapid testing or access to testing without seeing a clinician.
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Tang, Haiping, Jane S. Hocking, Glenda Fehler, Hennriette Williams, Marcus Y. Chen, and Christopher K. Fairley. "The prevalence of sexually transmissible infections among female sex workers from countries with low and high prevalences in Melbourne." Sexual Health 10, no. 2 (2013): 142. http://dx.doi.org/10.1071/sh12114.
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Objectives To assess the proportion of female sex workers (FSWs) from low-prevalence (‘other’) and high-prevalence countries (HPCs) for sexually transmissible infections (STIs) in Melbourne. Methods: Retrospective data analysis from the Melbourne Sexual Health Centre database for February 2002–May 2011. Results: Some 1702 HPC FSWs, 2594 other FSWs and 13 644 nonFSW women were included, with 12 891 and 21 611 consultations, respectively, for HPC FSWs and other FSWs. Proportions of HPC FSWs with chlamydia (Chlamydia trachomatis) (4.2% v. 3.3%, P = 0.14), gonorrhoea (Neisseria gonorrhoeae) (0.24% v. 0.31%, P = 0.66) or trichomonas (0.65 v. 0.46, P = 0.42) at first visit were similar to those of other FSWs, but nonFSWs had a higher prevalence of chlamydia and gonorrhoea (P < 0.01). On return visits, chlamydia (1.2% v. 0.92%, P < 0.05) and gonorrhoea (0.29% v. 0.10%, P = <0.05) were more common in HPC FSWs than other FSWs. The presence of any of these STIs among FSWs was predicted by having private nonpaying partners in the last year (adjusted odds ratio (AOR): 1.99 (95% confidence interval (CI): 1.52–2.61)), having private partners from overseas (AOR: 1.69 (95% CI: 1.33–2.16)) and being a HPC FSW (AOR: 1.38 (95% CI: 1.12–1.72)). Injecting drug use was less common in HPC FSWs than in other FSWs (0.82% v. 16.54%, P < 0.0001). Conclusions: STI prevalence was low among FSWs from countries with high and low background STI. Among FSWs having private sex partners and private partners from overseas were the primary predictors for STIs.
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Kong, Fabian Y. S., Jane S. Hocking, Chris Kyle Link, Marcus Y. Chen, and Margaret E. Hellard. "Sex and sport: sexual risk behaviour in young people in rural and regional Victoria." Sexual Health 7, no. 2 (2010): 205. http://dx.doi.org/10.1071/sh09071.
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Background: To determine the prevalence of chlamydia and understand sexual risk behaviour in 16–29 year olds in rural Victoria through a chlamydia testing program undertaken at local sporting clubs. Methods: Young people were recruited from the Loddon Mallee region of Victoria, Australia between May and September 2007. After a night of sporting practice, participants provided a first pass urine sample and completed a brief questionnaire about sexual risk behaviour. Those positive for chlamydia were managed by telephone consultation with a practitioner from Melbourne Sexual Health Centre. Results: A total of 709 young people participated (77% male, 23% female) in the study; 77% were sexually active. Overall chlamydia prevalence in sexually active participants was 5.1% (95% confidence interval [CI]: 3.4–7.3); 7.4% in females (95% CI: 3.5–13.6) and 4.5% in males (95% CI: 2.7–6.9). Approximately 60% of males and 20% of females consumed alcohol at high ‘Risky Single Occasion Drinking’ levels at least weekly and 60% had used an illicit drug in their lifetime. Nearly 45% reported having sex in the past year when they usually wouldn’t have because they were too drunk or high. Sexually transmissible infection (STI) knowledge was generally poor and only 25% used a condom the last time they had sex. Conclusion: Chlamydia prevalence was high in our study population. Many participants had poor knowledge about STIs and low condom use. These findings combined with high levels of risky alcohol use and having sex while intoxicated highlights the need for programs in rural and regional Victoria that combine both STI testing and prevention and education programs.
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Lee, D. M., C. K. Fairley, J. Kit Sze, T. Kuo, R. Cummings, J. Bilardi, and M. Y. Chen. "18. INCREASING ACCESS TO SEXUAL HEALTH ADVICE FOR HIGH RISK INDIVIDUALS THROUGH AN AUTOMATED, INTERNET BASED SERVICE." Sexual Health 4, no. 4 (2007): 291. http://dx.doi.org/10.1071/shv4n4ab18.
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Objective: It may be difficult for young people to know if they need testing for sexually transmitted infections and some primary care physicians may be unsure about what tests to order for patients with different risk profiles. Our aim was to help overcome these barriers by implementing an automated, internet based service that allowed internet users to receive specific recommendations for STI screening based on their online responses to a series of questions relating to their recent sexual practices ('Check Your Risk' (CYR), available at: www.mshc.org.au). This study evaluated this service and compared the risk profile of individuals using CYR with that of patients attending a sexual health centre in the same city over the same time period. Methods: An automated and individualised web based algorithm was developed using current recommendations for STI testing. The characteristics of individuals visiting CYR were compared to those attending the Melbourne Sexual Health Centre (MSHC) for the first time over the same 6 month period, from January to June 2006. Results: There were 2492 (59% men, 41% women) who visited the CYR online service and 2735 (59% men, 41% women) who attended the MSHC over the period. 513 (22%) of the men visiting CYR and 467 (18%) of the men visiting MSHC reported sex with other men, with a median of 6 (SD 26.4) and 6 (SD 29.4) partners in the previous 12 months respectively (p�=�0.9). 43 (1.8%) of the women visiting CYR and 54 (2.1%) of the women visiting MSHC reported sex with other women, with a median of 1 (SD 9.3) and 1 (SD 2.1) partners in the previous 12 months respectively (p�=�0.5). Among men reporting sex with women only, the median number of female sex partners in the preceding 12 months was 2 (SD 10.6) and 3 (SD 5.8) for those visiting CYR and MSHC respectively (p�=�0.8). For women reporting sex with men only, the median number of male partners was 2 (SD 11.1) and 2 (SD 4) for those visiting CYR and MSHC respectively (p�=�0.03). Participants responded favourably to the CYR online service, with 70% rating it as 'useful'; or 'very useful'. Conclusions: This internet based sexual risk assessment tool was accessed frequently by individuals with a high risk profile that was similar to those who attended the sexual health service in the same city. The CYR service cost A$4000 to set up. CYR effectively increased the outreach of the centre's services substantially, via the internet and was given a positive rating by the majority of its users.
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Phillips, Tiffany R., Nicholas Medland, Eric P. F. Chow, Kate Maddaford, Rebecca Wigan, Christopher K. Fairley, Jason J. Ong, and Jade E. Bilardi. "“Moving from one environment to another, it doesn’t automatically change everything”. Exploring the transnational experience of Asian-born gay and bisexual men who have sex with men newly arrived in Australia." PLOS ONE 15, no. 11 (November 20, 2020): e0242788. http://dx.doi.org/10.1371/journal.pone.0242788.
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Asian-born gay, bisexual and other men who have sex with men (gbMSM) who are newly arrived in Australia are at a higher risk of acquiring HIV than Australian-born gbMSM. We used a social constructionist framework to explore HIV knowledge and prevention strategies used by newly-arrived Asian-born gbMSM. Twenty four Asian-born gbMSM, aged 20–34 years, attending Melbourne Sexual Health Centre, who arrived in Australia in the preceding five years, participated in semi-structured, face-to-face interviews. Interviews were recorded, transcribed verbatim and analysed thematically. Participants described hiding their sexual identities in their country of origin, particularly from family members, due to fear of judgement and discrimination resulting from exposure to sexual identity and HIV related stigma in their countries of origin, although some were open to friends. Despite feeling more sexual freedom and acceptance in Australia, many were still not forthcoming with their sexual identity due to internalised feelings of stigma and shame. Exposure to stigma in their country of origin led many to report anxiety around HIV testing in Australia due to a fear of testing positive. Some described experiencing racism and lack of acceptance in the gay community in Australia, particularly on dating apps. Fear of discrimination and judgement about their sexual identity can have a significant impact on Asian-born gbMSM living in Australia, particularly in terms of social connectedness. Additionally, HIV-related stigma can contribute to anxieties around HIV testing. Our data highlights the potential discrimination Asian-born gbMSM face in Australia, which has implications for social connectedness, particularly with regard to LGBTQI communities and HIV testing practices. Future studies should determine effective strategies to reduce sexual identity and HIV-related stigma in newly-arrived Asian-born gbMSM.
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Marrone, J., C. K. Fairley, M. Saville, C. Bradshaw, F. J. Bowden, B. Donovan, and J. S. Hocking. "31. WHY HAS TRICHOMONAS VAGINALIS DECLINED DRAMATICALLY AMONG VICTORIAN WOMEN (1947-2005)?" Sexual Health 4, no. 4 (2007): 296. http://dx.doi.org/10.1071/shv4n4ab31.
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Trichomonas vaginalis (TV) diagnosis rates have decreased considerably in some countries during the last two decades. It is unclear why TV has decreased only in some countries. This study investigated the relationships between: 1) TV diagnosis rates among women attending the Melbourne Sexual Health Centre (MSHC), and among Pap smears screened by Victorian Cytology Services (VCS); 2) the use of nitroimidazoles in Australia and; 3) gonorrhoea notification data for Victoria to assess changes in sexual behaviour. TV diagnosis rates among women attending MSHC rose from under 5% in the 1940's, to 20% to 30% in the 1960's and then declined 5% to 10% during the 1970's. From 1980 onwards, TV diagnosis rates fell progressively to below 1% by 1991, with 0.1% in 2004. A similar pattern was seen in TV at VCS, but with lower absolute percentages. Metronidazole was introduced into Australia in 1961 and tinidazole in 1976 and by 1987 there were 400 000 nitroimidazole prescriptions per year. Pap smear screening in Victoria began in 1965, only including 20% of women per year (aged 15 to 69) by the mid 1980's. Post 1980's, screening rose until 2000, stabilising at 35% of women per year. Gonorrhoea notification rates peaked during times TV was experiencing its greatest falls. The initial decline of TV seen in Victoria was associated with the introduction of effective antibiotics. The further decline to less than 1% was seen when Pap smear screening participation increased during the 1990's.
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CHOW, E. P. F., K. DUTT, G. FEHLER, I. DENHAM, M. Y. CHEN, C. BATROUNEY, J. PEEL, T. R. H. READ, C. S. BRADSHAW, and C. K. FAIRLEY. "Duration of syphilis symptoms at presentations in men who have sex with men in Australia: are current public health campaigns effective?" Epidemiology and Infection 144, no. 1 (June 1, 2015): 113–22. http://dx.doi.org/10.1017/s0950268815001168.
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SUMMARYThe rapid rise in syphilis cases has prompted a number of public health campaigns to assist men who have sex with men (MSM) recognize and present early with symptoms. This study aimed to investigate the temporal trend of the duration of self-report symptoms and titre of rapid plasma reagin (RPR) in MSM with infectious syphilis. Seven hundred and sixty-one syphilis cases in MSM diagnosed at the Melbourne Sexual Health Centre (MSHC) from 2007–2013 were reviewed. Median duration of symptoms and RPR titres in each year were calculated. The median durations of symptoms with primary and secondary syphilis were 9 [interquartile range (IQR) 6–14] days and 14 (IQR 7–30) days, respectively. The overall median titre of RPR in secondary syphilis (median 128, IQR 64–256) was higher than in primary syphilis (median 4, IQR 1–32) and in early latent syphilis (median 32, IQR 4–64). The median duration of symptoms for primary syphilis, secondary syphilis and titre of RPR level did not change over time. Public health campaigns were not associated with a significant shorter time from onset of symptoms to treatment. Alternative strategies such as more frequent testing of MSM should be promoted to control the syphilis epidemic in Australia.
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Vodstrcil, Lenka A., Christopher K. Fairley, Deborah A. Williamson, Catriona S. Bradshaw, Marcus Y. Chen, and Eric P. F. Chow. "Immunity to hepatitis A among men who have sex with men attending a large sexual health clinic in Melbourne, Australia, 2012–2018." Sexually Transmitted Infections 96, no. 4 (March 13, 2020): 265–70. http://dx.doi.org/10.1136/sextrans-2019-054327.
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BackgroundOutbreaks of hepatitis A are being reported more commonly among men who have sex with men (MSM) globally. Australia has also reported a sharp increase in the number of cases of hepatitis A in 2017. This study aimed to determine the level of immunity to hepatitis A among MSM attending a large urban sexual health clinic in Victoria in the lead up to recent outbreak.MethodsThis was a retrospective audit of serological testing data from first-time MSM attendees at Melbourne Sexual Health Centre (MSHC) in Australia from 1 January 2012 to 31 December 2018. We determined the proportion of MSM who were tested and who had serological detection of hepatitis A IgG, stratified by age and calendar year. We used univariable and multivariable logistic regression to investigate factors associated with testing for and detection of hepatitis A IgG.ResultsThere were 16 609 first-time MSM attendees at MSHC over the 7-year period, of which 9718 (59%, 95% CI 58% to 60%) were tested for hepatitis A IgG. There was a 2% annual increase in the proportion of men tested (from 60% in 2012 to 69% in 2018; OR=1.02, 95% CI 1.00 to 1.03, p=0.025). Men born outside of Australia/New Zealand, and younger men <30 years had higher odds of being tested. Of those tested, 44% (n=4304, 95% CI 43% to 45%) had hepatitis A IgG detected at their first visit, with no change over time (OR=1.01, 95% CI 0.99 to 1.03, p=0.210). Detection of hepatitis A IgG was associated with being aged 30 years or older (adjusted OR=2.06, 95% CI 1.89 to 2.24, p<0.001) or being born overseas versus Australia/New Zealand (AOR=1.21, 95% CI 1.11 to 1.31, p<0.001).ConclusionHepatitis A immunity among MSM remains below the estimated 70% required to prevent outbreaks. Measures including increased testing and higher vaccination coverage are needed to prevent outbreaks and to limit the number of cases and deaths.
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CHOW, E. P. F., A. C. LIN, T. R. H. READ, C. S. BRADSHAW, M. Y. CHEN, and C. K. FAIRLEY. "Ratio of anogenital warts between different anatomical sites in homosexual and heterosexual individuals in Australia, 2002–2013: implications for susceptibility of different anatomical sites to genital warts." Epidemiology and Infection 143, no. 7 (August 19, 2014): 1495–99. http://dx.doi.org/10.1017/s0950268814002118.
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SUMMARYThere is little known regarding the transmissibility of human papillomavirus (HPV) between different sites in men who have sex with men (MSM) and heterosexual individuals. We conducted a retrospective analysis investigating all new patients attending the Melbourne Sexual Health Centre in Australia between 2002 and 2013. We describe the prevalence and ratio of the first episode of anogenital warts in MSM and heterosexual males and females. The proportion of new MSM clients with anal and penile warts was 4·0% (362/8978) and 1·6% (141/8978), respectively; which gave an anal-to-penile wart ratio of 1:2·6. About 13·7% (1656/12112) of heterosexual males had penile warts and 10·0% (1121/11166) of females had vulval warts, which yielded a penile-to-vulval wart ratio of 1:0·7. Penile–anal transmission has a higher ratio than penile–vulval transmission, suggesting that the anal epithelium may be more susceptible to HPV infection than the vulval epithelium in females; these ratios are important in modelling the control of HPV in MSM.