Publications by authors named "Hamish Mcmanus"

Article Synopsis
  • Australia struggles to effectively monitor the HIV epidemic due to insufficient population data, prompting this study to use incidence prevalence ratios (IPRs) to assess the epidemic trends among specific groups: men who have sex with men, women, and people who inject drugs.
  • The study employed mathematical modeling to create IPRs from various data sources, comparing them against benchmarks based on life expectancy after HIV acquisition, illuminating trends from 2015 to 2022.
  • The findings showed a significant decline in IPRs across all groups, with overall rates dropping by 80%, and many groups surpassing benchmarks, indicating a positive trend in managing HIV transmission in Australia.
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Article Synopsis
  • The study analyzed the effectiveness of subsidised HIV pre-exposure prophylaxis (PrEP) in Australia from April 2018 to March 2023, focusing on HIV incidence among users over a 5-year period.
  • A total of 66,206 people were included in the study, with an overall HIV incidence rate of 1.07 per 1000 person-years, indicating that higher adherence to PrEP substantially reduced the risk of HIV acquisition.
  • Key factors influencing HIV acquisition included previous treatment for hepatitis C, younger age (18-29), and attending prescribers in areas with lower prevalence of gay men.
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Objectives: To estimate notification rates for infectious syphilis in women of reproductive age and congenital syphilis in Australia.

Study Design: Retrospective cohort study; analysis of national infectious syphilis and enhanced congenital syphilis surveillance data.

Setting, Participants: Women aged 15-44 years diagnosed with infectious syphilis, and babies with congenital syphilis, Australia, 2011-2021.

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Article Synopsis
  • In Australia, a controversial blood donation policy prevents men who have had sex with other men in the past 3 months from donating, which many criticize as discriminatory and rather simplistic.
  • A recent study of 5,178 survey participants revealed that only 40.2% of gay, bisexual, and other men who have sex with men (GBM) were eligible to donate blood under current rules, while a potential new criterion could increase this number to 73.6%.
  • The study indicates that there is a significant lack of awareness among GBM regarding the 3-month deferral period, highlighting the need for better education on blood donation criteria to increase participation.
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Background And Objectives: Until 25 July 2022, people who spent more than 6 months in the United Kingdom during the variant Creutzfeldt-Jakob disease (vCJD) risk period 1980-1996 (UK donors) were deferred from blood donation in Australia. Regulatory approval to remove the deferral was underpinned by published mathematical modelling predicting negligible vCJD transmission risk increase with a gain of 58,000 donations.

Materials And Methods: The donor questionnaire retained the UK deferral screening question until a version update effective 12 February 2023, which enabled identification of the newly eligible cohort of UK donors.

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Background: Reliable estimates of the population proportion eligible to donate blood are needed by blood collection agencies to model the likely impact of changes in eligibility criteria and inform targeted population-level education, recruitment, and retention strategies. In Australia, the sole estimate was calculated 10+ years ago. With several subsequent changes to the eligibility criteria, an updated estimate is required.

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HIV self-testing allows people to collect samples and test themselves at home, addressing known barriers to facility-based testing. We aimed to measure the uptake of home HIV testing among Australian gay and bisexual men (GBM). Using national cross-sectional data from the Australian Gay Community Periodic Surveys, we assessed trends in home HIV testing among non-HIV positive GBM between 2018 and 2020.

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Background: Although HIV treatment-as-prevention reduces individual-level HIV transmission, population-level effects are unclear. We aimed to investigate whether treatment-as-prevention could achieve population-level reductions in HIV incidence among gay, bisexual, and other men who have sex with men (GBM) in Australia's most populous states, New South Wales and Victoria.

Methods: TAIPAN was a longitudinal cohort study using routine health record data extracted from 69 health services that provide HIV diagnosis and care to GBM in New South Wales and Victoria, Australia.

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Purpose: Following a national population-based trachoma survey in Malawi one round of azithromycin mass drug administration (MDA) was carried out, with a post-MDA impact survey showing TF prevalence below 5% and considered eliminated as a public health problem. However, active trachoma was still present in over 200 children. We assessed whether water, sanitation, and hygiene (WASH) factors were associated with ongoing presence of TF in children aged 1-9 years following MDA.

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Article Synopsis
  • The study aimed to investigate changes in syphilis positivity rates among women and heterosexual men in major Australian cities from 2011 to 2019, focusing on various health determinants.
  • A total of 88,562 first tests were analyzed, revealing that the syphilis positivity rate increased for both groups over the years, with 0.34% of women and 0.66% of men testing positive.
  • Socio-economic disadvantage, Indigenous status, and recent injection drug use significantly contributed to higher positivity rates, while bisexual women and those engaged in recent sex work showed lower rates compared to heterosexual women.
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  • Tenofovir disoproxil fumarate (TDF), used for HIV treatment, is linked to kidney issues, but data on its impact during pre-exposure prophylaxis (PrEP) is limited.
  • A study across 52 Australian clinics from 2009-2019 found that patients on PrEP experienced significantly lower rates of renal impairment (0.7%) compared to those living with HIV (4.1%).
  • Factors like older age and lower baseline kidney function increased the risk of renal issues, but even after adjusting for these factors, PrEP users still had a lower risk of renal impairment than those prescribed TDF for HIV.
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Introduction: HIV pre-exposure prophylaxis (PrEP) has been government subsidized in Australia since April 2018 and while uptake is high among men who have sex with men, rates of discontinuation are also high. The aims of this study were to examine the impact of discontinuation on overall PrEP usage, the proportion of PrEP users who discontinue and the predictors of discontinuation.

Methods: We used linked de-identified dispensing records of all government subsidized PrEP in Australia between April 2018 and September 2021: a whole-of-population data set.

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Aims: The 2016 Global Health Sector Strategy (GHSS) on viral hepatitis aims to reduce new hepatitis C virus (HCV) infections by 80% by 2030, including a 30% reduction by 2020. This study aimed to estimate primary HCV incident infection among a national sample of people who inject drugs (PWID) before and after the introduction of unrestricted access to HCV direct-acting antiviral (DAA) therapy via Australia's Pharmaceutical Benefits Scheme in 2016.

Design: A simple deterministic linkage method identified repeat respondents in serial cross-sectional surveys conducted among PWID.

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Introduction: COVID-19 related lockdowns have impacted the sexual activity of gay and bisexual men (GBM). We investigated trends in sexual behaviors and the COVID-19 context in which they occurred (COVID-notification rates and jurisdictional restrictions) to understand changes in the duration and severity of periods of lockdown on the sexual behavior of Australian GBM.

Methods: In an online, prospective observational study of 831 GBM from May 2020 to May 2021, we investigated associations between changes in sexual behavior among Australian GBM, lockdowns, and COVID-19 notification rates through weekly surveys from May 2020 to May 2021.

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Background: Although data from large implementation trials suggest that sexually transmissible infection (STI) risk increases among gay and bisexual men who initiate HIV pre-exposure prophylaxis (PrEP), there are few data on the trends in population-level STI incidence in the years following widespread PrEP implementation. We aimed to describe trends in bacterial STI incidence among gay and bisexual men using PrEP across Australia in the context of broad PrEP availability through Australia's subsidised medicines scheme.

Methods: We analysed linked clinical data from HIV-negative gay and bisexual men aged 16 years or older who had been prescribed PrEP across a sentinel surveillance clinical network, including 37 clinics in Australia, between Jan 1, 2016, and Dec 31, 2019.

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Background And Objectives: Most of the 233 worldwide cases of variant Creutzfeldt-Jakob disease (vCJD) have been reported in the United Kingdom and 3 have been associated with transfusion-transmission. To mitigate the potential vCJD risk to blood safety, Australian Red Cross Lifeblood imposes restrictions on blood donation from people with prior residency in, or extended travel to, the United Kingdom during the risk period 1980-1996. We have modified a previously published methodology to estimate the transfusion-transmission risk of vCJD associated with fresh component transfusion in Australia if the UK residence deferral was removed.

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Article Synopsis
  • This study investigates trends in hepatitis C virus (HCV) incidence among primary care patients over time to assess public health strategies for HCV elimination.
  • Researchers analyzed data from 6711 patients, identifying 210 new HCV infections and calculating an overall incidence rate of 1.1 per 100 person-years, with higher rates in patients prescribed opioid-related pharmacotherapy.
  • The findings indicate a decline in HCV incidence from 2009 to 2020, suggesting improvements in public health efforts, particularly with increased access to direct-acting antiviral (DAA) therapy.
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Background: Previous WHO guidance on tenofovir disoproxil fumarate-based oral pre-exposure prophylaxis (PrEP) suggests measuring creatinine levels at PrEP initiation and regularly afterwards, which might represent barriers to PrEP implementation and uptake. We aimed to systematically review published literature on kidney toxicity among tenofovir disoproxil fumarate-based oral PrEP users and conducted an individual participant data meta-analysis (IPDMA) on kidney function among PrEP users in a global implementation project dataset.

Methods: In this systematic review and meta-analysis we searched PubMed up to June 30, 2021, for randomised controlled trials (RCTs) or cohort studies that reported on graded kidney-related adverse events among oral PrEP users (tenofovir disoproxil fumarate-based PrEP alone or in combination with emtricitabine or lamivudine).

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Objective: Aboriginal women living in remote Australia experience a high burden of both chlamydia and gonorrhoea infections and disproportionately high rates of pelvic inflammatory disease (PID). We estimated for the first time the fraction of PID attributable to these infections in young Aboriginal women living in these settings.

Methods: Using published data from two large Australian studies (2002-2013; 2010-2014), we calculated the fraction of emergency department presentations and hospitalisations for PID attributable to chlamydia and/or gonorrhoea infection in Aboriginal women aged 16-29 years living in remote Australia.

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Article Synopsis
  • Australia has seen significant declines in genital warts diagnoses due to the success of its HPV vaccination programs, especially among young individuals.
  • A study analyzing data from 34 sexual health clinics between 2004 and 2018 found a 64% overall decrease in genital warts cases, with a notable 72% decline among Australian-born patients.
  • The decline is less pronounced but still significant among overseas-born patients, particularly those from countries without robust HPV vaccination initiatives.
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Condom use among female sex workers (FSWs) is dynamic. We conducted a survey, by anonymous questionnaire, of condom use among FSWs routinely attending our clinical service in Northern Sydney. Logistic regression models determined associations with inconsistent condom use.

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Article Synopsis
  • - The study analyzed the HIV care cascade in Australia, focusing on the time it takes for gay and bisexual men (GBM) to move through key stages of care, including diagnosis, starting treatment, and achieving viral suppression.
  • - Researchers used data from 2196 GBM newly diagnosed with HIV from 2012 to 2019 and found that the time to link to care and start treatment has significantly improved over the years.
  • - By the end of the study period, the likelihood of starting antiretroviral therapy within 90 days of linking to care rose dramatically, and the chances of achieving viral suppression soon after starting treatment also increased.
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