Inequities in PrEP use according to Medicare status in a publicly funded sexual health clinic; a retrospective analysis.

New HIV diagnoses continue to disproportionately affect overseas-born men who have sex with men (MSM). A retrospective study of all pre-exposure prophylaxis (PrEP)-eligible MSM attending Sydney Sexual Health Centre for the first time in 2021 analysed self-reported PrEP-use, PrEP prescribed at the initial consult, and PrEP taken during 2021 using binomial logistic regression models. A total of 1367 clients were included in the analysis, 716 (52.

Understanding the health care needs of transgender and gender diverse people engaging with rural Australian sexual health centres: a qualitative interview study.

Background: Although there is a presumption that LGBTQ+ people living in rural Australia will have poorer health outcomes than those living in metropolitan areas, minimal research has focused specifically on the perspectives of transgender and gender diverse (henceforth referred to as 'trans') people living in these regions. The purpose of this study was to understand what health and wellbeing means to trans people in a regional or rural community and identify their health needs and experiences.

Methods: A total of 21 trans people were recruited through two regional sexual health centres (SHC) and interviewed between April and August 2021.

Chlamydia home sampling in the real world: a cross-sectional analysis.

Background: Retesting rates for chlamydia in Australia are low. Chlamydia home sampling has been shown to increase retesting rates. Sydney Sexual Health Centre introduced chlamydia home sampling in 2019.

Non-empirical management of asymptomatic chlamydia and gonorrhoea reduces unnecessary antibiotic use fivefold: a before and after study.

Objectives: In 2019, informed by favourable patient and provider acceptability surveys and concerns about antimicrobial resistance, Sydney Sexual Health Centre stopped routinely providing empirical antibiotic treatment to asymptomatic contacts of (chlamydia) and (gonorrhoea). We aimed to assess if this policy change had any negative impact on patient outcomes.

Methods: A retrospective file review of people who presented as asymptomatic contacts of chlamydia and gonorrhoea cases before and after the policy change was conducted.

Comparing HIV Post-Exposure Prophylaxis, Testing, and New Diagnoses in Two Australian Cities with Different Lockdown Measures during the COVID-19 Pandemic.

Australia introduced a national lockdown on 22 March 2020 in response to the COVID-19 pandemic. Melbourne, but not Sydney, had a second COVID-19 lockdown between July and October 2020. We compared the number of HIV post-exposure prophylaxis (PEP) prescriptions, HIV tests, and new HIV diagnoses during these lockdown periods.

A survey of condom use among female sex workers in Northern Sydney; declining condom use for fellatio.

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.

Ask Dr Google: what STI do I have?

Objectives: Between 2013 and 2014, a third of Australian adults reported using the internet to investigate medical symptoms before consulting a medical practitioner. However, there is limited evidence regarding internet health information seeking behaviour (HISB) in sexual health. This study aims to determine the frequency, predictors and accuracy of internet HISB for sexual health self-diagnosis.

Characteristics of clients newly diagnosed with HIV in central Sydney in 2016-17: a retrospective audit comparing a community-based testing site and a clinical sexual health service.

In New South Wales (NSW), Australia, innovative community-based testing models have been implemented to increase HIV testing among populations at risk. The characteristics of patients newly diagnosed with HIV at a community-based testing site and at a traditional clinical service in Sydney, NSW, were compared. Compared with the clinical service, clients diagnosed at the community-based site were more likely to be diagnosed at their first visit and report no prior HIV test.

Neisseria gonorrhoeae positivity in clients presenting as asymptomatic contacts of gonorrhoea at a sexual health centre.

Unlabelled: Background Previous guidelines at the Sydney Sexual Health Centre (SSHC) recommended empirical antibiotic treatment for asymptomatic contacts of Neisseria gonorrhoeae at the time of testing. With increasing concerns around gonorrhoea antibiotic resistance, it has been suggested that asymptomatic contacts should only be treated based on test results.

Methods: This retrospective study of data from the SSHC electronic medical record included a total of 295 gonorrhoea contacts from 1 January 2018 to 30 June 2018.

Predictors of Daily Adherence to HIV Pre-exposure Prophylaxis in Gay/Bisexual Men in the PRELUDE Demonstration Project.

Adequate adherence to pre-exposure prophylaxis (PrEP) is critical to prevent HIV infection, but accurately measuring adherence remains challenging. We compared two biological [blood drug concentrations in plasma and peripheral blood mononuclear cells (PBMC)] and two self-reported measures (facilitated recall to clinicians and self-report in online surveys) and identified predictors of daily PrEP adherence among gay and bisexual men (GBM) in their first 12 months on PRELUDE, an open-label, single-arm PrEP demonstration project in New South Wales, Australia. 327 participants were enrolled; 263 GBM attended their 12-month follow-up visit (81% retention).

Cross-sectional survey of Chinese-speaking and Thai-speaking female sex workers in Sydney, Australia: factors associated with consistent condom use.

Unlabelled: Background Previous studies have described inconsistent condom use in Chinese- and Thai-speaking female sex workers in Sydney, Australia. In the present study, we describe the demographics and safe sexual practices in the Chinese- and Thai-speaking female sex workers attending the Sydney Sexual Health Centre (SSHC) in 2014-15.

Methods: A self-completed 60-item anonymous questionnaire, adapted from previous surveys conducted in 1993 and 2003, was translated into Chinese and Thai and administered to female sex workers attending the SSHC or seen on outreach.

Baseline Preferences for Daily, Event-Driven, or Periodic HIV Pre-Exposure Prophylaxis among Gay and Bisexual Men in the Demonstration Project.

Introduction: The effectiveness of daily pre-exposure prophylaxis (PrEP) is well established. However, there has been increasing interest in non-daily dosing schedules among gay and bisexual men (GBM). This paper explores preferences for PrEP dosing schedules among GBM at baseline in the demonstration project.

Validation of participant eligibility for pre-exposure prophylaxis: Baseline data from the PRELUDE demonstration project.

Background: In Australia, pre-exposure prophylaxis (PrEP) is targeted to individuals at high risk for HIV infection. We describe the HIV risk profile and characteristics of PRELUDE participants, and evaluate the population validity of the sample in representing high-risk gay and bisexual men (GBM) eligible for PrEP.

Methods: PRELUDE is an on-going, open-label, single-arm observational study.

Dolutegravir with tenofovir disoproxil fumarate-emtricitabine as HIV postexposure prophylaxis in gay and bisexual men.

Objectives: Completion rates for HIV postexposure prophylaxis (PEP) are often low. We investigated the adherence and safety of dolutegravir (DTG; 50 mg daily) with tenofovir disoproxil fumarate-emtricitabine (TDF-FTC; 300/200 mg, respectively) as three-drug PEP in gay and bisexual men.

Design: Open-label, single-arm study at three sexual health clinics and two emergency departments in Australia.

Does Living Outside of a Major City Impact on the Timeliness of Chlamydia Treatment? A Multicenter Cross-Sectional Analysis.

Background: Timely treatment of Chlamydia trachomatis infection reduces complications and onward transmission. We assessed client, process, and clinic factors associated with treatment delays at sexual health clinics in New South Wales, Australia.

Methods: A retrospective review of 450 consecutive clients with positive chlamydia results (not treated at the time of the consultation) was undertaken at 6 clinics (1 urban, 3 regional, and 2 remote) from October 2013.

Single-Tablet Emtricitabine-Rilpivirine-Tenofovir as HIV Postexposure Prophylaxis in Men Who Have Sex With Men.

Background: Completion rates for human immunodeficiency virus (HIV) postexposure prophylaxis (PEP) are low. We investigated the adherence and safety of coformulated emtricitabine (FTC), rilpivirine (RPV), and tenofovir disoproxil fumarate (TDF) as a 3-drug, single-tablet regimen for PEP in men who have sex with men (MSM).

Methods: In an open-label, single-arm study at 2 public sexual health clinics and 2 hospital emergency departments in urban Australia, 100 HIV-uninfected MSM requiring 3-drug PEP received single-tablet FTC-RPV-TDF once daily for 28 days.

Positivity at test of cure following first-line treatment for genital Mycoplasma genitalium: follow-up of a clinical cohort.

Objectives: To describe antibiotic use for treatment of Mycoplasma genitalium (MG) at an urban sexual health centre in Australia. To describe MG positivity rates in those returning for 1 month test of cure (TOC) following first-line antibiotic treatment for MG.

Methods: Retrospective cross-sectional case-note review for all patients diagnosed with MG at Sydney Sexual Health Centre from 2009 to 2013.

Screening of HIV-infected patients for non-AIDS-related morbidity: an evidence-based model of practice.

Objective: To develop guidelines to facilitate management of HIV infection as a chronic disease within the setting of a sexual health or other HIV outpatient clinic.

Methods: We undertook a literature search to identify published guidelines and expert panel commentaries on screening and managing non-AIDS comorbidities in the general and HIV-infected population. We developed evidence-based guidelines for screening and management of non-AIDS comorbidities in HIV-positive clients attending the Sydney Sexual Health Centre (SSHC) that could be used in other HIV outpatient settings.

Downregulation of Fas gene expression in Sézary syndrome is associated with promoter hypermethylation.

Sézary Syndrome (SS) is an aggressive leukemic variant of primary cutaneous T-cell lymphoma characterized by the presence of tumor or Sézary cells that generally display a mature memory T-cell immunophenotype. Sézary cells proliferate poorly and therefore their accumulation may be due to defective T-cell homeostasis involving resistance to apoptosis. In this study, we analyzed Fas expression in CD4+ lymphocytes at the mRNA and protein levels in a large cohort of SS patients as compared with healthy controls.