Publications by authors named "Traeger M"
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.
Background: Reversing declining rates of people initiating and completing hepatitis C (HCV) treatment, observed in many countries, is needed to achieve global HCV elimination goals. Providing financial incentives to increase HCV testing and treatment uptake among people at-risk of or living with HCV infection could be an effective intervention. We conducted a systematic review to assess evidence regarding the effectiveness of financial incentives to improve engagement and progression through the HCV care cascade.
View Article and Find Full Text PDFBackground: Gay and bisexual men (GBM) remain overrepresented among syphilis diagnoses in Australia and globally. The extent to which changes in sexual networks associated with HIV pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) may have influenced syphilis transmission among GBM at the population-level is poorly understood. We describe trends in syphilis testing and incidence among GBM in Australia over eleven years spanning widespread uptake of HIV PrEP and TasP.
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- Doxycycline used as postexposure prophylaxis (doxyPEP) can significantly lower the risk of bacterial STIs if taken within 72 hours after sex, yet knowledge and usage among at-risk populations remain unclear.!* -
- An online survey of 903 mainly gay and bisexual men revealed that while nearly half were aware of antibiotic use for STI prevention and most expressed interest, only about 21% had actually used it, with doxycycline being the most common choice.!* -
- Many users deviated from recommended dosages, and most reported unchanged condom use during prophylaxis, highlighting a need for better education on effective STI preventative measures among sexually active individuals.!*
Objective: Guidelines recommend annual hepatitis C virus (HCV) testing for gay and bisexual men (GBM) with HIV and GBM prescribed HIV pre-exposure prophylaxis (PrEP). However, there is a limited understanding of HCV testing among GBM. We aimed to examine trends in HCV testing and positivity from 2016 to 2022.
View Article and Find Full Text PDFBackground: In Australia, the incidence of hepatitis C virus (HCV) has declined among gay and bisexual men (GBM) with human immunodeficiency virus (HIV) since 2015 and is low among GBM using HIV preexposure prophylaxis (PrEP). However, ongoing HCV testing and treatment remains necessary to sustain this. To assess the potential utility of sexually transmissible infections (STIs) to inform HCV testing among GBM with HIV and GBM using PrEP, we examined the association between bacterial STI diagnoses and subsequent primary HCV infection.
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- - The World Health Organization aims to eradicate viral hepatitis by 2030, and this study evaluates how effective community pharmacies are in testing and treating hepatitis B and C.
- - The research involved analyzing 27 studies, revealing that injected drug use was the most common risk factor identified, with a 16.6% positive antibody rate for hepatitis C among participants tested.
- - The study found that targeting high-risk groups for testing significantly increased positive outcomes (32.5%) compared to non-targeted approaches (4.0%), while attendance for pre-treatment assessments was notably higher in pharmacies (92.7%) versus other venues (53.5%).
Article Synopsis
- - The study examined hepatitis C virus (HCV) reinfection rates among gay and bisexual men (GBM) with HIV in Australia from 2016 to 2020, amidst concerns about the impact of reinfection on HCV micro-elimination efforts.
- - Data were collected from 39 clinics, revealing that out of 12,213 GBM with HIV, 540 were eligible for reinfection analysis, with 38 (7%) showing evidence of reinfection during the study period, resulting in a reinfection rate of 3.4 cases per 100 person-years.
- - The results indicated a 30% average annual decline in HCV reinfection incidence since the introduction of government-funded direct-acting antiviral
HIV prevention programs typically focus on changing individuals' risk behaviors, often without considering the socioecological factors that can moderate this risk. We characterized HIV risk among men who have sex with men (MSM) in Indonesia (n = 1314) using latent class analysis and used multinomial logistic regression to identify latent class relationships with demographics, social/sexual networks, and community-level socioecological indicators of HIV risk. Three HIV risk latent classes were identified-"Sexually Moderate" (n = 333), "Sexual Explorative" (n = 575), and "Navigating Complexities" (n = 406).
View Article and Find Full Text PDFIntroduction: HIV preexposure prophylaxis (PrEP) is highly effective at preventing HIV. We aimed to assess mental and physical health among long-term PrEP users in Australia's X-PLORE cohort.
Methods: In early 2021, 1485 X-PLORE participants were emailed a survey covering demographics, sexual practices, ongoing PrEP use, physical and psychological diagnoses received since commencing PrEP, substance use, and impacts of the COVID-19 pandemic.
Article Synopsis
- * It found a significant decrease in "frequent comprehensive testing" among HIV-negative GBM using PrEP, dropping from 71.7% in 2017 to 58.6% in 2021, with similar declines in non-PrEP users and HIV-positive participants.
- * The research suggests many GBM are not adhering to Australian STI testing guidelines of quarterly testing, prompting a call for further evaluation of the guidelines' relevance and necessity.
Article Synopsis
- The systematic review examines how different testing frequencies for hepatitis C virus (HCV) reinfection among key populations can impact detection and prevention of ongoing transmission.
- It analyzed data from 41 studies, finding an overall HCV reinfection rate of 4.13 per 100 person-years, with men who have sex with men (MSM) experiencing the highest rates.
- Results suggest that shorter testing intervals (≤6 months) may lead to higher detection rates of reinfections, emphasizing the need for more frequent testing to help in HCV elimination efforts.
Article Synopsis
- Doxycycline post-exposure prophylaxis (doxyPEP) is shown to effectively reduce STIs in individuals with HIV and those using PrEP, although there's concern over the broad increase in antibiotic use.
- A study analyzed electronic health records from a health center servicing gay and bisexual men, transgender women, and non-binary individuals, evaluating various doxyPEP prescribing strategies over five years.
- Results indicated that the most effective strategies focus on STI history rather than HIV status or PrEP use, potentially averting a significant number of STI diagnoses by tailoring doxyPEP prescriptions based on previous infections.
Article Synopsis
- Gay and bisexual men taking HIV PrEP are at a higher risk for sexually transmitted infections, but the risk of Hepatitis C (HCV) among these users has not been well defined.
- A systematic review and meta-analysis of studies found the HCV prevalence among PrEP users is relatively low, with the baseline prevalence of HCV antibodies at 0.97% and HCV RNA at 0.38%.
- Incidence rates of HCV were generally higher in studies conducted before the widespread availability of direct-acting antiviral therapy, indicating that local healthcare resources and timing can significantly impact infection rates.
Article Synopsis
- Benefits of pre-exposure prophylaxis (PrEP) include not just HIV risk reduction, but also improved emotional and social well-being reported by users, such as reduced anxiety and increased intimacy.
- * Clinicians need to provide comprehensive discussions about both the risks and benefits of PrEP, incorporating users' personal and relational experiences.
- * Training programs and guidelines for healthcare providers should be adapted to include community input and user-reported outcomes, emphasizing the need to prioritize the values and experiences of potential PrEP users, especially marginalized populations.
Article Synopsis
- Direct-acting antivirals (DAAs) are primarily approved for chronic HCV, creating a challenge for treating recently acquired HCV due to limited access to these treatments.
- A systematic review analyzed data from various studies on immediate DAA treatment in high-risk populations, finding a remarkable 95.9% success rate in achieving sustained virological response (SVR12).
- Results indicated that immediate treatment resulted in high cure rates and few serious adverse events, suggesting that early intervention for recently acquired HCV is beneficial and safe.
Background: Penile curvature is the most debilitating symptom of Peyronie's disease (PD); the evaluation of the degree of angulation is essential for planning treatment strategy. However, the most used method of penile at-home autophotography (AHP) is associated with some potential pitfalls and discrepancies compared with different assessment methods.
Objective: To compare the degree of penile curvature quantified by AHP and in-office intracavernosal alprostadil injection (ICI) prior to therapy.
Background: Rocky Mountain spotted fever (RMSF) is a deadly tickborne disease disproportionately affecting Arizona tribal communities. While the acute clinical effects of RMSF are well-documented, more complete understanding of the long-term health consequences is needed to provide guidance for providers and patients in highly impacted areas.
Methods: We performed a retrospective review of hospitalized RMSF cases from 2 tribal communities in Arizona during 2002-2017.
Article Synopsis
- In 2020, Victoria experienced extensive COVID-19 lockdowns, significantly impacting the testing for hepatitis C among people who inject drugs (PWID).
- Data from 11 specialized services showed a notable decrease in weekly antibody and RNA testing after both lockdowns, with drops of 31% and 46% after the first lockdown and 26% and 33% after the second.
- The missed testing opportunities during these lockdowns pose a challenge for Australia in meeting hepatitis C elimination targets, potentially delaying the identification and treatment of affected individuals in the PWID community.
Identifying groups most at risk of sexually transmissible infections (STIs) is important for prioritising screening, targeting prevention strategies and alleviating the burden of STIs. However, identifying those at risk of STIs is complicated by stigma associated with STIs, undisclosed risk behaviour, and the fact that STI epidemics are diversifying beyond traditional risk groups typically characterised by demographics and sexual behaviours alone. In this review, we describe the epidemiology of STIs among traditional and emerging risk groups, particularly in the context of uptake of HIV pre-exposure prophylaxis (PrEP), increasing STI transmission among heterosexual people, and the concentration of STI burden among specific subgroups not readily identifiable by health services.
View Article and Find Full Text PDFBackground: 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.
Article Synopsis
- The study highlights that there's a high rate of hepatitis C among people who inject drugs in Australia and emphasizes the importance of increasing testing in this at-risk group, especially within primary care settings that provide Opioid Agonist Treatment (OAT).
- Out of 5,429 individuals who received their first OAT prescription, only 17% were tested for hepatitis C within a year, but over half of those tested (56%) had a positive antibody result, indicating a significant health concern.
- Factors influencing higher testing rates included attending more clinical consultations, being female, and receiving a prescription more recently, while testing rates were lower for those on methadone and older individuals.
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.
Article Synopsis
- Point-of-care (POC) diagnostics can help people who inject drugs access hepatitis C (HCV) testing more easily, particularly through needle and syringe exchange programs (NSPs).
- In a pilot study, 70 participants tested positive for HCV RNA, with 63% prescribed direct-acting antivirals (DAAs); of those, 59% completed the treatment and 34% achieved a cure.
- Factors like being over 40 years old and having a secondary school education increased the likelihood of receiving treatment, while homelessness had a negative impact; overall, POC testing reduced the time from diagnosis to treatment.