International consensus on testosterone treatment for women

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Jean Hailes, 2 September 2019

The first Global Position Statement on the use of testosterone in the treatment of women, led by the International Menopause Society (IMS), was published in four leading international medical journals today.

The statement has been authored by a diverse team of leading experts based around the world and has been endorsed by internationally-esteemed medical societies.

It follows years of debate regarding testosterone therapy for women and, for the first time, provides agreement among experts and medical societies about how testosterone could be prescribed for women.

Access the statement: 

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Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility

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Clinical Infectious Diseases, ciz429, https://doi.org/10.1093/cid/ciz429
Published: 24 August 2019

Abstract

Background

We evaluated the risk of pelvic inflammatory disease (PID), ectopic pregnancy, and infertility in women with a previous Chlamydia trachomatis (CT) diagnosis compared with women who tested negative for CT and CT untested women, considering both targeted and incidental (ie, prescribed for another indication) use of CT-effective antibiotics.

Methods

This was a retrospective study of women aged 12–25 years at start of follow-up within the Clinical Practice Research Datalink GOLD database linked to index of multiple deprivation quintiles, 2000–2013. CT test status and antibiotic use were determined in a time-dependent manner. Risk of PID, ectopic pregnancy, or female infertility were evaluated using of Cox proportional hazard models.

Results

We studied 857 324 women, contributing 6 457 060 person-years. Compared with women who tested CT-negative, women who tested CT-positive had an increased risk of PID (adjusted hazard ratio [aHR], 2.36; 95% confidence interval [CI], 2.01–2.79), ectopic pregnancy (aHR, 1.87; 95% CI, 1.38–2.54), and infertility (aHR, 1.85; 95% CI, 1.27–2.68). The PID risk was higher for women with 2 or more positive CT tests than those with 1 positive test. PID risk increased with the number of previous antibiotic prescriptions, regardless of CT test status.

Conclusions

We showed an association between CT-positive tests and 3 adverse reproductive health outcomes. Moreover, this risk increased with repeat CT infections. CT-effective antibiotic use showed no decreased risks of subsequent PID regardless of CT history. Our results confirm the reproductive health burden of CT, which requires adequate public health interventions.

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STI/BBV testing tool for asymptomatic people

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NSW STI Programs Unit, ASHM & Qld. Govt.,  2019

This resource has charts and information about how routine STI/BBV testing can be offered, who to, and how to follow up.

Developed by NSW STI Programs Unit, NSW Australia, and reproduced with permission by the Sunshine Coast Hospital and Health Service, ASHM and Communicable Diseases Branch.

 

 

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Hyde Street Practice: a service of SHINE SA

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SHINE SA, September 2019

Hyde Street Practice is a service of SHINE SA. We offer affordable appointments with friendly and non-judgemental staff.

We are a safe and inclusive practice with general practitioners, specialist services, sexual health and relationship wellbeing services.

Services include:

  • General Practitioners

General GP services, including support for diabetes and cardiovascular health, Pre and post exposure HIV prevention (PEP and PrEP), HIV, hepatitis B and hepatitis C prescribing, STI testing and management

  • Sexual Health Services

SHINE SA sexual health services including contraception, STI testing and management, HIV, PEP & PrEP

  • Sexual Health Physician

A private specialist sexual health and HIV service available by referral

HIV, sexual health, PEP & PrEP, hepatitis C, transgender medicine, LGBTI health

  • Rapido – Rapid HIV Testing

Walk in and Wait service, peer led with results in 20 minutes

  • Psychologist and Counselling

General psychological services and sexual health counselling

  • Gender Wellbeing Service

Professional, peer support and information services for people who are questioning their gender or who identify as trans or gender diverse

  • SAMESH

Support services for gay men, MSM (men who have sex with men), trans men and people living with HIV and people at risk of HIV and STIs, health promotion and education

  • Bobby Goldsmith Foundation

Financial assistance for health related issues to people living with HIV on low incomes

Details:

57 Hyde Street, Adelaide
Call 7099 5320
Monday – Friday 9:00 am – 5:00 pm
Fees available on hydestreet.com.au
To make an appointment visit
www.hydestreet.com.au

or call 7099 5320

Rapido – Rapid HIV Testing
Mondays 3:00 – 6:00 pm
(except Public Holidays)

Sexual Health Service
Walk in and Wait
Fridays 1:00 – 4:00 pm

Clean Needle Program
Monday – Friday 9:00 am – 5:00 pm

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STIs among transgender men and women attending Australian sexual health clinics

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Med J Aust. 2019 Aug 29. doi: 10.5694/mja2.50322. [Epub ahead of print]

Abstract

Objectives

To estimate rates of HIV infection, chlamydia, gonorrhoea, and infectious syphilis in transgender men and women in Australia; to compare these rates with those for cisgender people.

Design

Cross‐sectional, comparative analysis of de‐identified health data.

Setting, participants

We analysed data for 1260 transgender people (404 men, 492 women, 364 unrecorded gender), 78 108 cisgender gay and bisexual men, and 309 740 cisgender heterosexual people who attended 46 sexual health clinics across Australia during 2010–2017.

Main outcome measures

First‐visit test positivity for sexually transmitted infections (STIs), stratified by patient group and year; demographic and behavioural factors associated with having STIs.

Results

14 of 233 transgender men (6.0%) and 34 of 326 transgender women (10%) tested during first clinic visits were chlamydia‐positive; nine transgender men (4%) and 28 transgender women (8.6%) were gonorrhoea‐positive. One of 210 tested transgender men (0.5%) and ten of 324 tested transgender women (3.1%) were diagnosed with infectious syphilis; 14 transgender men (3.5%) and 28 transgender women (5.7%) were HIV‐positive at their first visit. The only significant change in prevalence of an STI among transgender patients during the study period was the increased rate of gonorrhoea among transgender women (from 3.1% to 9.8%). Compared with cisgender gay and bisexual men, transgender men were less likely (adjusted odds ratio [aOR], 0.46; 95% CI, 0.29–0.71; P = 0.001) and transgender women as likely (aOR, 0.98; 95% CI, 0.73–1.32; P = 0.92) to be diagnosed with a bacterial STI; compared with heterosexual patients, transgender men were as likely (aOR, 0.72; 95% CI, 0.46–1.13; P = 0.16) and transgender women more likely (aOR, 1.56; 95% CI, 1.16–2.10; P = 0.003) to receive a first‐visit bacterial STI diagnosis.

Conclusions

The epidemiology of STIs in transgender people attending Australian sexual health clinics differs from that of cisgender patients. Gender details must be captured by health data systems to facilitate appropriate delivery of sexual health care.

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Analysis of cervical cancer and abnormality outcomes in an era of cervical screening and HPV vaccination in Australia

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Australian Institute of Health and Welfare, Release Date: 

This is the third report from an Australian-first project, combining screening, cancer, death, and HPV vaccination data to demonstrate the effects of screening and HPV vaccination on cervical cancer, precancerous abnormalities and cervical screening behaviour.

Screen-detected cervical cancers were less likely to cause death than those diagnosed in never-screened women, and HPV-vaccinated women were more likely to participate in cervical screening, and less likely to have a high-grade abnormality.

 

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