Syphilis jumps to WA: doctors say ‘complacent’ safe sex attitudes to blame

ABC News, 17/03/2018

Some sexually transmitted diseases are on the rise in Western Australia, with Aboriginal communities in the north hit particularly hard by a syphilis outbreak.

Australian Medical Association president Omar Khorshid said Aboriginal people in the north had been failed.

“It’s really sad that we’ve actually had and outbreak of syphilis that started in north Queensland that’s gone right across the north of Australia, through the Northern Territory and into the Kimberley through our Aboriginal populations,” Dr Khorshid said.

“In this day and age, in a medical system that’s had a cure for that condition for many decades, the fact we are still seeing an outbreak of such an easily treated infectious disease really says a lot about our failure as a community to deal with the health issues in our Aboriginal communities.”

 

 

What is really going on with STIs in Indigenous kids?

The Age, 10 March 2018

Detailed new statistics on sexually transmitted infections among Indigenous children in the Northern Territory reveal the number of cases is declining and there is little evidence to link STI rates to child abuse.

 

What Is the Optimal Time to Retest Patients With a Urogenital Chlamydia Infection? (RCT)

Sex Transm Dis. 2018 Feb;45(2):132-137. doi: 10.1097/OLQ.0000000000000706.

BACKGROUND:

Chlamydia trachomatis is a common, often recurring sexually transmitted infection, with serious adverse outcomes in women. Current guidelines recommend retesting after a chlamydia infection, but the optimum timing is unknown. We assessed the optimal retest interval after urogenital chlamydia treatment.

METHODS:

A randomized controlled trial among urogenital chlamydia nucleic acid amplification test positive heterosexual clients of the Amsterdam sexually transmitted infection clinic. After treatment, patients were randomly assigned for retesting 8, 16, or 26 weeks later. Patients could choose to do this at home (and send a self-collected sample by mail) or at the clinic. Retest uptake and chlamydia positivity at follow-up were calculated.

RESULTS:

Between May 2012 and March 2013, 2253 patients were included (45% men; median age, 23 years; interquartile range, 21-26). The overall uptake proportion within 35 weeks after the initial visit was significantly higher in the 8-week group (77%) compared with the 16- and 26-week groups (67% and 64%, respectively, P < 0.001), and the positivity proportions among those retested were comparable (P = 0.169). The proportion of people with a diagnosed recurrent chlamydia infection among all randomized was similar between the groups (n = 69 [8.6%], n = 52 [7.4%], and n = 69 [9.3%]; P = 0.4).

CONCLUSIONS:

Patients with a recent urogenital chlamydia are at high risk of recurrence of chlamydia and retesting them is an effective way of detecting chlamydia cases. We recommend inviting patients for a re-test 8 weeks after the initial diagnosis and treatment.

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Australia’s Annual Report Card on STIs and blood-borne viruses

Kirby Institute, Monday, 6 November 2017

Gonorrhoea and syphilis diagnoses are increasing in Australia, HIV is stable, and more than 30,000 Australians have been cured of hepatitis C, according to the latest Annual Surveillance Report on HIV, viral hepatitis and sexually transmissible infections (STIs) in Australia, released today by the Kirby Institute at UNSW Sydney.

The latest data shows that gonorrhoea has increased by 63% over the past five years, with particular rises among young heterosexual people in major cities.

Among Aboriginal and Torres Strait Islander peoples, chlamydia and gonorrhoea rates were three and seven times higher than in the non-Indigenous population and the gaps were greater in regional and remote areas. Since 2011, there has been a resurgence of infectious syphilis among young Aboriginal and Torres Strait Islander people living in regional and remote areas of Northern Australia.

The report shows that HIV diagnoses have remained stable in Australia for the past five years, with 1,013 new diagnoses in 2016. However, gaps in testing remain, particularly among heterosexual people.  The report indicates that HIV diagnoses among Aboriginal and Torres Strait Islander people have increased by 39% since 2012, with a greater proportion of diagnoses due to injecting drug use and heterosexual sex, compared to non-Indigenous populations.

Between March and December 2016, an estimated 30,434 people have been cured of hepatitis C due to the availability of new direct acting antiviral therapy for hepatitis C.  The report also shows that only 63% of the estimated 230,000 people living with chronic hepatitis B in Australia by the end of 2016 were diagnosed. Of those, only 27% were having appropriate clinical monitoring tests for their infection. But a decline in hepatitis B diagnoses is evident in younger Aboriginal and Torres Strait Islander
people, and newly diagnosed cases in the the non-Indigenous population remained stable.

Rising Chlamydia and Gonorrhoea Incidence and Associated Risk Factors Among Female Sex Workers in Australia

Rising Chlamydia and Gonorrhoea Incidence and Associated Risk Factors Among Female Sex Workers in Australia: A Retrospective Cohort Study

Authors

Denton Callander, PhD,*† Hamish McManus, PhD,* Rebecca Guy, PhD,* Margaret Hellard, PhD,‡ Catherine C. O’Connor, DrPH,*§¶ Christopher K. Fairley, PhD,||** Eric P.F. Chow, PhD,||** Anna McNulty, MM,†† David A. Lewis, DA, PhD,‡‡§§ Christopher Carmody, MB, BS,¶¶ Heather-Marie A. Schmidt, PhD,|||| Jules Kim,*** and Basil Donovan, MD*††

From the *The Kirby Institute, †Centre for Social Research in Health,
UNSW Australia, Sydney, NSW; ‡Burnet Institute, Melbourne, VIC;
§RPA Sexual Health Clinic, Community Health, Sydney Local Health
District; ¶Central Clinical School, University of Sydney, Sydney, NSW;
||Melbourne Sexual Health Centre, Alfred Health; **Central Clinical
School, Faculty of Medicine, Nursing and Health Sciences, Monash
University, Melbourne, VIC; ††Sydney Sexual Health Centre,
Sydney Hospital, Sydney; ‡‡Western Sydney Sexual Health Centre,
Parramatta; §§Marie Bashir Institute for Infectious Diseases and
Biosecurity & Sydney Medical School-Westmead, University of
Sydney, Sydney; ¶¶Liverpool Sexual Health Centre, Liverpool; ||||
New South Wales Ministry of Health; and ***Scarlet Alliance, Australian
Sex Worker Association, Sydney, NSW, Australia

Abstract:

Background: Female sex workers in Australia have achieved some of the lowest documented prevalences of human immunodeficiency virus (HIV) and other sexually transmissible infections globally but rates overall are increasing in Australia and warrant closer investigation.

Methods: We constructed a retrospective cohort using repeat testing data extracted from a network of 42 sexual health clinics. Poisson and Cox regression were used to determined trends in incidence and risk factors for HIV, chlamydia, gonorrhoea, and infectious syphilis among female sex workers.

Results: From 2009 to 2015, 18,475 women reporting sex work attended a participating service. The overall incidence of urogenital chlamydia was 7.7/100 person years (PY), declining by 38% from 2009 to 2013 before increasing by 43% to 2015 (P < 0.001); anorectal chlamydia incidence was 0.6/100 PY, and pharyngeal was 1.9/100 PY, which increased significantly during the study period (P < 0.001, both). For gonorrhoea, the urogenital incidence was 1.4/100 PY, anorectal incidence was 0.3/100 PY, P < 0.001), and 3.6/100 PY for pharyngeal; urogenital incidence doubled during the study period, anorectal increased fivefold, and pharyngeal more than tripled (P < 0.001, all). Incidence of infectious syphilis was 0.4/100 PY, which remained stable from 2009 to 2015 (P = 0.09). There were seven incident infections of HIV among female sex workers (0.1/100 PY). Inconsistent condom use with private partners, higher number of private partner numbers, recent injecting drug use, younger age, and country of birth variously predicted sexually transmissible infections among female sex workers.

Conclusions: Although infectious syphilis and HIV remain uncommon in female sex workers attending Australian sexual health clinics, the increasing incidence of gonorrhoea across anatomical sites and increasing chlamydia after a period of decline demands enhanced health promotion initiatives.

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In[ter]view: SHINE SA’s Dr Amy Moten

Verse magazine, Edition 18, September 2017

This edition we talked to Amy, SHINE SA’s Medical Educator, who is answering all your questions when it comes to the ‘what’s this’ and ‘how do I check that’ of sex.

  1. How often should people who are sexually active get tested?

You should have a test when symptoms of a Sexually Transmitted Infection (STI) are first noticed or if a sexual partner is diagnosed with an STI or has symptoms of an STI. Even if you have no symptoms STI screening is recommended for any new sexual contact. Annual screening for people under 30 is recommended, but you can have a test every 3 months if you think you may be at higher risk.