STI and BBV control in remote communities: Clinical practice and resource manual

SAHMRI / Young Deadly Free, 2019

This manual was developed by SAHMRI as part of the Young Deadly Free project, to support clinicians in efforts to boost STI and BBV testing rates for young people living in and visiting remote communities.

The manual provides tips on offering STI and BBV testing as part of routine consults with young people; collates the various STI and BBV clinical guidelines relevant to regional and remote communities; catalogues induction and training resources; and features Young Deadly Free health promotion resources for use in community education. The manual is designed as an induction and training kit, and for daily use by doctors, nurses and Aboriginal Health Workers.

STIs among transgender men and women attending Australian sexual health clinics

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.

New report: Surveillance of STIs and Blood-Borne Viruses in South Australia, 2018

Communicable Disease Control Branch, SA Health, July 2019

In 2018, there were 8,556 new notifications of STI and BBV in South Australia. This represents a 3% increase in the number of new notifications compared to notifications received in 2017.

In 2018, there were 6,256 notifications of Chlamydia trachomatis (chlamydia) making this the most commonly notified STI in South Australia. The demographics of people diagnosed with chlamydia have remained relatively stable over the past five
years.

There were no notifications of donovanosis in 2018.

There were 1,288 notifications of gonorrhoea in 2018. The notification rate of gonorrhoea increased from 45 per 100,000 population in 2014 to 74 per 100,000 population in 2017 and 2018. The rate in the Aboriginal population was 813 per 100,000 population in 2018 compared to 55 per 100,000 population in the non-Indigenous population.

There were 203 notifications of infectious syphilis in 2018, the highest number of annual notifications in the past 10 years. The notification rate of infectious syphilis in 2018 was 11.7 per 100,000 population, more than double the rate in 2016 of 5.2 per 100,000 population. In 2018, 88% of notifications were in males, the majority being among men who have sex with men (MSM) (75%). Infectious syphilis remains high in the Aboriginal population. There were no notifications of congenital syphilis in 2018.

There were 39 new diagnoses of human immunodeficiency virus (HIV) infection in 2018. Thirty-two of the 39 notifications were in males (82%). In 2018, 63% of male cases reported male-to-male sex. Six females acquired their infection overseas and one in South Australia.

There were four notifications of newly acquired hepatitis B infection in 2018, below the five year average (2013-2017) of eight cases per year. There were no notifications in the Aboriginal population. There were 254 notifications of unspecified hepatitis B infection reported in 2018, a decrease compared to the five year average (2013-2017) of 325 cases per year. The notification rate has declined in the Aboriginal population over the past five years.

There were 41 notifications of newly acquired hepatitis C in 2018. Sixty-one per cent of cases were males, and 66% were aged 30 years and over. The notification rate of unspecified hepatitis C infection was 22.2 per 100,000 population in 2018, with a
total of 385 notifications in 2018 compared to 465 in 2017.

There were five new diagnoses of hepatitis D infection in 2018, below the five year average (2013-2017) of 9.8 cases per year.

 

Increased screening for syphilis and HIV in SA – new advice for clinicians (video)

SHINE SA,  

SHINE SA have released a short video resource for health professionals providing advice on the current syphilis outbreak in South Australia.

Syphilis is a sexually transmitted infection (STI). It presents a serious public health issue as it causes harm to the developing foetus and increases the transmission and acquisition of HIV.

The 5 minute video SA Syphilis Outbreak – Advice for Clinicians urges health professionals to be aware that syphilis is increasing rapidly in SA and that there is a need to respond with increased screening.

Experts debate whether kissing is to blame for gonorrhoea spread

Sydney Morning Herald, July 18, 2019 — 2.00am

The long-held position of sexual health experts is that gonorrhoea is transmitted by the penis, but an Australian researcher is studying the possibility the infection can be spread by kissing.

At the STI and HIV World Conference in Vancouver on Thursday, Professor Kit Fairley from Monash University will be arguing his case in a debate with Professor Emeritus H. Hunter Handsfield from the University of Washington.

HIV diagnoses in Australia drop to lowest number in 18 years: report

Kirby Institute, July 3rd, 2019

Australia continues to lead the world in HIV prevention and in 2018 recorded the lowest number of HIV diagnoses since 2001.

According to a report released today by the Kirby Institute at UNSW Sydney, last year there were 835 HIV diagnoses across the country, which represents a decline of 23% over five years.

The declines reported today are largely due to reductions in the number of HIV diagnoses that are reported as attributable to sex between men. Over the past five years, HIV diagnoses have reduced by 30% among this population.

The report reveals no declines among heterosexual populations, with new diagnoses relatively stable among this group.

Similarly, there have been no declines in HIV diagnoses among Aboriginal and Torres Strait Islander populations.