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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Gonorrhoea and syphilis on the rise among among heterosexual men and women in Melbourne

ABC News, 16th January 2018

Melbourne is facing a rapid increase in cases of the sexually transmitted diseases syphilis and gonorrhoea.

Data from the Melbourne Sexual Health Clinic shows the number of gonorrhoea infections has increased 30 per cent annually since 2015.

Can you get gonorrhoea from kissing?

ABC Radio (Hack), 8th November 2017

In a troubling development, Melbourne researchers suspect gonorrhoea is being spread by kissing, overturning years of conventional wisdom.

Although it’s early days and not cause for alarm, there is evidence to suggest ‘throat-to-throat transmission’ may be driving the spread of gonorrhea in inner-city Australia.

It’s been generally understood you could only get gonorrhea by having vaginal, anal or oral sex with someone who has gonorrhea. Dr Vincent J Cornelisse, a sexual health physician and PhD candidate at Monash University, has been conducting research that challenges this idea.

Professor Basil Donovan, head of the Sexual Health Program at the Kirby Institute, told Hack the finding was “highly tenuous”. “You’ll need a lot more science before you put out a warning,” he said.

 

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.

New periodic survey on sexual health among young heterosexual people

Centre for Social Research in Health, UNSW, 2017

Between December 2015 and March 2016, the ‘It’s Your Love Life’ periodic survey recruited 2,120 heterosexually-identified young people aged 15–29 years and living in New South Wales (NSW). The data collected through the survey contributes new knowledge on the attitudes and practices of heterosexual young people and their exposure to sexual health promotion initiatives.

Results indicate that substantial effort is required to support heterosexual young people in ensuring their sexual health.

Contents include:

  • Knowledge of sexually transmissible infections (STIs)
  • Perceived severity of STIs
  • Perceived risk of contracting an STI
  • Condom use-related views
  • Carrying condoms while being on a date
  • Sexual intercourse with and without condoms
  • Contraception
  • STI testing-related views
  • Testing for STIs and/or human immunodeficiency virus (HIV)
  • Exposure to messages promoting condom use and testing for STIs
  • Familiarity and engagement with sexual health promotion resources, activities and services
  • Sexual health education in secondary schools

IYLL is an online cross-sectional survey that will be repeated annually. A first round of data collection was completed between December 2015 and March 2016

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.