Diagnosis and Management of Syphilis in Patients With HIV Co-infection

Khaw, C., Malden, C., Ratnayake, M. et al. Diagnosis and Management of Syphilis in Patients With HIV Co-infectionCurr Treat Options Infect Dis (2020). https://doi.org/10.1007/s40506-020-00225-6

Published

Purpose of review

Syphilis cases are on the increase especially in men who have sex with men (MSM) in urban areas of high-income countries.

There is a strong association between syphilis and HIV infections.

We review the more recent literature regarding the epidemiology, clinical manifestations, diagnostic investigations, treatment and follow-up of syphilis in HIV infection.

  • Read abstract here (For full text access you can purchase from the publisher or see your librarian)

Coronavirus disease (COVID-19), HIV & hepatitis C: What you need to know

CATIE (Canada), 17 March 2020

  • An HIV-positive person on effective treatment is not expected to be at higher risk of becoming seriously ill with COVID-19
  • A person with untreated HIV or a low CD4+ cell count may be at higher risk of becoming seriously ill with COVID-19
  • People with HIV or hepatitis C are more likely to have other conditions that carry a greater risk of becoming seriously ill with COVID-19

 

 

Female genital cutting (FGC) & cervical screening: A guide for practitioners

CANCER COUNCIL VICTORIA & WOMEN’S HEALTH WEST FARREP
PROGRAM, First published 2017

The World Health Organization defines female genital cutting (FGC) as ‘all procedures that include partial or total removal of female genital organs or other injury to female genital organs for non-medical reasons’.

‘Female genital mutilation’ is the term used in Australian and Victorian legislation, but the preferred way to refer to the practice using culturally sensitive language is ‘female circumcision’ or ‘traditional cutting’. The age at which this occurs varies from infancy to 15 years.

The practice is referred to as FGC throughout this document.

This 2-page guideline document includes facts about prevalance, type, appropriate questioning, examination technique, and more.

 

Updated Guidelines: Australian STI & HIV Testing Guidelines 2019 for Asymptomatic MSM

Sexually Transmissible Infections in Gay Men Action Group (STIGMA), September 2019

Most sexually transmitted infections (STIs) are asymptomatic. Testing and treatment of asymptomatic men who have sex with men (MSM) is the most effective method to interrupt transmission and reduce the burden of illness. In particular, syphilis is increasingly common, is often asymptomatic, and can cause significant morbidity.

The main barriers to STI control are insufficient frequency of testing in MSM, and incomplete testing. For example, chlamydia and gonorrhoea tests should be performed at all three sites (swab of oropharynx and anorectum, and first
pass urine), and syphilis serology should be performed every time a HIV test or HIV treatment monitoring is performed.

HIV is now a medically preventable infection. All men who are eligible under the Australian HIV Pre-Exposure guidelines should be actively offered PrEP: www.ashm.org.au/HIV/PrEP All people with HIV should be advised to commence treatment and, where possible, have an undetectable viral load.
These guidelines are intended for all MSM, including trans men who have sex with other men .

This current version is endorsed by the Australasian Society for HIV, Viral Hepatitis, and Sexual Health Medicine, Australasian Sexual Health Alliance, Australasian Chapter of Sexual Health Medicine of the Royal Australasian College of Physicians and is approved as an accepted clinical resource by the Royal Australian College of General Practitioners.

A community perspective: On Human Papillomavirus (HPV)-related cancer among women and, trans and gender diverse people

Positive Life NSW & Femfatales, April 2019

Authors: Liz Sutherland, Lance Feeney, Katya Samodurov

Human papillomavirus (HPV) is a common virus which can be passed through skin to skin contact during sexual activity. Evidence to date shows that women living with HIV are 3 to 6 times more likely to develop cervical cancer than the general female population. They are also at greater risk of developing anal, vaginal, oropharyngeal and vulvar cancers.

There are other groups who may have a higher but preventable risk because they are often left out of the conversation about HPV and related cancers. Trans men are less likely to be up-todate with Pap tests to screen for cervical cancer. Furthermore, several studies have highlighted that trans and gender diverse people, and lesbian and bisexual cis-gendered women are often disregarded as not being at risk.

Positive Life and Femfatales developed a cross-sectional study to:

• Assess awareness and knowledge of HPV infection and risk for 4 HPV-related cancers (cervical, vaginal, vulvar, and anal) among women and, trans and gender diverse people in Australia;

• Assess the knowledge gaps to inform the development and implementation of population-specific educational resources to increase community and healthcare professional awareness of HPV and related cancers;

• Assist with the prevention of morbidity and mortality by increasing screening, early detection and treatment of HPV-related cancers, and;

• Assess rates of HPV vaccination in women and, trans and gender diverse people

KEY FINDINGS:

1. The results from this survey highlighted a lack of awareness of risk, prevention,
symptoms, and early detection of HPV-related vaginal, vulvar, and anal cancers.

2. Approximately 28% of HIV-positive respondents were unaware that a vaccination
against HPV exists and 71% of HIV-positive respondents had not been vaccinated
against HPV.

3. Over half (60%) of HIV-positive respondents believe their risk of anal cancer was either‘about the same’, ‘lower’, or ‘much lower’ than the general female population’s risk.

4. While all HIV-positive respondents had screened for cervical cancer at some point in
their lives, 91.7% had never had an anal examination for anal cancer.

5. Among HIV-positive and HIV-negative but immunocompromised respondents who had undergone staging or treatment for either cervical, vaginal, or vulvar cancer, none had ever screened for anal cancer.

6. Of the HIV-positive respondents who do not receive screening reminder notifications, none were aware of the new 3 yearly National Cervical Screening Guidelines and changes.

7. Qualitative responses indicated that respondents generally preferred having clinician-initiated conversations with female doctors or nurses who were non-judgemental, non-dismissive, clear, and made them feel comfortable.

8. In an open-ended short-answer question, more than 25% of qualitative respondents felt that more awareness and normalising talking about HPV in the public realm would help increase their chance of detecting HPV-related cancer early.

SHINE SA and FPAA condemn Alabama law to ban abortions (media release)

On 17 May 2019, Family Planning Alliance Australia (FPAA) released a statement condemning a new law in Alabama which makes abortion a crime in almost all cases. This is the most restrictive abortion law in the United States and follows a wave of anti-abortion laws in 2019¹.

FPAA state:

“The restrictive and extreme abortion ban violates women’s reproductive rights and penalises health care practitioners for providing basic health care. As an organisation committed to empowering reproductive choice and improving access to health care, we find this law disturbing and unjust.”

Natasha Miliotis, SHINE SA’s Chief Executive Officer said that:

“SHINE SA supports the FPAA statement and recognises that access to safe abortion services reduces the mortality and morbidity that occurs as a result of dangerous and illegal abortion. This is evidenced by a higher frequency of abortion-related deaths in countries with restrictive abortion laws than in countries with less restrictive laws².

SHINE SA, a member of FPAA, advocates for reproductive freedom and for provision of legal, safe, affordable and accessible abortion in Australia and worldwide. We recognise that trans, gender diverse and intersex people may also need access to abortion, but also that measures such as this disproportionately affect women.

SHINE SA believes that both medical and surgical abortion are safe and effective health interventions and that abortion is a private medical decision that should not be politicised.”

To read the FPAA statement visit this link. For further information contact Tracey Hutt, Director Workforce Education and Development via email. 

 

¹ https://www.theguardian.com/world/2019/may/17/we-have-to-fight-alabamas-extreme-abortion-ban-sparks-wave-of-activism

² https://www.researchgate.net/publication/26677181_Unsafe_Abortion_Unnecessary_Maternal_Mortality