Disparities in characteristics in accessing public Australian sexual health services between Medicare‐eligible and Medicare‐ineligible MSM

Disparities in characteristics in accessing public Australian sexual health services between Medicare‐eligible and Medicare‐ineligible men who have sex with men

Australian and New Zealand Journal of Public Health

Anysha M. Walia, Christopher K. Fairley, Catriona S. Bradshaw, Marcus Y. Chen, Eric P.F. Chow

First published: 31 August 2020
https://doi.org/10.1111/1753-6405.13029
Abstract:

Objectives: Accessible health services are a key element of effective human immunodeficiency virus (HIV) and sexually transmitted infection (STI) control. This study aimed to examine whether there were any differences in accessing sexual health services between Medicare‐eligible and Medicare‐ineligible men who have sex with men (MSM) in Melbourne, Australia.

Methods: We conducted a retrospective, cross‐sectional study of MSM attending Melbourne Sexual Health Centre between 2016 and 2019. Demographic characteristics, sexual practices, HIV testing practices and STI diagnoses were compared between Medicare‐eligible and Medicare‐ineligible MSM.

Results: We included 5,085 Medicare‐eligible and 2,786 Medicare‐ineligible MSM. Condomless anal sex in the past 12 months was more common in Medicare‐eligible compared to Medicare‐ineligible MSM (74.4% vs. 64.9%; p<0.001) although the number of partners did not differ between groups. There was no difference in prior HIV testing practices between Medicare‐eligible and Medicare‐ineligible MSM (76.1% vs. 77.7%; p=0.122). Medicare‐ineligible MSM were more likely to have anorectal chlamydia compared to Medicare‐eligible MSM (10.6% vs. 8.5%; p=0.004).

Conclusions: Medicare‐ineligible MSM have less condomless sex but a higher rate of anorectal chlamydia, suggesting they might have limited access to STI testing or may be less willing to disclose high‐risk behaviour.

Implications for public health: Scaling up access to HIV and STI testings for Medicare‐ineligible MSM is essential.

Australian Burden of Disease Study: Illicit Drug Use, Intimate Partner Violence, Unsafe Sex

 Australian Institute of Health and Welfare, Last updated: 

Burden of disease is a measure of the years of healthy life lost from living with, or dying from disease and injury. A portion of this burden is preventable, being due to modifiable risk factors. This report provides information on the deaths and burden of disease due to risk factors included in the Australian Burden of Disease Study 2015. 

New analyses of the key drivers of change over time in the burden of disease due to selected risk factors have recently been added to these data visualisations (August 2020).

The following excerpts may be of interest:

Or you can see all the data here

 

 

Keeping up with hepatitis, liver, and COVID-19 resources

Hepatitis SA, May 2020

Hepatitis SA currently have a collection of hepatitis/liver related COVID-19 resources available online through their library catalogue.

Hepatitis SA maintains a specialist library of physical and online resources; including books, reports, audio-visual resources, journals and newsletters, with the services of a professional librarian.

 

 

Clinical Characteristics and Results of Semen Tests Among Men With Coronavirus Disease

Li D, Jin M, Bao P, Zhao W, Zhang S. Clinical Characteristics and Results of Semen Tests Among Men With Coronavirus Disease 2019. JAMA Network Open. 2020;3(5):e208292. doi:10.1001/jamanetworkopen.2020.8292

Research Letter

Infectious Diseases

May 7, 2020

Discussion

In this cohort study, we found that SARS-CoV-2 can be present in the semen of patients with COVID-19, and SARS-CoV-2 may still be detected in the semen of recovering patients. Owing to the imperfect blood-testes/deferens/epididymis barriers, SARS-CoV-2 might be seeded to the male reproductive tract, especially in the presence of systemic local inflammation. Even if the virus cannot replicate in the male reproductive system, it may persist, possibly resulting from the privileged immunity of testes. So far, researchers have found 27 viruses associated with viremia in human semen. But the presence of viruses in semen may be more common than currently understood, and traditional non–sexually transmitted viruses should not be assumed to be totally absent in genital secretions.5,6 Studies on viral detection and semen persistence are beneficial to clinical practice and public health, especially concerning viruses that could cause high mortality or morbidity, such as SARS-CoV-2.

This study is limited by the small sample size and the short subsequent follow-up. Therefore, further studies are required with respect to the detailed information about virus shedding, survival time, and concentration in semen.

If it could be proved that SARS-CoV-2 can be transmitted sexually in future studies, sexual transmission might be a critical part of the prevention of transmission, especially considering the fact that SARS-CoV-2 was detected in the semen of recovering patients.

Changes to Post-Exposure Prophylaxis (PEP) Distribution

SHINE SA,  

SHINE SA will now temporarily provide a full 28-day supply of Post-exposure Prophylaxis (PEP) medication in place of the usual five-day starter pack. This measure has been put in place with the assistance of SA Health to help limit movement during the COVID-19 pandemic.

Prior to the pandemic, clients received a five-day HIV PEP starter pack and then the remaining medication after a follow-up appointment. Clients can now call SHINE SA for a telehealth appointment where our team will guide clients through the process including supply of the medications and blood tests. Follow-up care arrangements will remain in place.

What is PEP?

PEP is a four week long course of medication taken to reduce the risk of HIV infection. It needs to be initiated within 72 hours of possible contact with HIV in order to help prevent the chance of infection. Exposure can occur through unprotected sex or the sharing of needles and other injection equipment.

It’s important that PEP is accessed as soon as possible after you think you may been exposed to HIV. If you are outside of the time-frame you can still contact your local GP or SHINE SA for further assistance.

What are the most common reasons for needing PEP?

  • Sex without a condom or sex where a condom broke or slipped off, with a person who has, or might have, HIV.
  • Sharing needles or syringes with a person who has, or might have, HIV.

How can I find out more?

  • The PEP Hotline is available 24 hours a day on 1800 022 026. The Registered Nurse on the PEP hotline will help assess your needs and indicate where to access PEP near you.
  • To speak to SHINE SA about accessing PEP call 8300 5300.
  • To learn more about PEP you can visit the SAMESH website or call 7099 5300.

From: https://www.shinesa.org.au/changes-to-pep/

Information about TRUVADA and ATRIPLA delisting

Australian Federation of AIDS Organisations (AFAO), March 30th 2020

From 1 April 2020 Truvada for HIV treatment and for pre-exposure prophylaxis (PrEP) will no longer be available through the Pharmaceutical Benefits Scheme (PBS).

There are alternatives to Truvada for PrEP in Australia.

Community members eligible for PrEP can access generic versions of Truvada supplied by Apotex, Mylan and Lupin Generic Health. The drugs manufactured by these three suppliers contain the same active ingredients as Truvada.

In addition, from October 2020 Atripla will be delisted. A generic equivalent of Atripla has been approved by the PBS for community members who wish to continue using Atripla.

We encourage you to talk to your prescribing doctor if you want more information about these changes.

For more information, visit the following websites: