Rapid HIV testing increases testing frequency among gay and bisexual men: a controlled before–after study

Sexual Health – https://doi.org/10.1071/SH18161

Keen Phillip, Jamil Muhammad, Callander Denton, Conway Damian P., McNulty Anna, Davies Stephen C., Couldwell Deborah C., Smith Don E., Holt Martin, Vaccher Stefanie J., Gray James, Cunningham Philip, Prestage Garrett, Guy Rebecca, (2019)

Published online: 4 April 2019

Abstract:

BackgroundRapid HIV testing was introduced at 12 clinics in New South Wales (NSW) for routine testing and promoted with social marketing. The effect of the availability of rapid HIV testing on testing frequency among gay and bisexual men (GBM) was evaluated.

Methods: An observational design using patient data from 12 clinics was used. The primary outcome was the mean number of HIV tests in 12 months. The intervention group comprised GBM who had one or more rapid tests from October 2013 to September 2014 and this was compared with two control groups; a concurrent group (no rapid test in the same period) and a historical group (attended between July 2011 and June 2012). Independent sample t-tests were conducted to compare mean number of tests among men in the intervention, concurrent and historical groups. Multivariate logistic regression was used to assess the association between rapid HIV testing and testing frequency.

Results: Men in the intervention group (n = 3934) had a mean of 1.8 HIV tests in 12 months, compared with 1.4 in the concurrent group (n = 5063; P < 0.001) and 1.4 in the historical group (n = 5904; P < 0.001); testing frequency was higher among men at increased risk of HIV in the intervention group compared with the other two groups (mean 2.2, 1.6 and 1.5 respectively; P < 0.001). Membership of the intervention group was associated with increased odds of having two or more HIV tests in 12 months (AOR = 2.5, 95%CI 2.2–2.8; P < 0.001) compared with the concurrent group, after controlling for demographic and behavioural factors.

Conclusion: Introducing and promoting rapid HIV testing in clinics in NSW was associated with increased HIV testing frequency among GBM.

 

Cervical cancer self-tests helping to break down barriers and increase screening rates

ABC Health & Wellbeing, Posted Friday 8th March 2019 at 14:54

In Australia, 80 per cent of cervical cancers are found in women who are overdue for screening or have never been screened.

“We know there’s an equity issue in our cervical screening program,” said Dr Saville, executive director of the VCS Foundation, a cervical screening not-for-profit.

“Women from lower socio-economic settings, Aboriginal and Torres Strait Islander women, and women from culturally and linguistically diverse backgrounds do not screen as often … and are more likely to get cancer.”

In a bid to overcome these barriers, a self-testing process was introduced to Australia’s National Cervical Screening Program in 2017.

Cervical cancer could be all but eliminated in 80 years: Lancet study

RACGP News, 20 Feb 2019

The Lancet Oncology modelling study found 149 of 181 countries could cut rates of the preventable cancer to four per 100,000 women by the end of the century – the threshold for considering it eliminated as a public health problem.

The study finds that combining high uptake of the vaccine with high screening could prevent up to 13.4 million cases of cervical cancer within 50 years, with the most benefit in low and middle income countries.

 

Factors associated with testing for HIV in people aged ≥50 years

BMC Public Health 2018 18:1204

https://doi.org/10.1186/s12889-018-6118-x

Published: 26 October 2018

Factors associated with testing for HIV in people aged ≥50 years: a qualitative study

Abstract

Background

Despite a decline in the number of new HIV infections in the UK overall, the number and proportion of new HIV diagnoses in people aged ≥50 years continues to increase. People aged ≥50 years are disproportionately affected by late diagnosis, which is associated with poorer health outcomes, increased treatment complexity and increased healthcare costs. Late HIV diagnosis also has significant public health implications in terms of onward HIV transmission. It is not fully understood what factors affect the decision of an older person to test for HIV. The aim of this study was to identify factors associated with testing for HIV in people aged ≥50 years who tested late for HIV.

Methods

We interviewed 20 people aged ≥50 years diagnosed late with HIV to identify factors associated with HIV testing. Interviews were audio recorded, transcribed verbatim and thematically analysed.

Results

Seven themes associated with HIV testing in people aged ≥50 years were identified: experience of early HIV/AIDS campaigns, HIV knowledge, presence of symptoms and symptom attribution, risk and risk perception, generational approaches to health and sexual health, stigma, and type of testing and testing venue.

Conclusion

Some factors associated with testing identified in this study were unique to older individuals. People aged ≥50 years often do not perceive themselves to be at risk of HIV. Further, stigma and a lack of knowledge of how to access HIV testing suggest a need for health promotion and suggest current sexual health services may need to adapt to better meet their needs.

Hepatitis C Virus – for GPs, Nurses and Allied Health Professionals

Sonder, October 2018

In this education session, presenters Dr Dep Huynh, Ms Margery Milner and Mr Jeff Stewart will provide attendees with an update on the risk factors associated with Hepatitis C Virus (HCV) and the management options available.

The presenters will also provide information on liver cirrhosis tests and how to choose and initiate the most appropriate HCV treatment for patients.

Learning objectives

  • Identify and understand the risk factors for HCV screening;
  • Perform correct diagnosis of chronic HCV using reflexive testing;
  • Assess and manage patients for liver cirrhosis using non-invasive tests;
  • Improve patient safety by choosing the most appropriate HCV treatment according to the patient’s characteristics and co-medications;
  • Discuss and improve your understanding on how to initiate HCV treatment.

Presented by

Dr Dep Huynh, Gastroentrologist & Staff Specialist at Queen Elizabeth Hospital,
Clinical Lecturer, University of South Australia

Margery Milner & Jeff Stewart, Nurses at Queen Elizabeth Hospital

Agenda

6.30pm – 7.00pm Registration and dinner
7.00pm – 8.00pm Presentation by Dr Dep Huynh, Gastroentrologist & Staff Specialist at Queen Elizabeth Hospital, Clinical Lecturer, University of South Australia8.00pm – 8.10pm Tea/coffee break
8.10pm – 9.10pm Presentation by Margery Milner & Jeff Stewart, Nurses at Queen Elizabeth Hospital
9.10pm – 9.30pm Questions, evaluation & close

RACGP QI & CPD Category 2, 4 Points

DATE AND TIME

Mon. 5 November 2018

6:15 pm – 9:30 pm ACDT

LOCATION

Arya Restaurant

30/81 O’Connell Street

North Adelaide, SA 5006

This program is funded by the Adelaide Primary Health Network - an Australian Government initiative

 

Translation and implementation of the Australian-led PCOS guideline

Translation and implementation of the Australian-led PCOS guideline: clinical summary and translation resources from the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

Med J Aust 2018; 209 (7 Suppl): S3-S8. || doi: 10.5694/mja18.00656
Published online: 2018-10-01

Abstract

Introduction: We have developed the first international evidence-based guideline for the diagnosis and management of polycystic ovary syndrome (PCOS), with an integrated translation program incorporating resources for health professionals and consumers. The development process involved an extensive Australian-led international and multidisciplinary collaboration of health professionals and consumers over 2 years. The guideline is approved by the National Health and Medical Research Council and aims to support both health professionals and women with PCOS in improving care, health outcomes and quality of life. A robust evaluation process will diagnoenable practice benchmarking and feedback to further inform evidence-based practice. We propose that this methodology could be used in developing and implementing guidelines for other women’s health conditions and beyond.

Main recommendations: The recommendations cover the following broad areas: diagnosis, screening and risk assessment depending on life stage; emotional wellbeing; healthy lifestyle; pharmacological treatment for non-fertility indications; and assessment and treatment of infertility.

Changes in management as a result of this guideline: •Diagnosis:▪when the combination of hyperandrogenism and ovulatory dysfunction is present, ultrasound examination of the ovaries is not necessary for diagnosis of PCOS in adult women;▪requires the combination of hyperandrogenism and ovulatory dysfunction in young women within 8 years of menarche, with ultrasound examination of the ovaries not recommended, owing to the overlap with normal ovarian physiology; and▪adolescents with some clinical features of PCOS, but without a clear diagnosis, should be regarded as “at risk” and receive follow-up assessment.•Screening for metabolic complications has been refined and incorporates both PCOS status and additional metabolic risk factors.•Treatment of infertility: letrozole is now first line treatment for infertility as it improves live birth rates while reducing multiple metapregnancies compared with clomiphene citrate.