Baby born with “avoidable” congenital syphilis: experts

InDaily, June 04, 2020

The recent birth of a child in South Australia with congenital syphilis, despite the mother being previously diagnosed and treated for the sexually transmitted infection, has prompted SA Health concern about the quality of the treatment.

[A] public health alert [sent by SA Health] “reminds and advises health practitioners of their responsibilities” in managing syphilis cases and contacts.

General practitioner at not-for-profit sexual health service SHINE SA Amy Moten said the case was “significant” because it was an avoidable outcome.

Webinar: Syphilis Outbreak in the Indigenous Community

SHINE SA, posted May 14, 2020

This free education session is presented by Adelaide Sexual Health Centre and will provide an update on syphilis.

General practitioners, nurses and/or midwives, Aboriginal Health Practitioners and Aboriginal Health Workers are encouraged to register for this training.

COURSE DETAILS

Date: 16 June 2020
Time: 7:00pm – 9:00pm

The webinar will cover:

  • Update on epidemiology
  • Review of diagnosis, staging and management of syphilis cases
  • How to interpret syphilis serology
  • Syphilis in pregnancy
  • Approaches to Partner Notification
  • Introduction to the South Australian Syphilis Register

Presenters:
Dr Alison Ward, Senior Consultant Sexual Health Physician
Njirrah Rowe, Aboriginal STI Education Coordinator and Partner Notification Officer

This activity is pending RACGP approval for 4 CPD activity points

This session is part of the Syphilis Outbreak Response and is a partnership between SHINE SA and Adelaide Sexual Health Centre.

No cost to attend.

Internet-based self-sampling for Chlamydia trachomatis testing

Söderqvist JGullsby KStark L, et al
Internet-based self-sampling for Chlamydia trachomatis testing: a national evaluation in Sweden

Abstract:

Objective Internet-based testing for Chlamydia trachomatis (CT) with self-sampling at home has gradually been implemented in Sweden since 2006 as a free-of-charge service within the public healthcare system. This study evaluated the national diagnostic outcome of this service.

Methods Requests for data on both self-sampling at home and clinic-based sampling for CT testing were sent to the laboratories in 18 of 21 counties. Four laboratories were also asked to provide data on testing patterns at the individual level for the years 2013–2017.

Results The proportion of self-sampling increased gradually from 2013, comprising 22.0% of all CT tests in Sweden in 2017. In an analysis of 14 counties (representing 83% of the population), self-sampling increased by 115% between 2013 and 2017 for women, compared with 71% for men, while test volumes for clinic-based sampling were fairly constant for both sexes (1.8% increase for women, 15% increase for men). In 2017 self-sampling accounted for 20.3% of all detected CT cases, and the detection rate was higher than, but similar to, clinic-based testing (5.5% vs 5.1%). The proportion of self-sampling men was also higher, but similar (33.7% vs 30.8%). Analysis of individual testing patterns in four counties over 5 years showed a higher proportion of men using self-sampling only (67%, n=10 533) compared with women (40%, n=8885).

Conclusions Self-sampling has increased substantially in recent years, especially among women. This service is at least as beneficial as clinic-based screening for detection of CT, and self-sampling reaches men more than clinic-based testing.

Increased usage and confidence in antiretroviral PrEP for the prevention of HIV found in UNSW study

UNSW, December 2019

The number of gay and bisexual men using PrEP to prevent HIV infection has almost doubled in the last two years, according to the latest report from the PrEPARE Project.  

The national online survey of Australian gay and bisexual men found that 43% of gay and bisexual men had used the antiretroviral drug in 2019, up from 24% in 2017. This increase aligns with falling HIV infections among gay and bisexual men in many jurisdictions.

The PrEP users surveyed reported positive experiences of using the drug, with the majority reporting reduced concern about HIV and increased sexual pleasure as a result. They also reported fewer concerns about disclosing PrEP use to others.

  • Read the 2019 survey report by the Centre for Social Research in Health.

 

“I’m never having sex with anybody ever again”: what helps PLHIV get over these feelings

nam/aidsmap, 27 January 2020

For people living with HIV, sexual adjustment after diagnosis is affected by fears of transmitting the virus and of possible rejection by sexual partners, new qualitative research shows. Healthy sexual adjustment over time is facilitated by partner acceptance; peer, community and professional support; and up-to-date knowledge of HIV transmission, including U=U.

Barriers to healthy sexual adjustment include the persistence of undue fears of transmission and rejection long after diagnosis, which may result in avoiding sex or pairing it with drugs and alcohol. Based on these findings, Dr Ben Huntingdon and colleagues at the University of Sydney propose a new model of sexual adjustment to HIV, published in the BMC Infectious Diseases journal.

Thirty participants (19 male, 11 female) out of 45 PLWH who agreed to be contacted completed the interview and questionnaire as part of the study.

Delayed linkage to HIV care among asylum seekers

Kronfli, N., Linthwaite, B., Sheehan, N. et al. Delayed linkage to HIV care among asylum seekers in Quebec, CanadaBMC Public Health 191683 (2019). https://doi.org/10.1186/s12889-019-8052-y

Abstract:

Background

Migrants represent an increasing proportion of people living with HIV in many developed countries. We aimed to describe the HIV care cascade and baseline genotypic resistance for newly diagnosed asylum seekers referred to the McGill University Health Centre (MUHC) in Montreal, Quebec, Canada.

Methods

We conducted a retrospective cohort study of patients linked to the MUHC from June 1, 2017 to October 31, 2018. We calculated the median time (days; interquartile range (IQR)) from: 1) entry into Canada to immigration medical examination (IME) (i.e. HIV screening); 2) IME to patient notification of diagnosis; 3) notification to linkage to HIV care (defined as a CD4 or viral load (VL) measure); 4) linkage to HIV care to combination antiretroviral therapy (cART) prescription; and 5) cART prescription to viral suppression (defined as a VL < 20 copies/mL). We reviewed baseline genotypes and interpreted mutations using the Stanford University HIV Drug Resistance Database. We calculated the proportion with full resistance to > 1 antiretroviral.

Results

Overall, 43% (60/139) of asylum seekers were newly diagnosed in Canada. Among these, 62% were late presenters (CD4 < 350 cells/μl), 22% presented with advanced HIV (CD4 < 200 cells/μl), and 25% with high-level viremia (VL > 100,000 copies/ml). Median time from entry to IME: 27 days [IQR:13;55]; IME to notification: 28 days [IQR:21;49]; notification to linkage: 6 days [IQR:2;19]; linkage to cART prescription: 11 days [IQR:6;17]; and cART to viral suppression: 42 days [IQR:31;88]; 45% were linked to HIV care within 30 days. One-fifth (21%) had baseline resistance to at least one antiretroviral agent; the K103 N/S mutation was the most common mutation.

Conclusions

While the majority of newly diagnosed asylum seekers were late presenters, only 45% were linked to care within 30 days. Once linked, care and viral suppression were rapid. Delays in screening and linkage to care present increased risk for onward transmission, and in the context of 21% baseline resistance, consideration of point-of-care testing and immediate referral at IME screening should be made.