For almost two decades, higher notification rates for chlamydia and gonorrhoea have been reported among Aboriginal than non-Aboriginal Australians. We evaluated a tailored sexual health quality improvement program (QIP), implemented in four regional Aboriginal Community Controlled Health Services (ACCHS), to determine whether it had an effect on chlamydia and gonorrhoea testing in 15-29 year olds.
Method: The QIP involved extracting and analysing of STI clinic data from patient management systems; six-monthly service visits to discuss current testing rates and the development of action plans by ACCHS staff. Using a before-and-after design, we compared the proportion of 15-29 year olds tested for chlamydia and gonorrhoea in a 12-month baseline (March 2011-February 2012) to a 12-month QIP period (March 2012-February 2013), by age group and sex. We used a chi-squared test to assess if the percentage tested was different between the two periods. –
Results: There were 2,422 15-29 year olds who attended the services in the baseline and 2,559 in the QIP period. Overall chlamydia testing was 14% and increased from the baseline compared to in the intervention period (8% to 21%,p<0.01). In females, the greatest increase in chlamydia testing was in 15-19 year olds (8% to 24%, p<0.01) and for males the greatest increase was seen in 20-24 year olds (4% to 21%,p<0.01). Similar increases were seen for gonorrhoea testing. Over the study period, chlamydia positivity was 12%, highest in 15-19 year olds (15%), followed by 20-24 (12%) and 25-29 years olds (6%). There were 70 chlamydia diagnoses in the QIP compared to 31 in the baseline period. Less than five cases of gonorrhoea were detected.
Conclusion: Implementation of QIP was followed by an increase in chlamydia and gonorrhoea testing among 15-29 year olds and resulted in the detection of more infections, particularly in 15-24 year olds.
Background: STI prevalence is changing. With society aging, life expectancy increasing and changes in sexual practices, STIs in senior citizens are of interest from economic, health related and social burden perspectives. Few studies on STIs in older men greater than 60 years of age exist, hence, a need to obtain further information about this subpopulation.
Conducting clinical audits in the context of continuous quality improvement (CQI) programs in Aboriginal Community Controlled Health Services (ACCHS) has provided valuable information regarding what factors facilitate or create challenges to improving outcomes in sexual health service delivery.
Homosexual men are at increased risk of anal cancer. Screening and treatment of the precursor, HSIL, has been advocated by some, but screening is not recommended in widely-accepted guidelines. We aimed to describe the prevalence, incidence, and clearance rates of anal HSIL, and association with human papillomavirus (HPV) status, in a community-recruited cohort of homosexual men.
Since 2009, the Victorian syphilis enhanced surveillance system has been collecting HIV status and syphilis re-infection status for infectious syphilis cases. Baseline data from 2009 showed that 31% of the infectious syphilis cases were HIV positive and 18% reported were re-infections. This suggested that syphilis transmission among a pool of HIV positive MSM was making a considerable contribution to the syphilis epidemic in Victoria. We analysed the data from 2009 to 2012 to determine whether this pattern of transmission is continuing. Notification data for infectious syphilis between 2009 and 2012 were reviewed by HIV infection status, syphilis re-infection status and risk factor exposures.
HIV positive gay men have high rates of cigarette smoking. The risks of smoking in addition to the elevated risk of cardiovascular disease and some malignancies in people with HIV means smoking cessation interventions should be prioritised.
We investigated the association between chlamydia detection and stage in the menstrual cycle to investigate whether chlamydia detection was higher at different stages of the cycle. Electronic medical records for women attending Melbourne Sexual Health Centre March 2011 - 31st December 2012, who were tested for chlamydia by nucleic acid amplification of high vaginal, cervical, or urinary samples, and who recorded a date of last normal menstrual period (LNMP) between 0-28 days were included in the analysis. Logistic regression was used to calculate OR (95%CI) for the association of chlamydia with menstrual cycle adjusted by demographics and behavioural variables.