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Prevalence of CSF Alzheimer’s disease-like in middle-aged HIV+ individuals

Prevalence of CSF Alzheimer’s disease-like in middle-aged HIV+ individuals

To provide external CSF references, we tested 3 HIV-negative controls aged 64±2 and 5 AD patients aged 63±6 years. CSF was examined blind to the AD or HIV-associated neurocognitive disorder (HAND) status and vice versa. Risk for AD was evaluated using published cut-offs, which combines the three CSF biomarkers.

Based on the cut-offs: no elderly controls had a CSF-AD profile; all AD patients had at least one CSF-AD profile. Of the HIV+ individuals, 11.4% had a CSF-AD profile. Logistic regressions showed that APOE ε4/ε4 (p=0.03), having previously diagnosed severe HAND (p<0.03) and having lower current neurocognition (p<.002) were associated with a CSF-AD like profile.

Some patients with chronic HIV disease have 10-fold higher risk for AD based on CSF biomarkers, relative to the general population of the same age. However, it is not clear if this finding has the same clinical significance as in the general population. Known genetic factors for this age group were associated with a CSF-AD like profile, as well as past HAND and lower current neurocognition. Our research argues for renewed research effort to understand the consequences of brain ageing in HIV+ persons.


AIDS 2014

Immune Control of the HIV reservoirs

Prevalence of Sexually Transmitted Infections (STIs) and patient characteristics of older men over 60 years of age attending a public STD clinic in South Australia

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 to improve sexual health service delivery in primary health care services: Successes, challenges and lessons learnt

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.

High prevalence, incidence and clearance of anal high-grade squamous intraepithelial lesions (HSIL) in homosexual men: early evidence from the Study of the Prevention of Anal Cancer (SPANC)

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.

Is the stage of the menstrual cycle related to chlamydia detection?

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.

Unpacking Chlamydia in Victoria: Retrospective analysis of surveillance data to estimate reinfection

Chlamydia is prevalent among young Australians. The latest national surveillance report (2011) shows a rate of diagnosis of 1400 per 100,000 population aged 15-29 years. In Victoria, the number of notifications in 2011 was 19,238; 81% in 15-29 year olds; however notifications continue to rise in all age groups. International evidence suggests chlamydia reinfection is responsible for a substantial burden of infections. Given the associated health risks, monitoring reinfection in the population is important to understand disease burden and evaluate interventions. We describe the rate of reinfection and time between infections in Victoria, 2004-2011.

Online banner advertising: not the preferred medium for promoting a publicly funded sexual health clinic targeting men who have sex with men

Based on evidence of the success of utilising online campaigns to access MSM, RPA Sexual Health, a publically funded sexual health service (PFSHS) in the inner-west of Sydney, trialled two clinic advertising campaigns over a three year period. Both campaigns were developed with community consultation, targeting MSM and were predominantly online. They were evaluated and compared to measure their success and the effectiveness of advertising a PFSHS online.