Background: RACGP ‘Red Book’ guidelines recommend annual chlamydia testing for women and men aged 16–29 years, but there are a number of barriers to rural young people seeking testing in their local area. This mixed method analysis investigates the acceptability of chlamydia testing ingeneral practice for young adults living in rural Australia.
Methods: Quantitative and qualitative data collected as part of the Australian Chlamydia Control Effectiveness Pilot (ACCEPt) were used. Patients aged 16–29 attending 150 mostly rural participating clinics were asked to complete a questionnaire and provide a specimen for chlamydia testing. The questionnaire asked about future chlamydia testing intent and attitudes towards chlamydia testing reminders. In addition, interviews were conducted with 20 patients attending participating clinics.
Results: 4284 men and women completed questionnaires (response rate = 70%). Over 80% of participants were attending a general practitioner (GP) in their local area and 76% were attending for a non–sexual health reason. Most respondents (86%; 80% males versus 88% females, p<.01) were willing to have another chlamydia test in 12 months and 91% (86% males versus 93% females, p<.01) found reminders to have another test in 12 months acceptable. Interview participants favoured being ‘offered’ the test as an opportunity rather than a mandate, and supported being offered the test in a non–sexual health consultation. Patients were also strongly in support of being reminded to have another test in 12 months. Cost of the test was seen as a potentially significant barrier, and female participants expressed a preference to consult with female GPs.
Conclusions: Young people in rural areas will agree to a chlamydia test if offered by their local GP, even if they are attending for a non–sexual health reason. Cost of the test and lack of female GPs were identified as deterrents to testing. Disclosure of Interest Statement: ACCEPt was commissioned and funded by the Australian Government Department of Health and Ageing. Additional funding has been received from the National Health and Medical Research Council, the Victorian Department of Health and NSW Health.
The majority of HIV diagnoses including delayed diagnoses in Australia occur among men who report homosexual contact – hereafter called gay and bisexual men (GBM). Delayed diagnosis is strongly associated with increased HIV-related mortality and morbidity. People who are unaware of their HIV-positive status may also be unwittingly transmitting HIV. We assessed trends in delayed HIV diagnoses among GBM in Australia.
HIV-associated leishmaniasis, endemic in the Mediterranean basin is a growing problem in India, Brazil and East Africa. Despite surviving for than 20 years, the clinical course of our visceral-leishmania (VL)-HIV co-infected patient illustrates several management challenges including diagnosis, speciation and drug resistance; monitoring burden of disease; access to and use of VL-treatments; end-organ toxicity and the combined immunosuppressive effects of HIV-VL.
Adherence to combination antiretroviral therapy (cART ) plays an important role on treatment outcomes. The TREAT Asia Studies to Evaluate Resistance – Monitoring Cohort Study (TASER-M) collects patients’ adherence based on a Visual Analogue Scale. The aim of this analysis was to assess the rates of, and factors associated with, suboptimal adherence in the first 24 months of initial cART in Asian patients.
REACH was a collaborative research and practice initiative to develop evidence building frameworks, capacity, tools and resources with the Victorian HIV community partnership.
HIV disease is associated with chronic inflammation and activation of the innate immune system. This state, as measured using plasma markers of inflammation, persists following suppression of HIV viremia using antiretroviral therapy, and may increase risk of non-AIDS co-morbidities. The causes of innate immune activation in the setting of virological suppression are unclear. Natural killer (NK) cells are innate immune cells that kill virus-infected and transformed cells without prior sensitization. We have shown that NK cells are activated both phenotypically (elevated expression of HLA-DR) and functionally (increased spontaneous degranulation measured by CD107a surface expression) in virologically suppressed (VS) HIV+ individuals. NK cells also lose expression of CD16, the receptor which mediates antibody-dependent cellular cytotoxicity.
Regular HIV testing is recommended in men who take sexual risks. We assessed the relationship between perceived barriers to HIV testing, and frequency of testing among men who engaged in unprotected anal intercourse with casual partners (UAIC), to inform HIV testing strategies.
Gay men remain the primary population affected by HIV in Australia. While recent attention has been focused on increasing HIV testing and the use of antiretroviral-based prevention to reduce infections, it is equally important to sustain safe sex and other risk reduction practices. Increases in unprotected anal intercourse (UAI), for example, may counteract any beneficial changes in testing and treatment.