Studies have shown that attendance rates of patients for review following NPEP, particularly at the three and six month intervals are not satisfactory. The follow-up of patients taking NPEP is important for the following reasons: 1. To increase compliance rates of NPEP regime completion 2. Ensure HIV seroconversion has not occurred 3. Allow regular STI screening in at risk patients 4. Reinforce education / behavioural counselling to decrease future high risk behaviours.
A pilot study we conducted of 13 patients receiving NPEP showed significant improvement in follow up attendance rates with active recalling. As a result this has become standard practice at our institution and we now present prospective data of MSM attendance for NPEP over the last 2 ½ years. Patients attending for NPEP are actively recalled by the clinic nurse/counsellor via phone call, sms or email to remind them of their upcoming appointment. Follow up attendance rates were prospectively collected and medical files reviewed for evidence of changes in high risk behaviour on subsequent visits.
A total of 52 MSM patients attended our institution for NPEP between September 2010 and February 2013. 44% of the study cohort was aged less than 25 years. 5 were excluded from analysis as they continued their management at another clinic. Of the remaining 47 patients; • 36/47 (76.6%) attended their 3 month appointment (compared to previously reported rates of 30-51% ) • 32/47 (68%) attended their 6 month appointment (compared to previously reported rates of 20% ) Of the 11 patients who did not attend their 3-month appointment, 6 still completed NPEP treatment. 23/47 patients (49%) reported new risk reduction behaviour on subsequent visits. 3 patients later acquired HIV though in all these cases it was unrelated to the initial risk behaviour incident for which NPEP was administered.
This follow up study suggests active recalling increases subsequent clinic attendance post NPEP, providing opportunity for essential STI screening / monitoring, education and further risk reduction counselling. A large proportion 23/47 (49%) reported risk reduction behaviour following this practice.
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.
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.
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.
Background: Medical termination of pregnancy (MTOP) has been available and successfully used as an option for women internationally since 1988. The regimen for MTOP results in abortion in 99% of cases. Since Mifepristone’s recent availability in Australia, Marie Stopes International has performed more than 10,000 MTOP procedures in Australia since 2009. In Victoria, the Law Reform Commission removed pregnancy termination (“abortion”) from the criminal statutes in August 2008, which provided women and health care professionals with protection from criminal prosecution for their legal involvement in termination of pregnancy (TOP).