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.
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.
This presentation, "Responding to the needs of consumers with complex trauma histories a consumer perspective" focuses on the needs of adult survivors of child abuse, highlighting the frequent