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.
HIV positive individuals were referred by clinicians in the local area to a smoking cessation clinic established at RPA Sexual Health and offered a combination of nicotine replacement therapy (NRT ) and counselling. Demographic and behavioural data were collected, including an objective measurement of smoking (Smokalyzer) and a measurement of nicotine dependence (Fagerström score).
41 men aged 29-69 (median 46 years) were enrolled. More than half (51%) had been diagnosed with depression and less than one-third (30%) were currently employed. Participants had smoked for a median of 27 years (range 14-54 years), and mean number of cigarettes per day (CPD) smoked was 23 (range 4-50). Only 21 of 41 participants (51%) returned for at least one follow-up visit and 5 had successfully quit smoking. Successful quitting was associated with more years of smoking (p=0.031) and older age (p=0.060), but not baseline Fagerström score (p=0.582). Of participants who attended 6-month (n=18) and 12-month (n=16) follow-up, there was a significant decline in mean CPD from baseline (6-month:14 vs 27,p=0.003; 12-month:15 vs 26, p<0.001). Self-reported reduction in CPD was supported by Smokalyzer results at 6 months. 20/21 (95%) participants rated the intervention as helpful/very helpful. Participants identified the most helpful interventions as NRT (76%) and psychological support (71%).
Follow-up was poor in this disadvantaged population of HIV-positive men. Only 12% of participants were known to have quit smoking. Nonetheless, participants who attended follow-up significantly reduced their CPD and rated the intervention highly. Offering this service after-hours may improve attendance of a more diverse group of HIV positive individuals.
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.
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.
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.