Introduction: Chlamydia retesting at three months after treatment is recommended to detect reinfections, but retesting rates are low. We assessed the impact of combining home-collection with SMS reminders on retesting rates in three risk groups. Methods: A randomised controlled trial was undertaken, involving 600 participants diagnosed with chlamydia: 200 men who have sex with men (MSM), 200 women and 200 heterosexual men. Participants were recruited from Melbourne and Sydney Sexual Health Centres and randomised to the home group (SMS reminder at 3 months and home-collection) or the clinic group (SMS reminder).
The mailed home-collection kit included a self-collected vaginal swab (women), UriSWAB (Copan) for urine collection (heterosexual men), and UriSWAB plus rectal swab (MSM). The primary outcome was the proportion retested at 1-4 months after chlamydia diagnosis, and the secondary outcome was the proportion with repeat positive results at the 1-4 month retest. Any testing outside of study sites was collected and included in the outcomes. An intention to treat analysis was conducted.
Results: Overall 61% (183/300) of home group participants retested within 1-4 months of chlamydia diagnosis compared with 39% (118/300) in the clinic group, (p=<0.001). According to risk group, the differences were: 62% vs 45% (MSM), 65% vs 38% (women) and 55% vs 34% (heterosexual men), all p<0.05. Overall the proportion with a repeat positive result at the 1-4 month re-test was 16% (95%CI:11-23) (30/183) in the home group compared with 10% (95%CI:5-17) (12/118) in the clinic: 26% (95%CI:16-39) vs 11% (95%CI:4-24) (MSM), 12% (95%CI:5-22) vs 5% (95%CI:1-18) (women) and 11% (95%CI:4-22) vs 15% (95%CI:5-31) (heterosexual men).
Conclusion: SMS reminders combined with home-based collection was a very effective strategy to increase chlamydia retesting in all three risk groups, and also detected additional repeat infections in MSM. The acceptability to patients and health care provider costs are currently being evaluated.
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.
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.
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.