Introduction: Non-gonococcal urethritis (NGU) is a common but poorly understood clinical syndrome. Little has been published on aetiological agents with respect to sexual preference. This large series examines epidemiological and laboratory characteristics in acute NGU.
Methods: Retrospective review using the electronic medical-record database of Melbourne Sexual Health Centre, Australia, from January 2006 to December 2011. Cases were men with first presentation of symptomatic acute NGU. First-stream urine was routinely tested for C.trachomatis and M.genitalium by PCR, and selectively tested, for trichomoniasis by culture, HSV-1/2 and adenoviruses by PCR. To explore characteristics associated with pathogens, analyses were conducted stratifying by pathogen, pathogen-clusters and sexual preference. results: Of 5452 acute NGU cases, 4326(79%) first presentations were included; 799(19%) had C.trachomatis and 264(6%) M.genitalium detected. Viruses and trichomoniasis were tested selectively. Compared to heterosexual cases (MSW ), MSM (men who have sex with men) were less likely to have C.trachomatis(OR=0.5; 0.4-0.6) or M.genitalium(0.6; 0.5-0.9), more likely to report consistent condom use for anal/vaginal sex (AOR=3.9; 3.3-4.7) or only unprotected oral sex (UPOS) (14.5, 8.7-24.3). Pathogen-negative-NGU, when compared to bacterial-NGU, was significantly associated with exclusive UPOS (AOR=1.9, 1.2-3.0) and consistent condom use for anal/vaginal sex (AOR=2.1, 1.7-2.6); viral-NGU had similar characteristics to pathogen-negative NGU. Only 63% cases with bacterial-NGU and 32% with viral-NGU had ≥5 PMNL/HPF on urethral Gram-stain.
Conclusion: C.trachomatis or M.genitalium are less common in MSM with acute NGU compared to MSW. Pathogen-negative and viral-NGU have similar epidemiological characteristics; associated with recent sexual activity with males and report of low-risk practices such as oral sex and protected anal sex. These data indicate that the aetiologic spectrum of pathogens differs between MSM and MSW in acute NGU and behavioural associations implicate the oropharynx as a likely source of infection. Further identification of pathogens responsible for currently pathogen-negative NGU is required including possible oral pathogens. Disclosure of Interest Statement: None.
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.