Patients enrolled in the TREAT Asia HIV Observational Database (TAHOD) and receiving first-line ART were included. Treatment modification was defined as ≥1 drug change and failure was defined according to the WHO 2010 criteria. Logistic regression was used to determine predictors of antiretroviral use. Predictors of modification and failure were analyzed using Cox models.
Data from 7461 eligible patients were analysed. Non-nucleoside reverse transcriptase inhibitors (NNRTIs) have gained popularity over protease inhibitors (PIs) in the past 10 years. The adjusted odds of starting an NNRTI in 2011/12 were 6 times what they were prior to 2002 (p<0.01). Since 2005, lamivudine/emtricitabine has been used by almost 100% of ART initiators whilst tenofovir and zidovudine are replacing the use of stavudine (figure 1). Efavirenz and nevirapine use has changed little over time whilst the waning demand for first-line PIs is now dominated by lopivavir and atazanavir. First-line treatment modification was associated with earlier year of ART start, older age, homosexual and intravenous drug use exposure groups, and prior exposure to mono/dual ART. Treatment failure was associated with earlier year of ART start, low baseline CD4 cell count and previous exposure to mono/dual ART.
The observed trends in first-line ART use in Asia reflect changes in availability and global treatment recommendations. In conjunction with other improvements in HIV care, these changes have resulted in a declining rate of treatment modification and treatment failure over the past decade.
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.
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.
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.