Patient delivered partner therapy (PDPT) is an important strategy for the control of chlamydia, yet only one jurisdiction in Australia has legalised the practice. We assessed the uptake of PDPT among clinicians working at Family Planning clinics (FPCs) and predictors of its use.
Methods: A cross sectional online survey of doctors and nurses working in Australian FPCs was conducted in May-June 2012. Logistic regression was used to assess factors associated with PDPT use.
Results: A total of 168 clinicians working at Australian FPCs participated in the survey (79% response rate). Over 80% saw PDPT as clinically beneficial in various ways. Sixty five per cent (n=100) of clinicians reported never using PDPT. There were 54 (35%) clinicians who reported ever using PDPT, 25% used it ‘sometimes’, and 10% used it ‘half the time’/’usually’/‘always’. In multivariate analysis, the following factors were independently associated with ever using PDPT: doctors compared to nurses (adjusted odds ratio(AOR):15.1,95%CI:4.9-46.2); over 5 years experience in reproductive and sexual health (AOR:5.25,95%CI:1.2–22.2); lower likelihood of encouraging clients to tell their partner to see a doctor (AOR:5.3:95%:1.5-18.4) and higher likelihood of following up with clients to check partner notification had been undertaken (AOR:9.8,95%CI:2.8–34.8). PDPT use was lower among clinicians who had concerns about PDPT’s legal status (AOR:0.16,95%CI:0.06-0.48). Other common concerns which were not statistically associated with PDPT use were: potential for allergic reaction; partner not receiving testing/treatment; partner may have another sexually transmitted infection not treated by antibiotic, missed opportunities for partner counselling.
Conclusion: PDPT was used by clinicians at FPCs, but not systematically. Uptake was greater among doctors and those with extensive experience in sexual and reproductive health. Although the vast majority of clinicians acknowledged the benefits of PDPT, concern about its legal status was a major impediment to the uptake of the strategy.
The case is of a 30 year-old HIV positive Zimbabwean woman (UK resident) who arrived in Australia in January 2011 on a one-year working visa. She was diagnosed with HIV in 2003 in the UK and commenced on Atripla® in 2005. She was first seen in Adelaide in May 2011, requesting a script for Atripla.®.
Background: Liquid based anal Papanicolaou smears, followed by High Resolution Anoscopy (HRA) guided biopsies are increasingly being advocated to identify areas of High Grade Anal Intraepithelial Neoplasia (HGAIN). We hypothesized that the ability to identify HGAIN would increase with experience of the anoscopist, and that comparison with contemporary Papanicolaou smears might yield insights into technical abilities.
Indigenous Australians experience a greater burden of sexually transmitted infections, however are less likely than the general population to access sexual health services. We examined the effectiveness of an Indigenous cultural appropriateness audit in assessing a sexual health clinic with low rates of Indigenous clients.
Despite the high proportion of young people annually accessing general practices, including Aboriginal Medical Services (AMS), testing for Chlamydia trachomatis remains relatively low in urban areas. A project officer was employed within the Institute of Urban Indigenous Health (IUIH) to serve a mentoring and facilitation role for the SE Queensland network of AMS and their sexual health workers, with a view to improving testing, management and follow-up of chlamydia and other STIs by community controlled medical services.
Monocytes are a heterogeneous cell population having specialised functions and differing phenotype. They are a link between innate immune system and adaptive immune system therefore, to identify if immune activation exists in HIV-1 individuals with controlled virema and recovered CD4 T cell counts, we assessed cell surface monocyte activation markers (MAM) within the monocyte subsets.
Involving consumers in healthcare decisions is important for high quality care. We previously tested a brief, consumer-led intervention consisting of three questions in a trial employing trained, standardized patients. The intervention enhanced discussion of evidence and increased patient involvement. We now report a research translation study which tested implementation with real patients at a reproductive and sexual health clinic.