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Helicobacter pylori infection and sexual risk factors: data from the heatlh in men study

Helicobacter pylori infection and sexual risk factors: data from the heatlh in men study

The routes of transmission of Helicobacter pylori (H. pylori) remain in question and studies about possible sexual transmission have been inconclusive. Understanding transmission routes may have important implications for prevention and treatment. Therefore, we decided to study the possible association between sexual risk factors and H. pylori infection in a community based cohort of HIV-negative homosexual men in Sydney.

Participants were 1,427 men from the Health in Men cohort study recruited from 2001 to 2004 and followed till 2007. Participants underwent annual face-to-face interviews regarding demographics, sexual risk factors and sexual transmitted infections, and blood samples were collected and stored. Stored sera were analyzed using H. pylori multiplex serology based on a GST capture immunosorbent assay combined with fluorescent bead technology (Luminex). Seropositivity was defined as reactivity with at least three out of 6 recombinant proteins.

At baseline, 1333 men had serum available for analysis and 249 (18.7%, 95% CI 16.6 – 20.9) were seropositive for H. pylori. In multivariate analyses, prevalent H. pylori infection was significantly associated with increasing age (p<0.001), positive syphilis serology (OR=2.03, 95% CI 1.03-4.00) and HSV 1 seropositivity (OR=2.65, 95% CI 1.70-4.14). Circumcised men were less likely to test positive (OR=0.59, 95% CI 0.43-0.81). Among those who were seronegative at baseline, 30 seroconverted during the study, an incidence of 0.85 per 100 person-years (95% CI 0.60-1.23). In multivariate analyses, H. pylori seroconversion was significantly associated with urethral gonorrhoea in the last 12 months (HR=5.95, 95% CI 1.98-17.86) and reporting receptive fisting with casual partners (HR=4.62, 95% CI 1.59-13.93). Circumcised men were less likely to seroconvert to H. pylori (HR=0.39, 95% CI 0.19-0.80).
The association of H pylori infection with some sexual practices, circumcision, syphilis, gonorrhoea and HSV1 infection, suggests a role for sexual transmission. Further studies to elucidate these assocations are warranted.

Areas of Interest / Categories: Australasian Sexual Health Conference 2011

Australasian Sexual Health Conference 2011

Current Medical Treatment of Premature Ejaculation

Over the past 20-30 years, the Premature Ejaculation (PE) treatment paradigm, previously limited to behavioural psychotherapy, has expanded to include drug treatment. Animal and human sexual psychopharmacological studies have demonstrated that serotonin and 5-HT receptors are involved in ejaculation and confirm a role for SSRIs in the treatment of PE. Multiple well-controlled evidence-based studies have demonstrated the efficacy and safety of SSRIs in delaying ejaculation, confirming their role as first-line agents for the medical treatment of lifelong and acquired PE. Daily dosing of SSRIs is associated with superior fold increases in IELT compared to on-demand SSRIs.

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ACCEPt is a multi-state cluster randomised trial that aims to increase annual chlamydia testing in 16-29 year olds attending general practice. 54 postcodes (80% in rural areas) are being randomised to a multi-faceted intervention and GP clinics within each postcode enrolled. The primary outcome is change in chlamydia prevalence, and a prevalence study is being conducted at the beginning and end of the trial. We report on the findings of the baseline prevalence study.

Surgical Aspects of Transgender Medicine

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