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Some serological hazards of HIV and Syphilis testing

Some serological hazards of HIV and Syphilis testing

Accurate automated Serological screening tests for syphilis and HIV have been developed in recent the years. These automated chemiluminesence assays are both sensitive and specific (>99%) and ideally suited for screening. However in a diagnostic setting there are still potential hazards in test selection, performance and interpretation with both syphilis and HIV serology. The traditional RPR test is labour intensive and has poor reproducibility when used for quantitative assessments of response to treatment. The prozone phenomenon can occur with this assay and result in false negative results being reported.

When performing Syphilis serology on Cerebrospinal because the sensitivity of the VDRL is as low as 20% therefore accurate diagnosis of neurosyphilis requires the use of sensitive assays such as TPPA and FTA. Contamination of CSF with serum form either damaged tissue in the CNS or traumatic lumbar puncture must be identified in order to eliminate false positive results with these assays.
The recently developed HIV “combo” tests can detect both HIV antigen and antibody in serum and have been shown to detect infection earlier than tests that detect antibody alone. Most clinicians now accept that a negative combo test 6 weeks after an exposure excludes HIV infection but antiviral treatment can alter the pattern of these serological tests in early infection. Confirmation of HIV infection requires a reactive western Blot but in advanced disease the blot pattern may revert to indeterminate and other supplemental testing may be required.

Areas of Interest / Categories: Australasian Sexual Health Conference 2011, HIV

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.

The importance of mobility in sustaining high STI prevalence in remote indigenous communities

Despite high rates of screening and treatment in many remote Indigenous communities in Australia, diagnosis rates for sexually transmitted infections (STI), chlamydia and gonorrhoea in particular, remain alarmingly high. One contributing factor may be the high rate of temporary mobility for residents of remote communities. We use mathematical modelling to explore the impact of mobility on STI transmission within remote communities.

Gay men prefer partner notification by short message service (SMS) rather than e-postcards: a web-based evaluation

In 2006 two new innovative features were added to the WhyTest website; the ‘Tell them’ service allowing visitors to forward anonymous e-postcard or short message services (SMS) to sexual partners who may have been exposed to an STI, and the ‘remind me’ service allowing visitors to register for a 3, 6 or 12 monthly SMS reminder for a sexual health check. We describe the usage of the new website functionality, and recognition of a health promotion campaign conducted in January-June 2007 to promote these new features.

Lighting the fire, not filling the pail - positioning sexuality in the Australian curriculum

This symposium presentation will discuss conceptual approaches to how processes underway to develop the Australian Curriculum might link to improved sexual health outcomes. It will also explore the assumptions underpinning the ‘partnership’ between health and education sectors to uncover both the opportunities and the pitfalls for those who want to promote young people’s learning. 

Oropharyngeal carcinoma related to human papillomavirus

Human papillomavirus (HPV) induced oropharyngeal squamous cell carcinoma is a unique subtype of oropharyngeal cancer. It has a significantly better prognosis than that caused by tobacco and/ or alcohol. The incidence of HPV related oropharyngeal cancer is raising in the western countries.

High chlamydia prevalence found among young Australian men and women - results from the Australian Chlamydia Control Effectiveness Pilot (ACCEPt).

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

Surgery for gender dysphoria was not routinely available prior to the 80’s, surgery and psychiatry having had an unhappy liaison. While gender dysphoria is DSM classified it’s not because it is deemed to be an illness, rather than to give guidelines as to establishing a diagnosis, and surgery is now deemed to be an appropriate activity.