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What is new in POC tests for STIs? Can we treat more STIs with POC tests?

What is new in POC tests for STIs? Can we treat more STIs with POC tests?

Since young adults and high-risk populations with health inequities bear the significant portion of infections, more acceptable tests such as point of care tests (POCT) and more easily available techniques for diagnosing STIs, are required in order to address the epidemic of STDs. Molecular tests for the detection of STIs are now the gold standard for diagnosing Chlamydia trachomatis infections, such assays are becoming increasing available, and are now recommended as the tests of choice by the Centers for Disease Control and Prevention.

Since young adults and high-risk populations with health inequities bear the significant portion of infections, more acceptable tests such as point of care tests (POCT) and more easily available techniques for diagnosing STIs, are required in order to address the epidemic of STDs. Molecular tests for the detection of STIs are now the gold standard for diagnosing Chlamydia trachomatis infections, such assays are becoming increasing available, and are now recommended as the tests of choice by the Centers for Disease Control and Prevention. However having an accurate and rapid POC test which has result of having the patient being treated before leaving the clinic or doctor’s office has much appeal and can be potentially cost saving.  
This presentation will provide an update on the use of new and older nucleic acid amplification tests (NAATs) for the detection of STIs. It will present how non-invasive specimen types are now being used to screen individuals in non-traditional venues. Methods of using self-collected urogenital samples at home can provide outreach into the community for screening. POC tests that are in the development pipeline will be discussed.
There are four commercially available NAAT assays for the diagnosis of chlamydia: Amplicor PCR, ProbeTec SDA, APTIMA Combo2 TMA and RT-PCR m2000. One new NAAT test, kPCR is in clinical trials. There is now a commercial NAAT amplification test for Trichomonas vaginalis, that is FDA cleared. Sensitivities and specificities are uniformly high and range well above 90% for sensitivity and above 98-99% for specificity. New specimen types such as urine, self-collected vaginal swabs, and liquid PAP cervical samples are approved for detection of STIs using NAATs. Additionally, self-collected samples have been shown to be able to be successfully used outside the clinic in non-traditional venues and to provide screening for asymptomatic patients, who might not attend a clinic. Internet recruited home samples are showing promise as a new way to screen individuals at risk for STIs. Home collected samples are acceptable to individuals and are highly accurate. New POC tests will soon be available.   New tests and new methods of reaching individual at risk for STIs will provide effective tools for preventing transmission of STIs. 
 


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 Sexuality Education of Australian GLBTIQ Youth: Messages, Usefulness, Recommendations

There have been many recent media debates and controversies in Australia over what sexuality education in schools should constitute. Concerns for sexual health can inform pushes for educating young people on topics such as hygiene, biology or safe sex. Yet other agendas privilege censorship, the teaching of abstinence, a focus on sexual morality or the inclusion of gay rights and other diverse perspectives. A review of the literature uncovered the key approaches to sexuality education, and 14 specific messages they offer young people about their sexuality. This presentation considers the relevance of these messages for gay, lesbian, bisexual, transgender and intersex students.

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.

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.

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.

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.