Trichomonas vaginalis infection among women in a low prevalence setting

Sexual Health ◽  
2011 ◽  
Vol 8 (1) ◽  
pp. 65 ◽  
Author(s):  
Ruby N. N. Uddin ◽  
Nathan Ryder ◽  
Anna M. McNulty ◽  
Lynne Wray ◽  
Basil Donovan
Keyword(s):  
Sexual Health ◽  
Trichomonas Vaginalis ◽  
Health Centre ◽  
Health Clinic ◽  
Access To Health Services ◽  
Health Seeking ◽  
Retrospective Case ◽  
Access To Health ◽  
Data Collection Instrument ◽  
Low Prevalence

Objectives: Trichomonas vaginalis has become rare in Australian cities but remains endemic in some remote regions. We describe the prevalence and associations of infection among women attending an urban Australian sexual health clinic. Methods: A retrospective case control study was conducted with women diagnosed with T. vaginalis at Sydney Sexual Health Centre between January 1992 and December 2006. Proforma medical records for all women were reviewed to extract demographic, behavioural and diagnostic variables using a predefined data collection instrument. Results: Over the 15-year period, 123 cases of T. vaginalis were diagnosed, with a prevalence of 0.40%. Factors independently associated with infection were older age, vaginitis symptoms (adjusted odds ratio (AOR) 6.47; 95% confidence interval (CI), 3.29–12.7), sex with a partner from outside Australia (AOR 2.33; 95% CI, 1.18–4.62), a concurrent (AOR 3.65; 95% CI, 1.23–10.8) or past (AOR 2.67; 95% CI, 1.28–5.57) sexually transmissible infection, injecting drugs (AOR 7.27; 95% CI, 1.43–36.8), and never having had a Papanicolaou smear (AOR 7.22; 95% CI, 2.81–18.9). Conclusions: T. vaginalis infection was rare in women attending our urban clinic. Rarity, combined with an association with sex outside Australia, points to imported infections accounting for a large proportion of T. vaginalis infections in an urban population. The association with never having had cervical cancer screening, along with injecting drug use, likely reflects an increased prevalence in those with reduced access to health services or poor health seeking behaviours.

Transgender people attending a Sydney sexual health service over a 16-year period

Sexual Health ◽  
2007 ◽  
Vol 4 (3) ◽  
pp. 189 ◽  
Author(s):  
Victoria L. Hounsfield ◽  
Eleanor Freedman ◽  
Anna McNulty ◽  
Christopher Bourne
Keyword(s):  
Health Service ◽  
Sexual Health ◽  
Sex Work ◽  
Health Centre ◽  
Health Clinic ◽  
Risk Behaviours ◽  
Retrospective Case ◽  
Transgender People ◽  
Sexual Health Service ◽  
Sexually Transmissible Infections

Background: Previous studies have concluded that transgender people are a marginalised and stigmatised group, with high rates of sexually transmissible infections (STI), sex work, injecting drug use and multiple sexual partners. To our knowledge, this is the first study in Australia to focus on the sexual behaviour and sexual health needs of transgender people attending an urban sexual health clinic. Methods: A retrospective case note review was undertaken of the transgender attendees of the Sydney Sexual Health Centre between 1990 and 2006. Demographics, gender characteristics, risk behaviours, sexual health morbidity, psychosocial information and other significant features of the transgender population were assessed. Results: Forty clients were identified as transgender, of whom 36 (90%) were male-to-female and four (10%) were female-to-male. Seventeen (43%) had a history of sex work, 16 (40%) had injected drugs, 14 (35%) had had unprotected anal or vaginal sex in the past 3 months. Twenty (50%) clients had histories of a STI, including three (7.5%) that were HIV positive, and two were co-infected with hepatitis C. Genital warts and chlamydia were the most common diagnoses made during the study period. Physical examination was inadequately documented in 53% of first visits. Psychosocial morbidity was common. Conclusions: Transgender clients presented infrequently at this clinic. Although half reported few risks, the other half reported multiple risk behaviours and had most STI. These findings suggest that there needs to be improved sexual health service for transgender clients at our clinic.

Neisseria gonorrhoeae infection in urban Sydney women: prevalence and predictors

Sexual Health ◽  
2009 ◽  
Vol 6 (3) ◽  
pp. 241 ◽  
Author(s):  
Paula McDonagh ◽  
Nathan Ryder ◽  
Anna M. McNulty ◽  
Eleanor Freedman
Keyword(s):  
Sexual Health ◽  
Case Control Study ◽  
Health Centre ◽  
Case Control ◽  
Nucleic Acid Amplification ◽  
Health Clinic ◽  
Notification Rate ◽  
Low Prevalence ◽  
Asymptomatic Women ◽  
Control Study

Background: The notification rate of female gonorrhoea in urban Sydney is very low. With the increasing use of nucleic acid amplification tests (NAAT), demonstrating a low prevalence of gonorrhoea in women would have important implications for the reliability of positive results. We determined the prevalence of female cervical gonorrhoea in our urban sexual health clinic and identified associated clinical, behavioural and demographic variables that may allow more targeted screening practices. Methods: The Sydney Sexual Health Centre database was used to identify women tested for cervical gonorrhoea between 1997 and 2007. Diagnostic, demographic and behavioural information were extracted to ascertain the prevalence of gonorrhoea and describe variables associated with infection. Additionally, a case control study was conducted of cervical gonorrhoea cases from January 2000 to December 2005, with two gonorrhoea negative women selected for each case as controls. A blinded researcher examined each medical record to determine genital symptoms, being a contact of gonorrhoea, sex work, sex outside of Australia, injecting drug use. Results: Between 1997 and 2007, 77 women were diagnosed with cervical gonorrhoea, a prevalence of 0.37%. Results of the case control study reveal that women with gonorrhoea were more likely to be symptomatic [odds ratio (OR) 3.7, 95% confidence interval (CI) 1.7–8.4], be a known contact of gonorrhoea (OR 264, 95% CI 149–470), or have had recent sex overseas, or with a partner from overseas (OR 1.75, 95% CI 1.11–2.75). Conclusion: Cervical gonorrhoea infection is rare in our urban sexual health clinic, and even more unlikely in asymptomatic women without risk factors. This low prevalence of gonorrhoea, particularly in asymptomatic women, decreases the reliability of positive NAAT test results. This has important implications for the screening of asymptomatic women presenting to urban sexual health clinics in Australia.

49. SYPHILIS SCREENING PROFILE AT SEXUAL HEALTH CLINIC, ST GEORGE HOSPITAL & SUTHERLAND HOSPITAL

Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 303
Author(s):  
H. Tran ◽  
P. Konecny ◽  
C. Carmody
Keyword(s):  
Sexual Health ◽  
Health Centre ◽  
Health Clinic ◽  
Sexual Health Information ◽  
Presenting Symptoms ◽  
Information Program ◽  
Syphilis Screening ◽  
Behavioural Factors ◽  
Syphilis Serology

A retrospective analysis was conducted to describe the cases of Syphilis identified and managed at Short Street Centre and The Sutherland Sexual Health Centre, in South Eastern Sydney and Illawarra Area, from January 2000 to June 2007. Syphilis serology is routinely offered as part of an STI screen to new and follow-up patients as appropriate. Information on the diagnoses, demographic and other variables was extracted from the clinical database Sexual Health Information Program (SHIP) and analysed in SPSS v11. Information on age, gender, relationship status, country of birth, presenting symptoms, stage of Syphilis, type of treatment and subsequent RPR levels were confirmed from patient records. An analysis of the relative frequency of the stages of Syphilis from over 130 patients will be presented and their relationship to a number of demographic and behavioural factors.

21. GONORRHOEA INFECTION IN SYDNEY WOMEN

Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 292
Author(s):  
C. R. Emerson ◽  
P. McDonagh ◽  
A. McNulty ◽  
E. Freedman
Keyword(s):  
Demographic Data ◽  
High Rate ◽  
Health Clinic ◽  
Controlled Study ◽  
Retrospective Case ◽  
Time Period ◽  
Tubal Factor ◽  
Low Prevalence ◽  
Clinic Population ◽  
General Community

Background: Gonorrhoea is associated with undesirable reproductive health outcomes in women including pelvic inflammatory disease and tubal factor infertility. However there is low prevalence in the general community and some authors have suggested that only those women with risk factors should be tested. But can we predict who will have a positive gonorrhoea result? Methods: A retrospective, case controlled, study was undertaken in an inner Sydney public Sexual Health clinic between January 2000 and December 2005. Cases were all women with culture proven cervical n.gonorrheoea infection in the time period. These were case matched with subsequent women with a negative gonorrhoea culture test. Variables examined included demographics, sex worker status, country of birth, injecting drug use (IDU) status, presence of symptoms and concurrent STIs. Results: There were 40 women who were n.gonorrhoea culture positive during the study period and 27 cases and 23 controls reported any genital symptoms. (what were the confidence intervals?) The relative risk of having gonorrhoea if discharge was described was 1.75 (p�<�0.05). The cases had a high rate of concurrent STI including chlamydia. Conclusions: The only significant predictor of gonorrhoea in this group was the symptom of vaginal discharge. Thus in our clinic population behaviour, demographic data or cannot be used to determine who gets tested for gonorrhoea.

Triage in a public outpatient sexual health clinic

Sexual Health ◽  
2006 ◽  
Vol 3 (2) ◽  
pp. 87 ◽  
Author(s):  
Vickie Knight ◽  
Anna McNulty
Keyword(s):  
Sexual Health ◽  
Waiting Times ◽  
Health Centre ◽  
Wait Time ◽  
Health Clinic ◽  
Average Wait Time ◽  
Survey Tool ◽  
Time Flow ◽  
Sexually Transmissible Infections ◽  
Nurse Triage

Background:The increasing prevalence of sexually transmissible infections in Australia, coupled with a NSW Health Department requirement to target services to those most in need, has led many services to investigate patient triage as a way of better using scarce resources.2 In October 1997, a Triage Nurse position was trialled that aimed to facilitate the optimal flow of patients through the Sydney Sexual Health Centre (SSHC) clinic in an efficient and patient-focussed manner. A pre and post implementation time-flow study was conducted to analyse the effect. A staff survey was also completed to ascertain staff acceptance of the Nurse Triage system. Methods:A time-flow data survey tool was developed and placed in the medical record of every person attending the SSHC in one month in 1997 and again in 1999. The staff survey was an 11-item likert scale questionnaire administered to all centre staff. Data were analysed and average visit and waiting times were generated. Results:When comparing 1997 with 1999 data, the main results of note were that the length of consultation had been stable or decreased, the average wait time had remained stable or decreased and the wait time in the medical and nursing unbooked clinic had decreased. The average wait time for the unbooked clinic had decreased from ~24 minutes in 1997 to ~12 minutes in 1999. Conclusions:Since the introduction of Nurse Triage, the average overall waiting times for those who attend without an appointment has halved and the wait to see a doctor and a nurse has decreased. The majority of staff felt that the triage process had improved patient flow.

Do all women attending urban sexual health services need testing for gonorrhoea?

Sexual Health ◽  
2005 ◽  
Vol 2 (4) ◽  
pp. 259 ◽  
Author(s):  
Tim R. H. Read ◽  
Marcus Y. Chen ◽  
Catriona S. Bradshaw ◽  
Sriyakantha Beneragama ◽  
Christopher K. Fairley
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Sexual Health ◽  
Medical Records ◽  
Health Centre ◽  
Identifiable Risk Factor ◽  
Health Centres ◽  
Health Services Need ◽  
Low Prevalence ◽  
Asymptomatic Women

Asymptomatic women are often screened for gonorrhoea at Australian sexual health centres. The medical records of all women diagnosed with gonorrhoea at the Melbourne Sexual Health Centre (MSHC) between January 2002 and December 2003 were audited and the database was examined for risk factors in all women tested in 2003. Fifteen cases of gonorrhoea were identified among women at MSHC, all had symptoms or an identifiable risk factor. Asymptomatic women without risk factors may not require screening for Neisseria gonorrhoeae in low prevalence populations.

Introduction of screening guidelines for men who have sex with men at an STD clinic, the Melbourne Sexual Health Centre, Australia

Sexual Health ◽  
2005 ◽  
Vol 2 (4) ◽  
pp. 241 ◽  
Author(s):  
Nichole A. Lister ◽  
Anthony Smith ◽  
Christopher K. Fairley
Keyword(s):  
Sexual Health ◽  
Health Centre ◽  
Health Clinic ◽  
Chlamydia Screening ◽  
Screening Guidelines ◽  
Computer Reminder ◽  
Sex With Men ◽  
New Guidelines ◽  
One Year ◽  
The Impact

Background: A recent audit indicated that a substantial proportion of men who have sex with men (MSM) were not screened for rectal gonorrhoea and chlamydia at the Melbourne Sexual Health Clinic, Melbourne, Australia. In response, screening guidelines for MSM were introduced at the clinic using a computer reminder. The aim of this study was to evaluate the impact of the guidelines and alert on screening MSM for gonorrhoea and chlamydia. Methods: The medical records of MSM were reviewed for gonorrhoea and chlamydia screening by site (pharyngeal, urethral and rectal), four months before the implementation of the guidelines and alert (July to October 2002), and one year thereafter (beginning November 2002). Results: After the introduction of the guidelines there was a significant increase in rectal chlamydia testing (55% to 67%, P < 0.001), and significant reduction in pharyngeal chlamydia and gonorrhoea testing (65% to 28%, P < 0.001, and 83% to 76%, P = 0.015 respectively). The proportion of tests that were positive by any site did not change (7% to 7%). Conclusions: The introduction of a computer reminder for new guidelines was temporally associated with screening that conformed more closely to clinical guidelines.

Fuckbuddy partnerships among men who have sex with men – a marker of sexually transmitted infection risk

2017 ◽  
Vol 29 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Vincent J Cornelisse ◽  
Christopher K Fairley ◽  
Tiffany Phillips ◽  
Sandra Walker ◽  
Eric PF Chow
Keyword(s):  
Sexual Health ◽  
Health Centre ◽  
Romantic Attachment ◽  
Sexual Partners ◽  
Health Clinic ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Hiv Prevention Strategies ◽  
Sex With Men ◽  
Exposure Prophylaxis

‘Fuckbuddies’ are a type of regular sexual partner with whom men have ongoing sexual contact, generally in the absence of romantic attachment. We surveyed 989 men who have sex with men (MSM) at the Melbourne Sexual Health Centre, Australia, with the aim of determining the frequency of ‘fuckbuddy’ partnerships among sexual health clinic attendees and assessing their sexual risk. The majority (60%) of 1139 regular partnerships were described as ‘fuckbuddies’. Most MSM (63%) with a ‘fuckbuddy’ had multiple ‘fuckbuddies’. MSM with ‘fuckbuddies’ were more likely to also have casual sexual partners (odds ratio [OR] 5.7; 95% confidence interval 3.6–8.9) and had more casual sexual partners (median of 4 versus 1, p < 0.001) and more rectal chlamydia (12.4% versus 5.7%; adjusted OR 2.3; p < 0.05) than MSM without ‘fuckbuddies’, and this risk persisted after adjusting for total numbers of sexual partners. Our findings suggest that patients with ‘fuckbuddies’ are at particular risk of sexually transmitted infections. We argue that clinicians should specifically ask about ‘fuckbuddy’ partnerships as part of their risk assessment during patient interviews, as these patients may benefit from HIV prevention strategies such as pre-exposure prophylaxis (PrEP).

Cervicitis: limited clinical utility for the detection of Mycoplasma genitalium in a cross-sectional study of women attending a New Zealand sexual health clinic

Sexual Health ◽  
2013 ◽  
Vol 10 (3) ◽  
pp. 263 ◽  
Author(s):  
Jeannie Oliphant ◽  
Sunita Azariah
Keyword(s):  
Sexual Health ◽  
Trichomonas Vaginalis ◽  
Clinical Utility ◽  
Clinical Symptoms ◽  
Mycoplasma Genitalium ◽  
Cross Sectional Study ◽  
Health Clinic ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sexually Transmissible Infections

Background Although multiple studies have confirmed Mycoplasma genitalium as a cause of nongonococcal urethritis in men, there is less evidence of its pathogenicity in women. Our aims were to determine the prevalence of M. genitalium in a sample of women attending a sexual health clinic and to assess whether there was any association between the detection of M. genitalium and a diagnosis of cervicitis in this population. Methods: A cross-sectional study recruited women who required screening for sexually transmissible infections. Endocervical swabs to detect the presence of M. genitalium were taken in addition to routine testing for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. Data were collected on demographics, sexual behaviour, clinical symptoms and the presence of clinical or microscopic cervicitis. Results: The prevalence of M. genitalium was 8.4% (n = 22, 95% confidence interval (CI): 5.4–12.5%) in the study sample of 261 women. There was an association between the finding of cervical contact bleeding (odds ratio OR): 5.45; 95% CI: 1.93–15.42, P = 0.001) and microscopic cervicitis (OR: 2.64; 95% CI: 0.95–7.34, P = 0.06) and the presence of M. genitalium when compared with women with no diagnosed infection; however, the latter finding was not statistically significant. Conclusions: Although the prevalence of M. genitalium was high at 8.4%, the overall lack of any association between the findings of cervicitis and the detection of M. genitalium support the conclusion that cervicitis has poor clinical utility as an indicator for the presence of M. genitalium infection.

Follow-up of renal impairment results among attendees taking HIV Pre-Exposure Prophylaxis at a Sydney Sexual Health Clinic

2020 ◽  
Vol 31 (7) ◽  
pp. 689-693
Author(s):  
NB Comninos ◽  
R Foster ◽  
R Varma ◽  
C Bourne
Keyword(s):  
Renal Impairment ◽  
Sexual Health ◽  
Service Provision ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Health Centre ◽  
Health Clinic ◽  
Immunodeficiency Virus ◽  
Exposure Prophylaxis

Renal monitoring is recommended for Pre-Exposure Prophylaxis (PrEP) users. We aimed to explore follow-up and outcomes among PrEP users with renal impairment (defined as estimated glomerular filtration rate <65 mL/min/1.73 m2) attending Sydney Sexual Health Centre. Time to follow-up was analysed for impairment results over a 12-month period (January–December 2018); 48/2504 (1.9%) tests among 1700 attendees showed impairment. Follow-up occurred in 39/48 (81.3%) impairment results after a median of 42 days. PrEP was ceased in 3/6 cases of non-resolving/persisting impairment, with one case of subsequent human immunodeficiency virus infection. Maintaining engagement and follow-up of those with renal impairment are important aspects of PrEP service provision.

Sign in / Sign up

Export Citation Format

Share Document