HIV results by phone: can we predict who will test HIV-negative?

Sexual Health ◽  
2010 ◽  
Vol 7 (4) ◽  
pp. 417 ◽  
Author(s):  
Simon Wright ◽  
Nathan Ryder ◽  
Anna M. McNulty
Keyword(s):  
Risk Factors ◽  
Sexual Health ◽  
Health Centre ◽  
Sexual Partners ◽  
Health Clinic ◽  
Test Results ◽  
Face To Face ◽  
Hiv Test ◽  
Sex With Men ◽  
Pro Forma

Introduction: In order to review the requirement for all patients to return for HIV test results, we sought to describe the number of cases of HIV infection detected at Sydney Sexual Health Centre among people who did not disclose known risk factors before testing. Method: The clinic database identified all HIV testing episodes between January 2004 and January 2007, along with gender, gender of sexual partners and test result. Pro-forma medical records were reviewed for each person who tested positive for gender of sexual partners, condom use, and sexual contact with a person from a country known to have a high HIV prevalence and injecting drug use. Results: During the 3-year period, a total of 13 290 HIV tests were performed. In men who have sex with men, 6194 tests were performed and 55 (0.88%) tested positive. In women and heterosexual men 7096 tests were performed, and only four (0.06%) tested positive. All four reported known risks for HIV before testing. Conclusion: Clients with no recognised risk factors for HIV are unlikely to test positive at our Australian sexual health clinic. Providing the option for low risk people to obtain their results other than face to face has advantages for both the clinic in terms of service provision and the clients in terms of time and the proportion who receive their result.

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).

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.

HIV is rare among low-risk heterosexual men and significant potential savings could occur through phone results

Sexual Health ◽  
2010 ◽  
Vol 7 (4) ◽  
pp. 495 ◽  
Author(s):  
Matiu R. Bush ◽  
Henrietta Williams ◽  
Christopher K. Fairley
Keyword(s):  
Sexual Health ◽  
Health Centre ◽  
Low Risk ◽  
Female Partner ◽  
Hiv Positive ◽  
Heterosexual Men ◽  
Test Results ◽  
Health Clinics ◽  
Hiv Test ◽  
Sexual Health Clinics

Background: The legislation in Victoria requires HIV-positive results to be given in person by an accredited health professional. Many sexual health clinics require all men to receive HIV results in person. Our aim was to determine the proportion of low-risk heterosexual men at a sexual health centre who tested HIV-positive. Methods: The electronic data on all HIV tests performed between 2002 and 2008 on heterosexual men at the Melbourne Sexual Health Centre (MSHC) was reviewed. The individual client files of all heterosexual men who tested HIV-positive were reviewed to determine their risks for HIV at the time that the HIV test was ordered. Results: Over the 6 years there were 33 681 HIV tests performed on men, of which 17 958 tests were for heterosexual men. From these heterosexual men, nine tested positive for the first time at MSHC (0.05%, 95% confidence interval (CI): 0.01%, 0.09%). These nine cases included six men who had had sex with a female partner from the following countries: Thailand, Cambodia, China, East Timor, Botswana and South Africa. Two men had injected drugs and one had a HIV-positive female partner. Of the 17 958 test results for heterosexual males, 14 902 (83% 95% CI: 84%, 86%) test results were for men who did not have a history of intravenous drug use or had sexual contact overseas. Of these 14 902 low-risk men, none tested positive (0%, 95% CI: 0, 0.00025). Conclusion: Asking the 83% of heterosexual men who have an extremely low risk of HIV to return in person for their results is expensive for sexual health clinics and inconvenient for clients. We have changed our policy to permit heterosexual men without risk factors to obtain their HIV-negative results by phone.

Hepatitis A vaccine uptake among men who have sex with men from a time-limited vaccination programme in Melbourne in 2018

2019 ◽  
Vol 96 (2) ◽  
pp. 110-114 ◽  
Author(s):  
Sam Burrell ◽  
Lenka A Vodstrcil ◽  
Christopher K Fairley ◽  
Alex Kilner ◽  
Catriona S Bradshaw ◽  
...  
Keyword(s):  
Sexual Health ◽  
Vaccination Programme ◽  
Hepatitis A ◽  
Health Centre ◽  
Vaccine Uptake ◽  
Health Clinic ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Living With Hiv ◽  
To Receive

ObjectivesIn 2017, an outbreak of hepatitis A among gay, bisexual and other men who have sex with men (MSM) was reported in Victoria, Australia. In 2018, the Victorian government implemented a free hepatitis A vaccination programme targeting all Victorian MSM. This study aimed to determine hepatitis A vaccine uptake among MSM in a sexual health clinic in Melbourne.MethodsAll MSM attending the Melbourne Sexual Health Centre (MSHC) in 2018 were included. Chart review was performed to determine the proportion of men vaccinated for at least one dose of hepatitis A and to examine why men did not receive the vaccine. Multivariable logistic regression was performed to examine the factors associated with vaccine uptake. Vaccine uptake was defined as receipt of at least one dose of hepatitis A vaccine.ResultsOf the 9582 MSM who attended MSHC in 2018, 61.3% (95% CI 60.3% to 62.2%) self-reported already being immune to hepatitis A. Of the 3713 remaining eligible men, 62.7% (95% CI 61.1% to 64.2%) received at least one dose of the hepatitis A vaccine on the day of attendance. Compared with MSM not living with HIV and not taking pre-exposure prophylaxis (PrEP), MSM taking PrEP (adjusted OR 1.28; 95% CI 1.01 to 1.62) were more likely to receive the vaccine. 1386 men (37.3%) did not receive the vaccine and 55.4% were not offered the vaccine by their treating clinician. 300 men (21.6%) were identified as non-immune after serological testing but did not return for vaccination. By the end of 2018, 85.5% of MSHC attendees (8196/9582) were immune to hepatitis A.ConclusionThe critical vaccination threshold for hepatitis A has been estimated at >70%. Continuation of the targeted hepatitis A vaccination programme will improve immunity among the MSM population to prevent ongoing transmission and the likelihood of future outbreaks.

Hepatitis A susceptibility in newly attending men who have sex with men to an urban sexual health centre

2020 ◽  
pp. 095646242096196
Author(s):  
Colin Fitzpatrick ◽  
Fionnuala Finnerty ◽  
Deborah Williams ◽  
Daniel Richardson
Keyword(s):  
Sexual Health ◽  
Hepatitis A ◽  
Health Centre ◽  
Herd Immunity ◽  
Risk Groups ◽  
Health Clinic ◽  
Record System ◽  
Young Msm ◽  
Sex With Men ◽  
The Uk

Within the UK, the majority of hepatitis A occurs in high risk groups such as men who have sex with men (MSM). It has been estimated that 70% of MSM need immunity to provide adequate herd immunity. We aimed to estimate the proportion of hepatitis A susceptibility in MSM throughout a 10-year period (2010–2019), and explore associated demographic factors. Using our Electronic Patient Record system, we extracted anonymous clinical data between for MSM at their first attendance; including hepatitis A IgG result, age, country of birth and diagnosis of an STI. Overall, 1401/6884(20%) were tested for hepatitis A IgG at their first attendance, with 626/1401 (45%, 95% CI = 42%–47%) showing susceptibility. Testing rates increased between 2010–2019 (OR = 67.79, 95%CI = 39.09–117.60, p = <0.0001); however, susceptibility remained similar (OR = 0.98, 95%CI = 0.33–2.89, p = 0.98). MSM aged 35 and under had significantly higher susceptibility vs MSM aged over 35 (OR 3.4176, 95%CI = 2.71–4.31, p = <0.0001). UK-born had significantly higher susceptibility vs non-UK born (OR 1.5, 95%CI = 1.2147–1.8618, p = 0.0002). Susceptibility of hepatitis A in MSM may be higher than necessary to control future outbreaks. It is important that effective targeting of MSM, particularly young MSM, occur at all levels of healthcare and not solely rely on opportunistic presentation at a sexual health clinic.

The impact of Grindr advertising on attendance and HIV testing by men who have sex with men at a sexual health clinic in northern Sydney

2020 ◽  
Vol 31 (10) ◽  
pp. 989-995
Author(s):  
Ashley Ubrihien ◽  
Andrew C Stone ◽  
Karen Byth ◽  
Stephen C Davies
Keyword(s):  
Sexual Health ◽  
Hiv Testing ◽  
Time Trends ◽  
Rate Ratio ◽  
Smartphone Application ◽  
Sexual Partners ◽  
Health Clinic ◽  
Heterosexual Men ◽  
Sex With Men ◽  
The Impact

Grindr is a geolocation smartphone application popular among men who have sex with men (MSM) to find sexual partners. We conducted a study to assess if attendance and HIV testing amongst MSM increased due to advertisements on Grindr that promoted our service. We measured clinic website hits by users clicking through from Grindr; we counted self-reported registrations that nominated referral from Grindr; and we compared new patient attendances and HIV tests in MSM with heterosexual men, for the 18 months preceding the intervention and the 18 months of the intervention. During the intervention the clinic’s website received 11,799 unique hits from Grindr users. The average monthly rate of attendances by new MSM increased 70.3% from 19.0 to 32.3, compared with a 5.5% increase among new heterosexual men from 45.6 to 48.1. The average monthly rate of HIV tests among MSM increased 43.6% from 47.0 to 67.6, compared with a 3.9% increase amongst heterosexual men from 40.0 to 41.6. The MSM:heterosexual men rate ratio for new patient attendances changed from 0.42 to 0.67 ( p < 0.001, adjusted for possible underlying time trends in each period), and for HIV tests this rate ratio changed from 1.18 to 1.63 ( p < 0.001, adjusted for possible underlying time trends in each period). The effects of the intervention did not significantly change over the course of the 18-month intervention. This study suggests that advertising on Grindr was effective and durable as a means of increasing attendance and HIV testing rates among MSM in northern Sydney.

scholarly journals HIV testing amongst older sexual health clinic attendees in England: an epidemiological study

2018 ◽  
Vol 30 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Sadie Bell ◽  
Joy Adamson ◽  
Fabiola Martin ◽  
Tim Doran
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Sexual Health ◽  
Hiv Testing ◽  
Health Clinic ◽  
Health Clinics ◽  
Hiv Test ◽  
Increased Risk ◽  
Sex With Men ◽  
Sexual Health Clinics

Older adults with HIV are at increased risk of late diagnosis. We aimed to explore the association between age and HIV testing rates in sexual health clinics in England using Public Health England data for 2009–2014. We investigated associations between attendee age and likelihood of HIV test offer, acceptance, and coverage. For each year, increasing age was associated with reduced likelihood of test offer (Rs −0.797 to −0.958, p < 0·01). Offer rates were highest for men who have sex with men (MSM), and lowest for heterosexual females (HSFs). HSFs had the greatest decline in offer rates with age (from 86.2% for age 25–29 to 52.1% for age 70+ in 2014). Odds ratios for test offer in 2014 for attendees aged 15–49 compared with attendees aged 50+ were 1.94 (95%CI: 1.88, 2.00) for heterosexual males (HSMs), 1.86 (95%CI: 1.81, 1.91) for HSFs, and 1.54 (95%CI: 1.45, 1.64) for MSM. Overall, there was no significant association between age and test acceptance in any year (Rs −0.070 to −0.547; p > 0·05). The strongest determinant of acceptance was sexual orientation; for attendees aged 50+, compared with HSMs, acceptance was higher for MSM (OR: 1.10; 95%CI: 1.06, 1.13) and lower for HSFs (OR: 0.30; 95%CI: 0.30, 0.31).

scholarly journals Can an HIVSmart! App-optimized Self-Testing Strategy be Operationalized in Canada?

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S426-S426
Author(s):  
Nitika Pant Pai ◽  
Megan Smallwood ◽  
Laurence Desjardins ◽  
Alexandre Goyette ◽  
Anne-Fanny Vassal ◽  
...  
Keyword(s):  
Testing Procedure ◽  
The Self ◽  
Health Clinic ◽  
Test Results ◽  
Testing Strategy ◽  
Self Testing ◽  
Hiv Test ◽  
Post Test ◽  
Self Test ◽  
Sex With Men

Abstract Background Although HIV self-tests are recommended by the WHO, they are not yet approved in Canada. Service delivery gaps such as linkages to counseling and care remain unachieved by offering self-tests without adequate support. In this first Canadian study, we evaluated the feasibility of operationalizing an innovative HIVSmart! app-optimized oral HIV self-testing strategy in men who have sex with men (MSM), presenting at a large sexual health clinic in Montreal. Methods Between July 2016 to February 2017, participants were offered the OraQuick In-Home HIV Test, and a tablet installed with the HIVSmart! app, at a private office in the clinic to simulate an unsupervised home environment. With the HIVSmart! app, participants independently performed and interpreted self-tests, and were linked to in-person post-test counseling and care. Self-test results were confirmed by laboratory tests (p24, Western Blot, RNA as needed). Results The mean age of the 451 participants was 34 years (18–73); 85% were well educated (beyond high school, n = 371/438); 53% (230/438) were frequent testers (past 6 months), and 13% were on PrEP (52/451). 99% (417/422) of participants found the HIVSmart! app helpful in guiding them through the self-testing procedure; 93% (418/451) of participants interpreted their tests accurately; and 94% (395/419) stated they would recommend the app-optimized self-testing strategy to their partners. Feasibility (completion rate of self-testing) was 93% (419/451), and acceptability of the strategy was high at 99% (451/458). All HIV self-test negative participants (448/451, 100%) were counseled following the self-test. Three participants self-tested positive, were confirmed HIV positive (0.7% prevalence), and were rapidly linked to care with a physician. Conclusion The HIVSmart! app-optimized strategy was feasible, and highly accepted by an educated, frequently testing, urban MSM population of Montréal. With the app, participants were able to interpret their test results accurately and were rapidly linked to care. Innovations like HIVSmart! which engage, aid, and facilitate linkages to care, can be adapted to suit the needs of many populations in Canada and internationally, maximizing global impact through reverse innovation. Disclosures All authors: No reported disclosures.

scholarly journals International travel as risk factor for Chlamydia trachomatis infections among young heterosexuals attending a sexual health clinic in Melbourne, Australia, 2007 to 2017

2019 ◽  
Vol 24 (44) ◽  
Author(s):  
Ei T Aung ◽  
Eric PF Chow ◽  
Christopher K Fairley ◽  
Jane S Hocking ◽  
Catriona S Bradshaw ◽  
...  
Keyword(s):  
Risk Factor ◽  
Chlamydia Trachomatis ◽  
Sexual Health ◽  
Health Centre ◽  
Sexual Partners ◽  
International Travel ◽  
Health Clinic ◽  
Inconsistent Condom ◽  
Number Of Sexual Partners ◽  
Males And Females

Background International travel is considered a risk factor for acquiring Chlamydia trachomatis; however, there are little empirical data to support this. Aim To examine the prevalence and risk factors for Chlamydia trachomatis infections among heterosexual international travellers (n = 28,786) attending the Melbourne Sexual Health Centre (MSHC), Australia, compared to Australian residents (n = 20,614). Methods We conducted a repeated cross-sectional study and analysed sexual behaviours and chlamydia positivity among heterosexual males and females aged ≤ 30 attending MSHC for the first time between January 2007 and February 2017. ‘Travellers’ were defined as individuals born outside of Australia who had resided in the country < 2 years. Associations between patient characteristics and chlamydia positivity were examined. Results Chlamydia positivity was higher among travellers (11.2%) compared with Australian residents (8.5%; p < 0.001). Male travellers had higher chlamydia positivity (12.1%) than Australian males (9.3%; p < 0.001), as did female travellers (10.4%) compared with Australian females (7.7%; p < 0.001). Travellers had a higher mean number of sexual partners than Australian residents among males (5.7 vs 4.7; p < 0.001) and females (3.6 vs 3.2; p < 0.001). Travellers from the United Kingdom, Europe, Ireland and New Zealand accounted for 29.6%, 21%, 8.5% and 5.8% of C. trachomatis infections, respectively. Chlamydia in males and females was associated with younger age (≤ 25), inconsistent condom use, a higher number of sexual partners (≥ 4 partners) and being a traveller (p < 0.001). Conclusions We found that international travel is an independent risk factor for chlamydia among young heterosexual travellers in Australia, who should therefore be a target group for chlamydia prevention.

scholarly journals Meningococcal vaccine uptake among men who have sex with men in response to an invasive meningococcal C disease outbreak in Melbourne, Australia

2020 ◽  
Vol 96 (4) ◽  
pp. 246-250
Author(s):  
Mario Martín-Sánchez ◽  
Christopher K Fairley ◽  
Catriona S Bradshaw ◽  
Marcus Y Chen ◽  
Eric P F Chow
Keyword(s):  
Sexual Health ◽  
Vaccination Programme ◽  
Health Centre ◽  
Vaccine Uptake ◽  
Health Clinic ◽  
Meningococcal Vaccine ◽  
Male Partners ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Hiv Negative

ObjectiveIn 2017, there was an outbreak of invasive meningococcal disease (IMD) serogroup C among men who have sex with men (MSM) in Victoria, Australia. A government-funded free meningococcal (MenACWY) vaccination programme targeting all MSM living in Victoria was launched between December 2017 and December 2018. The aim of this study was to examine the vaccine uptake among MSM attending a sexual health clinic in Melbourne.MethodsThis was a retrospective clinical audit of MSM attending the Melbourne Sexual Health Centre (MSHC) during the vaccination programme. We calculated the proportion of MSM who received the meningococcal vaccine on their first visit and at any time during the programme. We performed univariable and multivariable logistic regression to identify the factors associated with the vaccine uptake on the first visit.ResultsOf the 10 370 MSM who attended MSHC, 55.5% received the vaccine on their first visit and 67.4% at any time during the programme. MSM had higher odds of receiving the vaccine on the first visit if they were aged 16–25 years (adjusted OR (aOR) 1.21; 95% CI 1.08 to 1.35) or 26–35 years (aOR 1.17; 95% CI 1.07 to 1.29) in comparison with MSM older than 35 years; were HIV-negative and not on pre-exposure prophylaxis (aOR 1.80; 95% CI 1.56 to 2.09); had more than four male partners in the last 12 months (aOR 1.16; 95% CI 1.06 to 1.27); had male partners only (aOR 2.24; 95% CI 1.96 to 2.55); or were born overseas (aOR 1.11; 95% CI 1.03 to 1.21).ConclusionsTwo-thirds of the MSM attending a sexual health clinic received at least one dose of meningococcal vaccine. The vaccination programme coincided temporally with a dramatic reduction in the incidence of IMD. Vaccination should be further promoted among MSM and men who have sex with both men and women.

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