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.

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.

Investigation of isolated positive syphilis enzyme immunoassay (ICE Murex) results

2002 ◽  
Vol 13 (11) ◽  
pp. 761-764 ◽  
Author(s):  
C Ooi ◽  
P Robertson ◽  
B Donovan
Keyword(s):  
Sexual Health ◽  
Enzyme Immunoassay ◽  
Health Centre ◽  
Health Clinic ◽  
Control Groups ◽  
History Of ◽  
Syphilis Serology ◽  
Clinic Population ◽  
Manual Review ◽  
Control Study

This study was conducted to determine the significance of an isolated positive (where all other syphilis serology is negative) syphilis enzyme immunoassay (EIA) test (ICE syphilis: Murex Diagnostics) in a sexual health clinic population. There were significantly greater numbers of isolated positive syphilis EIA tests at Sydney Sexual Health Centre (SSHC) (22/5478) compared to lower risk populations; Southeastern Sydney antenatal clinics (1/11560, P<0.01) and Sydney Children's Hospital (0/3550, P<0.01). We conducted a case control study comparing the cases at SSHC with two control groups drawn from the clinic population. A manual review of the case medical records searched for a history of suggested syphilis. Within the 22 cases, 32% had clinical grounds for suspecting that the EIA test signified syphilis. Men reporting homosexual contact in the past 12 months significantly distinguished cases from controls who tested negative for syphilis (OR=6.06). An isolated positive EIA test should prompt further investigation for syphilis, past or present.

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.

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).

scholarly journals Co-locating art and health: engaging civil society to create an enabling environment to respond to HIV in Indonesia

Sexual Health ◽  
2021 ◽  
Vol 18 (1) ◽  
pp. 84 ◽  
Author(s):  
Jamee Newland ◽  
Dwi Lestari ◽  
Mashoeroel Noor Poedjanadi ◽  
Angela Kelly-Hanku
Keyword(s):  
Civil Society ◽  
Sexual Health ◽  
Health Information ◽  
Health Clinic ◽  
Structured Interviews ◽  
Sexual Health Information ◽  
Interactive Engagement ◽  
Stigma And Discrimination ◽  
Health Project ◽  
Shared Understandings

Background This paper will report on the successful co-location of a community-based arts and sexual health project that aimed to engage, educate and create testing, treatment and care pathways at a co-located mobile sexual health clinic and community-controlled art gallery in Yogyakarta, Indonesia. Methods: Mixed methods were used to evaluate the project, including a visitor (n = 1181) and artist (n = 85) log book, a convenience audience survey (n = 231), and qualitative semi-structured interviews (n = 13) with artists and audience to explore the effect of arts-based activities on access to sexual health information and services, and stigma and discrimination. Results: In total, 85 artists curated five separate exhibitions that were attended by 1181 people, of which 62% were aged ≤24 years. Gallery attendance improved awareness and participatory and interactive engagement with sexual health information through a medium described as interesting, fun, cool, and unique. The co-located clinic facilitated informal pathways to sexual health services, including HIV/AIDS testing, treatment, and care. Importantly, the project created shared understandings and empathy that challenged stereotypes and myths, reducing stigmatising beliefs and practices. Conclusions: Arts-based programs are transformative and can be effectively implemented, replicated and scaled up in low-resource settings to create awareness and initiate for HIV prevention, testing, treatment, and care. Art-based health programs engages people in their communities, mobilises civil society, builds enabling environments to reduce stigma and discrimination and improves access to testing and prevention; essential features needed to end AIDS in Indonesia (and the Southeast Asia region) while improving the lives of those most vulnerable to infection.

scholarly journals Pre-Exposure Prophylaxis Counseling in a Community Sexual Health Clinic for Men Who Have Sex with Men in Lisbon, Portugal

2019 ◽  
Vol 32 (6) ◽  
pp. 441 ◽  
Author(s):  
Sofia Ribeiro ◽  
Miguel Rocha
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Sexual Health ◽  
National Health ◽  
Antiretroviral Drugs ◽  
Health Clinic ◽  
Eligibility Criteria ◽  
Sex With Men ◽  
Exposure Prophylaxis

Introduction: Pre-exposure prophylaxis is defined as the use of antiretroviral drugs to prevent HIV acquisition in uninfected individuals. Recognizing the increasing use of informal pre-exposure prophylaxis in Portugal, CheckpointLX, a community clinic targeted to men who have sex with men in Lisbon, Portugal, began offering counselling and follow-up services prior to formal introduction. This study aims to characterize pre-exposure prophylaxis users attending CheckpointLX before formal pre-exposure prophylaxis introduction in Portugal, and those who were referred to pre-exposure prophylaxis in the National Health Service following formal approval of pre-exposure prophylaxis.Material and Methods: Data was collected by peer counsellors between May 2015 and September 2018 and inserted in a database. Medical care followed the European AIDS Clinical Society recommendations for pre-exposure prophylaxis eligibility, initiation and follow-up. For formal pre-exposure prophylaxis, the General-Directorate for Health’s Pre-exposure Prophylaxis guidelines checklist was used.Results: Until the end of May 2018, CheckpointLX had a total of 90 appointments for wild pre-exposure prophylaxis, of which 64 (71%) were first time visits. As for the 380 service users referred to the National Health Service, most were Portuguese (n = 318, 84%), and the mean age was 31 (8.9) years old. Condomless sex in the last six months with partners of unknown HIV status was the most common eligibility criteria (n = 59, 83%).Discussion: Pre-exposure prophylaxis delivery should be complemented with effective information on the importance of immunization and education on safer practices of drug administration, in the scope of broader preventive sexual health care.Conclusion: Much remains to be done in Portugal to ensure that pre-exposure prophylaxis is available to those who need it the most. Offering pre-exposure prophylaxis at community clinics could be a first step.

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.

Screening of HIV-infected patients for non-AIDS-related morbidity: an evidence-based model of practice

Sexual Health ◽  
2011 ◽  
Vol 8 (1) ◽  
pp. 30 ◽  
Author(s):  
Rosalind Foster ◽  
Sian Morris ◽  
Nathan Ryder ◽  
Lynne Wray ◽  
Anna McNulty
Keyword(s):  
Chronic Disease ◽  
Sexual Health ◽  
Lifestyle Modification ◽  
Health Centre ◽  
Assessment Tools ◽  
Health Clinic ◽  
Significant Shift ◽  
Evidence Based ◽  
Traditional Role ◽  
Outpatient Settings

Objective: To develop guidelines to facilitate management of HIV infection as a chronic disease within the setting of a sexual health or other HIV outpatient clinic. Methods: We undertook a literature search to identify published guidelines and expert panel commentaries on screening and managing non-AIDS comorbidities in the general and HIV-infected population. We developed evidence-based guidelines for screening and management of non-AIDS comorbidities in HIV-positive clients attending the Sydney Sexual Health Centre (SSHC) that could be used in other HIV outpatient settings. Results: Guidelines have been developed that describe the recommended tests and an interpretation of results, and outline actions to take if abnormal. A summary document can be placed in the medical notes to record completed tests, and resources such as lifestyle modification pamphlets and cardiovascular risk assessment tools made easily available in clinics. Conclusions: These guidelines are being used by nurses and doctors to facilitate the management of HIV as a chronic disease in the SSHC. This represents a significant shift in practice from the traditional role of a sexual health clinic, and is likely to become increasingly important in resource-rich countries such as Australia where individuals with HIV are expected to live beyond their seventh decade. This model could be used in other HIV outpatient settings including general practice.

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