2015 Participant Summaries

2017 Participant Summaries

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Study:
Neisseria gonorrhoeae DNA bacterial load in men with symptomatic and asymptomatic gonococcal urethritis

Researchers:
Priest D, Ong JJ, Chow EPF, Tabrizi S, Phillips S, Bissessor M, Fairley CK, Bradshaw CS, Read T, Garland S, Chen M

Publication:
Sexually Transmitted Infections. 2017 doi: 10.1136/sextrans-2016-052950

Summary:
We measured the amount of bacteria causing gonorrhoea in men with symptoms of urethral discharge and men with no urethral symptoms. The amount of gonorrhoea bacteria in both groups was measured by urethral swab samples. Twenty men were recruited into the study: 16 had urethral discharge and 4 others had no symptoms with urethral gonorrhoea. The amount of gonorrhoea bacteria was much higher in the men with symptoms compared to men with no symptoms.


Study:
The influence of sexual activity on the vagina microbiota and Gardnerella vaginalis clade diversity in young women.

Researchers:
Vodstrcil LA, Twin J, Garland SM, Fairley CK, Hocking JS, Law MG, Plummer EL, Fethers KA, Chow EPF, Tabrizi SN, Bradshaw CS

Publication:
PLoS ONE 2017. 12(2): e0171856 doi:10.1371/journal.pone.0171856

Summary:
Vaginal bacteria remained remarkably the same over time, particularly when lactobacilli were the main bacteria found. Vaginal bacteria in women having unprotected penile-vaginal sex were more likely to be Lactobacilli iners or Gardnerella vaginalis. Women who reported penile-vaginal sex or who developed bacterial vaginosis (BV) were more likely to have more than one type of Gardnerella vaginalis compared to a single type. The presence of Gardnerella vaginalis type 4 was found more often in women with developing or having BV. While penile-vaginal sex did not appear to result in a persistent change in the vaginal bacteria over time, it was associated with an increased in Gardnerella vaginalis types in young women with and without BV, supporting sexual transmission of Gardnerella vaginalis types and those types found in bacterial vaginosis



Study:

Patterns of sexual behaviour and sexual healthcare needs among transgender individuals in Melbourne, Australia, 2011-2014
Researchers: Bellhouse C, Walker S, Fairley CK, Vodstrcil LA, Bradshaw CS, Chen MY, Chow EPF

Publication:
Sexually Transmitted Infections 2017, September 2016, doi: 10.1136/sextrans-2016-052710

Summary:
The majority of transgender individuals in this study were single or had never married. Almost half of the individuals had engaged in sex work during their lifetime. Low rates of condom use with both male and female sexual partners were reported and also much lower rates of injecting drug use (IDU). Chlamydia was found in 7%; gonorrhoea in 5%; 5% had syphilis and 1% had HIV. Hormone use for reassignment was reported by 63% of individuals and reassignment surgery was reported by 27%.



Study:

Effect of availability of HIV self-testing on HIV testing frequency among gay and bisexual men at higher risk of infection: a wait-list randomised controlled trial (FORTH)

Researchers:
Jamil MS, Prestage G, Fairley CK, Grulich AE, Smith KS, Chen MY, Holt M, McNulty A, Bavington BR, Conway DP, Wand H, Keen P, Bradley J, Kolstee J, Batrouney C, Russell D, Law M, Kaldor JM, Guy RJ

Publication:
Lancet HIV, February 2017 6(4):e241-250 doi.10.1016/S2352-3018(17)30023-1


Summary:
Frequent testing of individuals at high risk of HIV is vital to current prevention strategies. HIV-negative high-risk gay and bisexual men who reported no condoms use for anal intercourse or more than five male sexual partners in the past 3 months were included and assigned to either free HIV self-testing plus facility-based testing or standard care with facility-based testing only. HIV self-testing increased the frequency of testing in high-risk gay and bisexual men, and those who delayed testing or had never been tested before compared to standard care testing.


Study:

Willingness to change behaviours to reduce the risk of pharyngeal gonorrhoea transmission and acquisition in men who have sex with men: a crossectional survey

Researchers:
Eric PF Chow, Sandra Walker, Tiffany Phillips, Christopher K Fairley

Publication:
Sex Transm Infect 2017; 0:1–3. doi: 10.1136/sextrans-2017-053148


Summary:
Participants of this study were asked how likely they would change their behaviours to reduce the risk of throat gonorrhoea. Six different options for possible prevention were included: (1) stop tongue kissing; (2) stop having receptive oral sex; (3) stop performing rimming; (4) stop using saliva as a lubricant during anal sex; (5) use condoms during oral sex; and (6) use alcohol-containing mouthwash daily. Of the 926 MSM who completed the questionnaire, most said (65%) they were likely to use mouthwash daily to reduce the risk of throat gonorrhoea; would stop using saliva as a lubricant (63%), and would stop rimming (50%). Most of the MSM said they were unlikely to stop tongue kissing (78%). Younger MSM who had less male partners were unlikely to use mouthwash daily as an intervention to reduce the risk of throat gonorrhoea.


Study:
Asymptomatic and symptomatic urethral gonorrhoea in men who have sex with men attending a sexual health service

Researchers:
Ong JJ, Fethers K, Howden BP, Fairley CK, Chow EPF, Williamson DA, Petalotis I, Aung E, Kanhutu K, De Petra V, Chen MY

Publication:
Clinical Microbiology and Infection 2017 25L1) doi. 10.1016/j.cmi.2017.02.020

Summary:

Gonorrhoea testing was performed on all urine specimens from MSM including MSM with reported symptoms of urethral discharge or reported no symptoms. Gonorrhoea was found in urine samples in men without symptoms. Screening MSM with no reported symptoms for gonorrhoea is recommended.


Study:

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

Researchers:
Cornelisse VJ, Fairley CK, Phillips T, Chow EPF

Publication:
International Journal of STD and AIDS 2017
doi: 10.1177/0956462417717647

Summary:
Clinicians describe sexual partners as either regular partners or casual partners. Having casual partners is linked to a greater risk of getting an STI or HIV. Fuckbuddies are a type of regular partner, but are found to be strongly at risk of having STIs. In this study we showed that MSM who have fuckbuddies have roughly double the risk of anal chlamydia compared to those who don't have fuckbuddies. Having anal chlamydia infection is a sign for receptive anal sex without condoms, and a flag for being at risk for HIV. Clinicians and researchers should specifically ask patients about fuckbuddies, as this partnership type is not recognised by asking about regular and casual partners.


Study:

Biological and behavioural factors associated with positive chlamydia retests

Researchers:
Smith KS, Guy R, Danielewski J, Tabrizi SN, Fairley CK, McNulty AM, Rawlinson W, Saville M, Garland SM, Donovan B, Kaldor JM, Hocking JS

Publication:
Sexually Transmitted Diseases 2017 44(7): 417 – 422 doi: 10.1097/OLQ.0000000000000616

Summary:  
Repeat chlamydia infection after treatment is common. Participants with chlamydia (200 women, 200 heterosexual men, and 200 men who have sex with men (MSM) were invited for repeat testing after 3 months and to complete a survey at 4 months. A total of 290 participants (100 women, 89 heterosexual men, 101 MSM) were retested Positive retests were more common among MSM than heterosexuals. Treatment failure was more common in MSM with rectal chlamydia, reinforcing concerns about azithromycin treatment failure

 


Study:
Post-treatment detection of azithromycin in high-vaginal material using liquid chromatography and tandem mass spectrometry (LC-MS/MS).

Researchers:
Vodstrcil LA, Rupasinghe TWT, Kong KYS, Tull D, Worthington K, Chen MY, Huston WM, Timms P, McConville MJ, Fairley CK, Bradshaw CS, Tabrizi SN, Hocking JS

Publication:
PLoS One 2017 12(5): 177615 doi.org/10.1371/journal.pone.0177615

Summary:
Azithromycin is recommended for the treatment of urogenital chlamydia infection although the standard 1 gram dose sometimes fails to get rid of the infection (treatment failure). One hypothesis proposed for treatment failure has been insufficient levels of the antibiotic at the site of infection. We used an assay to measure azithromycin concentration in high-vaginal swabs to monitor how concentrations changes over time following routine azithromycin treatment. Our study confirmed that a single 1g dose of azithromycin is rapidly absorbed and remains in the vagina at relatively high levels for at least a week, suggesting that poor antibiotic absorption is unlikely to be an explanation for treatment failure.

Study:
A qualitative study of means to improve partner notification following an HIV diagnosis among men who have sex with men in Australia.

Researchers:
Tomnay JE, Hulme-Chambers A, Bilardi JE, Fairley CK, Huffam S, Chen MY

Publication:
AIDS Patient Care and STDs 2017, 31 (6): 269 – 274 doi: 10.1089/apc.2017.0080

Summary:
Men who have sex with men (MSM) recently diagnosed with HIV were interviewed about partner notification (PN). MSM found PN difficult and uncomfortable and described fear about potential consequences of PN. However, they felt it was the right thing to do. Regular partners were more likely to be notified in person, because of the availability of contact information and because of a sense of moral responsibility. Few contact details for casual partners were kept and they preferred PN strategies that allowed them to remain anonymous, mainly because they met casual partners online or through apps and were often a once-off or anonymous sex. Most described unexpected positive responses from partners who were contacted personally by the men. Our study showed that participants want professional support to carry out PN, especially with casual partners, as well as support around having HIV and treatments of HIV infection.


Study:
Saliva use in sex: associations with use of smartphone dating applications in men who have sex with men

Researchers:
Eric PF Chow, Vincent J Cornelisse, Tim RH Read, Marcus Y Chen, Catriona SBradshaw and Christopher K Fairley

Publication:
International Journal of STD & AIDS July 2017, doi: 10.1177/0956462417727669

Summary:
This study aimed to investigate whether MSM who met their partners via smartphone dating applications are more likely to engage in sexual practices such as rimming (oro-anal sex), and use partner’s saliva as a lubricant. MSM who used smartphone dating applications were more likely to get rimmed, and more likely to use partner’s saliva as a lubricant during anal sex, compared to MSM who met their partners in gay bars. These practices are highly associated with the risk of gonorrhoea.


Study:
Medication adherence, condom use and sexually transmitted infections in Australian PrEP users: interim results from the Victorian PrEP Demonstration Project

Researchers:
Lal L, Audsley J, Murphy D, Fairley CK, Stoove M, Roth N, Moore R, Tee BK, Puratmaja N, Anderson PL, Leslie D, Grant RM, De Wit J, Wright E
Publication: AIDS 2017 31(12): 1709 - 1714 doi: 10.1097/QAD.0000000000001519

Summary:
Taking HIV pre-exposure prophylaxis (PrEP) is associated with less condoms being used for anal sex. Participants recruited from three general practice clinics and one sexual health clinic in Melbourne consented to take daily PrEP for 30 months. Sexual practice data, HIV and sexually transmitted infection (STI) test results were collected at baseline and 3-monthly during follow up. Adhering to taking PrEP medication was high. A decline in condom use was found together with an increase in STIs over the first 12 months of PrEP.


Study:
Saliva use as a lubricant for anal sex is a risk factor for rectal gonorrhoea among men who have sex with men; a new public health message

Researchers:
Chow EPF, Cornelisse VJ, Read TRH, Lee D, Walker S, Hocking JS, Chen MY, Bradshaw CS, Fairley CK

Publication:
Sexually Transmitted Infection, 2017; 92(7): 532 - 536  doi: 10.1136/sextrans-2015-052502


Summary:
Apart from penile–anal intercourse, other anal sexual practices are common in men who have sex with men (MSM) including rimming, fingering and saliva use as a lubricant for anal sex. A survey was conducted in MSM attending Melbourne Sexual Health Centre. Other anal sexual practices were common among MSM: receptive rimming (70.5%), receptive fingering or penis dipping (84.3%) and using partner’s saliva as a lubricant for anal sex (68.5%). Using saliva as a lubricant for anal sex is a common sexual practice in MSM, and was linked to having rectal gonorrhoea, whereas receptive rimming and fingering or penis dipping were not linked to having rectal gonorrhoea. Almost half of rectal gonorrhoea cases could be eliminated if MSM stopped using partner’s saliva for anal sex.


Study:
Getting the terminology right in sexual health research: the importance of accurately classifying fuck buddies among men who have sex with men

Researchers:
Clare Bellhouse, Sandra Walker, Christopher K Fairley, Eric PF Chow, Jade E Bilardi

Publication:
Sexually Transmitted Infections 2017; 29 March doi.10.1136/sextrans-2016-053000

Summary:
The aim of this report was to raise attention of how terminology about partners in men who have sex with men (MSM) is used in research, in particular to ‘fuck buddies’. Thirty MSM attending the Melbourne Sexual Health Centre were interviewed and asked for their views on terms they used to describe their relationships and sexual partners. Emotional attachment often defined the type of relationship. There was a consensus among men that partners for ‘sex only’ were classified as casual partners and partners with whom there was an emotional attachment or had a formal relationship with were classified as ‘regular partners’. The use of the term ‘fuck buddy’ for both a regular partner and a casual partner was less clear.


Study:
Human papillomavirus prevalence in unvaccinated heterosexual men after a national female vaccination program

Researchers:
Dorothy A. Machalek, Eric P. F. Chow, Suzanne M. Garland, Rebecca Wigan, Alyssa M. Cornall, Christopher K. Fairley, John M Kaldor, Jane S. Hocking, Henrietta Williams, Anna McNulty, Charlotte Bell, Lewis Marshall, Catriona Ooi, Marcus Y. Chen, and Sepehr N. Tabrizi

Publication:
Journal of Infectious Disease 2017; 215: 203-208

Summary:
The high uptake of the human papillomavirus (HPV) vaccine in Australia has led to a large drop in human papillomavirus (HPV) genotypes 6, 11, 16, and 18 in women and girls aged less than 26 years. In 2014 to 2016 511 sexually active unvaccinated heterosexual males aged 16–35 years provided a penile swab sample for HPV genotyping and also completed a questionnaire. The 4 genotypes in the vaccine were much lower in unvaccinated males aged less than 26 years (3%) than in those aged more than 26 years (14%). The other genotypes not included in the vaccine were similar in men aged less than 26 years and in those aged 26 or more years. Unvaccinated younger men may have benefited from vaccination of their female partners (herd protection).


Study:
Women view key sexual behaviours as the trigger for the onset and recurrence of bacterial vaginosis

Researchers:
Bilardi, JE, Walker, S, Bellhouse, Temple-Smith, M., C, McNair, R., Mooney-Somers J, Vodstrcil L., Fairley CK., Bradshaw C

Publication:
PLoS ONE 2017; 12(3): e0173637.doi:10.1371/journal.pone.0173637

Summary:
Women who previously had bacterial vaginosis completed a questionnaire about their experience of BV. Women reported that the onset and reoccurrence of BV was triggered by sexual activity rather than other lifestyle factors. The top 3 factors women attributed to both BV onset and recurrence were: 1) unprotected sex; 2) sex with a new male partner; and 3) sex in general. While many women felt BV was sexually transmitted and supported partner treatment, they did not consider BV an STI.


Study:
Molecular diagnosis of bacterial vaginosis: does adjustment for total bacterial load or human cellular content improve diagnostic performance?

Researchers:
Plummer EL, Garland SM, Bradshaw CS, Law MG, Vodstrcil LA, Hocking JS, Fairley CK, Tabrizi SN

Publication:
Journal of Microbiological Methods 2017; 133: 66 - 68 doi:10.1016/j.mimet.2016.12.024

Summary:
We looked at using a molecular diagnostic test that measured the amount of bacteria in bacterial vaginosis (BV) among women. A diagnosis of BV did not increase when compared to current methods of diagnosis.


Study:
Self-reported use of mouthwash and pharyngeal gonorrhoea detection by nucleic acid amplification test

Researchers:
Eric P.F. Chow, Sandra Walker, Tim R.H. Read, Marcus Y Chen, Catriona S Bradshaw and Christopher K Fairley

Publication:
Sexually Transmitted Diseases, May 2017; doi: 10.1097/OLQ.0000000000000654

Summary:
Using alcohol-containing mouthwash may reduce throat gonorrhoea. We looked at whether men who have sex with men (MSM) who said they used mouthwash had throat gonorrhoea. The men completed a short questionnaire on their mouthwash use and they were also tested for throat gonorrhoea. Throat gonorrhoea was found more often in younger men under 24 years than men over 25 years. Reported daily use of mouthwash increased with age. More detailed studies are needed to examine whether mouthwash could be recommended to reduce throat gonorrhoea.

 


Study:

Quadrivalent vaccine-targeted human papillomavirus genotypes in heterosexual men after the Australian female human papillomavirus vaccination programme: a retrospective observational study

Researchers:
Chow EPF, Machalek DA, Tabrizi SN, Danielewski JA, Fehler G, Bradshaw CS, Garland SM, Chen MY, Fairley CK

Publication:
Lancet Infectious Diseases 2017; 17(1): 68–77 doi: 10.1016/S1473-3099(16)30116-5 

Summary:
Australia introduced a national human papillomavirus vaccination (HPV) programme for young women in April, 2007. This study reports the HPV yearly trends among young, sexually active, predominantly unvaccinated heterosexual men with chlamydia infection during an 11-year period. A dramatic fall was seen in the 4 HPV genotypes included in the vaccine in Australian-born men after the introduction of a national female vaccination programme. This fall in the 4 HPV genotypes fits in with reductions in genital warts in men reported in previous studies. These findings provide the first evidence that the female vaccine provides indirect protection (herd protection) to their male partners from the HPV genotypes included in the vaccine. 

 


Study:
HIV testing self-efficacy is associated with higher HIV testing frequency and perceived likelihood to self-test among gay and bisexual

Researchers:
Jamil M, Bavinton B, Fairley CK   Grulich AE, Holt M, Smith K, Chen MY, McNaulty A, Conway D, Keen P, Bradley J, Russell D, Kaldor J

Publication:
Sexual Health 2017; 14: 164-169  doi: 10.1071/SH16100

Summary:
This study looked at whether there has been a change in HIV testing among men who have sex with men (MSM) over the past 20 years at the South Australia Specialist Sexual Health (SASSH) clinic. Medical records of MSM who attended the SASSH at their first visit between 1994 and 2015 were used. The number of MSM who reported as ever having a test for HIV went down. The proportion of MSM who returned to the clinic for HIV testing within 12 months did not change, with less than 40% returning for HIV tests. The number who had an HIV test on the day they attended the clinic increased to approximately 90%. Regular and frequent  HIV testing is essential for HIV prevention and care. New approaches are needed to encourage the uptake of HIV testing to find early HIV infection.