SMS reminders increased HIV/STI re-testing among HIV negative MSM. SMS offers a cheap, efficient system to increase HIV/STI re-testing in a busy clinical setting.
SMS reminders increased re-screening in patients diagnosed as having chlamydia at a sexual health clinic. The clinic now plans to introduce electronic prompts to maximise the uptake of the initiative and consider strategies to further increase re-screening.
Guidelines for universal blood and body fluid precautions (UBBFP) designed to protect health care workers from occupational exposure to blood borne pathogens have been developed by the US Centers for Disease Control. These guidelines have been adopted by the New South Wales Department of Health and all major Australian hospitals. To determine the degree of understanding and utilization of UBBFP by Australian nurses, 192 nurses were asked about UBBFP, recent occupational exposures and understanding of hepatitis B transmission. Seventy-three per cent of nurses stated they 'used UBBFP at all times', yet only 58% of these nurses stated they always used gloves when 'handling blood or blood equipment' and just 85% reported always using 'gloves to clean up urine and faeces'. Overall 146 (76%) nurses experienced 230 occupational exposures (168 mucocutaneous, 48 percutaneous) in the previous 6 months. These were more common in men (P=0.024) and in operating theatres (95% of nurses) and high dependency units (88%). Percutaneous exposures were significantly more frequent in nurses who stated they did not wear gloves when handling blood/blood equipment (P=0.036), whereas mucocutaneous exposures were significantly more frequent among nurses who stated they do not adhere to UBBFP at all times (P=0.005). Eighty-three per cent of nurses experiencing exposures did not report all of them. In this study knowledge and adoption of UBBFP translated directly into lower risk for an occupational exposure. It is concluded that educational strategies to improve understanding and adoption of UBBFP by nurses are required.
The Xpress clinic improved the patient journey, and although not fully used, more patients were seen overall in the clinic with minimal additional costs. Marketing of the Xpress clinic is underway.
Clinician prompts to reduce missed opportunities and multiple recall interventions may be needed to increase HBV vaccination completion in this high risk population.
Background
Sexually transmissible infections (STIs) have been increasing in men who have sex with men (MSM) in recent years; however, few studies have investigated the prevalence or antimicrobial resistance in rectal Mycoplasma genitalium in this group. This study aimed to determine the prevalence and predictors of rectal M. genitalium in MSM attending an urban sexual health service in Sydney, Australia, namely the Sydney Sexual Health Centre (SSHC), as well as estimate the rate of macrolide resistance. Methods: A prospective cross-sectional analysis was conducted of rectally asymptomatic MSM having a rectal swab collected as part of their routine care. Participants self-collected a rectal swab to be tested for M. genitalium and completed a 14-item questionnaire that provided information on behavioural risk factors. The prevalence of rectal M. genitalium was determined and multivariate analysis was performed to assess the associations for this infection. Positive specimens then underwent testing for macrolide-resistant mutations (MRMs) using the ResistancePlus MG assay (SpeeDx, Eveleigh, NSW, Australia). Results: In all, 742 patients were consecutively enrolled in the study. The median age was 31 years (interquartile range 27–39 years), with 43.0% born in Australia. Overall, 19.0% of men were bisexual, 22.9% were taking pre-exposure prophylaxis (PrEP) and 4.3% were HIV positive. The prevalence of rectal M. genitalium was 7.0% (95% confidence interval (CI) 5.3–9.1) overall and 11.8% in those taking PrEP. On multivariate analysis, PrEP use was significantly associated with having rectal M. genitalium (odds ratio 2.01; 95% CI 1.09–3.73; P = 0.01). MRMs were detected in 75.0% (36/48; 95% CI 60.4–86.4%) of infections. Conclusion: Rates of rectal M. genitalium infection were high among asymptomatic MSM attending SSHC and MRMs were detected in 75% of infections. PrEP use was found to be significantly associated with rectal M. genitalium infection. These data contribute to the evidence base for screening guidelines in MSM.
The scope of practice of Australian sexual health nurses is varied. While questions remain as to the reasons for difference, the authors argue that the specialty needs to work toward a national model for basic sexual health nursing care. It is recommended that this model be based on knowledge of and rationales for variations in practice.
This study identified that free testing kits and online communication worked well as a means of engaging young people and raising awareness of sexual health. However, the requirement to drop-off urine samples at selected locations was not well accepted.
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