HIV Incidence and Predictors of Incident HIV among Men Who Have Sex with Men Attending a Sexual Health Clinic in Melbourne, Australia

Cheung, King Tung; Fairley, Christopher K.; Read, Tim; Denham, Ian; Fehler, Glenda; Bradshaw, Catriona; Chen, Marcus Y; Chow, Eric P F

doi:10.1371/journal.pone.0156160

Cited by 30 publications

(19 citation statements)

References 23 publications

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“…While these two studies employed a different methodology to estimate incidence, their results suggest that incidence has remained relatively stable and high over the past 10 years among men attending STI clinics [19]. Our estimates are also comparable with those for cohorts of MSM in Portugal (2.8 per 100 PY) [20], Spain (2.4 per 100 PY) [21], Germany (3.3%) [22] and the USA (2.4 per 100 PY) [23] but higher than that for clinic-attending MSM in Australia (1.3 per 100 PY) [24]. Different mathematical models have been developed to estimate HIV incidence among the general MSM population.…”

Section: Discussionsupporting

confidence: 78%

HIV incidence in an open national cohort of men who have sex with men attending sexually transmitted infection clinics in England

et al. 2017

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Objective: To determine HIV incidence among men who have sex with men (MSM) who repeat test for HIV at sexually transmitted infection (STI) clinics in England, and identify associated factors.Design/methods: Annual HIV incidence and 95% confidence interval (CI) was calculated for a national cohort of MSM who tested HIV negative at any STI clinic in England in 2012 and had a follow up test within one year using routinely collected data. Cox regression analyses were performed to identify predictors of HIV acquisition and population attributable risk for HIV was calculated for predictors.Results: In 2012, 85,500 MSM not known to be HIV positive attended any STI clinic in England, and 31% tested for HIV at least twice within a year at the same clinic. HIV incidence was 2.0/100 personyears (py) (95%CI 1.8-2.2) among repeat testers. Incidence was higher among MSM of black ethnicity (3.2/100 py); and those with a bacterial STI diagnosis at the initial attendance (3.2/100 py). MSM with a previous syphilis or gonorrhoea infection were at significantly greater risk of acquiring HIV in the subsequent year (adjusted hazard ratio: 4.1 95%CI 2.0-8.3 and 2.1 95%CI 1.4-3.2, respectively).The predictors accounted for 37% of HIV infections.

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Section: Discussionsupporting

confidence: 78%

HIV incidence in an open national cohort of men who have sex with men attending sexually transmitted infection clinics in England

et al. 2017

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“…Potential antibiotic resistance has raised concerns that we may see further rises in gonorrhoea among MSM [12–16] with possible associated rises in HIV acquisition [17–22]. …”

Section: Introductionmentioning

confidence: 99%

Pharyngeal Gonorrhoea: The Willingness of Australian Men Who Have Sex with Men to Change Current Sexual Practices to Reduce Their Risk of Transmission—A Qualitative Study

et al. 2016

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BackgroundThe pharynx is a common site of gonorrhoea among men who have sex with men (MSM) and may serve as a reservoir for infection, with saliva implicated in transmission possibly through oral sex, kissing, and rimming. Reducing sexual activities involving saliva may reduce pharyngeal gonorrhoea. This study aimed to explore MSM’s views and knowledge of pharyngeal gonorrhoea and their willingness to change saliva transmitting sexual practices. MSM were also asked their views on using alcohol-containing mouthwash to potentially reduce transmission.MethodsUsing a qualitative descriptive approach, 30 MSM who were part of a larger study (GONE) conducted at the Melbourne Sexual Health Centre agreed to take part in semi-structured interviews between 14th May and 8th September 2015. The 10 interviews conducted face to face and 20 by telephone, lasted between 20–45 minutes. Data were analysed using qualitative content analysis.ResultsMost men considered pharyngeal gonorrhoea to be a non-serious sexually transmitted infection and attributed transmission primarily to oral sex. Almost all men reported they would not stop kissing, oral sex, or consider using condoms for oral sex to reduce their risk of pharyngeal gonorrhoea. Kissing and oral sex were commonly practised and considered enjoyable low risk sexual activities. Men were more likely to consider stopping sexual activities they did not enjoy or practice often, in particular insertive rimming. If proven effective, the majority of men reported they would use alcohol-containing mouthwash to reduce or prevent their risk of pharyngeal gonorrhoea.ConclusionFindings from this study suggest MSM are unlikely to stop saliva transmitting sexual practices they enjoy and consider low risk. Men would, however, consider using alcohol-containing mouthwash if found to be effective, highlighting the importance of exploring innovative strategies to reduce pharyngeal gonorrhoea.

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“…Untreated, gonorrhea can lead to severe sequelae, most notably pelvic inflammatory disease, ectopic pregnancy, and infertility in women (1). Moreover, gonorrhea infection can promote the transmission of other STIs, including HIV (2). A recent World Health Organization (WHO) report suggested there were 87 million new cases of gonorrhea in 2016 (3).…”

Section: Introductionmentioning

confidence: 99%

Trends and Risk Factors for Antimicrobial-Resistant Neisseria gonorrhoeae , Melbourne, Australia, 2007 to 2018

Williamson

Fairley

Howden

et al. 2019

Antimicrob Agents Chemother

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Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a major public health problem. Traditionally, AMR surveillance programs for N. gonorrhoeae have focused mainly on laboratory data to describe the prevalence and trends of resistance. However, integrating individual-level risk factors (e.g., sexual orientation or international travel) with laboratory data provides important insights into factors promoting the spread of resistant N. gonorrhoeae. Here, over a 12-year period, we assessed the trends and risk factors for resistant N. gonorrhoeae in individuals attending a large publicly funded sexual health center in Melbourne, Australia. A total of 7,588 N. gonorrhoeae isolates were cultured from 5,593 individuals between 1 January 2007 and 31 December 2018. The proportion of isolates with penicillin resistance decreased from 49.5% in 2007 to 18.3% in 2018 (ptrend < 0.001) and from 63.5% in 2007 to 21.1% in 2018 for ciprofloxacin resistance (ptrend < 0.001). In contrast, the proportion of isolates displaying decreased susceptibility to ceftriaxone increased from 0.5% in 2007 to 2.9% in 2018 (ptrend < 0.001), with a significant increase in low-level azithromycin resistance, from 2.5% in 2012 to 8.2% in 2018 (ptrend < 0.001). Multivariate analysis identified risk factors for multidrug-resistant (MDR) N. gonorrhoeae, namely, female sex and country of birth, with MDR isolates more common in individuals born in northeast Asia, further highlighting the importance of this region and international travel as factors in the cross-border transmission of MDR N. gonorrhoeae. Future surveillance work should incorporate additional epidemiological and genomic data to provide a comprehensive overview of the emergence and spread of resistant N. gonorrhoeae.

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HIV Incidence and Predictors of Incident HIV among Men Who Have Sex with Men Attending a Sexual Health Clinic in Melbourne, Australia

Cited by 30 publications

References 23 publications

HIV incidence in an open national cohort of men who have sex with men attending sexually transmitted infection clinics in England

HIV incidence in an open national cohort of men who have sex with men attending sexually transmitted infection clinics in England

Pharyngeal Gonorrhoea: The Willingness of Australian Men Who Have Sex with Men to Change Current Sexual Practices to Reduce Their Risk of Transmission—A Qualitative Study

Trends and Risk Factors for Antimicrobial-Resistant Neisseria gonorrhoeae , Melbourne, Australia, 2007 to 2018

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