Medicine & Health

Publication Search Results

Now showing 1 - 10 of 12
  • (2010) Lee, Evelyn; Holt, Martin; Zablotska, Iryna; Prestage, Garrett; McKenzie, Tex; Batrouney, Colin; Kennedy, Mike; Dixon, Matt; de Wit, John
    Report
    The Melbourne Gay Community Periodic Survey is a cross-sectional survey of gay and homosexually active men recruited at a range of gay community sites in Melbourne. The project was funded by the Victorian Department of Health and supported by the Victorian AIDS Council and PLWHA Victoria. The major aim of the survey was to provide data on sexual, drug use and testing practices related to the transmission of HIV and other sexually transmissible infections (STIs) among men involved in Melbourne’s gay community.

  • (2010) Holt, Martin; Zablotska, Iryna; Lee, Evelyn; Ryan, Dermot; Down, Ian; Heard, Todd; Nairn, Karen; Prestage, Garrett; de Wit, John
    Report
    The Town and Country Gay Community Survey is a cross-sectional survey of gay and homosexually active men recruited from Sydney and regional New South Wales. 1371 men were recruited for the Sydney Gay Community Periodic Survey in August 2009 and 469 men were recruited between August and November 2009 from regional New South Wales. This report compares these two groups of men (from the city and regional areas) on a range of indicators.

  • (2010) Deacon, Rachel; Newland, Jamee; Harris, Magdalena; Treloar, Carla; Maher, Lisa
    Report
    In NSW, hepatitis C has been the subject of specific surveillance and prevention programs for many years. Despite this experience and significant investment, there remain challenges both in understanding the epidemiology of this virus and in implementing effective prevention programs. This study aimed to enhance the public health surveillance program and contribute to the evidence base for hepatitis C prevention in NSW. The aim of Phase One was to develop and trial a methodology for an ongoing program of enhanced surveillance of hepatitis C virus (HCV) in NSW. Phase Two aimed to increase understanding of the practices, settings, networks and structures contributing to HCV infection.

  • (2010) Treloar, Carla; Byron, Paul; Mccann, Pol; Maher, Lisa
    Journal Article
    Several candidate vaccines for hepatitis C are currently in preclinical development or the early stages of clinical trials. Implementing trials of these vaccines among people who inject drugs will be challenging. Previous research, particularly willingness to participate studies in relation to HIV vaccines in marginalised groups, has focused on the modifiable characteristics of individual participants. This qualitative research with people who inject drugs, health staff and clinicians focuses on social, organisational and structural elements of vaccine trial designs which may exclude or reduce the participation of people who inject drugs.

  • (2010) Kelly, Angela; Worth, Heather; Man, N.; Nosi, S.; Emori, R.; Mek, A.; Akuani, F.; Kupul, M.; Kepa, B.; Walizopa, L.; Pirpir, L.; Cangah , B.; Siba , P.; Frankland, Andrew; Rawstorne, Patrick
    Journal Article
    Papua New Guinea (PNG) is in a phase of scaling up access to antiretroviral therapy (ART), and adherence to the newly available drug therapy is becoming an important issue. This paper examines adherence to ART in a sample of 374 HIV-positive people in six provinces in PNG. Participants were recruited to the study using non-probability sampling. Sixty-two % of participants reported complete adherence (no missed or late doses in the past week) and 79% reported not missing any doses in the last week. Revival church members were significantly more likely to report having missing a treatment dose(s) (66%). Those living in the Highlands and those attending Catholic health clinics were significantly more likely to be adherent to their treatment. Age, gender, marital status, education level and employment type did not show significant association with treatment adherence. Adherence rates in PNG are not alarming, indicating that people with HIV can adhere to treatment despite the challenges of living in PNG.

  • (2010) Prestage, Garrett; Imrie, John; Kippax, Susan; Donovan, Basil; Templeton, David; Cunningham, Amy; Mindel, Adrian; Cunningham, Philip; Kaldor, John; Grulich, Andrew; Jin, Feng Yi
    Journal Article

  • (2010) Holt, Martin; Rawstorne, Patrick; Wilkinson, Jennifer; Worth, Heather
    Journal Article
    A significant minority of Australian men who have sex with men (MSM) have never been tested for HIV and many men do not test as often as recommended. Using data from 1770 HIV-negative and untested MSM collected in a national, online survey, we compared men who had never tested for HIV with those who had tested over 12 months ago and men who had tested over 12 months ago with those that had tested in the past year. Two multivariate logistic regression models were constructed. Compared with men tested over 12 months ago, untested men were younger, less educated, less likely to have unprotected anal intercourse with a regular male partner, less likely to have sought advice from a doctor, nurse or community organisation, more likely to expect HIV-negative disclosure, had fewer gay friends and spent more time using social networking websites. Compared with men who had tested over 12 months ago, men who had tested within the last year were younger, more likely to expect HIV-negative disclosure and disclose to casual partners, more likely to have sought advice from a doctor or nurse, had attended gay pools, gyms or beaches and had more gay friends and more male sex partners. Our findings suggest that the Internet and sex education in schools are important ways to promote HIV testing to untested MSM. Testing reinforcement messages delivered through gay community outreach and primary care will reach previously tested MSM.

  • (2010) Jin, Feng Yi; Jansson, James; Law, Matthew; Prestage, Garrett; Zablotska, Iryna; Imrie, John; Kippax, Susan; Kaldor, John; Grulich, Andrew; Wilson, David
    Journal Article
    Objective: The objective of this study is to estimate per-contact probability of HIV transmission in homosexual men due to unprotected anal intercourse (UAI) in the era of HAART. Design: Data were collected from a longitudinal cohort study of community-based HIV-negative homosexual men in Sydney, Australia. Methods: A total of 1427 participants were recruited from June 2001 to December 2004. They were followed up with 6-monthly detailed behavioral interviews and annual testing for HIV till June 2007. Data were used in a bootstrapping method, coupled with a statistical analysis that optimized a likelihood function for estimating the per-exposure risks of HIV transmission due to various forms of UAI. Results: During the study, 53 HIV seroconversion cases were identified. The estimated per-contact probability of HIV transmission for receptive UAI was 1.43% [95% confidence interval (CI) 0.48–2.85] if ejaculation occurred inside the rectum, and it was 0.65% (95% CI 0.15–1.53) if withdrawal prior to ejaculation was involved. The estimated transmission rate for insertive UAI in participants who were circumcised was 0.11% (95% CI 0.02–0.24), and it was 0.62% (95% CI 0.07–1.68) in uncircumcised men. Thus, receptive UAI with ejaculation was found to be approximately twice as risky as receptive UAI with withdrawal or insertive UAI for uncircumcised men and over 10 times as risky as insertive UAI for circumcised men. Conclusion: Despite the fact that a high proportion of HIV-infected men are on antiretroviral treatment and have undetectable viral load, the per-contact probability of HIV transmission due to UAI is similar to estimates reported from developed country settings in the pre-HAART era.

  • (2010) Jin, Feng Yi; Prestage, Garrett; Matthews, Gail; Zablotska, Iryna; Rawstorne, Patrick; Kippax, Susan; Kaldor, John; Grulich, Andrew
    Journal Article
    Background An increasing incidence of hepatitis C virus (HCV) infection in HIV-positive homosexual men has recently been described, but it is uncertain to what extent this reflects sexual transmission. We report prevalence, incidence and risk factors for HCV infection in community-based cohorts of HIV-negative and HIV-positive homosexual men in Sydney. Methods Both cohorts recruited participants using similar community-based strategies. Men underwent annual face-to-face interviews, and reported history of injecting-drug use (IDU) and sexual and other behaviours that might lead to blood contact. HCV screening was offered to consenting participants from 2001 to 2007. Results At baseline, HCV prevalence was 1.07% in the HIV-negative and 9.39% in the HIV-positive men. HCV seropositivity was strongly associated with a history of IDU in both cohorts (OR=56.18, 95% CI 12.55 to 251.5 in HIV-negative, and OR=24.46, 95% CI 5.44 to 110.0 in HIV-positive). In the HIV-negative cohort, five men seroconverted to HCV over 4412.1 person-years of follow-up, an incidence of 0.11 per 100 person-years (95% CI 0.03 to 0.26). Only one seroconverter reported IDU. Of the five, four reported sexual contact with HIV-positive men (HR=8.23, 95% CI 0.91 to 74.28), and two had an incident ulcerative sexually transmitted infection. In the HIV-positive cohort, none seroconverted over 238.1 person-years of follow-up (97.5% CI 0 to 1.54, single-sided). Conclusion HCV prevalence was almost 10 times higher in HIV-positive homosexual men. Although incident HCV infection was uncommon in both cohorts, cases of non-IDU-related transmission did occur, possibly linked to sexual contact with HIV-positive men.

  • (2010) Templeton, David; Jin, Feng Yi; Mcnally, P.; Imrie, John; Prestage, Garrett; Donovan, Basil; Cunningham, Philip; Kaldor, John; Kippax, Susan; Grulich, Andrew
    Journal Article