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(2008)Journal ArticleObjective: In 2002, New South Wales (NSW) Health introduced an updated policy for occupational screening and vaccination against infectious diseases. This study describes healthcare worker (HCW) immunity to hepatitis B, measles, mumps, rubella (MMR) and varicella based on serological screening, following introduction of this policy. Methods: HCW screening serology performed at two healthcare facilities in south western Sydney (Bankstown and Fairfield) was extracted for the period September 2003 to September 2005. Immunity to hepatitis B, MMR and varicella was quantitated and cross-tabulated against age, sex and staff risk category. Results: A total of 1,320 HCWs were screened. Almost two thirds were immune to hepatitis B while immunity to MMR and varicella ranged from 88% to 94%. Age stratification showed lower levels of measles immunity in those born after 1965. Conclusions: Despite availability of vaccination for over two decades, a significant proportion of HCWs at these two facilities were non-immune to hepatitis B. This is of concern for those non-immune staff involved in direct clinical care, who are at risk of blood and body fluid exposures. The small group of HCWs non-immune to MMR and varicella pose a risk to themselves and others in the event of an outbreak. Implications: There is a need for improved implementation of the occupational screening and vaccination policy, including better education of HCWs about the risks of non-immunity to vaccine preventable diseases. The revised 2007 NSW Health policy may assist this process and will need evaluation to determine whether HCW immunity improves in the coming years.
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(2004)Journal ArticleThere is significant interest in developing chemoprevention trials for women at high risk for breast cancer, yet it is not clear how acceptable these strategies are. Results of clinical trials with tamoxifen have demonstrated a reduction in the incidence of breast cancer in women at increased risk, but rates of participation in such trials have been lower than expected. No previous Studies have assessed the attitudes of high-risk women toward participating in chemoprevention trials using drugs causing ovarian Suppression. All women who had attended a large familial cancer clinic in Sydney, New South Wales, between 1994 and 2000 who were eligible for the Raloxifene and Zoladex Research Study being piloted in the United Kingdom at the time were approached. Telephone interviews were conducted with the 35 high-risk women willing to participate in this study. Almost half the women Surveyed expressed willingness to participate in a randomized trial, and slightly fewer women considered participating in a nonrandomized trial. The women who Would consider participating were younger than those who would not. The most frequently mentioned reasons for interest In participating in trials were to aid research, help others, and learn more, which indicates that altruism may have played a significant part in the women`s willingness to participate. Most women interviewed were participating in risk reduction and early detection strategies and expressed high interest in research screening tests. Given the interest in randomized trials and the fact that women at high risk for breast cancer consider the side effects as mainly acceptable, undertaking Such trials may be worthwhile.
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(2008)Journal ArticleThe hypotheses of a visual basis to reading disabilities in some children have centered around deficits in the visual processes displaying more transient reponses to stimuli although hyperactivity in the visual processes displaying sustained reponses to stimuli has also been proposed as a mechanism. In addition, there is clear evidence that colored lenses and/or colored overlays and/or colored backgrounds can influence performance in reading and/or may assist in providing comfortable vision for reading and, as a consequence, the ability to maintain reading for longer. As a consequence, it is surprising that the color vision of poor readers is relatively little studied. We assessed luminance increment thresholds and equi-luminous red-green and blue-yellow increment thresholds using a computer based test in central vision and at 10 degrees nasally employing the paradigm pioneered by King-Smith. We examined 35 poor readers (based on the Neale Analysis of Reading) and compared their performance with 35 normal readers...
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(2010)Journal ArticleSeveral 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.
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(2010)Journal ArticlePapua 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.
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(2009)Journal ArticleBackground: HIV prevalence data suggest that men who have sex with men (MSM) in low-income and middle-income countries (LMIC) are at increased risk of HIV The aim of this article is to present global estimates on key HIV prevention needs and responses among MSM in LMIC. Methods: Data on HIV testing, HIV prevention coverage, HIV knowledge and condom use among MSM were derived from UNGASS country progress reports submitted in 2008. Eligible country estimates were used to calculate global and regional estimates, weighted for the size of MSM populations. Results: Of 147 LMIC, 45% reported at least 1 indicator that reflects the HIV prevention needs and responses in MSM. Global weighted estimates indicate that on average 31 % of MSM in LMIC were tested for HIV; 33% were reached by HIV prevention programs; 44% had correct HIV knowledge; and 54% used condoms the last time they had anal sex with a man. Conclusions: The 2008 UNGASS country reports represent the largest harmonized data set to date of HIV prevention needs and responses among MSM in LMIC. Although reporting is incomplete and does not always conform to requirements, findings confirm that, in many LMIC, HIV prevention responses in MSM need substantial strengthening.
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(2009)Journal ArticleWe explored seroguessing (serosorting based on the assumption of HIV seroconcordance) and casual unprotected anal intercourse (UAIC) associated with seroguessing. The ongoing Positive Health and Health in Men cohorts, Australia, provided data for trends in seroconcordant UAIC and HIV disclosure to sex partners. In event-level analyses, we used log-binomial regression adjusted for within-individual correlation and estimated prevalence rate ratios (PRRs) and 95% confidence intervals (95% CIs) for the association between the knowledge of a casual partner`s seroconcordance and UAIC. UAIC and HIV disclosure significantly increased during 2001-2006. HIV-positive men knew partners were seroconcordant in 54% and assumed it in 13% of sex encounters (42 and 17% among HIV-negative men). Among HIV-positive men, the likelihood of UAIC was higher when a partner`s status was known (Adjusted PRR = 5.17, 95% CI: 3.82-7.01) and assumed seroconcordant because of seroguessing (Adjusted PRR = 3.70, 95% CI: 2.56-5.35) compared with unknown. Among HIV-negative men, the likelihood of UAIC was also higher when a partner`s status was known (Adjusted PRR = 1.88, 95% CI: 1.58-2.24) and assumed seroconcordant (Adjusted PRR = 2.12, 95% CI: 1.72-2.62) compared with unknown. As levels of UAIC remain high, seroguessing increasingly exposes gay men to the risk of HIV infection. Because both HIV-positive and HIV-negative men often seroguess, education and prevention programs should address the fact that HIV-negative men who engage in UAI due to this practice may be at high risk of HIV infection. HIV prevention should take into account these contemporary changes in behaviors, especially among HIV-negative gay men.
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(2007)ReportGay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics.