HPV
- SPANC: http://kirby.unsw.edu.au/projects/study-prevention-anal-cancer-spanc
- Prospective 3 year study on anal HPV in older gay/MSM i.e. 35 years & older; important because this will be a mostly unvaccinated cohort
- HPV 16: ~ 50% of all HPV related cancers plus it is the type least likely to be cleared
- HSIL (high grade intra-epithelial lesion): found in 30-50% of HIV +ve men
- Cochrane review: there is no current evidence that treatment of high grade lesions prevents progression to cancer
- Research being done into the potential for anal cancer biomarkers to predict disease persistence
Syphilis
- Australian surveillance data 2006 - 2015: 14,200 notifications for syphilis
- Indigenous Australians are 6 times more likely to be infected with syphilis
- Significant increase in syphilis in MSM during the 10 years to 2015
- Rates of syphilis in MSM in Victoria => approx. the same rates in both HIV +ve & HIV -ve men (differs from epidemiology data in other jurisdictions where the rates of syphilis in HIV +ve men tend to be far higher than in HIV -ve men)
Gonorrhoea
- Studies into gonorrhoea site-specific infections in MSM couples => the number of gonorrhoea infections in certain sites did not correlate with the expected # of infections (in certain sites) when considering reported sexual behaviours e.g. far more throat infections than expected => leading to the hypothesis that kissing may be a significant factor in gonorrhoea transmission
- Condom use: even when condom use is reported to be high (for anal intercourse) there was no significant difference in the rates of gonorrhoea transmissions overall
IDU
- significantly higher numbers of all STI's in IDU vs non-IDU
- far more HIV +ve MSM inject drugs vs HIV -ve MSM
Testing for MSM
- Community based testing services are far more likely to attract gay/MSM plus have a significantly higher STI yield when compared to non-community based services. Conclusion: very important to maintain community based testing services