ASHM Report Back

Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.

Recent blog posts

This presentation was given by Associate Professor Suzanne Belton from the Menzies School of Health Research.

A/Prof Belton presented data from the study using quantitative and qualitative data to capture clinical process and outcome data from a telehealth abortion provider, Tabbot telehealth service.

She explained that access to abortion in Australia is limited by several factors, especially in regional, rural and remote areas.

Since the TGA approval of medical abortion in Australia, only 1.5% of registered medical practitioners have obtained certification to prescribe.

Telehealth models of care have been found to work well internationally. The study looked at whether telehealth abortion was a safe, effective and acceptable option in Australia.

The study aimed to provide information to health managers and policy makers which can be used to inform a responsive reproductive health care system.

The clinical outcomes included efficacy and safety , and process outcomes included acceptability by women using the service.

The data showed that one quarter of women chose not to proceed with a telehealth abortion, but for whose who did, clinical outcomes were very good. No adverse events were reported.

Interestingly, of the 717 women in the study, only 8 (1%) and 2 (<1%) of women registering with the Tabbot telehealth service were from remote or very remote areas respectively. 296 (41%) of women were from major cities and 318 (44%) from inner regional areas.

The women interviewed reported high levels of satisfaction, privacy, quality of care and levels of support.

In conclusion, telehealth abortion is safe, effective and acceptable to Australian women who experience limited reproductive health service options.

A/Prof Belton also presented a comparison of three telehealth abortion services available in Australia. These included the Tabbot Foundation, Cairns Doctors and Marie Stopes. The Tabbot Foundations provided the cheapest option for patients at $250 (no medicare rebate). Aside from cost, the three services were found to be similar in the way they are set up and run and in terms of patient requirements.

The presentation provided some valuable insights into access issues for medical abortion in Australia, and innovative ways to help provide women with choices and improved access.

 

I attended this great talk given by Kevin McGeechan on Wednesday 8/11.

 

Kevin McGeechan is a senior lecturer in Biostatistics at the School of Public Health, University of Sydney and acts as a consultant statistician for Family Planning NSW.

The topic of abortion law in NSW was presented and discussed in further detail the following day at the symposium addressing "Abortion:2017 and Beyond" with several other excellent presentations on the topic. 

A bit of background to start:

Abortion remains a crime in the NSW Crimes Act 1900, punishable by up to 10 years jail. However, as a result of case law, abortion can be provided legally, but only to protect the life or health of the woman. Abortion law reforms have taken place in all other Australian jurisdictions except NSW and Queensland. This leaves women in these states vulnerable to prosecution.

 

In September 2015 , The Greens NSW commissioned a community survey to inform development of an abortion law reform bill.

This bill was introduced to the NSW Parliament in May 2017 and was debated but defeated.

The survey was conducted anonymously online by a market research company.

1015 male and female adult residents of NSW participated

Of these, 76% were unaware that abortion is a crime in NSW.

73% thought it should be decriminalised and regulated as a healthcare service.

These results were consistent across gender, age groups, metropolitan/regional and rural areas as well as all levels of education.

There was also strong support for women seeking abortion to be protected from harassment (89%) and for protest exclusion zones around abortion clinics (81%)

Support for decriminalisation and protection of women seeking an abortion was higher amount regional/rural residents than Sydney based respondents.

I found it interesting to learn about the differences across Australian jurisdictions regarding abortion law. In addition, it is surprising how many people are unaware of the law pertaining to this in NSW. I think as a medical practitioner it is important to be aware of these issues and what barriers this may pose to women wanting to access abortion services in NSW or Queensland. 

 

                                    

Barriers And Facilitators Relevant To An HIV-Testing Clinic Model Among Chinese And Thai MSM At Sydney Sexual Health Centre (SSHC)

Dr Mcnulty talked about a decrease in HIV diagnosis in Australian born MSM but with no change in non-Australian MSM. She stated the Sydney Sexual health center is increasing its testing options which are free, far from being judgemental with expert staff who are confidentiality conscious. The center introduced the express clinic to overcome waiting times. They complete a number of questions on the computer with a brief encounter with a nurse.It attracted a hard to reach people born overseas although she was quick to explore more testing options with emphasis on confidentiality, free and non-judgemental services.

 

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Lymphogranuloma Venereum in the era of PrEP: are we heading for another epidemic?

Professor David Templeton. Normal 0 false false false MicrosoftInternetExplorer4

Professor Templeton presented a paper on the transmission dynamics of rectal LGV.  He gave information regarding the prevalence of infection being significantly more prevalent in gay and bisexual men (GBM) and even more significantly higher in HIV positive men.  He posed the question ‘Is it all behaviour or does immunodeficiency play a role?’

The research he had looked at suggested a differing theory of CT transmission (including the LGV serovars) this being the role of ano-oral transmission from gut reservoirs of infection passed through faecal-oral contamination.  In comparison to the thinking that it might be past via rimming and fisting. CT can be transmitted from the urethra of men into the throat of their partners, it then is carried through the gut (the gut with it’s down-regulation of inflammatory responses allows CT to survive), it then infects the rectal mucosa and sets up a persisting infection (that then might lead to symptomatic or asymptomatic carriage of LGV or CT.)

 

This has been suggested by several authors that I found in the reference list of the paper Professor Templeton was quoting –  The Enigma of Lymphogranuloma Venereum Spread in Men Who Have Sex With Men: Does Ano-Oral Transmission Play  a Role? de Vries, Sexually Transmitted Diseases 43, 7, 2016.  Some of the work is based on animal models – where animal CT and ‘LGV – like’ infections occur and persist in the GIT and are not cleared with macrolide treatments.  

There are some studies by one author who looked at  infection in babies at risk of CT infection at birth and how long it took for the infection to get to the anus of the baby and the vagina of the baby girls – postulating that the infection had to travel through the gut and then through feacal contamination enter the vagina. (for further information read  Hidden in Plain Sight: Chlamydial Gastrointestinal Infection and Its Relevance to Persistence in Human Genital Infection Rank & Yeruva, Infection and Immunity 2014 ;82 :4,  1362–1371.

In practice this has implications for testing and treatment as rectal CT and LGV are vastly different to uro-genital infection.  Therefore non-sexual health clinicians must ask about sexual practices (or just test every orifice in both men and women), GBM with proctitis or procto-colitis who get sent to Gastro-enterologist must have an anal swab first (symptomatic LGV can present as Crohns Disease for example and be missed) and any GBM with ano-rectal CT infection should have their sample sent for LGV serovar testing.  The research is suggesting that heterosexual transmission of LGV is very unusual however continuing vigilance and surveillance is needed to detect shifts in infection dynamics within our community.

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Are we there yet? Reaching global goals for HIV in Asia and Pacific Regions

Treatment approaches should also be within context of a country’s culture. Any approaches for it to work must be culturally appropriate. HIV and drug use are indeed global issues but unfortunately, successful approaches in first world countries does not automatically translate to the same level of success in third world countries. Take the Philippines as an example. MSM is an issue that is still taboo in many places, particularly in very remote places; therefore, collecting accurate data will remain questionable. Studies will always be one sided for not all views will be collected. Drug program and HIV intervention as mentioned, are treated separately for the reason stated above. Are we there yet? Certainly not. But until culturally appropriate treatment strategies could be devised, HIV will always remain a stigma and the 90-90-90 target will remain a long way from achievement.

Presentation by Ruth Hennessy showed a study in a Sydney based HIV clinic.  This demonstrated a higher level of mental health issues, depression, anxiety, suicide, alcohol and IV drug use, social isolation in people who are HIV positive.

It was also found that these client has issues compliance to treatment in general thereby mitigated against optimal care

 Considering this complex association between HIV and mental health illnesses it is suggested that;

-          A multidisciplinary intensive specialist care should be adopted in caring for people with HIV

 

-          Establishing guidelines for identifying patients who will require extra supports and appropriate referrals will ensure adequate care for people living with HIV

Wonderful talk by Prof. Gracelyn Smallwood who brought in her wealth of experience and activism to elucidate the sexual health burdens faced by the indigineous populations resulting from inequities in health care due to unfavorable governmental policies that has long disadvantaged the ATSI

 

Everyone will agree that for equity in health care to be achieved in the country as a whole, governmental policies has to be aligned to carter for the disproportionate distribution of social determinant of health which includes; social/physical environments, education, access to health services, health literacy, housing and employment amongst the ATSI

Mark Bloch elucidated several advantages of rapid self-testing which includes

1.      Privacy

2.      Convenience

3.      Short time interval to obtain result

4.      Less anxiety period prior to knowing test result

5.      Easy to use in remote communities with little or no access to health care

Results of the NSW study demonstrated a high uptake and usability of people performing a  rapid self-testing and also correctly following all the steps.

 

 Clinicians are still concerned about commencing treatment based on results of this self-tests which is also self-reported by patient.

 Example, after a patient self-tests, how will a clinician have documented evidence of test result in patients chart prior to commencement of therapy or even referrals to a specialist

In addition, after a positive self-testing and a patient fails to present for treatment, how can one ensure follow ups.

 

The Atomo device would undoubtedly improve access to HIV testing but much work has to be done regarding guidelines to clarify concerns as above to make it universally acceptable

 

I enjoyed the talk given by Natalia Edmiston on predictors of unplanned admissions.

It was surprising to note that studies have shown that most unplanned admissions amongst HIV infected people were due to multi-morbidity rather than HIV specific factors.

 

Natalie, also demonstrated that recommendations from the NSW studies is in keeping with other international studies such as National Institutes for Health and Care (NICE) guidelines.

Recommendations:

-          Clinicians should consider a mult-morbidity approach to care in treating people with HIV

-          Obtain a CIRS score at entry to care and update this annually

 

-          CIRS score is a very strong predictor of hospital admissions in HIV positive individuals

Prof Georg Behrens discussed the impact of co-morbidities in HIV patients.

This is relevant in every area of care in people with HIV but I was particularly interested in the pathophysiology of HIV and co-morbid conditions.

 

The speaker stated that HIV infections is associated with varieties of co-morbid conditions including; Hepatitis B virus, Diabetes, Cardiovascular diseases, Myocardial infarctions, Osteoporosis and Cancers.

These co-morbidities are as a result of chronic inflammation which stems from the virus infection

Keeping these in mind, a whole patient approach is important in the care of people with HIV.

In addition to treating the virus, attending to the co-morbid conditions is necessary for optimal management of HIV patients.

 

Commencing antiretroviral drugs early (“Starting early”) will lead to immune re-construction and a fall in CD4 counts and further improve life expectancy in HIV patients

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PrEP Implementation

Brent Clifton is the Manager of Gay Men’s Sexual Health Programs. He has taken us to the journey of PrEP implementation. They developed 2 models: Nurse led, and Peer led.

He described how on the early days, PrEP medications can be accessed through import from doctors and from reputable medical sites

That all changed on December 2015, when then Health Minister Jillian Skinner announced a landmark clinical trial on PrEP in NSW named Epic NSW ("Expanded PrEP Implementation in Communities"). A proposal was then sent from ACON to: support the implementation and rollout of the Epic-NSW Study; lead the education and increase community awareness of PrEP. These proposals included a PrEP mailing list, a full-time staff position to lead the community education of PrEP, holding community forums (9 in total were held), community awareness during Mardi Gras Festival and the development of the campaign “Is PrEP right for You?”

They have 2 clinical partners RPA Sexual Health and SSHC. Both centres deliver Nurse and Peer led programs. One of the key services offered was dispensing of PrEP medications on site. This program saw a substantial increase in enrolment within a month.

Some of the peer experiences  they had were feeling less anxious about sex, what will be the possible side effects? they had more conversation about STI, undetectable viral load and some comments like “I’m not high risk enough but still want PrEP.

Some of the take home notes are If we have enough support and education on marginalized population we will be able to eliminate HIV. The availability of PrEP is very crucial in HIV elimination.

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Associate Professor David Whiley, Principle Research Fellow, Pathology QLD and the University of QLD, Australia looked at the different Neisseria Gonorrhoeae (NG) genotypes within NSW and in particular the genotypes associated with MSM and the heterosexual community.  David’s team collected samples over a period of time and applied NG genotyping and whole genome sequencing to the NG isolates, using MassARRAY iPLEX technology. Amongst many interesting findings the majority of isolates collected from female patients of all ages belonged to 1-5 clusters.

 

Having an understanding of the NG genotypes is fascinating, especially in the face of antibiotic resistance. Following on from Davids presentation, Dr. Eric Chow, senior research fellow, Melbourne Sexual Health Centre, VIC, Australia then presented an interesting session on Risk Factors for NG in heterosexuals. As it stands NG is the second most prevalent STI, which has been attracting a lot of media attention due to the first line antibiotic resistant strains.

 

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Dr. Chow looked at a number of risk factors associated with the increase. The risk factors included condom use, dating apps, bisexual sex, alcohol use and international travel. Increased International travel seemed to be the most feasible risk associated with the increase. The take home message from this; always ask clients about overseas travel and to educate them on safe sex abroad. 

 

 

 

 

 

By Lauren Coelli.

Refugees from DRC

Client Experiences -

Torture and trauma

Many women have been exposed to HIV through rape and may have witnessed the murder or rape of family members.  Many have fled without their children to safety or experienced the trauma of their children being kidnapped.  

Attitudes to HIV

Highly anxious about the diagnosis, fear of death, fear of transmission, fear of disclosure, discrimination, worry of children's futures and difficulty understanding the need for monitoring and management processes.

Living with HIV-

Confidentiality

Anxiety about attending for monitoring and medication especially if other people from their community or culture are also there.  Distrust of phone interpreters.

Pregnancy

Bottle feeding identifies the mother as having HIV.  Fear of disclosure during pregnancy, anxiety about family and case workers finding out during the monitoring processes.  Baby requiring ART and repeated blood tests being potentially identifying.

Strategies

Build trust and rapport, use a flexible walk-in model and spend time upskilling clinical staff.  Work arounds to avoid identifying HIV status - use of immunocompromised on medical files to reduce risk of disclosure. 

Education needs to include health professional, community, WLWHA and the Men from DRC.

 

 

 

 

Dr Roanna Lobo

There has been significant progress towards the virtual elimination of new HIV transmissions in Australia by 2020.  This is evident by collaboration and community partnerships, combination of prevention strategies such as PrEP, PeP and TasP and the quality of life focus for PLHIV.  

Despite this there are still many challenges with late diagnoses and undiagnosed rates higher in Aboriginal peoples, heterosexuals, SE Asian populations, CaLD communities and other regional communities.  There is both a moral and human rights approach to leave no-one behind.


How can this be achieved -

  • Equitable access to new HIV testing, harm reduction services and biomedical intervention for groups at highest risk
  • Reduce barriers to accessing treatment and care
  • Increase health literacy
  • Meaningful involvement with affected communities
  • Shared care models
  • Improved data and surveillance, research and evaluation
  • Continued investment and partnerships

 

 

Rates of Transmitted Drug Resistant Mutations in Newly Diagnoses HIV in NSW 2004-2016

Angie Pinto

This was interesting as the results showed more transmitted HIV drug resistant mutations  found in the rural and regional areas of NSW, in younger people, with <10% mutations found.  Although Ms Pinto suggested this could not be generalised to populations outside of the NSW research areas I think it highlighted the need for vigilance in remote, rural and regional Australia.

Fortunately living in a rich nation we are able to request HIV genotyping tests with each newly diagnosed HIV case  and this is usual practice. It is also very fortunate that there were no resistance mutations found in Tenofovir and only a tiny number against Emtricitabine  -  which of course are the 2 drugs used in PrEP.

“There has probably never been a population both more heavily impacted and less discussed at scientific meetings than the transgender population around the world” Dr Tonia Poteat CROI 2016

This was a recurring theme at the ASHM conference this year and not before time!  Zahra and Teddy spoke to a paper that they plan to launch on World AIDS Day this year.

As background, trans people have been severely underserved in HIV/AIDS responses worldwide, and in Australia, with Victoria as the only state listing trans people as a priority population.

There is a lack of data on the prevalence of trans people living with HIV worldwide, however figures presented were:  19.1% of trans women, limited data for trans men, and no data for non-binary people. Australian figures from the Kirby ACCESS data showed of 696 people, 5.2% were HIV positive - 8.9% for trans women and 4.5% for trans men. However 40% had no gender identity recorded.

An interesting comment was the lack of knowledge by health professionals about trans gender issues and how, as a patient, they end up educating their health providers about trans gender issues, especially when having to meet narrow medical models for care which doesn't always sit well.

I thought this presented quote summed up further risks for HIV for trans people very well:

“Other barriers to health and health care are the numerous socioeconomic determinants of health that legally, economically and socially marginalize trans people. These include discrimination in employment, education, housing, and relationship recognition: police harassment, often as a result of actual or assumed association with sex work; and identity document policies that deny many trans people legal recognition in their true gender. They also include aspects of structural violence such as racism, violence against women, and poverty.”  Open Society Foundation, 2013

So what can we do to support trans people in the HIV response?

  •  Include trans and gender diverse people as priority populations in HIV strategies
  • Start collecting gender and sexuality data better! See attached photo of a suggested way of collecting gender data
  •  Positive interactions with medical community
  •  Access, informed consent
  • Meaningful inclusion in health promotion campaigns
  • Meaningful engagement and decision making by communities

I’ve also included a photo of the fab presenters. Thank you for an articulate and engaging presentation and panel discussion. 

Warning: this report deals with torture, trauma and rape/sexual violence so a trigger warning is provided.

Lauren gave a strong, emotionally challenging presentation regarding the setting up of a specific service to cater for the needs of women who are refugees from the Democratic Republic of the Congo.

Wodonga in regional Victoria began receiving refugees via women at Risk Visa 204 of the Humanitarian Refugee Resettlement program in 2015.

Lauren spoke about the history of trauma, torture and rape that these women had experienced in their former lives and how this impacted on the service delivery model established. She spoke of how these women have been unwilling to engage and maintain engagement in care, and strategies used to resolve this situation.

The Democratic Republic of Congo (DRC) is incredibly unstable with wars that have been ongoing for more than 20 years. There are up to 70 separate militia, with internal mini-wars frequently occurring. DRC has the world’s largest UN peacekeeping force and is described as ‘dangerously unstable’.

Traditional cultural values regarding women’s status are vastly different to our own. For example,  DRC has legislated that a wife ‘owes obedience to her husband’ and  that marital rape is not an offence. Marital rape is common, with 1 in 3 women reporting this. Women have no right to own property or wealth.

Rape has occurred to many of the girls and women of women of the DRC regardless of marital status. The reasons for rape are many reflect both the incredible instability created by war and the powerlessness of the women in the society. These include: punitive rape – to punish or silence; status rape; ceremonial rape; exchange rape as a bargaining tool; theft rape –abduction; and survival rape.

All of the women in the service acquired HIV as a result of rape. Many witnessed the murder of their husband and other family members; kidnapping, rape and loss of their children; were subjected to extreme physical violence and often fled with children other than their own e.g. nieces and nephews. Families fleeing were separated with no knowledge of the whereabouts or outcome of family members.

Attitudes to HIV were very fearful in this community. Fears included disclosure, death, transmission, ostracism and discrimination. Women with HIV are often blamed for the infection. This leads to lack of understanding for reasons both for ongoing monitoring of health but also engagement at all due to fears of being seen at any of the points of care. Some of the strategies to encourage the receiving of healthcare included: not having specific HIV clinics so that clients would not meet each other; flexible walk in model; not noting HIV on medical notes – the generic ‘immunocompromised’ was used instead; and care with interpreters – using only trusted phone interpreters, not using names nor using the term HIV.

Lauren talked about issues around pregnancy; so far they have had one baby born and another baby is due. This involved upskilling of staff – both community health and maternity staff. One GP decided to get her S100 prescribers approval which was a great outcome for the community. However pregnancy and parenting has provided further issues for the women such as questions about why they are bottle feeding,  questions about why the child is receiving medication and having blood tests, as well as fears of disclosure during the contact with health workers.

Lauren saw the future as education involving all those involved: Women living with HIV, men from the DRC, the community and healthcare professionals.

I was very keen to attend this presentation as I work in a sexual health service in a nearby town and state, and this service has offered further choice for HIV care in the regional community.  I congratulate Gateway Health staff – Lauren, Catherine and Ange on this successful ground-up initiative, which is inherently very difficult to achieve. I look forward to refugee women finding a voice to tell their own stories at future events.

 

 

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2.  Tuesday 7th

Labiaplasty: factors leading to increased requests among women from a survey of GP experience.

Magdalena Simonis

This talk was really very sad in many respects.  In my own practice I have experience of young women (as young as 15yrs) wanting to have their labia modified, often without ever seeing other labia to know how normal they are.  With the adolescent body changing so dramatically at 15 it isn’t hard to understand the horror some young women must feel when they notice the changes to their genitals-  looks, skin, hair, discharge etc. Luckily these concerns can be addressed and reduce the health anxieties of the client with correct information.  Unfortunately, many young women in our society are not given any information about this – and certainly in my practice many women have no idea that they need a vaginal discharge every day for example.

Some of the concerns raised included the lack of knowledge of how these surgeries when done are going to affect the women as she ages – with atrophying of the labia during menopause.  There is now knowledge however on how it may cause considerable distress and discomfort if the surgery is not performed correctly or if there is some complication – bleeding, infection and pain etc. 

Some of the long-term effects may be hypersensitivity – especially if the clitoral hood is shortened to expose the clitoral bud. When even the wearing of clothes may be painful. There may be decreased sexual sensitivity if the edges of the labia minora are removed (there is a technique where the body of the labia is ‘wedge-resected” to avoid the more sensitive edges of the labia.) 

This procedure is the 4th most common cosmetic surgery after the nose, liposuction and breast augmentation in Australia, the surgeon does not have to be a registered cosmetic surgeon and the client over 18 years does not have to have counseling or a cooling off period.  Women under the age of 18 have to have a 3-week cooling off period just in case they change their mind.

I have heard some arguments that this surgery is no different than having other parts of the body being modified  - the women's reasons for having their labia reduced is because of the physical look (aesthetics) or a functional concern but this talk that gave examples of the research around the psycosexual distress, relationship concerns and sexual assault that women have experienced when counselled. 

As part of the closing plenary, there was a panel on the role for STI prophylaxis and it's potential use in Australia. The concept of bacterial STI prophylaxis is similar to that of PrEP in preventing HIV infection, however the use of antibiotics instead of anti-virals (of course).

The consideration of this raises several differing points of view among panel members from a number of backgrounds. I myself initially considered the use of antibiotics in an age of increasing resistance to our current frontline antibiotics to be a potential issue. This was an eye opener into what could be a potentially very effective tool for prevention of bacterial STI's.

Facilitated by

Associate Prof. David Templeton, Senior Staff Specialist, RPA Sexual Health Clinic, HARP Unit, Kirby Institute.

Panel Members

Craig Cooper, CEO Positive Life NSW.

Dr Bridget Haire, Research Fellow, Kirby Institute, UNSW.

Dr Jeffrey Klausner, Prof of Medicine, Division of Infectious Diseases University of California.

Prof David Lewis, Director of Western Sydney Sexual Health Centre, NSW.

Chris Williams, Co-founder of PrEP'd for Change, Victoria.

Dr Kathryn Daveson, Staff Specialist, Canberra Hospital, ACT.

 

As with my previous reporting to panels, I will not attempt to assign particular quotes to people, lest I lose their ability to articulate their point, being from their particular backgrounds and expertise. Rather I will paraphrase the panel and draw attention to particular themes raised.

Pro

That there is great potential for a range of populations ie. MSM, but should be used in combination with other treatments.

Con

There may be issues with accessibility for clients to medications (rural/remote, clinics, ? GP's) and feasibility of executing programs effectively (time sensitive large scale dosing, organisation and adherence).

Pro

Targeted groups with Doxycycline could be effective. It has been proven to be safe for use (ie. treating acne in teenagers). There has been no documented resistance to Chlamydia or Syphilis (to doxycycline). The potential for doses post high risk episode has potential (ie. single dose 200mg doxycycline).

Con

From an antibiotic stewardship point of view, this can have issues. Already significant change in bacterial resistance to antibiotics, noted in some strains of STI's. Largely, Australia is yet to see this but it is becoming more of an issue.

Pro

There is a lot of interest from people in the PrEP community to opt into this type of treatment. Treatments such as this would help to diminish the stigma associated with STI infections.

Con

Outside of Sexual Health, antimicrobial resistance has already become a significant issue. Skin and soft tissue infections are becoming more significant and risks of sepsis from resistant bacteria causing significant issues in other areas of health.

 

Okay, I'll change my rule on quotes because there were two that were great.

"We think we're smarter than the bugs but we're not!" and (if you're concerned about microbial resistance "STOP EATING FACTORY FARMED MEAT AND FISH".

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This brings me to the end of my reporting from the ASHM HIV & AIDS Conference in Canberra, 2017.

 

I would like to thank ASHM for the opportunity to have attended this conference and recognise the efforts of all the organisers and presenters this conference. It was a fantastic conference with much learnt and I look forward to the conference next year in 2018 to be held in Sydney.

Thank you.

Dr Eric Chow is Senior Research Fellow at Melbourne Sexual Health Centre

 

Risk factors for gonorrhoea in heterosexuals

 

Eric came in after Praveena a research fellow at Kirby Institute discussed the rise in gonorrhoea infections in women aged between 20-39yrs in the period 2007-2016. She did not have any tangible evidence as to why the increase. One of her to do list was to research as to why?

 Eric timely came in to give possible risk factors that might have prompted the rise of gonorrhoea infections in this group of women. Possible factors were sexual partners and condom use, bisexual men, dating sites/apps, alcohol and drug use, travel and other unexplored factors.

There was not enough evidence on 5 of these risk factors to prove that they were the reason for the rise in Gonorrhoea. More information is required and its still work in progress.

 

Travel and sex to or from a high place of prevalence was the only reason why there is a rise in Gonorrhoea infections. 

Please join us for a memorial event celebrating the life of one of Australia’s leading HIV advocates, Levinia Crook… https://t.co/N7dof5xaGa

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