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.

Sexual Health Day 1 Session 3 HPV and Syphilis in Northern Australia

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Notes:

HPV associate with 90% of anal cancers. HPV 16/18 is associated with 92% of the HPV related anal cancers.

Being an MSM associated with a 40x risk of HPV anal cancer. Being an MSM who is living with HIV shows an up to 100x risk of HPV related anal cancers. 

Spanc study showed that while a percentage of men with self clear of anal HPV infection this is less likely with HPV 16 infection.

Despite treatment guidelines not recommending HPV vaccination in men older than 26 the SPANC study showed that many older men have not been exposed to HPV 16. This opens the suggestion that vaccination with 9 strain HPV vaccine may offer benefit beyond the age of 26.

The indigenous population of Australia is suffering with disproportionate levels of STI's. Risk are 3x for Chlamydia, 18 x for Gonorrhoea, 4x for Syphilis. Barriers have been identified for men to get STI testing including lack of information as well as culturally appropriate male health workers to engage with clients for testing.

There has been a significant rise in Syphilis infections within Northern Australia's indigenous population. Rates are similar in men and women in the younger age group 15-29 years old. 

Given risk of congenital syphilis and intrauterine death a robust testing campaign has been initiated to test all women of child rearing age as well as intensive screening of pregnant women. 

Testing in pregnancy includes up to 5 tests during pregnancy and if a female has had a positive test she is then testing monthly till delivery and followed for 3 months post delivery to ensure no reinfections.

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