Stand-out points: Day 1 Sexual Health Conference 14th November

HPV

• SPANC: http://kirby.unsw.edu.au/projects/study-prevention-anal-cancer-spanc

1. 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
2. HPV 16: ~ 50% of all HPV related cancers plus it is the type least likely to be cleared
3. HSIL (high grade intra-epithelial lesion): found in 30-50% of HIV +ve men
4. Cochrane review: there is no current evidence that treatment of high grade lesions prevents progression to cancer
5. 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