Day two of the Australasian Sexual Health Conference 2016

In the Gollow lecture Rebecca Guy discussed the important role of new technology for STI prevention including interventions such as: -

-CASI an electronic self-registration tool has proven acceptable reduced waiting times and improved data collection.

- ACCEPT showed the need for opportunistic Sexual health screens in primary care for young people due to high prevalence of CT and presenting complaint often not being sexual health related simple computer prompts increased testing by 30%

- SMS and postal test kits have been used to improve re-testing rates

Mark Hayter called for collaborations within sexual health with other specialities such as family planning and drug and alcohol services. Incorporation of family increased consult time but decreased unintended pregnancy, without increasing STI rates.  In addition inks with family planning could even go someway to dispel contraception myths held by Australian men as highlighted in Mary Stewarts lecture ‘contraception and the Australian male’.

Craig Rigney, CEO Kornar Winmil Yunti spoke about the KWY community based response to high rates of Aboriginal family violence and a lack of accessible culturally appropriate services. The Aboriginal family violence program maintained client safety through ‘women’s business’ and ‘men’s business’. Men’s business included a perpetrator program, which was aimed to unpack perpetrators own held trauma so that they can be accountable for their own violence.  Although initially many attendees were mandated from court self-referrals are on the increase. Rigney discussed that undoubtedly valuable outcomes are hard to evaluate.

In ‘rethinking testing and management of sexually transmissible infections’ Catriona Bradshaw drew attention to the lack of guidelines internationally for rectal MG with treatment shifting towards doxycycline. She called for a reduction in macrolide use and improved contact tracing and TOC rates.

Jane Tomnay analysed PDPT in the Australian context drawing attention to challenges in primary care such as who will pay for PDPT? And how do you write a script for the partner if the partner has never attended the practise.

PDPT was criticised in NT in 2012 when it coincided with child abuse allegations as a way that abuse could remain hidden – something to think about especially in relation to pick up rates of family violence/ domestic violence. 

Daniel Richardson proposes HCV testing should be considered in relation to sex in certain groups even if heterosexual (namely women) and in HIV negative MSM on PrEP – when asked about increased cost due to Australian labs only performing HCV RNA, Richardson suggested lobbying for HCV antigen tests he denied value of LFT’s as a screen, referring to the MSM in PROUD and EPIGAY whom contracted HCV through sex having had no change in transaminases.

In the sexuality lectures Hilary Caldwell Challenged gender based narratives about the Australian sex industry stating that its no longer sustainable to claim only men command and objectify bodies when buying sex or that that power dependent activity is inherently oppressive. She described how women buying sex (WBS) In Australia are more likely to do so from women than men and that these women were diverse with any ethnicity and any income. WBS stay for longer and buy sex less often prioritising safety and a sexpert. Angela Davies looked at the impact of pornography on young peoples sexual lives. There are concerns that porn can normalise risk behaviour promote harmful attitude. An Online survey of 15-29y revealed both male and females used porn. Porn was considered a more detailed sex resource compared to formal sex education where pleasure is the goal instead of risk. There were positive and negative impacts. Positives impact included – positive body image, sex positive, normalising taboos, ‘a safe space to sexplore’, in some males prevented other risk behaviour. Negative impact included  - negative body image, unrealistic expectations, and limited representation of sexuality, harmful attitude and behaviour. A significant portion reported no impact of porn. Do this group have protective factors preventing impact or are these most at risk who lack insight?

A huge thank you to Gracelyn Smallwood who gave an inspirational talk around the importance of involving appropriate people in a community to deliver culturally appropriate health promotion that engages communities as a whole.

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