PLENARY 2 Gollow Lecture

Plenary 2 Tuesday 15/11/2016

GOLLOW LECTURE :Rebecca Guy Assoc Professor Kirby Institute:surveillance,evaluation and research program

Presented new technologies for STI  Prevention

Re thinking Sexual Health 

And how can we use new technologies for disease prevention

Specifically Information technology

To embrace what people are using therefore currency

In a world open 24 hours

Primary and secondary prevention:STI testing and diagnoses

What technology has been evaluated

PROBLEM: STI Testing;time consuming/registration 

Solution electronic client self register:self appoint

Outcome evaluation significant benefit re time saved

Problem of awkward conversations 

Solved by computer assisted survey instrument (CASI) 

Linked with management system

Evaluated as efficient, acceptable,

Problem of STI test with clinic capacity

Solution Xpress clinic

Evaluated 

All leading back to reflection and constant need to improve efficiency of practice and improved outcomes for clinic and client

GP still low STI  testing rates despite 80% young people go to GP

Latest findings suggest poorly targeted

ACCEPT survey:

150 GP clinics

73.4% of chlamydia presentations asympto clients attending for non sexual health issues /missed opportunistic test

.? COMPUTER PROMPTS 

Evaluated and helpful 30% increase testing

Need comprehensive screening eg previously rectal swabs not done MSM

User friendly software

Low Syphilis   testing in increasing STI rates

Solution:opt out/opt in syphilis test in HIV management

Simple cheap study in 2007 by DR Melanie Bissessor and MSM with HIV

Simple sticker on file requesting syphilis check

Pre 21%

Post 85% :such simple cheap intervention.

Study 2

Syphilis testing same day as HIV VLautomatic,could deselect:

Colaboration required clinics, labs under Burnett Istitute

ACCESS checks how tracking

Generally need to increase testing rates

Problem of treatment delays especially Remote areas

Discussed SMS reminders recall possibilities

TTANGO (test treat and go);Colaboration 12 Health Services

Key message is the mean time to treatment

With POCT 4/7

Lab test 19/7

And partners to be treated

Use of "Let them know"websiteMSHC, evaluated/acceptable:SMS

BUT people not returning TOC, reinfection and dangers PID etc

Discused other clinical strategies and efficiency eg: REACT RCT:

Not suitable for test kits mailed to address parents,partners

Other technologies not comprehensively evaluated

WA online educational resources parents and adolescents

Poor condom use reported: Adolescents report "no condoms it just happened"

The new world of online websites to meet and connect and how to tap into that population group to encourage testing

The difficulty of behavioural interventions

Technology must help research ,rapid info to inform  progress

data.kirby.unsw.edu.co JUST released

TAKE HOME MESSAGE

Why not all Health Services using IT/online technologies 

Is the future online Sexual Health Services.......

Need to all look at improved, efficient, acceptable and cost effective ways of increasing comprehensive STI I testing

Christopher Fairley  MSHC presented

The use of nformation technology to improve Sexual Health care in a following session

Which complimented Rebeccas presentation

Great comment; Health care is most important fight against STI

STI easier to control than treatment

Sexual Health does not deal with "noble organs" does not attract the $

need to be more efficient....like the Banks....

Need IT in clinical services

CAS:I :all staff  and clients love it

Use of SMS

Websites like Let them know

STI Atlas

Whats PREP

DATA OPENS EYES

CLINICIANS NEED TIO UNDERSTAND DATA

NEED A DATA BASE