2012 Participant Summaries

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Study:    
Oral human papillomavirus in men having sex with men: risk-factors and sampling

 
Researchers: 
Tim R. H. Read, Jane S. Hocking, Lenka A. Vodstrcil, Sepehr N. Tabrizi, Michael J. McCullough, Andrew E. Grulich, Suzanne M. Garland, Catriona S. Bradshaw, Marcus Y. Chen, Christopher K. Fairley
                                  
Publication:
PLoS ONE  2012, 7 (11);  e49324
 
Summary:
Human papillomavirus (HPV) associated mouth or throat cancer is becoming more common. We looked at the commonness and risk factors for oral HPV among men who have sex with men (MSM) and also compared sampling and transport methods for finding HPV in samples. In 2010, 500 MSM (249 HIV-positive) attending Melbourne Sexual Health Centre answered a questionnaire, had their mouth and throat swabbed and provided a gargled oral rinse sample for HPV testing. Any HPV was detected in 19% of HIV-infected men and 7% of HIV-negative men. HPV type 16 was detected in 4% of HIV-infected men and less than 1% of HIV-negative men. HPV 16 and 18 persisted in 10 of 12 men who retested after six months. Oral HPV was found more often in men with HIV infection, who smoked, and had more lifetime tongue-kissing and oral sex partners. HPV detection in the oral gargle rinse sample increased after recent tooth brushing from abrasions from brushing that increased the amount of infected cells. The liquid oral gargle rinse sample was more sensitive than a tampon-absorbed oral gargle rinse sample or the self-collected swab.



Study:
Lessons learnt from a chlamydia testing observation study in general practice
 
Researchers:
Temple-Smith M, Fairley CK, Pirotta M, Kneebone J, McNamee K, Bilardi J, Hocking JS
                                  
Publication:
Australian Family Physician 2012. 41(6): 413-416
 
Summary:
Chlamydia is the most frequently notified sexually transmissible infection in Australia and occurs most commonly in young people. Up to 80% of chlamydia infections have no symptoms. The Royal Australian College of General Practitioners recommends annual chlamydia testing for all sexually active people aged less than 25 years. This study explored potential barriers that might inhibit chlamydia testing in young women in general practice. The chlamydia testing pathways of 12 general practices were examined using a comprehensive practice assessment tool. The pathways of these clinics were compared to a best practice testing pathway, and clinics were offered advice to help improve their practice pathway. Clinics were followed up at 2 months. Little change to existing practices had been made. Clinics employing a practice manager were better equipped to enable systems for chlamydia testing to be developed. Results are discussed in light of May’s normalisation theory, which states that changing practices requires shared understanding and commitment by all staff. It is unlikely that chlamydia testing rates in general practice will reach the levels required to reduce the burden of chlamydia without a coordinated clinic level approach.


 
Study: 
Bacterial vaginosis (BV) candidate bacteria: associations with BV and behavioural practices in sexually-experienced and inexperienced women
 
Researchers:
Fethers K, Twin J, Fairley CK, Fowkes FJI, Garland SM, Fehler G, Morton AM, Hocking JS, Tabrizi SN, Bradshaw CS
                                
Publication:
PLoS ONE  2012, 7(2); e30633

Summary:
Recently 8 new bacteria associated with bacterial vaginosis have been described. We examined vaginal smears for BV by microscope and samples were tested for these newly described bacteria by molecular assays in 193 sexually-inexperienced university women and 146 women from a highly sexually-active clinic population in Melbourne. Detailed behavioural data was collected by questionnaire. The newly described bacteria associated with BV were found more often in women with BV compared to women with normal flora. The majority of BV associated bacteria were absent or rare in sexually-unexposed women, and were found more frequently with increasing sexual exposure, suggesting potential sexual transmission of BV associated bacteria


 

Study:
Chlamydia trachomatis incidence and re-infection among young women  - behavioural and microbiological characteristics
 
Researchers:
Walker J, Tabrizi SN, Fairley CK, Chen MY, Bradshaw CS, Twin J, Taylor N, Donovan B, Kaldor JM, McNamee K, Urban E, Walker S, Currie M, Birden H, Bowden F, Gunn J, Pirotta M, Gurrin L, Harindra V, Garland SM, Hocking JS.
 
Publication:
PLoS ONE, 2012, 7(5): e37778
 
Summary:
This study how commonly chlamydia was acquired and then among women with chlamydia, how commonly they acquired the infection again after treatment. 1,116 women aged 16 to 25 years were recruited from clinics in Australia. Women collected their own vaginal swabs were collected every 3 to 6 months for chlamydia testing. There were 47 cases of chlamydia diagnosed (4%). Younger employed women with more sexual partners acquired more chlamydia. Women who had taken recent antibiotic had less infections. Chlamydia is common among young women and a high proportion of women are re-infected within a short period of time, highlighting the need for effective partner treatment and repeat testing.


 
Study:
Clients’ views on a piloted telemedicine sexual health service for rural youth
 
Researchers: 
Cameryn  C Garrett, Maggie Kirkman, Marcus Y.Chen, Rosey Cummings, Candice Fuller, Jane Hocking, Jane E Tomnay, and Christopher K Fairley
 
Publication:
Sexual Health, 2012, 9, 192–193
 
Summary:
We tested a service where young people could have doctors visits through the telephone with posted specimens (called telemedicine service). A free telemedicine service (‘TESTme’) for rural youth offered telephone consultation or video consultation via computer. The Melbourne-based service was available to clients under 26 years, living in Victoria at least 150 km from Melbourne. After the phone or video consultation, a home testing chlamydia kit was sent to clients. The service was widely advertised through flyers, SMS, Face book, regional newspapers and youth magazines. Clients’ views were investigated. All clients aged 15–24 were given a questionnaire. Some were also interviewed. The service was used by 25 rural youths aged 15–24; 18 returned the questionnaire, 4 were interviewed. All had a telephone consultation. They reported being satisfied with the service; most preferred the telemedicine service to consulting a doctor in person. Online video consultations for sexual health may not yet be an acceptable option to young people in Australia.


 
Study:
Efficacy of oral metronidazole with vaginal clindamycin or vaginal probiotic for bacterial vaginosis: randomized placebo-controlled double-blind trial
 
Researchers:
Catriona S. Bradshaw, Marie Pirotta, Deborah De Guingand, Jane S. Hocking, Anna N. Morton, Suzanne M. Garland, Glenda Fehler, Andrea Morrow, Sandra Walker, Lenka A. Vodstrcil, Christopher K. Fairley
                                  
Publication:
PLoS ONE; April 2012: 7(4) e34540
 
Summary:
A study to determine if oral metronidazole with vaginal clindamycin-cream (1) or a lactobacillus acidophilus vaginal-probiotic containing oestriol (2) reduced bacterial vaginosis (BV) recurrence over 6 months. Women attending Melbourne Sexual Health Centre were included in the study with symptomatic BV confirmed by clinical assessment and microscopy for abnormal vaginal flora. There were 450 women randomly allocated and equally distributed to either of the treatments (1) or (2) or to a metronidazole and vaginal-placebo (3) treatment. The women were assessed microscopically at 1, 2, 3 and 6 months on self-collected vaginal-swabs. The BV recurrence rate at 6 months was 28%; with no difference between treatments. Combining the recommended first line therapies of oral metronidazole and vaginal clindamycin, or oral metronidazole with an extended-course of a commercially available vaginal-L.acidophilus probiotic did not reduce BV recurrence.
 
Trial Registration: ANZCTR.org.au ACTRN12607000350426