2015 Participant Summaries

2016 Participant Summaries

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Study:                         Polymorphisms in the CD14 and TLR4 genes independently predict CD4+ T-cell recovery in HIV-infected individuals on antiretroviral therapy

 

Researchers:             Yong YK, Shankar EM, Solomon A, Spelman T, Fairley CK, Elliott J, Hoy J, Cameron P, Kamarulzaman A, Lewin SR

 

Publication:               AIDS 2016; 30(14):2154-2168 doi: 10.1097/QAD.0000000000001179

                   

Summary:                  

Successful treatment in HIV infected individuals relies on the immune system recovering.  In HIV medicine we measure the immune systems strength by the number of special T cells, called CD4 T cells. We like to see patients’ CD4+ T-cell counts rise to at least 500 cells/ml.  This study tried to work out why some individuals achieve this more easily than others with the help of 125 individuals from The Alfred and Melbourne Sexual Health Centre before they started ART and at least once 12 months after starting HIV treatment.

 


Study:                         Neisseria gonorrhoeae bacterial DNA load in the pharynges and saliva of men who have sex with men

 

Researchers:             Chow EPF, Tabrizi SN, Phillips S, Lee DM, Bradshaw CS, Chen MY, Fairley CK

                                   

Publication:               Journal of Clinical Microbiology 2016; 54(10): 2485-2490 doi:10.1128/JCM.01186-16 

                   

Summary:                  

Gonorrhoea can be grown in the laboratory from the saliva of individuals with throat gonorrhoea. This study looked at how much DNA of gonorrhoea bacteria there was in the throat and saliva of men who have sex with men (MSM) who had not been treated yet. In 33 men who took part, the amount of DNA in the gonorrhoea bacteria was similar in the throat and saliva. The findings suggest that in men with throat gonorrhoea, there is enough gonorrhoea bacteria in their saliva that can be transmitted via sexual practices exposed to saliva like oral anal practices (rimming) or when saliva is used as a lubricant for anal sex.

 


Study:             Adherence to, and acceptability of, Listerine® mouthwash as a potential preventive intervention for pharyngeal gonorrhoea among men who have sex with men in Australia: a longitudinal study

 

Researchers:             Cornelisse VJ, Fairley CK, Walker S, Young T. Lee D, Chen MY, Bradshaw CS, Chow EPF

                                   

Publication:               Sexual Health; 2016. (Letter) 13(5): 494–496 doi: 10.1071/SH16026 

                   

Summary:                  

We investigated whether men who have sex with men (MSM) would use mouthwash daily to prevent throat gonorrhoea. Ten MSM attending the Melbourne Sexual Health Centre were asked to use a Listerine® alcohol containing mouthwash daily for 14 days in August 2015. Participants were asked to complete a questionnaire before and after using the mouthwash about the experience of using the mouthwash and asked to keep a daily diary to record mouthwash use over the 14-day study. Mouthwash was used at least once daily for 14 days. All 10 men were willing to use mouthwash on a daily basis, and nine men were willing to use mouthwash after oral sex. The daily use of mouthwash is an acceptable intervention to prevent throat gonorrhoea in MSM. 

 


Study:                         Quantifying Adaptive and Innate Immune Responses in HIV-Infected Participants Using a Novel High Throughput Assay

 

Researchers:             Yong KY, Cameron PU, Spelman T, Elliott JH, Fairley CK, Boyle J, Miyamasu M, Lewin SR

                                   

Publication:              PLoS One 2016; 11(12):e0166549 doi:10.1371/journal.pone.0166549

 

                   

Summary:                  

This study used blood from 79 individuals with HIV and blood from 229 individuals without HIV to measure the function of the special immune cells (T cells) that HIV attacks. The study tested a new efficient assay to test the function of the T cells and found the assay to be successful.  This more efficient assay will help understand how to improve the function of the immune system in individuals with HIV.

 



Study:                        Pharyngeal Gonorrhoea: The Willingness of Australian Men Who Have Sex with Men to Change Current Sexual Practices to Reduce Their Risk of Transmission—A Qualitative Study

          

Researchers:             Walker S, Bellhouse C, Fairley CK, Bilardi JE, Chow EPF

         

Publication:               PLoS ONE, 2016; 11(12): e0164033, doi:10.1371/journal.pone.0164033

 

Summary:                     

The throat is a common site of gonorrhoea infection among men who have sex with men (MSM) and may serve as a pool for infection, with saliva implicated in the spread possibly through oral sex, kissing, and rimming. This study included 30 MSM to get their views and knowledge of throat gonorrhoea and their willingness to change their sexual practices with saliva. Most men considered throat gonorrhoea to be a non-serious sexually transmitted infection and attributed transmission primarily to oral sex. Almost all men reported they would not stop kissing, oral sex, or consider using condoms for oral sex to reduce their risk of throat gonorrhoea. Kissing and oral sex were commonly practised and considered enjoyable low risk sexual activities. Men were more likely to consider stopping sexual activities they did not enjoy or practice often, in particular insertive rimming. If proven effective, the majority of men reported they would use alcohol-containing mouthwash to reduce or prevent their risk of throat gonorrhoea. Reducing sexual activities involving saliva may reduce throat gonorrhoea.

        


Study:                         Detection of Neisseria gonorrhoeae in the pharynx and saliva: implications for gonorrhoea transmission

 

Researchers:             Chow EPF, Lee D, Tabrizi SN, Phillips S, Snow A, Cook S, Howden BP, Petalotis I, Bradshaw CS, Chen MY, Fairley CK.

 

Publication:               Sexually Transmitted Infections, 2016; 92(5): 347-349, doi: 10.1136/sextrans-2015-052399

 

Summary: 

This study looked at men who have sex with men who tested positive for throat gonorrhoea at Melbourne Sexual Health Centre (MSHC) and returned to MSHC for treatment within 14 days between 13 October 2014 and 25 March 2015. Throat swabs and saliva samples were collected for culture and nucleic acid amplification tests (NAAT). Of 33 initially culture-positive throat swabs, 32 saliva samples and 31 throat swabs were positive by NAAT and 14 throat and 6 saliva samples were positive by culture within 14 days. There was a significant decline in the number of repeated throat culture samples positive by culture over time. The rapid decline suggests that throat gonorrhoea is short-lived, and the finding of gonorrhoea commonly in the saliva links this body fluid to the spread of infection.

 


Study:                         Antiseptic mouthwash against pharyngeal Neisseria gonorrhoeae: a randomised controlled trial and an in vitro study

 

 

Researchers:             Chow EPF, Howden BP, Walker S, Lee D, Bradshaw CS, Chen MY, Snow A, Cook S, Fehler G, Fairley CK

 

                                   

Publication:               Sexually Transmitted Infections, 2017; 93(2): 88-93, doi: 10.1136/sextrans-2016-052753

 

                   

Summary:                  

Gonorrhoea is increasing among men who have sex with men (MSM).  MSM with throat gonorrhoea who returned for treatment at the Melbourne Sexual Health Centre between May 2015 and February 2016 were included in this study. Untreated men had to rinse and gargle either with a commercial mouthwash product Listerine® Cool Mint or with saline solution for 1 minute. Throat swabs were taken before and after rinsing, and also the gargled solution to culture gonorrhoea in the laboratory. A total of 196 MSM were recruited, 58 (30%) were culture positive before using the solution. After gargling, men in the Listerine group were significantly less likely to be culture positive on the throat surface (52%) compared to men in the saline group (84%).Listerine, significantly reduced the amount of gonorrhoea on the throat surface. With daily use Listerine could have important implications for prevention.



Study:                                     

Saliva use as a lubricant for anal sex is a risk factor for rectal gonorrhoea among men who have sex with men; a new public health message

Researchers:                         

Chow EPF, Cornelisse VJ, Read TRH, Lee D, Walker S, Hocking JS, Chen MY, Bradshaw CS, Fairley CK

Publication:   

Sexually Transmitted Infection, 2016, 3 March, doi: 10.1136/sextrans-2015-052502

Summary:                              

Apart from penile–anal intercourse, other anal sexual practices are common among men who have sex with men (MSM) including rimming, fingering and saliva use as a lubricant for anal sex. The aim of this study was to evaluate whether these other anal sexual practices were risk factors for MSM becoming infected with rectal gonorrhoea. A survey was conducted among MSM attending Melbourne Sexual Health Centre between 31 July 2014 and 30 June 2015. Rectal gonorrhoea cases were identified by culture.  Among 1,312 MSM, 4.3% (n=56) had rectal gonorrhoea. Other anal sexual practices were common among MSM: receptive rimming (70.5%), receptive fingering or penis dipping (84.3%) and using partner’s saliva as a lubricant for anal sex (68.5%). Using saliva as a lubricant was found to have an important association with having rectal gonorrhoea whereas receptive rimming and fingering or penis dipping were not found to be associated with having rectal gonorrhoea. Using saliva as a lubricant for anal sex is a common sexual practice in MSM, and may play an important role in gonorrhoea transmission. Almost half of rectal gonorrhoea cases may be eliminated if MSM stopped using partner’s saliva for anal sex.


Study:                                     

Antibody responses following incident anal and penile infection with human papillomavirus in teenage men who have sex with men

Researchers:                        

Zou H, Tabrizi SN, Grulich AE, Hocking JS, Garland SM, Bradshaw CS, Cornall AM, Fairley CK, Chen MY

Publication:                           

International Journal of Cancer, 2016, 139(3): 639 – 646, doi: 10.1002/ijc.30093

Summary:                              

Men who have sex with men (MSM) are at risk for human papillomavirus (HPV)-related anal cancer. Few data exist on antibody responses following a new anogenital infection with HPV in teenage MSM. A cohort of 200 MSM aged 16–20 years from Melbourne, Australia were assessed at their first visit followed by month 3, 6 and 12 months. At each visit anal and penile swabs were collected for HPV DNA testing and blood for HPV antibodies for genotypes 6, 11, 16 and 18. The finding of HPV antibodies after a negative test result for the same HPV type at the first visit was considered as a seroconversion antibody response to a new infection. In this group of teenage MSM, overall seroconversion rates to HPV types 6, 11, 16 and 18 were high with a quarter of males developing antibodies to at least one of these HPV types over 12 months of follow-up. Overall, this was a sexually active group of men with a high incidence of anogenital HPV. Seroconversion could differ in other populations of young MSM depending on the extent of anal sex and partner change. The likelihood of antibody responses following anogenital HPV infections depends on the HPV type and site of infection



Study:                                     

Views of HIV-negative partners in heterosexual serodiscordant relationships regarding HIV Preexposure Prophylaxis – A Qualitative

Researchers:                         

Falcao J, Bradshaw C, Garrett C, Bilardi J, Chen M, Zablotska I, Fairley CK, Williams H                               

Publication:                           

Sexual Health 2016, 13(4): 345-352 doi.org/10.1071/SH15143              

Summary:                              

PrEP (pre-exposure prophylaxis) is a way to prevent HIV infection by taking a pill every day for people who do not have HIV, but who are at very high risk of becoming infected. PrEP may be an effective option to prevent HIV among heterosexual serodiscordant couples. The aim of this study was to explore the views of HIV-negative men and women in stable serodiscordant heterosexual relationships about the possible use of PrEP.  Interviews were conducted face-to-face or by telephone. In total, 13 HIV-negative partners were interviewed; six men and seven women. Their main concerns around using PrEP were the cost, not being fully effective, taking a tablet every day and side-effects. The HIV negative partner within the heterosexual couple would be willing to consider taking PrEP as part of an approach to HIV prevention especially when trying to conceive a child free of HIV infection. Men were more likely than women to entertain the idea of PrEP as they felt it might improve sexual pleasure if they could stop using condoms. Women did not feel as strongly about this as men. This was one of the first studies looking at attitudes towards PrEP in heterosexual communities.


 

Study:                                     

Chlamydia organism load and genovar among men who have sex with men with repeat rectal chlamydial infections

Researchers:                         

Kong FSK, Tabrizi SN, Fairley CK, Phillips S, Fehler GH, Law M, Vodstrcil LA, Chen MY, Bradshaw CS, Hocking JS                               

Publication:                           

Epidemiology and Infection 2016, 144: 2587 -2596 doi: 10.1017/S0950268816000996             

Summary:                              

Repeat rectal chlamydia infection is common in men who have sex with men (MSM) after treatment with single dose of azithromycin. This study describes the relationship between the amount of chlamydia bacteria in first and repeat rectal chlamydia infections in MSM with no symptoms. Rectal chlamydia-positive samples from 227 MSM were analysed for the amount of bacteria present in their first infection and following reinfection or treatment failure. Repeat rectal chlamydia was common in MSM with >28% MSM diagnosed with a repeat rectal chlamydia infection. Of the 64 men with repeat infection, an estimated 29 (13%) were classified as treatment failures and 35 (15%) as reinfections. We also found that the amount of rectal chlamydia bacteria was higher in repeat infection and treatment failure compared to first infection.




Study:

The acceptability and cost of a home-based chlamydia retesting strategy: findings from the REACT randomised controlled trial

Researchers:

Smith K, Kaldor J, Hocking JS, Jamil M, McNulty A, Read  P, Bradshaw  CS, Chen  MY, Fairley CK, Wand H, Worthington K, Blake S, Knight V, Rawlinson W, Saville M, Tabrizi S, Garland S, Donovan B, Guy R

Publication:

BMC Public Health 2016, 16:83. doi:10.1186/s12889-016-2727-412238

Summary:

Chlamydia retesting 3 months after treatment is recommended to detect reinfections, but retesting rates are typically low. The acceptability of home-based retesting for chlamydia using postal home-collection kits and SMS reminders was compared to SMS reminders only and the costs of the two strategies compared. REACT participants (retest after Chlamydia trachomatis) (200 women, 200 heterosexual men, 200 MSM) were asked to complete an online survey that included home-testing acceptability and preferred methods of retesting. Overall 445/600 (74%) participants completed the survey; 236/445 were from the home-testing arm, and 141 of these (60%) retested at home. The majority of home arm re-testers were comfortable having the kit posted to their home (86%); found it easy to follow the instructions and collect the specimens (96%); were confident they had collected the specimens correctly (90%); and reported no problems (70%). Most (65%) preferred home retesting, 21% had no preference and 14% preferred clinic retesting. The overall cost for the home retest was $154 (AUD), compared to $169 for the clinic-based retesting. Both options should be provided to maximise retesting rates. The trial was registered with the Australia New Zealand Clinical Trials Registry on September 9, 2011: ACTRN12611000968976



Study:

Cost-effectiveness of screening for anal cancer using regular digital ano-rectal examinations in men who have sex with men living with HIV

Researchers:

Ong J, Fairley CK, Carroll S, Walker S, Chen M, Read T, Bradshaw C, Grulich A, Kaldor J, Clarke P                                  

Publication:

Journal of International AIDS Society, 2016, 19:20514. doi: 10.7448/IAS.19.1.20514              

Summary:

Anal cancer in men who have sex with men (MSM) living with HIV is an important issue but there are no consistent guidelines for how to screen for this cancer. In settings where screening with anal cytology is unavailable, regular anal examinations have been proposed in some guidelines but their cost-effectiveness is unknown. Our objective was to estimate by modelling the cost-effectiveness of regular anal examinations to screen for anal cancer in HIV positive MSM living in Australia. Analysis estimated the average cost of screening for and management of anal cancer ranged from $195 for no screening to $1,915 for lifetime annual screening of men aged 50 years. Screening for anal cancer by incorporating regular anal examinations into routine HIV care for MSM aged 50 is most likely to be cost-effective by conventional standards. Given that anal pap smears are not widely available yet in many clinical settings, regular anal exams for MSM living with HIV to detect anal cancer earlier should be implemented.



Study:

Risk practices in the era of smartphone apps for meeting partners: a cross-sectional study among men who have sex with men in Melbourne, Australia

Researchers:

Chow EPF, Cornelisse VJ, Read TRH, Hocking JS, Walker S, Chen MY, Bradshaw CS, Fairley CK

Publication:

AIDS Patient Care and STDs (Letter), 2016, 4(30): 151 - 154

Summary:

MSM attending Melbourne Sexual Health Centre between July 2014 and June 2015, 1,902 completed a short questionnaire on sexual practices and methods they used to meet partners in the last 3 months. The majority of MSM (71%) had met their partners via mobile apps, followed by friends (46%), the internet (41%), gay bars (37%), and sex on premises venues (SOPV) (35%). A small proportion of MSM used one method for meeting partners. Of these 14% used mobile apps, 4% used the internet, 3% only via friends, 3% at gay bars, and none met partners at SOPV. MSM attending MSHC now appear to be using mobile apps more frequently than the internet and gay-oriented venues to meet partners. In our study younger MSM were more likely to use mobile apps than older MSM. MSM who used mobile apps were five times more likely to have had 3 partners in the last three months We also found that 14% of MSM only used mobile apps for meeting partners, while the majority (57%) of MSM used mobile apps and at least one other method for meeting partners. Given that the majority of MSM use mobile apps for meeting partners, more HIV/STI prevention programmes could be delivered via mobile apps. This could also improve access to hard-to-reach individuals such as young MSM.