• Mycoplasma Genitalium – what we can learn from smaller studies in the absence of bigger ones….

    A report on Rosie Latimer’s presentation “Clinical Features of Mycoplasma Genitalium Associated Pelvic Inflammatory Disease and Response to Moxifloxacin: A Case Series” as well as Ruthy McIver’s presentation "Men who have sex with men with Mycoplasma genitalium are more likely to have macrolide resistant strains than men with only female partners: a prospective study”   

     

    “Clinical Features of Mycoplasma genitalium associated Pelvic Inflammatory Disease and response to Moxifloxacin: a Case Series”

    As a sexual health doctor in the era of Mycoplasma genitalium’s (MG) fast increasing resistance to available antibiotics and a paucity of antibiotic choice, I frequently face conundrums around the treatment of patients with MG.  Previous meta-analyses have shown MG has a role in Pelvis Inflammatory Disease (PID) but there is little evidence on the characteristics of MG-associated PID. The findings of this study specifically comparing chlamydial and MGPID therefore interested me. 

    The aims of this first study were 2-fold: (1) to describe the clinical characteristics of MG PID and to determine how they differ from those associated with Chlamydial PID (CT-PID). (2) To determine the proportion of women cured of MG-PID following 14 days of Moxifloxacin, either by NAAT test or clinical cure. 

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  • Changing our approach to service provision for Culturally and Linguistically Diverse Groups

    A report on the Opening Plenary, delivered by Associate Professor Leonie Pihama, Professor Matthew Golden, and Associate Professor Carmen Logie.

    In this plenary, three presenters from three countries discussed how to make approaches to HIV and other STI programs workk in specific populations.

    Key learnings:

    Whilst didactic approaches to populations with good levels of literacy might be effective in certain circumstances, many other groups require different approaches. Hard to reach populations require innovation and dedication and may be far more labour intensive to ensure enrolment in, and maintainance of, programs. Programs that have failed to attract certain clients will continue to fail to attract these clients. What is needed is a different program and not a repetition of the existing program. 

    Developing understandings of diverse cultural groups can ensure that Practitioners can gain trust with their patients, which can help empower them to make decisions that impact their health positively. Aspects to be considered range from communication methods, including availability to care in their own language and the physical materials used, to practical logistic considerations such as provision of transport to access testing or treatment. Services may need to be free or nearly free and there must be consideration about longer-term sustainability.  

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  • The power of education in ensuring equitable access

    A report on Dr Richelle Douglas’ presentation “Abortion: empowering the clinical workforce” 

    This symposium explored equity of access to contraception and abortion, with Dr Douglas providing a clear voice in not only explaining what some of the issues are, but also what can be done to overcome them.  She discussed access and uptake of abortion globally, attitudes to abortion, implications of training and how we can begin to improve.  My main takeaway was that access to abortion training is limited, which has serious implications for our patients. 

    Half of all pregnancies are unintended and 1 in 4 women have a termination of pregnancy (TOP) at some time in their lives.  Unintended pregnancies have a higher risk of maternal morbidity and mortality. Therefore improving access to contraception and abortion can improve maternal mortality rates.  In general, these facts are not debated, but what is less straightforward is how to overcome this problem. In Australia there are limited public facilities that provide abortion training and services.  This results in massive inequity of access, with the most vulnerable people in our community often unable to pay for and access a TOP. 

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  • Future Contraceptive Options

    A report on Deborah Bateson’s presentation “ASHA Oration – Distinguished Services Awardee Presentation” 

    This presentation outlined some very innovative contraceptive options that may be used soon. Examples are smaller IUD’s for smaller women; self-injected sub-cutaneous Depo; male contraception; and a microchip that lasts for 16 years and can be turned on and off depending on fertility desires!  

    Another interesting potentiality is a monthly pill taken towards the end of the menstrual cycle that has different actions dependent on the whether the woman is pregnant or not. If the woman is not pregnant then she would have a normal monthly period, however if she is pregnant then this pill would terminate the pregnancy at the very early stage, even before a woman is aware that she is pregnant. These contraceptives are not yet approved for use in Australia and some will likely meet many obstacles to becoming available.

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  • Screening for anal cancer

    A report on Simon Comben's presentation "Stratifying Anal Cancer Risk in Gay and Bisexual Men"

    The Study of the Prevention of Anal Cancer (SPANC) found that of 312 participants screened, 30-40% had High-Grade Squamous Intraepithelial Lesion (HSIL) at baseline. Screening included anal swab for cytology and HPV DNA, followed by High Resolution Anoscopy (HRA) and directed biopsy of any visual abnormalities.

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  • Emerging STI concern - Shigellosis

    A report on Deborah Williamson's presentation "Dissecting STI Transmission using Genomics"

    It was fascinating to attend Dr Williamson’s presentation on using genomics to look at infections and whether they are linked to a particular outbreak by their unique DNA sequencing. Of particular concern was that Shigellosis has now been linked to a number of MSM sexual transmissions in Australia. It is caused by 2 Shigella bacteria that cause severe diarrhoea and in the past have been transmitted via the food or water in developing countries. However, there has been a change in the epidemiology in the last 15 years and it is has been found to be linked to travel and MSM sexual behaviours. Using genomics to dissect these cases in Australia, it was found that 120 cases were linked to the 1 outbreak.

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  • Consider cost when facilitating contraception

    A report on Catriona Murray's presentation "Barriers and Enablers to IUD use: Who can afford a Mirena?"

    Dr. Catriona Murray highlights the low use of the Mirena IUD especially among Maori and Pacific Peoples in New Zealand due to barriers in cost and service availability.

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  • Communicating sexy science

    A report on Andrew Grulich's and Bruce Richman's presentation "NZAF/Dynamix International - Communicating Sexy Science"

    My attendance at this lunchtime session on day two of the Conference was not planned however I found it extremely useful and enjoyable. Unfortunately I only managed to hear the last five minutes of the first of the speakers in this session - Dr Helen Petousis-Harris talking about countering anti-vaxxers. My take home message from this talk was to be aware of ‘fake news’ which is often embedded in posts, blogs, youtube clips, in this context, promoted by anti vaccine advocates.

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  • Prevention for bacterial vaginosis recurrence

    A report on Lenka Vodstrcil's presentation "Sexual Behaviours and Past Bacterial Vaginosis (BV) Contribute Significantly to BV Recurrence in Women Randomised to the Oral-Contraceptive Pill"

    Such an interesting presentation on Bacterial Vaginosis (BV) which is a common presentation for women with symptoms in sexual health services. I have encountered many women over the years who complain of BV symptoms which often return time and time again despite being treated.

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  • Mycoplasma genitalium is an important cause of urethritis in all men and macrolide resistance is common

    A report on Ruthy McIver's presentation "Men who have sex with men with Mycoplasma Genitalium-Positive Non-Gonococcal Urethritis are more likely to have macrolide resistant strains than men with only female partners"

    This session contained a wide mix of 5-10 min presentations dealing with clinical research. Ruthy McIver’s presentation looked at the prevalence of Mycoplasma genitalium (MG) in men with non-gonococcal urethritis (NGU), both men who have sex with men (MSM) and men with female partners only (MSW), presenting to Sydney Sexual Health Centre (SSHC).

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