HIV&AIDS and Sexual Health Conferences 2019 sexual health

A report back on Basil Donovan and Christopher Fairley's Debate: Doxycycline should be provided for syphilis prophylaxis in those at high risk. 

As the Sexual Health conference came to a close, it was time for some light-hearted debate between Basil Donovan and Kit Fairley on the use of doxycycline as syphilis prophylaxis. The session Chair, Lewis Marshall, introduced the debate as being akin to all good duels, such as that between David and Goliath or Buzz Lightyear and Woody! Hang on…. aren’t Buzz and Woody on the same team? And in fact, this was a good predictor of what was to come. Basil was tasked with the affirmative and set about laying the ground work for the potential to all but eliminate the syphilis epidemic in 10 years if we could convince about half of all men who have sex with more than 20 male partners a year to take daily prophylaxis. It is our moral obligation in fact to provide such chemoprophylaxis if one exists. Basil downplayed any potential for side effects and antimicrobial resistance (reassuring us that all the antimicrobial resistance to doxycycline has already occurred – hardly reassuring) and added in the benefit that we could also potentially prevent chlamydia and gonorrhoea. “The community want it”, Basil says and seeing as it works so well for HIV, chemoprophylaxis for syphilis is the logical next step. 

A reporty back on David Lewis and Catriona Bradshaw's presentation Clinical Management and Therapeutics – MGEN Symposium.

After a morning of antimicrobial resistant gonorrhoea, it was time to turn our attention to antimicrobial resistant Mycoplasma genitalium (MG).  Prof. David Lewis set the scene by outlining the prevalence (about 1-2%) and clinical role of MG and perhaps it was more a case of what we don’t know than what we do.  While the association between MG and non-gonococcal urethritis in men is clear, it is less certain when it comes to proctitis, epididymitis and balanoposthitis. 

A report back on the Australasian Sexual Health and HIV&AIDS Conference 2019. 

I work across the in-patient, (midwifery) setting, in the outpatient arm of our health service providing breastfeeding support, sexual health, women's health, and refugee health services. We collaborate regularly with the Aboriginal Health Service. I bear witness to the traumatising effects of colonisation on First Nation Peoples within our region. I see this as the number one priority, and few months ago I was elected to the Swan Hill Rural City Council  

My 'bio' almost speaks to the challenges of providing sexual health care in the regions. Taking on many roles, filling gaps, but also understanding the impacts of limited services, difficulty retaining medical staff, and the tyranny of distance. 

A report back on Miss Nicole Lima's presentation 'VITA RT-PCR, A MOLECULAR TEST FOR THE DETECTION AND DIFFERENTIATION OF VIABLE AND DEAD CHLAMYDIA TRACHOMATIS'

The final presentation of day 1 of the conference proved rewarding as Nicole Lima introduced us to the VITA RT-PCR, a molecular test which allows for the differentiation of viable and dead Chlamydia trachomatis and the potential impacts this test could have on clinical practice.

Current testing for Chlamydia using nucleic acid amplification tests detect the DNA of Chlamydia but tells us little about its viability. DNA can persist for a long time after effective treatment of Chlamydia and in patients who have been exposed to but self-cleared Chlamydia.

A report back on Teddy Cook and Shoshana Rosenberg’s presentation, ‘The inaugural Australian Trans and Gender Diverse Sexual Health Survey: Barriers, Resilience, and the Impact of Trans-Led Research’ 

I was delighted to see trans sexual health included in the opening plenary of the ASHM Sexual Health conference this year. Teddy Cook (Manager, Trans & Gender Diverse Health Equity, ACON) and Shoshana Rosenberg (University Associate, Curtin University) presented the findings from the largest ever Australian sexual health survey relating specifically to the trans and gender diverse (TGD) community. 

A report back on Dr Clare Huppatz's presentation, 'WA Syphilis Epidemiology'.

At the WA syphilis symposium we heard from Dr Clare Huppatz who outlined the syphilis epidemic as it has moved through Queensland, the Northern Territory, Western Australia and South Australia. We heard that women aged 20-34 were amongst those most affected in Western Australia. Similarly, Aboriginal and Torres Strait Islander people were disproportionately affected with a rate ratio for Indigenous to non-Indigenous of 14:1. We were shown lots of graphs of infectious syphilis going “up and up” and were told that this is not just due to increased awareness and testing but increased test positivity as well.