2015 Participant Summaries

2020 Participant Summaries

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Study:
Treating male partners of women with bacterial vaginosis (StepUp): a protocol for a randomised controlled trial to assess the clinical effectiveness of male partner treatment for reducing the risk of BV recurrence

Researchers:
Vodstrcil LA, Plummer EL, Doyle M, Fairley CK, McGuiness C, Bateson D, Hocking JS, Law MG, Petoumenos K, Donovan B, Chow EPF, Bradshaw CS

Publication:
BMC Infectious Diseases 2020: 20(1); 834 doi:10.1186/s12879-020-05563-w

Summary:
Bacterial vaginosis (BV) may affect 1 in 3 women and is often found with STI and HIV infections, preterm delivery and spontaneous abortion. Current recommended treatments have good short-term effect but 1 in 2 women experience reoccurring BV within 6 months of treatment. BV-bacteria are often found in male partners of women with BV and could be reinfecting women with BV-bacteria. This trial aims to determine if treating women with BV and their regular male partners will prevent BV reoccurring in their female partners. Women with BV and their regular male partner will be asked to take part in the study. Trial registration: The trial was prospectively registered on 12 February 2019 on the Australian and New Zealand Clinical Trial Registry (ACTRN12619000196145, Universal Trial Number: U1111–1228-0106, https://www.anzctr.org.au/Trial/Registration/Trial Review.aspx?id = 376883&is Review=true)


 

Study:
“Moving from one environment to another, it doesn’t automatically change everything.” Exploring the transnational experience of Asian-born gay and bisexual men who have sex with men newly arrived in Australia

Researchers:
Phillips TR, Medland N, Chow EPF, Maddaford K, Wigan R, Fairley CK, Ong JJ, Bilardi JE

Publication: 
PLoS ONE 2020; 15(11): e0242788 doi:10.1371/journal.pone.0242788

Summary: 
Asian-born men who have sex with men (MSM) who recently arrived in Australia were interviewed. Participants described hiding their sexual identities in their country of origin, particularly from family members, due to fear of judgement and discrimination resulting from their sexual identity and HIV related stigma in their countries of origin, although some were open to friends. Despite feeling more sexual freedom and acceptance in Australia, many were still not open about their sexual identity due to their own feelings of stigma and shame. Exposure to stigma in their country of origin led many to report anxiety around HIV testing in Australia due to a fear of testing positive. Some described experiencing racism and lack of acceptance in the gay community in Australia, particularly on dating apps.


 

Study: 
Sex is associated with the persistence of non-optimal vaginal microbiota following treatment for bacterial vaginosis: a prospective cohort study

Researchers:
Ratten LK, Plummer EL, Murray GL, Danielewski J, Fairley CK, Garland SM, Hocking JS, Tachedjian G, Chow EPF, Bradshaw CS, Vodstrcil LA

Publication: 
BJOG doi:10.1111/1471-0528.16430

Summary: 
All women were treated for BV and then followed for up to 6 months. The women who had sex with the same partner before being treated or who had a past history of BV had higher amounts of BV bacteria after treatment. They were also less likely to have normal vaginal bacteria composed of lactobacilli bacteria. These data further highlight the need for therapy that includes the partner.


 

Study: 
Incidence and duration of incident oropharyngeal gonorrhoea and chlamydia infections among men who have sex with men: a prospective cohort study

Researchers:
Chow EPF, Vodstrcil LA, Williamson DA, Maddaford K, Hocking JS, Ashcroft MM, De Petra V, Bradshaw CS, Fairley CK

Publication: 
Sexually Transmitted Infections. doi: 10.1136/sextrans-2020-054764

Summary:
This study looked at how common throat gonorrhoea and throat chlamydia is among men who have sex with men (MSM) over 12 weeks, and also what behaviour could increase their risk of getting these throat infections. A total of 100 MSM were included who were either on PrEp or had at least one casual partner. Self-collected saliva samples were sent each week by post for the 12 weeks together with a weekly questionnaire. Over the 12 weeks, 14 cases had throat gonorrhoea which tended to last for a short time of about 28 days.  All positives were treated at their final 12 week visit to the clinic. Only 2 cases of throat chlamydia were found. Throat gonorrhoea was more common if MSM had more kissing partners and more penile-oral sex partners but not with an increased number of insertive rimming partners. Infection with gonorrhoea in the throat is very common in MSM


Study:
Duration of gargling and rinsing among frequent mouthwash users: a cross-sectional study

Researchers:
Phillips TR, Fairley CK, Maddaford K, Trumpour S, Wigan R, Bradshaw CS, Hocking JS, Chow EPF

Publication: 
BMJ Open 2020; 10: e040754. doi:10.1136/ bmjopen-2020-040754

Summary:
This study looked at rinsing and gargling of mouthwash among people who used mouthwash four or more times per week. Participants were observed and audio recorded using mouthwash. Over a quarter of frequent users do not gargle mouthwash at all (35%) and used it for a much shorter period of time than it was used in the randomised trial (1 min) where it was shown to reduce the growth of gonorrhoea. Our findings suggest that many frequent mouthwash users do not follow the manufacturer instructions for using mouthwash and may not use mouthwash in a way that was shown to reduce the growth of throat gonorrhoea


Study: 
An open-label, parallel-group, randomised controlled trial of antiseptic mouthwash compared with antibiotics for oropharyngeal gonorrhoea treatment (OMEGA2)

Researchers:
Chow EPF, Maddaford K, Hocking JS, Bradshaw CS, Wigan R, Chen MY, Howden BP, William DA, Fairley CK

Publication: 
Scientific Reports 2020; 10:19386 doi: 10.1038/s41598-020-76184-1

Summary:
New treatments for throat gonorrhoea are needed because of rising antimicrobial resistance. The OMEGA2 trial gave men either rinsing, gargling or spraying mouthwash twice daily for 14 days or the standard antibiotic treatment. Participants were advised to go without sex and kissing with anyone for 14 days after joining the study. Throat swabs were collected for testing of gonorrhoea at each visit. This trial was stopped early due to a high failure rate in the mouthwash group. A 14-day course of mouthwash failed to cure throat gonorrhoea cases. This trial was registered on the Australian and New Zealand Clinical Trials Registry (ACTRN12618001380280).


Study: 
Postexposure prophylaxis during COVID-19 lockdown in Melbourne, Australia.

Researchers:
Chow EPF, Hocking JS, Ong JJ, Phillips TR, Fairley CK

Publication:                          
The Lancet HIV 2020; 7(8): e528-529
 doi: 10.1016/S2352-3018(20)30204-6

Summary: 
The Australian government introduced several lockdown measures in the state of Victoria on March 23, 2020, in response to the COVID-19 pandemic. The lockdown measures included the introduction of physical distancing, closure of non-essential services, the banning of indoor gatherings, shift to working from home for those who could, and restrictions requiring people to stay at home unless necessary for essential shopping, medical needs, exercise, or caring roles. Data from 56 Dean Street in London, UK, showed an 80% reduction in HIV postexposure prophylaxis (PEP) prescriptions in the first 4 weeks after the implementation of a similar lockdown in the UK. We expected to see a similar reduction in PEP prescriptions in Australia from reduced casual sex during the lockdown and were interested in how quickly causal sex would resume. A may have been due to reduced sexual risk during the COVID lockdown period rather than reduced access to services given our walk-in service remained open and accessible throughout the period. An increase in prescriptions was seen during the lockdown period reaching 17 prescriptions (May 11–17) and 20 prescriptions (May 18–24) in the 2 weeks immediately after restrictions began to on May 13, 2020, and individuals were allowed to visit friends and family indoors with no more than five visitors. If PEP prescriptions are used as a proxy for risky behaviour then our data suggest that any decrease in HIV and STI diagnoses will be temporary


Study:
Sex is associated with the persistence of non-optimal vaginal microbiota following treatment for bacterial vaginosis: a prospective cohort study.
 

Researchers:
Ratten LK, Plummer EL, Murray GL, Danielewski J, Fairley CK, Garland SM, Hocking JS, Tachedjian G, Chow EPF, Bradshaw CS, Vodstrcil LA

Publication: 
BJOG 2020; doi:10.1111/1471-0528.16430

Summary:
All women were treated for BV and then followed for up to 6 months. We found that the women who had sex with the same partner before and after being treated or who had a past history of BV had more BV-associated bacteria following treatment. They were also less likely to have normal vaginal bacteria which together with more BV bacteria increase the likelihood of BV occurring again. This data highlights the need for therapy that includes the partner.


Study: 
Age pattern of sexual activities with the most recent partner among men who have sex with men in Melbourne, Australia: a cross-sectional study

Researchers:
Kilner A, Fairley CK, Burrell S, Bradshaw CS, Chen MY, Chow EPF

Publication:                          
BMJ Sexual & Reproductive Health. Epub ahead.   doi:10.1136/bmjsrh-2020-200720

Summary:                             

This study aimed to examine the age pattern of a range of sexual activities among MSM with the most recent male sex partner. We conducted a survey among MSM attending the Melbourne Sexual Health Centre in 2017. This survey asked about nine different sexual activities with their most recent regular and casual partner. A total of 1596 men answered the survey and their average age was 30 years. With casual partners, kissing was the most common activity, followed by performing penile-oral sex and receiving penile-oral sex. The least common activity was insertive rimming. Young men were more likely to engage in kissing, receptive rimming and receptive penile-anal sex but they were less likely to have insertive penile-anal sex compared with older MSM. With regular partners, the most common activity was kissing, followed by touching penises and performing penile-oral sex. Age was not associated with most types of sexual activity with regular partners except mutual masturbation and receptive penile-anal sex. Younger men were more likely to masturbate mutually and engage in receptive penile-anal sex. The pattern of sexual activities shows age-related differences with casual partners but less so with regular partners in MSM. 


Study:                                     
Oro-anal sexual practice among female sex workers in Melbourne: implication for extragenital gonorrhoea and chlamydial transmission

Researchers:                         
Chow EPF and Fairley CF

Publication:                           
Sexual Health 2020; doi.org/10.1071/SH19219

Summary:                              
The prevalence of sexually transmissible infections has been low among female sex workers (FSWs) in Melbourne, Australia. Gonorrhoea and chlamydia found in the throat or anally has increased since the mid-2010s. Oro-anal sex (i.e. rimming) has been identified as a risk factor for throat and anal gonorrhoea and chlamydia. This study looked at whether rimming was practiced by FSWs with male clients. Forty-five FSWs completed the survey; and five (11%) FSWs reported insertive rimming and 19 (42%) reported receptive rimming with their male clients in an average working week. Insertive rimming is more commonly practiced than receptive rimming among FSWs with their male clients in an average working week


 Study:                                     
Changing the use of HIV pre-exposure prophylaxis among men who have sex with men during the COVID-19 pandemic in Melbourne, Australia

Researchers:                        
Chow EPF, Hocking JS, Ong JJ, Schmidt T, Buchanan A, Rodriguez E, Maddaford K, Patel P, Fairley CK
 

Publication:                           
Open Forum Infectious Diseases 2020; 7(7): ofaa275 
doi: 10.1093/ofid/ofaa275 

Summary:                              
We surveyed 204 men who have sex with men (MSM) who were pre-exposure prophylaxis (PrEP) users. One in 4 daily PrEP users stopped taking PrEP during the COVID-19 andemic, and 5% switched to on-demand PrEP. Most men reduced PrEP use because they stopped having casual sex and reduced the number of casual partners during the COVID-19 pandemic


 Study:                                    
 
Prevalence of mutations associated with resistance to macrolides and fluoroquinolones in Mycoplasma genitalium: a systematic review and meta-analysis

Researchers:                         
Machalek DA, Tao Y, Shilling H, Jensen JS, Unemo M, Murray G, Chow EP, Low N, Garland SM, Vodstrcil LA, Fairley CK, Hocking JS, Zhang L, Bradshaw CS

Publication:                           
The Lancet Infectious Diseases 2020;  
doi:.1016/S1473-3099(20)30154-7                            

Summary:                              
This study looked at treatment failures of (MG) by using gene tests in patients who were cured and those who failed treatment to find out more about MG failures to the first line treatments (moxifloxacin and azithromycin). Resistance to moxifloxacin in MG samples was 8%. This has not changed much over time, but was much higher in the Western Pacific region than in the European region. Resistance to both azithromycin and moxifloxacin among MG samples was 3%. 


Study:                                     
The preferred qualities of HIV testing and self-testing among men who have sex with men: a discrete choice experiment

Researchers:                         
Ong JJ, De Abreu Lourenco R, Street D, Smith K, Jamil M, Terris-Prestholt F, Fairley CK, McNulty A, Hynes A, Johnson K, Chow EPF, Bavinton B, Grulich AE, Stoove M, Holt M, Kaldor J, Guy R

Publication:                           
Value in Health 202023 (7): 670 - 879 
doi:10.1016/j.jval.2020.04.1826

Summary:                              
HIV self-testing (HIVST) is a promising approach to improve HIV testing coverage and looked at HIV testing preferences of men who have sex with men (MSM). In total, 1606 men participated in an online survey. We found four groups of men with distinct preferences for HIV testing: ‘prefer shorter window period’ (36%); ‘prefer self-testing’ (27%), ‘prefer highly accurate tests’ (22%); and ‘prefer low prices’ (15%). We also found four groups of men with distinct preferences for HIV self-testing:‘prefer low prices’ (48%), ‘prefer retail access (from pharmacy or online stores)’ (29%), ‘prefer access at sex-venues’ (15%), and ‘prefer to buy from healthcare staff’ (12%)


Study:
Drug use and the influence on kissing among gay and bisexual men who have sex with men in Melbourne, Australia

Researchers:             
Chow EPF, Ong JJ, Vodstrcil LA, Fairley CK

Publication:             
International Journal of STD & AIDS 2020; 31(1): 16-21 doi:10.1177/0956462419878338

Summary:  Kissing has recently been found to be a risk factor for spreading gonorrhoea. This study looked at recreational drugs used by MSM and how the different drugs effect the likelihood of kissing. Participants reported their use of eleven different drugs in the last three months and whether they felt the drug influenced them to kiss someone. Almost two-thirds of MSM reported the use of recreational drugs in the last 3 months. The three most used drugs among MSM in the last three months were poppers, marijuana and ecstasy. Older MSM were more likely to use drugs like crystal meth and Viagra. Party drugs like ecstacy were more likely to be used by younger MSM. The majority of users of ecstacy and GHB reported that the drug made them much more likely to kiss someone. The majority of MSM using heroin and Viagra/Cialis reported the drugs did not influence their kissing behaviour.


Study: 
Bacterial load of Chlamydia trachomatis in the posterior oropharynx tonsillar fossae and saliva among gay and bisexual men with untreated oropharyngeal chlamydia

 

Researchers:
Phillips TR, Fairley CK, Maddaford K, Danielewski J, Hocking JS, Lee D, Williamson DA, Murray G, Kong F, De Petra V, Bradshaw CS, Chen MY, Wigan R, Snow A, Howden BP, Garland SM, Chow EPF

Publication:
Journal of Clinical Microbiology 2020; 58(1) e0137519 doi:10.1128/JCM.01375-19

Summary:
This study looked at if chlamydia could be found in saliva and where in particular in the throat chlamydia is found. Men who have sex with men (MSM) who were diagnosed with throat chlamydia were invited to join the study at their return visit for treatment. Swabs were taken from 2 different sites in the throat (around the tonsils) and a saliva sample were collected. All the samples were tested for chlamydia and all positive tests were tested for the amount of chlamydia bacteria in the sample. Forty-two MSM were included. Thirty-two participants (76%) had chlamydia at both sites in the throat and there was no difference in the amount of bacteria found at the 2 sites. Twenty-nine MSM had chlamydia detected in saliva (69%). Among MSM with throat chlamydia, nearly three-quarters had chlamydia in their saliva but what that means for the spread of chlamydia infection is unknown.


 

Study:
 
Moxifloxacin and Sitafloxacin treatment failure in Mycoplasma genitalium infection: association with parC mutation G248T (S83I) and concurrent gyrA mutations

Researchers:
Murray GL, Bodiyabadu K, Danielewski J, Garland SM, Machalek DA, Fairley CK, Jensen JS, Williamson DA, Tan LY, Mokany E, Durukan D, Bradshaw CS

Publication: 
Journal of Infectious Diseases 2020; 221(6): 1017-1024 doi:10.1093/infdis/jiz550

Summary:                             
Mycoplasma genitalium (MG) can cause inflammation of the urethra in men and cervix in women who may develop pelvic inflammatory disease. MG often becomes resistant to antibiotics commonly used to treat MG. This study looked at where the changes in MG occur by using gene tests in patients who were cured and those who failed treatment to find out more about MG failures to respond to the therapies. The findings will provide information about the best tests needed to make sure the best antibiotics are selected for treating MG.


Study:
Extragenital Mycoplasma genitalium infections amongst men who have sex with men

Researchers:
Latimer RL, Vodstrcil LA, De Petra V, Fairley CK, Read TRH, Williamson D, Chow EPF, Bradshaw CS

Publication:  
Sexually Transmitted Infections 2020; 96(1):10-18 doi: 10.1136/sextrans-2019-054058   

Summary:
This study looked at how much rectal Mycoplasma genitalium (MG) there was in cases of rectal chlamydia and rectal gonorrhoea (NG). Throat swabs that had already been tested for chlamydia and gonorrhoea from MSM were also tested for MG. There was no difference between the MSM who had MG and chlamydia (13%) and those who had MG and gonorrhoea (14%). Low numbers of MG was found in the throat (2%)


Study:
Gardnerella vaginalis clade distribution is associated with behavioural practices and Nugent Score in women who have sex with women.

Researchers:                        
Plummer EL, Vodstrcil LA, Murray GL, Fairley CK, Danielewski JA, Garland SM, Chow EPF, Bulatch DM, Fethers KA, Hocking JS, Bradshaw CS

Publication:
Journal of Infectious Diseases 2020; 221(3): 454-463 doi.10.1093/infdis/jiz474

Summary:
The bacteria Gardnerella vaginalis is found in both women with and without bacterial vaginosis (BV). The finding of 4 different groupings (called Clades) of the bacteria G. vaginalis has raised the possibility that there are BV causing groups and those that do not cause BV. We looked at the behaviour among women who have sex with women diagnosed with BV or not and also at the grouping of G vaginalis bacteria. Specific groups were associated with differing behavioural practices. Clade 1 was associated with increasing number of recent sexual partners and smoking, whereas clade 2 was associated with penile-vaginal sex and sharing of sex toys with female partners. Our results suggest that G. vaginalis clades have varying levels of causing BV in WSW through sexual activity. The findings suggest that partner treatment may be an appropriate strategy to improve BV cure.


Study:                                    
Seasonal variations in kissing and sexual activities among men who have sex with men in Melbourne, Australia: implications for seasonal STI preventions and interventions

Researchers:                        
Chow EPF, Vodstrcil L, Fairley CK

Publication:                          
Sexual Health 2020 17(2): 149 – 154; doi:10.1071/SH19046

Summary:                             
The aim of this study was look at whether patterns of kissing and sex partners among gay, bisexual and other men who have sex with men (MSM) changed much between the seasons. Participants were asked to report the number of kissing-only, sex-only and kissing-with-sex male partners in the last 3 months. The number of kissing-only and sex-only partners increased considerably from autumn to summer among MSM in Melbourne. MSM reported the highest number of male partners for kissing-only and sex-only around summer and holiday seasons compared to other seasons. However, the number of kissing-with-sex partners remained stable across seasons.


Study:                                    
Pooling pharyngeal, anorectal and urogenital samples for screening asymptomatic men who have sex with men for Chlamydia trachomatis and Neisseria gonorrhoeae

Researchers:                        
Durukan D, Read TRH, Bradshaw CS, Fairley CK, Williamson D, De Petra V, Maddaford K, Wigan R, Chen MY, Tran A, Chow EPF

Publication:                          
Journal of Clinical Microbiology 2020; 58(5): pii: e01969-19 doi:10.1128/JCM.01969-19

Summary:                             
MSM who had a self-collected sample testing positive for chlamydia or gonorrhoea were recalled for treatment. They were asked to provide a new sample from each site and also a separate pooled-sample of all sites on the day of return. To make the pooled sample, the anal swab was mixed in the urine specimen. The throat swab and some urine sample were then added to the tube. Of the positive chlamydia samples retested 86% of the pooled samples were positive and 91% were positive for gonorrhoea. Using the pooled samples, 22 infections (15 chlamydia and 7 gonorrhoea) would be missed. Most of the infections were from one site. The number of positive tests lost by pooled samples being tested for chlamydia is about 10% from MSM without symptoms. The loss was not seen in gonorrhoea tests