140 results on '"McGregor, Skye"'
Search Results
2. Elimination and eradication goals for communicable diseases: a systematic review/Objectifs d'elimination et d'eradication des maladies transmissibles: revue systematique/Objetivos de eliminacion y erradicacion de enfermedades contagiosas: una revision sistematica
- Author
-
Khawar, Laila, Donovan, Basil, Peeling, Rosanna W., Guy, Rebecca J., and McGregor, Skye
- Subjects
Epidemics -- United Kingdom -- Australia ,Communicable diseases -- Health aspects -- Control -- Analysis ,Public health -- Analysis -- Health aspects ,Health ,Pan American Health Organization - Abstract
Objective To consolidate recent information on elimination and eradication goals for infectious diseases and clarify the definitions and associated terminology for different goals. Methods We conducted a systematic search of the World Health Organization's Institutional Repository for Information Sharing (WHO IRIS) and a customized systematic Google advanced search for documents published between 2008 and 2022 on elimination or eradication strategies for infectious conditions authored by WHO or other leading health organizations. We extracted information on names of infectious conditions, the elimination and eradication goals and timelines, definitions of goals, non-standardized terminology, targets and assessment processes. Findings We identified nine goals for 27 infectious conditions, ranging from disease control to eradication. In comparison with the hierarchy of disease control, as defined at the Dahlem Workshop in 1997, six goals related to disease control with varying levels of advancement, two related to elimination and one to eradication. Goals progressed along a disease-control continuum, such as end of disease epidemic to pre-elimination to elimination as a public health problem or threat. We identified the use of non-standardized terminology with certain goals, including virtual elimination, elimination of disease epidemics, public health threat and public health concern. Conclusion As we approach the 2030 target date to achieve many of the goals related to disease control and for other infections to become candidates for elimination in the future, clarity of definitions and objectives is important for public health professionals and policy-makers to avoid misperceptions and miscommunication. Objectif Rassembler les informations recentes concernant les objectifs d'elimination et d'eradication des maladies infectieuses, mais aussi clarifier la terminologie et les definitions associees aux differents objectifs. Methodes Nous avons mene une recherche systematique au sein des archives institutionnelles pour l'echange d'informations (IRIS) de l'Organisation mondiale de la Sante (OMS), ainsi qu'une recherche systematique personnalisee dans Google Advanced Search, afin de trouver des documents publies entre 2008 et 2022 portant sur les strategies d'elimination ou d'eradication de maladies infectieuses et rediges par l'OMS ou par d'autres organisations sanitaires majeures. Nous avons ensuite extrait les informations relatives aux noms des maladies infectieuses, aux objectifs et delais d'elimination ou d'eradication, a la definition des objectifs, a la terminologie non standardisee, aux orientations et aux processus d'evaluation. Resultats Nous avons identifie neuf objectifs pour 27 maladies infectieuses, allant de la lutte contre la maladie a son eradication. Selon la classification du controle des maladies telle que definie lors de l'Atelier Dahlem en 1997, six objectifs etaient lies a la lutte contre les infections a divers degres d'avancement, deux a l'elimination et un a l'eradication. Ces objectifs evoluaient dans un continuum de lutte contre les maladies, par exemple de la fin d'une epidemie a l'elimination de la maladie en tant que probleme ou menace pour la sante publique, en passant par sa pre-elimination. Nous avons constate l'emploi d'une terminologie non standardisee pour certains objectifs: elimination virtuelle, elimination d'epidemies, menace sanitaire et probleme de sante publique notamment. Conclusion A mesure que nous nous rapprochons de l'echeance de 2030 en matiere de realisation des objectifs de lutte contre les maladies, et pour que d'autres infections puissent pretendre a une elimination dans le futur, il est crucial de clarifier les definitions et les perspectives afin d'eviter toute erreur de communication et de perception chez les professionnels de la sante publique et les responsables politiques. Objetivo Consolidar la informacion reciente relativa a los objetivos de eliminacion y erradicacion de enfermedades infecciosas, y aclarar las definiciones y la terminologia asociada a los diferentes objetivos. Metodos Llevamos a cabo una investigacion sistematica del Repositorio Institucional para el Intercambio de Informacion de la Organizacion Mundial de la Salud (IRIS OMS) y una Busqueda sistematica Avanzada en Google de documentos publicados entre 2008 y 2022 que versaban sobre las estrategias de eliminacion y erradicacion de enfermedades infecciosas. Estos documentos habian sido redactados por la OMS o por importantes organizaciones sanitarias. Recabamos informacion acerca de nombres de enfermedades infecciosas, objetivos y plazos de eliminacion y erradicacion, definiciones de objetivos, terminologia no estandarizada, asi como fines y procesos de evaluacion. Resultados Identificamos nueve objetivos para 27 enfermedades infecciosas, desde el control de dichas enfermedades hasta su erradicacion. En funcion de la jerarquia de control de enfermedades, segun se definio en el Taller de Dahlem en 1997, existian seis objetivos relacionados con el control de enfermedades, que contaban con diferentes niveles de avance; dos objetivos relacionados con la eliminacion, y uno que trataba sobre la erradicacion. Los objetivos evolucionaron hacia un continuum en el control de enfermedades, desde el fin de la enfermedad epidemica a la preeliminacion y la eliminacion como problema o amenaza publica sanitaria. Detectamos el uso de terminologia no estandarizada en determinados objetivos. Ejemplos de esta terminologia son eliminacion virtual, eliminacion de enfermedades epidemicas, amenaza publica sanitaria y preocupacion publica sanitaria. Conclusion Dado que nos acercamos a la fecha limite establecida de 2030 para lograr numerosos objetivos relacionados con el control de enfermedades y con otras afecciones que puedan ser objeto de eliminacion en el futuro, es crucial mantener la claridad en las definiciones y en los objetivos para que los profesionales publicos sanitarios y las personas encargadas de la elaboracion de politicas no hagan uso de ideas erroneas y no haya problemas de comunicacion. [phrase omitted], Introduction In the past two decades, strong political and financial commitments have led to remarkable national and regional achievements in controlling communicable diseases. The World Health Organization (WHO) has called [...]
- Published
- 2023
- Full Text
- View/download PDF
3. Low HIV drug resistance prevalence among recently diagnosed HIV‐positive men who have sex with men in a setting of high PrEP use
- Author
-
King, Jonathan M., Di Giallonardo, Francesca, Shaik, Ansari, Mcgregor, Skye, Yeung, Julie Yuek Kee, Sivaruban, Tharshini, Lee, Frederick J., Cunningham, Philip, Dwyer, Dominic E., Nigro, Steven J., Grulich, Andrew E., and Kelleher, Anthony D.
- Subjects
HIV (Viruses) -- Drug therapy ,Genomics ,Drug resistance -- Drug therapy ,Highly active antiretroviral therapy ,Emtricitabine ,DNA polymerases ,Health - Abstract
: Introduction: New South Wales (NSW) has one of the world's highest uptake rates of HIV pre‐exposure prophylaxis (PrEP). This uptake has been credited with sharp declines in HIV transmission, particularly among Australian‐born gay and bisexual men. Concerns have been raised around the potential for the emergence of tenofovir (TFV) and XTC (lamivudine/emtricitabine) resistance in settings of high PrEP use. Such an emergence could also increase treatment failure and associated clinical outcomes among people living with HIV (PLHIV). Despite low levels of nucleoside reverse‐transcriptase inhibitor (NRTI) resistance relating to PrEP use in clinical settings, there are few published studies describing the prevalence of NRTI resistance among people newly diagnosed with HIV in a setting of high PrEP use. Methods: Using HIV antiretroviral drug resistance data linked to NSW HIV notifications records of people diagnosed from 1 January 2015 to 31 December 2021 and with HIV attributed to male‐to‐male sex, we described trends in TFV and XTC resistance. Resistance was identified using the Stanford HIV Drug Resistance genotypic resistance interpretation system. To focus on transmitted drug resistance, resistance prevalence estimates were generated using sequences taken less than 3 months post‐HIV diagnosis. These estimates were stratified by timing of sequencing relative to the date of diagnosis, year of sequencing, birthplace, likely place of HIV acquisition, and stage of HIV at diagnosis. Results: Among 1119 diagnoses linked to HIV genomes sequenced less than 3 months following diagnosis, overall XTC resistance prevalence was 1.3%. Between 2015 and 2021, XTC resistance fluctuated between 0.5% to 2.9% and was 1.0% in 2021. No TFV resistance was found over the study period in any of the sequences analysed. Higher XTC resistance prevalence was observed among people with newly acquired HIV (evidence of HIV acquisition in the 12 months prior to diagnosis; 2.9%, p = 0.008). Conclusions: In this Australian setting, TFV and XTC resistance prevalence in new HIV diagnoses remained low. Our findings offer further evidence for the safe scale‐up of PrEP in high‐income settings, without jeopardizing the treatment of those living with HIV., INTRODUCTION Australia has made remarkable progress in its effort to meet the UNAIDS 2030 target of ending AIDS as a public health threat with HIV diagnoses attributed to male‐to‐male sex [...]
- Published
- 2024
- Full Text
- View/download PDF
4. The application of new metrics for understanding trends in undiagnosed HIV among key populations
- Author
-
Gray, Richard T., Camara, Hawa, Khawar, Laila, Grulich, Andrew, GUY, Rebecca, Mcgregor, Skye, and Medland, Nicholas
- Published
- 2023
- Full Text
- View/download PDF
5. Applying population‐specific incidence prevalence ratio benchmarks to monitor the Australian HIV epidemic: an epidemiological analysis.
- Author
-
King, Jonathan M., McManus, Hamish, Gray, Richard T., Nigro, Steven J., Sisnowski, Jana, Dobbins, Timothy, Bavinton, Benjamin R., Grulich, Andrew E., Petoumenos, Kathy, Costello, Jane, and McGregor, Skye
- Subjects
DRUG abuse ,EPIDEMIOLOGY ,HIV infection transmission ,HIV-positive persons ,LIFE tables - Abstract
Introduction: Due to a lack of robust population denominators, Australia is unable to accurately monitor changes in the HIV epidemic for some populations. The ratio of HIV transmission relative to the number of people with HIV (an incidence prevalence ratio, or IPR) can measure such changes. The IPR is measured against an IPR benchmark derived from post‐HIV acquisition life expectancy, to indicate whether an HIV epidemic is shrinking or growing. Using IPRs and Australia‐specific IPR benchmarks, this study aims to describe the Australian HIV epidemic among three groups: men with HIV attributed to male‐to‐male sex, women with HIV and people with HIV attributed to injection drug use. Methods: Using mathematical modelling derived from HIV notifications, cohort and administrative data, IPRs were generated for each of the three groups. These IPRs were compared with IPR benchmarks derived from post‐HIV acquisition mortality estimates using abridged life tables for men, women and people who inject drugs. The IPR benchmark for men was applied to people with HIV attributed to male‐to‐male sex. Trends in the IPR over time were described for each reported population from 2015 to 2022. Results: Overall, the IPR fell by 80%, from 0.040 (range: 0.034−0.045) in 2015 to 0.008 (range: 0.003−0.013) in 2022 and fell below the benchmark (0.022) in 2020. Among people with HIV attributed to male‐to‐male sex, the IPR fell by 85%, from 0.041 (range: 0.034−0.047) in 2015 to 0.006 (range: 0.003−0.024) in 2022 and fell below the benchmark (0.022) in 2020. Among women with HIV, the IPR fell by 56%, from 0.032 (range: 0.026−0.039) in 2015 to 0.014 (range: 0.003−0.029) in 2022 and fell below the benchmark (0.022) in 2019. Among people with HIV attributed to injection drug use, the IPR fell by 61%, from 0.036 (range: 0.022−0.047) in 2015 to 0.014 (range: 0.002−0.057) in 2022 and fell below the benchmark (0.028) in 2019. Conclusions: Australian IPRs in all populations examined have dropped below the level required to sustain the HIV epidemic at current levels. By applying this method in other contexts, the changing scale of HIV epidemics may be better described for populations lacking robust population denominators. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
6. Genital warts trends in Australian and overseas-born people in Australia: A cross-sectional trend analysis to measure progress towards control and elimination
- Author
-
Khawar, Laila, McManus, Hamish, Vickers, Tobias, Chow, Eric P.F., Fairley, Christopher K, Donovan, Basil, Machalek, Dorothy A, Regan, David G, Grulich, Andrew E, Guy, Rebecca J, and McGregor, Skye
- Published
- 2021
- Full Text
- View/download PDF
7. A population‐level application of a method for estimating the timing of HIV acquisition among migrants to Australia
- Author
-
King, Jonathan M., Petoumenos, Kathy, Dobbins, Timothy, Guy, Rebecca J., Gray, Richard T., Nigro, Steven J., Si, Damin, Minas, Byron, and Mcgregor, Skye
- Subjects
Sentinel health events -- Models ,Immigrants -- Health aspects ,Public health administration -- Models ,HIV infection -- Diagnosis -- Care and treatment ,Health - Abstract
: Introduction: Australia has set the goal for the virtual elimination of HIV transmission by the end of 2022, yet accurate information is lacking on the level of HIV transmission occurring among residents. We developed a method for estimating the timing of HIV acquisition among migrants, relative to their arrival in Australia. We then applied this method to surveillance data from the Australian National HIV Registry with the aim of ascertaining the level of HIV transmission among migrants to Australia occurring before and after migration, and to inform appropriate local public health interventions. Methods: We developed an algorithm incorporating CD4[sup.+] T‐cell decline back‐projection and enhanced variables (clinical presentation, past HIV testing history and clinician estimate of the place of HIV acquisition) and compared it to a standard algorithm which uses CD4[sup.+] T‐cell back‐projection only. We applied both algorithms to all new HIV diagnoses among migrants to estimate whether HIV infection occurred before or after arrival in Australia. Results: Between 1 January 2016 and 31 December 2020, 1909 migrants were newly diagnosed with HIV in Australia, 85% were men, and the median age was 33 years. Using the enhanced algorithm, 932 (49%) were estimated to have acquired HIV after arrival in Australia, 629 (33%) before arrival (from overseas), 250 (13%) close to arrival and 98 (5%) were unable to be classified. Using the standard algorithm, 622 (33%) were estimated to have acquired HIV in Australia, 472 (25%) before arrival, 321 (17%) close to arrival and 494 (26%) were unable to be classified. Conclusions: Using our algorithm, close to half of migrants diagnosed with HIV were estimated to have acquired HIV after arrival in Australia, highlighting the need for tailored culturally appropriate testing and prevention programmes to limit HIV transmission and achieve elimination targets. Our method reduced the proportion of HIV cases unable to be classified and can be adopted in other countries with similar HIV surveillance protocols, to inform epidemiology and elimination efforts., INTRODUCTION UNAIDS has set the ambitious target to eliminate the global transmission of HIV by 2030 [1] and Australia is aiming for “virtual elimination” by the end of 2022 [2]. [...]
- Published
- 2023
- Full Text
- View/download PDF
8. Acceptability of sexual history questions in a gender‐neutral risk assessment for blood donation.
- Author
-
Mowat, Yasmin, Haire, Bridget, Masser, Barbara, Hoad, Veronica, Heywood, Anita, Thorpe, Rachel, McManus, Hamish, Kaldor, John, and McGregor, Skye
- Subjects
ANAL sex ,SEXUAL partners ,BLOOD donors ,CULTURAL awareness ,AUSTRALIANS - Abstract
Background: Currently in Australia, men are deferred from donating blood if they have had sex with another man within the past 3 months. However, a proposed gender‐neutral assessment (GNA) process will ask all donors questions about sex with new or multiple recent partners, with deferral based on responses to a question about anal sex. Understanding the acceptability of such questions among existing and potential blood donors is paramount for successful implementation of GNA. Study Design and Methods: We used data from a nationally representative survey to estimate the levels of comfort with the proposed GNA questions among the Australian population and subgroups, defined by self‐reported ethnicity and religion. Respondents were aged over 18 and living in Australia. Results were weighted to represent the population. Results: Most of the 5178 respondents described themselves as comfortable with answering questions about new partners (73.1%) or anal sex (64.0%) to donate blood. However, 2.2% and 4.5% indicated that questions about new sex partners and anal sex, respectively, would stop them from donating, and 4.4% and 7.7% respectively, said they were "completely uncomfortable." By religion, the least comfortable were Muslim or Eastern Orthodox respondents, and by country of birth, the least comfortable were those born in the Middle East, followed by those born in Southern Europe and Asia. Discussion: GNA appears to be broadly acceptable in the Australian context, but our findings suggest that key GNA questions are less acceptable in some population subgroups, indicating a need for targeted campaigns that consider cultural sensitivities. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
9. Notification rates for syphilis in women of reproductive age and congenital syphilis in Australia, 2011–2021: a retrospective cohort analysis of national notifications data.
- Author
-
Hengel, Belinda, McManus, Hamish, Monaghan, Robert, Mak, Donna B, Bright, Amy, Tolosa, Ximena, Mitchell, Kellie, Anderson, Lorraine, Thomas, Jackie R, Ryder, Nathan, Causer, Louise, Guy, Rebecca J, and McGregor, Skye
- Abstract
Objectives: To estimate notification rates for infectious syphilis in women of reproductive age and congenital syphilis in Australia. Study design: Retrospective cohort study; analysis of national infectious syphilis and enhanced congenital syphilis surveillance data. Setting, participants: Women aged 15–44 years diagnosed with infectious syphilis, and babies with congenital syphilis, Australia, 2011–2021. Main outcome measures: Numbers and rates of infectious syphilis notifications, by Indigenous status and age group; numbers and rates of congenital syphilis, by Indigenous status of the infant; antenatal care history for mothers of infants born with congenital syphilis. Results: During 2011–2021, 5011 cases of infectious syphilis in women aged 15–44 years were notified. The notification rate for Aboriginal and Torres Strait Islander women rose from 56 (95% confidence interval [CI], 45–65) cases per 100 000 in 2011 to 227 (95% CI, 206–248) cases per 100 000 population in 2021; for non‐Indigenous women, it rose from 1.1 (95% CI, 0.8–1.4) to 9.2 (95% CI, 8.4–10.1) cases per 100 000 population. The notification rate was higher for Aboriginal and Torres Strait Islander women than for non‐Indigenous women (incidence rate ratio [IRR], 23.1; 95% CI, 19.7–27.1), lower for 15–24‐ (IRR, 0.7; 95% CI, 0.6–0.9) and 35–44‐year‐old women (IRR, 0.6; 95% CI, 0.5–0.7) than for 25–34‐year‐old women, and higher in remote regions than in major cities (IRR, 2.7; 95% CI, 2.2–3.8). During 2011–2021, 74 cases of congenital syphilis were notified, the annual number increasing from six in 2011 to a peak of 17 in 2020; the rate was consistently higher among Aboriginal and Torres Strait Islander infants than among non‐Indigenous infants (2021: 38.3 v 2.1 per 100 000 live births). The mothers of 32 infants with congenital syphilis (43%) had not received antenatal care. Conclusions: The number of infectious syphilis notifications for women of reproductive age increased in Australia during 2011–2021, as did the number of cases of congenital syphilis. To avert congenital syphilis, antenatal screening of pregnant women, followed by prompt treatment for infectious syphilis when diagnosed, needs to be improved. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
10. Association between HTLV-1 infection and adverse health outcomes: a systematic review and meta-analysis of epidemiological studies
- Author
-
Schierhout, Gill, McGregor, Skye, Gessain, Antoine, Einsiedel, Lloyd, Martinello, Marianne, and Kaldor, John
- Published
- 2020
- Full Text
- View/download PDF
11. Strategies to improve control of sexually transmissible infections in remote Australian Aboriginal communities: a stepped-wedge, cluster-randomised trial
- Author
-
Ward, James, Guy, Rebecca J, Rumbold, Alice R, McGregor, Skye, Wand, Handan, McManus, Hamish, Dyda, Amalie, Garton, Linda, Hengel, Belinda, Silver, Bronwyn J, Taylor-Thomson, Debbie, Knox, Janet, Donovan, Basil, Law, Matthew, Maher, Lisa, Fairley, Christopher K, Skov, Steven, Ryder, Nathan, Moore, Elizabeth, Mein, Jacqueline, Reeve, Carole, Ah Chee, Donna, Boffa, John, and Kaldor, John M
- Published
- 2019
- Full Text
- View/download PDF
12. Trends in human immunodeficiency virus diagnoses among men who have sex with men in North America, Western Europe, and Australia, 2000–2014
- Author
-
Chapin-Bardales, Johanna, Schmidt, Axel J., Guy, Rebecca J., Kaldor, John M., McGregor, Skye, Sasse, André, Archibald, Chris, Rank, Claudia, Casabona Barbarà, Jordi, Folch, Cinta, Vives, Núria, Cowan, Susan A., Cazein, Françoise, Velter, Annie, an der Heiden, Matthias, Gunsenheimer-Bartmeyer, Barbara, Marcus, Ulrich, Op de Coul, Eline L.M., van Sighem, Ard, Aldir, Isabel, Cortes Martins, Helena, Berglund, Torsten, Velicko, Inga, Gebhardt, Martin, Delpech, Valerie, Hughes, Gwenda, Nardone, Anthony, Hall, H. Irene, Johnson, Anna S., and Sullivan, Patrick S.
- Published
- 2018
- Full Text
- View/download PDF
13. HIV incidence in Indigenous and non-Indigenous populations in Australia: a population-level observational study
- Author
-
Ward, James, McManus, Hamish, McGregor, Skye, Hawke, Karen, Giele, Carolien, Su, Jiunn-Yih, McDonald, Ann, Guy, Rebecca, Donovan, Basil, and Kaldor, John M
- Published
- 2018
- Full Text
- View/download PDF
14. Babies infected with syphilis are part of a growing tragedy - one that could be easily prevented.
- Author
-
McGregor, Skye, Hengel, Belinda, and Monaghan, Robert
- Subjects
SYPHILIS ,STILLBIRTH ,MISCARRIAGE ,INFANTS ,DISABILITIES - Abstract
Cases of infectious syphilis have risen sharply in the last decade, including in women in their reproductive years. That can lead to stillbirth, miscarriage or disability. [ABSTRACT FROM AUTHOR]
- Published
- 2024
15. The impact of blood donation deferral strategies on the eligibility of men who have sex with men and other sexual risk behavior in Australia.
- Author
-
Mowat, Yasmin, Hoad, Veronica, Masser, Barbara, Kaldor, John, Heywood, Anita, Thorpe, Rachel, McManus, Hamish, McGregor, Skye, and Haire, Bridget
- Subjects
HUMAN sexuality ,AT-risk behavior - Abstract
Background: In Australia, a man cannot donate blood if he has had sex with another man within the past 3 months. However, this policy has been criticized as being discriminatory as it does not consider lower risk subgroups, and led to calls for modifications to the policy that more accurately distinguish risk among gay, bisexual, and other men who have sex with men (GBM). Study Design and Methods: We used data from a nationally representative survey to estimate the proportion of GBM aged 18–74 years old who would be eligible to donate under current criteria and other scenarios. Results: Among the 5178 survey participants, 155 (3.0%) were classified as GBM based on survey responses, Among the GBM, 40.2% (95% CI 28.0%–53.7%) were eligible to donate based on current criteria, and 21.0% (95% CI 14.5%–29.5%) were ineligible due to the 3 months deferral alone. Eligibility among GBM, all men, and the population increased as criteria were removed. Under the new Australian plasma donation criteria, 73.6% (95% CI 64.4%–81.1%) of GBM, 68.4% (95% CI 65.5%–71.2%) of all men, and 60.8% (95% CI 58.8%–62.8%) of the full population were estimated to be eligible. Only 16.1% (95% CI 8.6%–28.1%) of GBM knew that the male‐to‐male sex deferral period is 3 months. Discussion: Changing the deferral criteria and sexual risk evaluation would lead to a higher proportion of GBM being eligible to donate blood. Knowledge of the current GBM deferral period is very low. Improved education about the current criteria and any future changes are required to improve blood donation rates. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
16. Trends in late and advanced HIV diagnoses among migrants in Australia; implications for progress on Fast-Track targets: A retrospective observational study
- Author
-
Marukutira, Tafireyi, Gunaratnam, Praveena, Douglass, Caitlin, Jamil, Muhammad S., McGregor, Skye, Guy, Rebecca, Gray, Richard Thomas, Spelman, Tim, Horyniak, Danielle, Higgins, Nasra, Giele, Carolien, Crowe, Suzanne Mary, Stoove, Mark, and Hellard, Margaret
- Published
- 2020
- Full Text
- View/download PDF
17. Incidence and time trends of anal cancer among people living with HIV in Australia
- Author
-
Jin, Fengyi, Vajdic, Claire M., Law, Matthew, Amin, Janaki, van Leeuwen, Marina, McGregor, Skye, Poynten, I. Mary, Templeton, David J., and Grulich, Andrew E.
- Published
- 2019
- Full Text
- View/download PDF
18. Two Distinct Gonorrhea Trends and Risk Factors Among Women in Australia
- Author
-
Whitford, Kate, Callander, Denton, Smith, Lucy Watchirs, Guy, Rebecca, Kong, Marlene, Ward, James, Donovan, Basil, McManus, Hamish, Bell, Stephen, McGregor, Skye, Menon, Arun, Russell, Darren, and OʼConnor, Catherine C.
- Published
- 2020
- Full Text
- View/download PDF
19. People Born in Non–Main English Speaking Countries Are Less Likely to Start HIV Treatment Early in Australia: A National Cohort Analysis, 2014–15
- Author
-
Gunaratnam, Praveena, McManus, Hamish, Watchirs-Smith, Lucy, McGregor, Skye, Callander, Denton, Brown, Graham, Lobo, Roanna, OʼConnor, Catherine, Hellard, Margaret, Medland, Nick, Lewis, David, Palmer, Cheryn, Law, Matthew, Gray, Richard, Donovan, Basil, and Guy, Rebecca
- Published
- 2018
- Full Text
- View/download PDF
20. Prevalence of blood donation eligibility in Australia: A population survey.
- Author
-
Mowat, Yasmin, Hoad, Veronica, Haire, Bridget, Masser, Barbara, Kaldor, John, Heywood, Anita, Thorpe, Rachel, McManus, Hamish, and McGregor, Skye
- Subjects
DEMOGRAPHIC surveys ,CREUTZFELDT-Jakob disease ,BLOOD collection ,IRON deficiency ,COLLECTION agencies - Abstract
Background: Reliable estimates of the population proportion eligible to donate blood are needed by blood collection agencies to model the likely impact of changes in eligibility criteria and inform targeted population‐level education, recruitment, and retention strategies. In Australia, the sole estimate was calculated 10+ years ago. With several subsequent changes to the eligibility criteria, an updated estimate is required. Study Design and Methods: We conducted a cross‐sectional national population survey to estimate eligibility for blood donation. Respondents were aged 18+ and resident in Australia. Results were weighted to obtain a representative sample of the population. Results: Estimated population prevalence of blood donation eligibility for those aged 18–74 was 57.3% (95% CI 55.3–59.3). The remaining 42.7% (95% CI 40.7–44.7) were either temporarily (25.3%, 95% CI 23.5–27.2) or permanently ineligible (17.4%, 95% CI 16.1–18.9). Of those eligible at the time of the survey, that is, with the UK geographic deferral for variant Creutzfeldt‐Jakob disease included, (52.9%, 95% CI 50.8–54.9), 14.2% (95% CI 12.3–16.3) reported donating blood within the previous 2 years. Eligibility was higher among men (62.6%, 95% CI 59.6–65.6) than women (52.8%, 95% CI 50.1–55.6). The most common exclusion factor was iron deficiency/anemia within the last 6 months; 3.8% (95% CI 3.2–4.6) of the sample were ineligible due to this factor alone. Discussion: We estimate that approximately 10.5 million people (57.3% of 18–74‐year‐olds) are eligible to donate blood in Australia. Only 14.2% of those eligible at the time of survey reported donating blood within the previous 2 years, indicating a large untapped pool of potentially eligible blood donors. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
21. Perspectives of primary health care staff on the implementation of a sexual health quality improvement program: a qualitative study in remote aboriginal communities in Australia
- Author
-
Hengel, Belinda, Bell, Stephen, Garton, Linda, Ward, James, Rumbold, Alice, Taylor-Thomson, Debbie, Silver, Bronwyn, McGregor, Skye, Dyda, Amalie, Knox, Janet, Guy, Rebecca, Maher, Lisa, Kaldor, John Martin, and on behalf of the STRIVE Investigators
- Published
- 2018
- Full Text
- View/download PDF
22. The seventh (and last?) International Microbicides Conference: from discovery to delivery
- Author
-
McGregor, Skye, Tachedjian, Gilda, Haire, Bridget, and Kaldor, John M.
- Published
- 2013
23. Second Primary Cancers in People With HIV/AIDS: A National Data Linkage Study of Incidence and Risk Factors.
- Author
-
Di Ciaccio, Pietro R., Van Leeuwen, Marina T., Amin, Janaki, Vajdic, Claire M., McGregor, Skye, Poynten, Isobel M., Templeton, David J., Law, Matthew, Grulich, Andrew E., Polizzotto, Mark N., and Jin, Fengyi
- Published
- 2023
- Full Text
- View/download PDF
24. Chronic hepatitis C burden and care cascade in Australia in the era of interferon‐based treatment
- Author
-
Hajarizadeh, Behzad, Grebely, Jason, McManus, Hamish, Estes, Chris, Razavi, Homie, Gray, Richard T, Alavi, Maryam, Amin, Janaki, McGregor, Skye, Sievert, William, Thompson, Alexander, and Dore, Gregory J
- Published
- 2017
- Full Text
- View/download PDF
25. Coinfection with Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis: a cross-sectional analysis of positivity and risk factors in remote Australian Aboriginal communities
- Author
-
Guy, Rebecca, Ward, James, Wand, Handan, Rumbold, Alice, Garton, Linda, Hengel, Belinda, Silver, Bronwyn, Taylor-Thomson, Debbie, Knox, Janet, McGregor, Skye, Dyda, Amalie, Fairley, Christopher, Maher, Lisa, Donovan, Basil, Kaldor, John, Chee, Donna Ah, Boffa, John, Glance, David, Law, Mathew, McDermott, Robyn, and Skov, Steven
- Published
- 2015
- Full Text
- View/download PDF
26. Incidence of curable sexually transmissible infections among adolescents and young adults in remote Australian Aboriginal communities: analysis of longitudinal clinical service data
- Author
-
Silver, Bronwyn J, Guy, Rebecca J, Wand, Handan, Ward, James, Rumbold, Alice R, Fairley, Christopher K, Donovan, Basil, Maher, Lisa, Dyda, Amalie, Garton, Linda, Hengel, Belinda, Knox, Janet, McGregor, Skye, Taylor-Thomson, Debbie, Kaldor, John M, Chee, Donna Ah, Boffa, John, Glance, David, Law, Mathew, McDermott, Robyn, and Skov, Steven
- Published
- 2015
- Full Text
- View/download PDF
27. Time trends in cancer incidence in Australian people living with HIV between 1982 and 2012.
- Author
-
Wong, Ian K. J., Grulich, Andrew E., Poynten, Isobel Mary, Polizzotto, Mark N., van Leeuwen, Marina T., Amin, Janaki, McGregor, Skye, Law, Matthew, Templeton, David J., Vajdic, Claire M., and Jin, Fengyi
- Subjects
HIV-positive persons ,HEAD tumors ,HODGKIN'S disease ,LIVER tumors ,LUNG tumors ,KAPOSI'S sarcoma ,ANAL tumors ,COLORECTAL cancer ,TUMORS ,STATISTICAL models ,LYMPHOMAS ,LONGITUDINAL method ,NECK tumors ,PROSTATE tumors - Abstract
Objectives: The aim of the study was to describe time trends in cancer incidence in people living with HIV (PLHIV) in Australia between 1982 and 2012. Methods: A population‐based prospective study was conducted using data linkage between the national HIV and cancer registries. Invasive cancers identified in PLHIV were grouped into AIDS‐defining cancers (ADCs), infection‐related non‐ADCs (NADCs), and non‐infection‐related NADCs. Crude and age‐standardized incidence rates of cancers were calculated and compared over five time periods: 1982–1995, 1996–1999, 2000–2004, 2005–2008 and 2009–2012, roughly reflecting advances in HIV antiretroviral therapy. Standardized incidence ratios (SIRs) compared with the Australian general population were calculated for each time period. Generalized linear models were developed to assess time trends in crude and age‐standardized incidences. Results: For ADCs, the crude and age‐standardized incidences of Kaposi sarcoma and non‐Hodgkin lymphoma substantially declined over time (P‐trend < 0.001 for all) but SIRs remained significantly elevated. For infection‐related NADCs, there were significant increases in the crude incidences of anal, liver and head and neck cancers. Age‐standardized incidences increased for anal cancer (P‐trend = 0.002) and liver cancer (P‐trend < 0.001). SIRs were significantly elevated for anal cancer, liver cancer and Hodgkin lymphoma. For non‐infection‐related NADCs, the crude incidence of colorectal, lung and prostate cancers increased over time, but age‐standardized incidences remained stable. Conclusions: Continuous improvements and high coverage of antiretroviral therapy have reduced the incidence of ADCs in PLHIV in Australia. Clinical monitoring of anal and liver cancers in people living with HIV should be performed, given the increasing incidence of these cancers. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
28. Modelling response strategies for controlling gonorrhoea outbreaks in men who have sex with men in Australia.
- Author
-
Duan, Qibin, Carmody, Chris, Donovan, Basil, Guy, Rebecca J., Hui, Ben B., Kaldor, John M., Lahra, Monica M., Law, Matthew G., Lewis, David A., Maley, Michael, McGregor, Skye, McNulty, Anna, Selvey, Christine, Templeton, David J., Whiley, David M., Regan, David G., and Wood, James G.
- Subjects
MEN who have sex with men ,GONORRHEA ,CONTACT tracing ,NEISSERIA gonorrhoeae ,TREATMENT failure ,DRUG efficacy - Abstract
The ability to treat gonorrhoea with current first-line drugs is threatened by the global spread of extensively drug resistant (XDR) Neisseria gonorrhoeae (NG) strains. In Australia, urban transmission is high among men who have sex with men (MSM) and importation of an XDR NG strain in this population could result in an epidemic that would be difficult and costly to control. An individual-based, anatomical site-specific mathematical model of NG transmission among Australian MSM was developed and used to evaluate the potential for elimination of an imported NG strain under a range of case-based and population-based test-and-treat strategies. When initiated upon detection of the imported strain, these strategies enhance the probability of elimination and reduce the outbreak size compared with current practice (current testing levels and no contact tracing). The most effective strategies combine testing targeted at regular and casual partners with increased rates of population testing. However, even with the most effective strategies, outbreaks can persist for up to 2 years post-detection. Our simulations suggest that local elimination of imported NG strains can be achieved with high probability using combined case-based and population-based test-and-treat strategies. These strategies may be an effective means of preserving current treatments in the event of wider XDR NG emergence. Author summary: In most high-income settings, gonorrhoea is endemic among men who have sex with men (MSM). While gonorrhoea remains readily treatable with antibiotics, there are major concerns about the threat of antimicrobial resistance arising from recent reports of treatment failure with first-line therapy and limited remaining treatment options. Here we investigated the potential for test-and-treat response strategies to eliminate such strains before their prevalence reaches a level requiring a shift to new first line therapies. Rather than directly consider resistance, we explore the mitigating effect of various test-and-treat measures on outbreaks of a generic imported strain which remains treatable. This is done within the framework of a realistic mathematical model of gonorrhoea spread in an MSM community that captures cases, anatomical sites of infection and sexual contacts at an individual level, calibrated to relevant Australian epidemiological data. The results indicate that strategies such as partner testing and treatment in combination with elevated asymptomatic community testing are highly effective in mitigating outbreaks but can take up to 2 years to achieve elimination. As there are currently no clear alternative drugs of proven efficacy and safety to replace ceftriaxone in first-line therapy, these promising results suggest potential for use of these outbreak response strategies to preserve current treatment recommendations. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
29. Transfusion-transmissible infections in Australia
- Author
-
Khawar, Laila, Seed, Clive, McGregor, Skye, Hoad, Veronica C, Guy, Rebecca, Ismay, Sue, Lee, June, Styles, Claire, and Pink, Joanne
- Published
- 2018
- Full Text
- View/download PDF
30. Population-level diagnosis and care cascade for chlamydia in Australia.
- Author
-
Gray, Richard T., Callander, Denton, Hocking, Jane S., McGregor, Skye, McManus, Hamish, Dyda, Amalie, Moreira, Clarissa, Braat, Sabine, Hengel, Belinda, Ward, James, Wilson, David P., Donovan, Basil, Kaldor, John M., and Guy, Rebecca J.
- Abstract
Objectives: Key strategies to control chlamydia include testing, treatment, partner management and re-testing. We developed a diagnosis and care cascade for chlamydia to highlight gaps in control strategies nationally and to inform efforts to optimise control programmes.Methods: The Australian Chlamydia Cascade was organised into four steps: (1) annual number of new chlamydia infections (including re-infections); (2) annual number of chlamydia diagnoses; (3) annual number of diagnoses treated; (4) annual number of diagnoses followed by a re-test for chlamydia within 42-180 days of diagnosis. For 2016, we estimated the number of infections among young men and women aged 15-29 years in each of these steps using a combination of mathematical modelling, national notification data, sentinel surveillance data and previous research studies.Results: Among young people in Australia, there were an estimated 248 580 (range, 240 690-256 470) new chlamydia infections in 2016 (96 470 in women; 152 100 in men) of which 70 164 were diagnosed (28.2% overall: women 43.4%, men 18.6%). Of the chlamydia infections diagnosed, 65 490 (range, 59 640-70 160) were treated (93.3% across all populations), but only 11 330 (range, 7660-16 285) diagnoses were followed by a re-test within 42-180 days (17.3% overall: women 20.6%, men 12.5%) of diagnosis.Conclusions: The greatest gaps in the Australian Chlamydia Cascade for young people were in the diagnosis and re-testing steps, with 72% of infections undiagnosed and 83% of those diagnosed not re-tested: both were especially low among men. Treatment rates were also lower than recommended by guidelines. Our cascade highlights the need for enhanced strategies to improve treatment and re-testing coverage such as short message service reminders, point-of-care and postal test kits. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
- View/download PDF
31. The Role of Lymphomas in Subsequent Primary Cancers in People with HIV/AIDS: An Australian National Population-Based Data Linkage Study
- Author
-
Di Ciaccio, Pietro R, Jin, Fengyi, Law, Matthew, Van Leeuwen, Marina, Grulich, Andrew, Amin, Janaki, Vajdic, Claire, McGregor, Skye, and Polizzotto, Mark N.
- Published
- 2020
- Full Text
- View/download PDF
32. HIV diagnoses in migrant populations in Australia—A changing epidemiology.
- Author
-
Gunaratnam, Praveena, Heywood, Anita Elizabeth, McGregor, Skye, Jamil, Muhammad Shahid, McManus, Hamish, Mao, Limin, Lobo, Roanna, Brown, Graham, Hellard, Margaret, Marukutira, Tafireyi, Bretaña, Neil Arvin, Lang, Carolyn, Medland, Nicholas, Bavinton, Benjamin, Grulich, Andrew, and Guy, Rebecca
- Subjects
EPIDEMIOLOGY ,PUBLIC health ,HIV antibodies ,HIV seroconversion ,CONGENITAL disorders - Abstract
Introduction: We conducted a detailed analysis of trends in new HIV diagnoses in Australia by country of birth, to understand any changes in epidemiology, relationship to migration patterns and implications for public health programs. Methods: Poisson regression analyses were performed, comparing the age-standardised HIV diagnosis rates per 100,000 estimated resident population between 2006–2010 and 2011–2015 by region of birth, with stratification by exposure (male-to-male sex, heterosexual sex–males and females). Correlation between the number of permanent and long-term arrivals was also explored using linear regression models. Results: Between 2006 and 2015, there were 6,741 new HIV diagnoses attributed to male-to-male sex and 2,093 attributed to heterosexual sex, with the proportion of diagnoses attributed to male-to-male sex who were Australian-born decreasing from 72.5% to 66.5%. Compared with 2006–2010, the average annual HIV diagnosis rate per 100,000 in 2011–15 attributed to male-to-male sex was significantly higher in men born in South-East Asia (summary rate ratio (SRR) = 1.37, p = 0.001), North-East Asia (SRR = 2.18, p<0.001) and the Americas (SRR = 1.37, p = 0.025), but significantly lower as a result of heterosexual sex in men born in South-East Asia (SRR = 0.49, p = 0.002), Southern and Central Asia (SRR = 0.50, p = 0.014) and Sub-Saharan Africa (SRR = 0.39, p<0.001) and women born in South-East Asia (SRR = 0.61, p = 0.002) and Sub-Saharan Africa (SRR = 0.61, p<0.001). Positive associations were observed between the number of permanent and long-term arrivals and HIV diagnoses particularly in relation to diagnoses associated with male-to-male sex in men from North Africa and the Middle East, North Asia, Southern and Central Asia and the Americas. Conclusion: The epidemiology of HIV in Australia is changing, with an increase in HIV diagnosis rates attributed to male-to-male sex amongst men born in Asia and the Americas. Tailored strategies must be developed to increase access to, and uptake of, prevention, testing and treatment in this group. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
33. Decline in prevalence of human papillomavirus infection following vaccination among Australian Indigenous women, a population at higher risk of cervical cancer: The VIP-I study.
- Author
-
McGregor, Skye, Saulo, Dina, Kaldor, John M., Brotherton, Julia, Liu, Bette, Phillips, Samuel, Tabrizi, Sepehr N., Garland, Suzanne, Skinner, S. Rachel, Luey, Michele, Oliver, Lisa, and Stewart, Mary
- Subjects
- *
CERVICAL cancer , *HUMAN papillomavirus vaccines , *INDIGENOUS women , *CONTRACEPTION , *CIGARETTE smokers - Abstract
Background Cervical cancer occurrence and mortality are strongly correlated with socioeconomic disadvantage, largely due to unequal access to screening and treatment. Universal human papillomavirus (HPV) vaccination provides the opportunity to greatly reduce this global health disparity. Australian Indigenous women have substantially higher rates of cervical cancer than non-Indigenous women, primarily due to under-screening. We investigated HPV infection rates in Indigenous women 7 years after implementation of the national HPV vaccination program. Methods We used a repeat cross-sectional design, with the baseline being provided by an HPV prevalence survey among Indigenous women attending clinics for cervical cytology screening, prior to the start of the vaccination program in 2007. We returned to clinics in four locations during 2014–15, and invited women aged 18–26 years attending for screening to provide a cervical specimen for HPV testing, as well as to complete a short questionnaire and consent to allow access of their records in the National HPV Vaccination Program Register. We used well-established laboratory methods to test specimens for specific HPV genotypes. Results A total of 142 women were recruited at participating sites and compared to 155 who had been recruited at the same locations in the 2007 pre-vaccine survey. The two groups were identical in regard to age, with the more recent group having a higher proportion of hormonal contraception users, and a lower proportion of smokers. The proportion found to have any HPV type fell from 58 to 36% with the decline being entirely due to reductions in vaccine types, which fell by 94% from 24 to 1.4%. Conclusion Australia’s national HPV vaccination program appears to be successfully protecting a very high proportion of Indigenous women against vaccine targeted HPV types, who have in the past been at elevated risk of cervical cancer. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
34. Patient, staffing and health centre factors associated with annual testing for sexually transmissible infections in remote primary health centres.
- Author
-
Hengel, Belinda, Wand, Handan, Ward, James, Rumbold, Alice, Garton, Linda, Taylor-Thomson, Debbie, Silver, Bronwyn, McGregor, Skye, Dyda, Amalie, Mein, Jacqueline, Knox, Janet, Maher, Lisa, Kaldor, John, Guy, Rebecca, and STRIVE Investigators
- Abstract
Background: In high-incidence Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) settings, annual re-testing is an important public health strategy. Using baseline laboratory data (2009-10) from a cluster randomised trial in 67 remote Aboriginal communities, the extent of re-testing was determined, along with the associated patient, staffing and health centre factors.Methods: Annual testing was defined as re-testing in 9-15 months (guideline recommendation) and a broader time period of 5-15 months following an initial negative CT/NG test. Random effects logistic regression was used to determine factors associated with re-testing.Results: Of 10559 individuals aged ≥16 years with an initial negative CT/NG test (median age=25 years), 20.3% had a re-test in 9-15 months (23.6% females vs 15.4% males, P<0.001) and 35.2% in 5-15 months (40.9% females vs 26.5% males, P<0.001). Factors independently associated with re-testing in 9-15 months in both males and females were: younger age (16-19, 20-24 years); and attending a centre that sees predominantly (>90%) Aboriginal people. Additional factors independently associated with re-testing for females were: being aged 25-29 years, attending a centre that used electronic medical records, and for males, attending a health centre that employed Aboriginal health workers and more male staff.Conclusions: Approximately 20% of people were re-tested within 9-15 months. Re-testing was more common in younger individuals. Findings highlight the importance of recall systems, Aboriginal health workers and male staff to facilitate annual re-testing. Further initiatives may be needed to increase re-testing. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
35. High chlamydia and gonorrhoea repeat positivity in remote Aboriginal communities 2009-2011: longitudinal analysis of testing for re-infection at 3 months suggests the need for more frequent screening.
- Author
-
Garton, Linda, Dyda, Amalie, Guy, Rebecca, Silver, Bronwyn, McGregor, Skye, Hengel, Belinda, Rumbold, Alice, Taylor-Thomson, Debbie, Knox, Janet, Maher, Lisa, Kaldor, John, Ward, James, and STRIVE Investigators
- Abstract
Background Extremely high rates of diagnosis of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) have been recorded in remote communities across northern and central Australia. Re-testing at 3 months, after treatment administered, of CT or NG is recommended to detect repeat infections and prevent morbidity and ongoing transmission.
Methods: Baseline CT and NG laboratory data (2009-2010) from 65 remote health services participating in a cluster randomised trial was used to calculate the proportion of individuals re-tested after an initial CT or NG diagnosis at <2 months (not recommended), 2-4 months (recommended) and 5-12 months and the proportion with repeat positivity on re-test. To assess if there were difference in re-testing and repeat positivity by age group and sex, t-tests were used.Results: There was a total of 2054 people diagnosed with CT and/or NG in the study period; 14.9% were re-tested at 2-4 months, 26.9% at 5-12 months, a total of 41.8% overall. Re-testing was higher in females than in males in both the 2-4-month (16.9% v. 11.5%, P<0.01) and 5-12-month (28.9% v. 23.5%, P=0.01) periods. Women aged 25-29 years had a significantly higher level of re-testing 5-12 months post-diagnosis than females aged 16-19 years (39.8% v. 25.4%, P<0.01). There was a total of 858 people re-tested at 2-12 months and repeat positivity was 26.7%. There was higher repeat NG positivity than repeat CT positivity (28.8% v. 18.1%, P<0.01).Conclusions: Just under half the individuals diagnosed with CT or NG were re-tested at 2-12 months post-diagnosis; however, only 15% were re-tested in the recommended time period of 2-4 months. The higher NG repeat positivity compared with CT is important, as repeat NG infections have been associated with higher risk of pelvic inflammatory disease-related hospitalisation. Findings have implications for clinical practice in remote community settings and will inform ongoing sexual health quality improvement programs in remote community clinics. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
36. Low HIV testing rates among people with a sexually transmissible infection diagnosis in remote Aboriginal communities.
- Author
-
Ward, James S., Dyda, Amalie, McGregor, Skye, Rumbold, Alice, Garton, Linda, Donovan, Basil, Kaldor, John M., and Guy, Rebecca J.
- Abstract
Objective: To determine the rates of HIV testing among people who had received positive test results for chlamydia, gonorrhoea and trichomoniasis, or who had been tested for syphilis.Design, Setting and Participants: Pathology data for the period January 2010 - December 2014 from 65 remote Aboriginal communities participating in the STRIVE trial of sexually transmissible infection (STI) control were analysed.Main Outcome Measures: Rates of HIV testing within 30 and 90 days of an STI test (for chlamydia, gonorrhoea or trichomoniasis), the result of which was positive, and within 30 days of a test for syphilis; factors independently associated with concurrent HIV testing.Results: 31.8% of 15 260 positive STI test results were linked with an HIV test within 30 days of the test (including 5.6% not on the same day), and 34.8% within 90 days; 44.1% were linked with syphilis testing within 30 days. 53.4% of all those tested for syphilis were also tested for HIV within 30 days. Multivariate analysis found that HIV testing was more likely for men, in geographical regions 3 and 4, in association with positive STI test results during 2012, 2013 or 2014 (v 2010), and in association with positive test results for gonorrhoea or chlamydia. Similar associations with these factors were found for syphilis testing.Conclusions: A significant challenge in Aboriginal health is avoiding an increase in the number of HIV infections. One critical intervention in this regard is timely and appropriate testing. Adhering to screening recommendations is clearly an aspect of the delivery of sexual health services to remote communities that can be improved in striving to achieve this aim. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
37. Capacity building in longitudinal HIV research
- Author
-
McGregor, Skye, henderson, Klara J, and Kaldor, John M
- Published
- 2015
- Full Text
- View/download PDF
38. Reasons for delays in treatment of bacterial sexually transmissible infections in remote Aboriginal communities in Australia: a qualitative study of healthcentre staff.
- Author
-
Hengel, Belinda, Maher, Lisa, Garton, Linda, Ward, James, Rumbold, Alice, Taylor-Thomson, Debbie, Silver, Bronwyn, McGregor, Skye, Dyda, Amalie, Knox, Janet, Kaldor, John, Guy, Rebecca, and Strive Investigators, On Behalf Of The
- Abstract
Unlabelled: Background Remote Aboriginal communities in Australia experience high rates of bacterial sexually transmissible infections (STIs). To control the transmission and decrease the risk of complications, frequent STI testing combined with timely treatment is required, yet significant delays in treatment have been reported. Perceived barriers to timely treatment for asymptomatic patients in remote communities were explored.Methods: A qualitative study was undertaken as part of the STRIVE (STIs in Remote communities, ImproVed and Enhanced primary health care) project; a cluster randomised controlled trial of a sexual health quality improvement program. During 2012, we conducted 36 in-depth interviews with staff in 22 clinics in remote Australia.Results: Participants included registered nurses (72%) and Aboriginal health practitioners (28%). A key barrier to timely treatment was infrequent transportation of specimens to laboratories often hundreds of kilometres away from clinics. Within clinics, there were delays checking and actioning test results, and under-utilisation of systems to recall patients. Participants also described difficulties in physically locating patients due to: (i) high mobility between communities; and (ii) low levels of community knowledge created by high staff turnover. Participants also suggested strategies to overcome some barriers such as dedicated clinical time to follow-up recalls and taking treatment out to patients.Conclusions: Participants identified barriers to timely STI treatment in remote Aboriginal communities, and systems to address some of the barriers. Innovative strategies such as point-of-care testing or increased support for actioning results, coupled with incentives to individual patients to attend for results, may also assist in decreasing the time to treatment. [ABSTRACT FROM AUTHOR]- Published
- 2015
- Full Text
- View/download PDF
39. Coinfection with Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis: a crosssectional analysis of positivity and risk factors in remote Australian Aboriginal communities.
- Author
-
Guy, Rebecca, Ward, James, Wand, Handan, Rumbold, Alice, Garton, Linda, Hengel, Belinda, Silver, Bronwyn, Taylor-Thomson, Debbie, Knox, Janet, McGregor, Skye, Dyda, Amalie, Fairley, Christopher, Maher, Lisa, Donovan, Basil, and Kaldor, John
- Subjects
SEXUALLY transmitted diseases ,MIXED infections ,CHLAMYDIA trachomatis ,NEISSERIA gonorrhoeae ,TRICHOMONAS vaginalis ,HEALTH of Aboriginal Australians - Abstract
Objectives To determine the co-occurrence and epidemiological relationships of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) in a high-prevalence setting in Australia. Methods In the context of a cluster randomised trial in 68 remote Aboriginal communities, we obtained laboratory reports on simultaneous testing for CT, NG and TV by nucleic acid amplification tests in individuals aged ≥16 years and examined relationships between age and sex and the coinfection positivity. ORs were used to determine which infections were more likely to co-occur by demographic category. Results Of 13 480 patients (median age: 30 years; men: 37%) tested for all three infections during the study period, 33.3% of women and 21.3% of men had at least one of them, highest in patients aged 16-19 years (48.9% in women, 33.4% in men). The most frequent combination was CT/NG (2.0% of women, 4.1% of men), and 1.8% of women and 0.5% of men had all three. In all co-combinations, coinfection positivity was highest in patients aged 16-19 years. CT and NG were highly predictive of each other's presence, and TV was associated with each of the other two infections, but much more so with NG than CT, and its associations were much stronger in women than in men. Conclusions In this remote high-prevalence area, nearly half the patients aged 16-19 years had one or more sexually transmitted infections. CT and NG were more common dual infections. TV was more strongly associated with NG coinfections than with CT. These findings confirm the need for increased simultaneous screening for CT, NG and TV, and enhanced control strategies. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12610000358044. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
40. Barriers and facilitators of sexually transmissible infection testing in remote Australian Aboriginal communities: results from the Sexually Transmitted Infections in Remote Communities, Improved and Enhanced Primary Health Care (STRIVE) Study.
- Author
-
Hengel, Belinda, Guy, Rebecca, Garton, Linda, Ward, James, Rumbold, Alice, Taylor-Thomson, Debbie, Silver, Bronwyn, McGregor, Skye, Dyda, Amalie, Knox, Janet, Kaldor, John, and Maher, Lisa
- Abstract
Unlabelled: Background Remote Australian Aboriginal communities experience high rates of bacterial sexually transmissible infections (STI). A key strategy to reduce STIs is to increase testing in primary health care centres. The current study aimed to explore barriers to offering and conducting STI testing in this setting.Methods: A qualitative study was undertaken as part of the STI in Remote communities, Improved and Enhanced Primary Health Care (STRIVE) project; a large cluster randomised controlled trial of a sexual health quality improvement program. We conducted 36 in-depth interviews in 22 participating health centres across four regions in northern and central Australia.Results: Participants identified barriers including Aboriginal cultural norms that require the separation of genders and traditional kinship systems that prevent some staff and patients from interacting, both of which were exacerbated by a lack of male staff. Other common barriers were concerns about client confidentiality (lack of private consulting space and living in small communities), staff capacity to offer testing impacted by the competing demands for staff time, and high staff turnover resulting in poor understanding of clinic systems. Many participants also expressed concerns about managing positive test results. To address some of these barriers, participants revealed informal strategies, such as team work, testing outside the clinic and using adult health checks.Conclusions: Results identify cultural, structural and health system issues as barriers to offering STI testing in remote communities, some of which were overcome through the creativity and enthusiasm of individuals rather than formal systems. Many of these barriers can be readily addressed through strengthening existing systems of cultural and clinical orientation and educating staff to view STI in a population health framework. However others, particularly issues in relation to culture, kinship ties and living in small communities, may require testing modalities that do not rely on direct contact with health staff or the clinic environment. [ABSTRACT FROM AUTHOR]- Published
- 2015
- Full Text
- View/download PDF
41. How Are Health Research Priorities Set in Low and Middle Income Countries? A Systematic Review of Published Reports.
- Author
-
McGregor, Skye, Henderson, Klara J., and Kaldor, John M.
- Subjects
- *
PUBLIC health , *COMMUNICABLE diseases , *RESEARCH methodology ,DEVELOPING countries - Abstract
Background: Priority setting is increasingly recognised as essential for directing finite resources to support research that maximizes public health benefits and drives health equity. Priority setting processes have been undertaken in a number of low- and middle-income country (LMIC) settings, using a variety of methods. We undertook a critical review of reports of these processes. Methods and Findings: We searched electronic databases and online for peer reviewed and non-peer reviewed literature. We found 91 initiatives that met inclusion criteria. The majority took place at the global level (46%). For regional or national initiatives, most focused on Sub Saharan Africa (49%), followed by East Asia and Pacific (20%) and Latin America and the Caribbean (18%). A quarter of initiatives aimed to cover all areas of health research, with a further 20% covering communicable diseases. The most frequently used process was a conference or workshop to determine priorities (24%), followed by the Child Health and Nutrition Initiative (CHNRI) method (18%). The majority were initiated by an international organization or collaboration (46%). Researchers and government were the most frequently represented stakeholders. There was limited evidence of any implementation or follow-up strategies. Challenges in priority setting included engagement with stakeholders, data availability, and capacity constraints. Conclusions: Health research priority setting (HRPS) has been undertaken in a variety of LMIC settings. While not consistently used, the application of established methods provides a means of identifying health research priorities in a repeatable and transparent manner. In the absence of published information on implementation or evaluation, it is not possible to assess what the impact and effectiveness of health research priority setting may have been. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
42. Blood borne viral (BBV) and sexually transmissible infections (STI) in Aboriginal and Torres Strait Islander peoples: Annual surveillance report.
- Author
-
McGregor, Skye and Monaghan, Robert
- Abstract
The annual surveillance report on blood borne viral (BBV) and sexually transmissible infections (STI) among Aboriginal and Torres Strait Islander peoples in Australia highlights both successes and challenges in prevention and control. The introduction of the HPV vaccination program has led to a significant decline in genital warts diagnoses among young Aboriginal and Torres Strait Islander women and men. Low numbers of hepatitis B notifications also indicate the success of vaccination programs. However, rates of chlamydia, gonorrhoea, and syphilis remain high or continue to increase, particularly in regional and remote settings. The report emphasizes the need for ongoing public health efforts to sustain low rates of HIV and address the complex factors contributing to STI cases. [Extracted from the article]
- Published
- 2023
43. STI in remote communities: improved and enhanced primary health care (STRIVE) study protocol: a cluster randomised controlled trial comparing 'usual practice' STI care to enhanced care in remote primary health care services in Australia.
- Author
-
Ward, James, McGregor, Skye, Guy, Rebecca J., Rumbold, Alice R., Garton, Linda, Silver, Bronwyn J., Taylor-Thomson, Debbie, Hengel, Belinda, Knox, Janet, Dyda, Amalie, Law, Matthew G., Wand, Handan, Donovan, Basil, Fairley, Christopher K., Skov, Steven, Chee, Donna Ah., Boffa, John, Glance, David, McDermott, Robyn, and Maher, Lisa
- Subjects
- *
MEDICAL care , *SEXUAL health , *LABOR incentives , *CHLAMYDIA - Abstract
Background: Despite two decades of interventions, rates of sexually transmissible infections (STI) in remote Australian Aboriginal communities remain unacceptably high. Routine notifications data from 2011 indicate rates of chlamydia and gonorrhoea among Aboriginal people in remote settings were 8 and 61 times higher respectively than in the non-Indigenous population. Methods/design: STRIVE is a stepped-wedge cluster randomised trial designed to compare a sexual health quality improvement program (SHQIP) to usual STI clinical care delivered in remote primary health care services. The SHQIP is a multifaceted intervention comprising annual assessments of sexual health service delivery, implementation of a sexual health action plan, six-monthly clinical service activity data reports, regular feedback meetings with a regional coordinator, training and financial incentive payments. The trial clusters comprise either a single community or several communities grouped together based on geographic proximity and cultural ties. The primary outcomes are: prevalence of chlamydia, gonorrhoea and trichomonas in Aboriginal residents aged 16-34 years, and performance in clinical management of STIs based on best practice indicators. STRIVE will be conducted over five years comprising one and a half years of trial initiation and community consultation, three years of trial conditions, and a half year of data analysis. The trial was initiated in 68 remote Aboriginal health services in the Northern Territory, Queensland and Western Australia. Discussion: STRIVE is the first cluster randomised trial in STI care in remote Aboriginal health services. The trial will provide evidence to inform future culturally appropriate STI clinical care and control strategies in communities with high STI rates. Trial registration: Australian and New Zealand Clinical Trials Registry ACTRN12610000358044 [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
44. Late HIV diagnoses among people from a culturally and linguistically diverse background in Australia.
- Author
-
McGregor, Skye and King, Jonathan
- Abstract
In 2020, 44% of new HIV diagnoses in Australia wereclassified as late diagnoses, up from 32% in 2016.Looking in more detail, the data show that among peopleborn overseas diagnosed with HIV in 2020, 52% werediagnosed late, compared to 37% among people born inAustralia. A late diagnosis of HIV has important individual andpublic health implications. Late HIV diagnoses arecharacterized by a CD4+ t-cell count of 350 cells or lessper cubic millimeter of blood at diagnosis (CD4+ t-cellsare immune system cells that are attacked by HIV). [Extracted from the article]
- Published
- 2022
45. Defining Elimination of Genital Warts—A Modified Delphi Study.
- Author
-
Khawar, Laila, Machalek, Dorothy A., Regan, David G., Donovan, Basil, McGregor, Skye, and Guy, Rebecca J.
- Subjects
GENITAL warts ,AUSTRALIANS ,HUMAN papillomavirus vaccines ,LIKERT scale ,SCHOLARSHIPS ,DEFINITIONS - Abstract
Background: Substantial declines in genital warts (GW) have been observed in countries with quadrivalent HPV vaccination programmes, with Australia showing the highest reductions due to early commencement and high vaccination coverage. There is a real potential to achieve GW elimination; however, no GW elimination definition exists. Taking Australia as a case study, we aimed to reach expert consensus on a proposed GW elimination definition using a modified Delphi process. Method: We used modelling and epidemiological data to estimate the expected number of new GW cases, from pre-vaccination (baseline) in 2006 to the year 2060 in Australian heterosexuals, men who have sex with men (MSM), and newly arrived international travellers and migrants. We used these data and the literature, to develop a questionnaire containing ten elimination-related items, each with 9-point Likert scales (1—strongly disagree; 9—strongly agree). The survey was completed by 18 experts who participated in a full day face-to-face modified Delphi study, in which individuals and then small groups discussed and scored each item. The process was repeated online for items where consensus (≥70% agreement) was not initially achieved. Median and coefficient of variation (COV) were used to describe the central tendency and variability of responses, respectively. Findings: There was a 95% participation rate in the face-to-face session, and 84% response rate in the final online round. The median item score ranged between 7.0 and 9.0 and the COV was ≤0.30 on all items. Consensus was reached that at ≥80% HPV vaccination coverage, GW will be eliminated as a public health problem in Australia by 2060. During this time period there will be a 95% reduction in population-level incidence compared with baseline, equivalent to <1 GW case per 10,000 population. The reductions will occur most rapidly in Australian heterosexuals, with 73%, 90% and 97% relative reductions by years 2021, 2030 and 2060, respectively. The proportion of new GW cases attributable to importation will increase from 3.6% in 2006 to ~49% in 2060. Interpretation: Our results indicate that the vaccination programme will minimise new GW cases in the Australian population, but importation of cases will continue. This is the first study to define GW elimination at a national level. The framework developed could be used to define GW elimination in other countries, with thresholds particularly valuable for vaccination programme impact evaluation. Funding: LK supported through an Australian Government Research Training Programme Scholarship; unconditional funding from Seqirus to support the Delphi Workshop. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
46. Update on HIV, hepatitis and STI rates.
- Author
-
DE WIT, JOHN, DORE, GREG, GUY, REBECCA, and MCGREGOR, SKYE
- Abstract
The article discusses Australia's 2015 report card on HIV, hepatitis, and sexually transmitted infections. Topics include the stability of the number of newly diagnosed HIV infections in Australia, the percentage of HIV diagnoses that belong to gay men and other men who have sex with men, and the benefit offered by the increase in treatment intake to prevention of HIV infection in Australia.
- Published
- 2015
47. STI in remote communities: improved and enhanced primary health care (STRIVE) study protocol : a cluster randomised controlled trial comparing 'usual practice' STI care to enhanced care in remote primary health care services in Australia
- Author
-
Basil Donovan, Skye McGregor, Debbie Taylor-Thomson, Janet Knox, Amalie Dyda, Lisa Maher, Donna Ah Chee, Linda Garton, Christopher K Fairley, Robyn McDermott, James Ward, Matthew Law, John Boffa, Bronwyn Silver, David Glance, Alice R. Rumbold, Handan Wand, Rebecca Guy, John M. Kaldor, Steven Skov, Belinda Hengel, Ward, James, McDermott, Robyn Anne, McGregor, Skye, Kaldor, John M, Guy, Rebecca J, and Rumbold, Alice R
- Subjects
Male ,Sexually transmitted disease ,Service delivery framework ,Rural Health ,Study Protocol ,0302 clinical medicine ,Protocol ,Prevalence ,Medicine ,030212 general & internal medicine ,Cluster randomised controlled trial ,rural health ,Chlamydia ,Aboriginal ,Continuous quality improvement ,Reproductive health ,education.field_of_study ,Rural health ,Remote ,program evaluation ,research design ,3. Good health ,Infectious Diseases ,Research Design ,Trichomonas ,Female ,Health education ,0305 other medical science ,Health care quality ,Adult ,medicine.medical_specialty ,Adolescent ,sexually transmitted diseases ,Population ,Sexually Transmitted Diseases ,Young Adult ,03 medical and health sciences ,Sexually transmitted infections ,Humans ,education ,030505 public health ,Primary Health Care ,business.industry ,Australia ,Indigenous ,Gonorrhoea ,primary health care ,Family medicine ,business ,Program Evaluation - Abstract
Background Despite two decades of interventions, rates of sexually transmissible infections (STI) in remote Australian Aboriginal communities remain unacceptably high. Routine notifications data from 2011 indicate rates of chlamydia and gonorrhoea among Aboriginal people in remote settings were 8 and 61 times higher respectively than in the non-Indigenous population. Methods/design STRIVE is a stepped-wedge cluster randomised trial designed to compare a sexual health quality improvement program (SHQIP) to usual STI clinical care delivered in remote primary health care services. The SHQIP is a multifaceted intervention comprising annual assessments of sexual health service delivery, implementation of a sexual health action plan, six-monthly clinical service activity data reports, regular feedback meetings with a regional coordinator, training and financial incentive payments. The trial clusters comprise either a single community or several communities grouped together based on geographic proximity and cultural ties. The primary outcomes are: prevalence of chlamydia, gonorrhoea and trichomonas in Aboriginal residents aged 16–34 years, and performance in clinical management of STIs based on best practice indicators. STRIVE will be conducted over five years comprising one and a half years of trial initiation and community consultation, three years of trial conditions, and a half year of data analysis. The trial was initiated in 68 remote Aboriginal health services in the Northern Territory, Queensland and Western Australia. Discussion STRIVE is the first cluster randomised trial in STI care in remote Aboriginal health services. The trial will provide evidence to inform future culturally appropriate STI clinical care and control strategies in communities with high STI rates. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12610000358044
- Published
- 2013
48. HIV incidence in people receiving government-subsidised pre-exposure prophylaxis in Australia: a whole-of-population retrospective cohort study.
- Author
-
Medland NA, McManus H, Bavinton BR, Fraser D, Traeger MW, Grulich AE, Stoove MA, McGregor S, King JM, Heath-Paynter D, and Guy RJ
- Subjects
- Humans, Male, Retrospective Studies, Incidence, Female, Adult, Australia epidemiology, Young Adult, HIV Infections prevention & control, HIV Infections epidemiology, HIV Infections drug therapy, HIV Infections transmission, Pre-Exposure Prophylaxis, Anti-HIV Agents therapeutic use, Anti-HIV Agents administration & dosage
- Abstract
Background: HIV pre-exposure prophylaxis (PrEP) is highly effective and has been government subsidised in Australia since April, 2018. We examined HIV incidence over 5 years in a retrospective observational cohort of people who had received subsidised PrEP., Methods: Linked de-identified dispensing records for all government-subsidised oral PrEP, HIV antiretroviral therapy (ART), and hepatitis C treatment were used. We included all people dispensed subsidised PrEP from April 1, 2018, to March 31, 2023, and examined records up to Sept 30, 2023. Exposure was measured from date of first PrEP prescription and days covered by PrEP calculated for individuals based on quantity and date supplied. Assuming that HIV was diagnosed 30 days before ART initiation, we imputed the date of acquisition as the midpoint between the diagnosis and the later of the last PrEP prescription or 6 months before the diagnosis. We calculated HIV incidence and its predictors using Poisson regression., Findings: We included 66 206 people dispensed PrEP: 64 757 (97·8%) were men; median age was 33 years (IQR 27-43). 207 people acquired HIV, with an overall incidence of 1·07 per 1000 person-years (95% CI 0·93-1·23). Incidence was 2·61 per 1000 person-years among those dispensed PrEP once only. Using this group as a comparator, those with 60% or more days covered by PrEP had a 78·5% reduction in incidence (0·56 per 1000 person-years, p<0·0001) and those with less than 60% days covered had a 61·6% reduction (0·99 per 1000 person-years, p=0·0045). Independent predictors of HIV acquisition were a record of hepatitis C treatment (9·83 per 1000 person-years, adjusted incident rate ratio [aIRR] 8·70, 95% CI 4·86-15·56), only attending prescribers outside of areas with a high estimated prevalence of gay men (1·66 per 1000 person-years, aIRR 1·50, 1·08-2·09), age 18-29 years (1·33 per 1000 person-years, aIRR 1·56, 1·11-2·21), and earlier year of first PrEP., Interpretation: The low observed incidence of HIV among people receiving government-subsidised PrEP highlights the success of a national programme of oral PrEP scale-up in achieving sustained reduction in community HIV transmission. However, incidence varied greatly, indicating that more research is needed to understand why people were not taking PrEP at times of risk and emphasising the need for new interventions focused on this population to achieve elimination of HIV transmission. Individuals dispensed PrEP once only and less frequent users might benefit from more support., Funding: None., Competing Interests: Declaration of interests NAM and RJG have received funding to their institution for investigator-initiated research unrelated to this work from Gilead Sciences. NAM and BRB have unpaid leadership and governance roles with ASHM and ACON, respectively. BRB has received funding to his institution for research unrelated to this work from ViiV Healthcare and Gilead Sciences, and payment, honoraria, or support for attending meetings from FHI 360, Gilead Sciences, Virology Education, and ViiV Healthcare. MWT has received funding to his institution for investigator-initiated research unrelated to this work and speaker's honoraria from Gilead Sciences. AEG has received funding to his institution for investigator-initiated research unrelated to this work from GSK and ViiV Healthcare, payment or honoraria from Clinical Care Options and Sequiris, and support for attending meetings from ViiV Healthcare. MAS has received funding to his institution for investigator-initiated research unrelated to this work from Gilead Sciences and AbbVie, and consulting fees for activities unrelated to this work from Gilead Sciences. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)
- Published
- 2024
- Full Text
- View/download PDF
49. Second Primary Cancers in People With HIV/AIDS: A National Data Linkage Study of Incidence and Risk Factors.
- Author
-
Di Ciaccio PR, Van Leeuwen MT, Amin J, Vajdic CM, McGregor S, Poynten IM, Templeton DJ, Law M, Grulich AE, Polizzotto MN, and Jin F
- Subjects
- Humans, Incidence, Risk Factors, Neoplasms, Second Primary complications, Neoplasms, Second Primary epidemiology, Acquired Immunodeficiency Syndrome complications, HIV Infections epidemiology, Neoplasms complications
- Abstract
Background: Evidence regarding the characteristics of second primary cancer (SPC) in people living with HIV (PLWHIV) is limited., Setting: We performed a national population-based data linkage study to determine the incidence and risk factors of SPC in PLWHIV in Australia between 1982 and 2012., Methods: We conducted a probabilistic data linkage study to compare the incidence of SPC over time, defined using HIV treatment eras, for SPCs related to oncogenic viral infection in comparison with non-infection-related SPCs. Risk factors considered included age at diagnosis of cancer, sex, HIV exposure modality, and CD4 + count., Results: Of 29,383 individuals diagnosed with HIV, 3123 individuals who developed a first primary cancer were included in the analysis. Among them, 229 cases of SPC were identified across 27,398 person-years of follow-up. The most common SPCs were non-Hodgkin lymphomas (n = 71, 31%). The incidence of SPC overall did not change over time; however, there was an increase in individuals diagnosed with HIV in later eras ( P trend =0.001). The incidence of non-infection-related SPC increased over time and was associated with older age ( P trend = 0.005) and the acquisition of HIV in later eras ( P trend <0.001). Conversely, the incidence of infection-related SPC decreased ( P trend <0.001), but this was no longer significant after adjustment for age ( P trend = 0.14)., Conclusions: The risk of SPC in PLWHIV in Australia remains high, with a temporal increase observed in non-infection-related cancer, likely due to aging of the population. Optimal screening and prevention strategies for SPC in PLWHIV are increasingly important., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
50. Australian Paediatric Surveillance Unit (APSU) Annual Surveillance Report 2021.
- Author
-
Teutsch SM, Nunez CA, Morris A, Eslick GD, Berkhout A, Novakovic D, Brotherton JM, McGregor S, Khawar L, Khandaker G, Booy R, Jones CA, Rawlinson W, Thorley BR, and Elliott EJ
- Subjects
- Female, Humans, Infant, Infant, Newborn, Pregnancy, Australia epidemiology, Infectious Disease Transmission, Vertical, Chickenpox epidemiology, Chickenpox prevention & control, Communicable Diseases epidemiology, Cytomegalovirus Infections, HIV Infections epidemiology, Influenza, Human epidemiology, Rubella Syndrome, Congenital
- Abstract
Abstract: The Australian Paediatric Surveillance Unit (APSU) has been conducting surveillance of rare communicable and non-communicable conditions in children since its inception in 1993. In this report, the results are described of surveillance of ten communicable diseases (and complications) for 2021, including the numbers of cases and incidence estimates; demographics; clinical features; and management and short-term outcomes. The included diseases are: acute flaccid paralysis (AFP); congenital cytomegalovirus (CMV); neonatal herpes simplex virus (HSV) infection; paediatric human immunodeficiency virus (HIV) infection; perinatal exposure to HIV; severe complications from influenza; juvenile-onset respiratory papillomatosis (JoRRP); congenital rubella syndrome; congenital varicella syndrome; and neonatal varicella infection. In 2021, cases of JoRRP were reported to the APSU for the first time since 2017, indicating potential gaps in HPV vaccination. AFP surveillance by APSU again contributed to Australia achieving a minimum target incidence of one AFP case per 100,000 children aged < 15 years. There were no cases of children with severe complications of influenza. No cases of varicella or congenital rubella were reported; however, at-risk populations, especially young migrant and refugee women from countries without universal vaccination programs, need to be screened and prioritised for vaccination prior to pregnancy. Cases of perinatal exposure to HIV continue to increase; however, the rate of mother-to-child-transmission remains at low levels due to the use of effective intervention strategies. Case numbers of congenital CMV and neonatal HSV remain steady in the absence of vaccines, prompting the need for greater awareness and education, with recent calls for target screening of at-risk infants for congenital CMV., (© Commonwealth of Australia CC BY-NC-ND.)
- Published
- 2022
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.