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Background: The aims of this study were to evaluate the experiences of telehealth for routine HIV care and identify preferred models of HIV routine care for the future. Methods: Anonymous, online questionnaire among people living with HIV aged 18 years or older. This survey was advertised via posters with a QR code in six sexual health clinics and one community organisation as well as on social media from November 2021 to December 2022. Results: Of 89 participants, the majority were males (80/89, 89.9%), between 36 and 55 years old (49/89, 55.1%), spoke English at home (74/89, 84.1%), had been living with HIV for >5 years (68/89, 76.4%) and reported having a telehealth consultation since the COVID-19 pandemic began (69/89, 77.5%). The top three liked aspects of telehealth were: the convenience of not leaving home or work (50/69, 72.5%); less travel time (48/69, 69.6%); and avoiding contact with other people (30/69, 43.5%). The top three dislikes of telehealth were: they could not be screened for sexually transmitted infections (STIs) or have a physical examination at the same time (29/69, 42.0%); it was an impersonal experience (20/69, 29.0%); and it was more difficult to discuss health concerns (18/69, 26.1%). Among all participants, the preference for future consultations was to have a mix between in-person and telehealth (40/89, 44.9%); however, nearly one-quarter prefer in-person consultations only (20/89, 22.5%). Conclusions: Use of telehealth during COVID-19 has been evaluated positively among people living with HIV that participated in this survey. Participants support the use of telehealth for routine care in conjunction with in-person consultations. As a consequence of COVID-19, sexual health clinics in Australia adopted the use of telehealth for the routine care of people living with HIV. Telehealth has been positively evaluated among this population. Hybrid models between in-person and telehealth conjunction were suggested for the future care model. [ABSTRACT FROM AUTHOR]

Introduction: Effective linkage to prevention and care is a crucial step following HIV testing services. This systematic review aimed to determine the proportion of individuals linked to prevention and care after HIV self‐testing (HIVST) and describe factors associated with linkage. Methods: Following PRISMA guidelines, a comprehensive search across eight databases (2010–October 2023) identified studies on linkage to care after HIVST, defined as receiving a confirmatory test or initiating antiretroviral therapy (ART) if the self‐test was reactive, and/or pre‐exposure prophylaxis (PrEP) if the self‐test was non‐reactive. A random‐effects meta‐analysis summarized the findings and meta‐regression explored study‐level covariates, such as world region, population type and service delivery model, that might explain the between‐study heterogeneity. Results: From 10,071 screened studies, 173 were included in the meta‐analysis. The majority of studies focused on key populations in Africa using unassisted, oral fluid‐based HIVST kits. Among those with reactive HIVST results, 92% (95% confidence interval [CI]: 88–95) were linked to confirmatory testing (n = 124 studies), and 89% (95% CI: 84–93) of newly diagnosed individuals initiated ART (n = 88 studies). Overall, 84% (95% CI: 74–93) of self‐testers were linked to care (n = 69 studies). However, only 9% (95% CI: 2–19) of individuals with non‐reactive HIVST results were linked to PrEP services (n = 9 studies). Assisted HIVST was associated with higher linkage rates to confirmatory testing and ART initiation compared to unassisted testing. Meta‐regression revealed that the type of delivery model for the HIVST kits influenced linkage and that individuals who obtained their HIVST kits through a social network‐based approach (SNA) were more likely to be linked to confirmatory testing (adjusted odds ratio = 1.28 [95% CI: 1.10–1.50], p = 0.001) compared to non‐SNA service delivery model. Discussion: In the context of expanding HIVST services globally, we found that linkage to confirmatory testing and ART initiation after HIVST is generally high, particularly when assisted HIVST or SNA‐based distribution is used. Conclusions: Strengthening timely linkage is vital for improving health outcomes, reducing HIV transmission and achieving the UNAIDS 95‐95‐95 goal. Ongoing research and collaboration with community‐based organizations are needed to overcoming barriers and ensuring positive outcomes for those using HIVST. PROSPERO Number: CRD42022357570. [ABSTRACT FROM AUTHOR]

: Objective: Examine the changes in service delivery Australian public sexual health clinics made to remain open during lockdown. Methods: A cross‐sectional survey designed and delivered on Qualtrics was emailed to 21 directors of public sexual health clinics across Australia from July‐August 2020 and asked about a variety of changes to service delivery. Descriptive statistics were calculated. Results: Twenty clinics participated, all remained open and reported service changes, including suspension of walk‐in services in eight clinics. Some clinics stopped offering asymptomatic screening for varying patient populations. Most clinics transitioned to a mix of telehealth and face‐to‐face consultations. Nineteen clinics reported delays in testing and 13 reported limitations in testing. Most clinics changed to phone consultations for HIV medication refills (n=15) and eleven clinics prescribed longer repeat prescriptions. Fourteen clinics had staff redeployed to assist the COVID‐19 response. Conclusion: Public sexual health clinics pivoted service delivery to reduce risk of COVID‐19 transmission in clinical settings, managed staffing reductions and delays in molecular testing, and maintained a focus on urgent and symptomatic STI presentations and those at higher risk of HIV/STI acquisition. Implications for public health: Further research is warranted to understand what impact reduced asymptomatic screening may have had on community STI transmission., In response to the COVID‐19 pandemic, Australia went into a nationwide lockdown that began on 22 March 2020 with stage one restrictions. These initial restrictions included closing non‐essential businesses as [...]

Background. The patterns of sexually transmitted infections (STIs) in populations may be influenced by the sexual mixing within the population. We aimed to investigate the assortative sexual mixing pattern by bisexuality in male-male partnerships. Methods. This was a retrospective repeated crosssectional study of men with mostly regular male partners attending the Melbourne Sexual Health Centre between 2011 and 2019. Data on sexual practices, including their sexual practices, presence of other male/female sex partners and the gender of sexual partners in the previous 3 and 12 months, were collected using computer-assisted self-interview. We calculated the proportion of male partnerships where at least one man in the partnership reported a female sex partner. Results. A total of 2056 male-male partnerships (i.e. 4112 individuals) with a median age of 29 years (IQR 25 to 35) were included. Overall, in 94.4% (1941/2056) of male-male partnerships both men had male partners only; however, in 5.5% (113/2056) of partnerships, one man had both male and female partners, and in 0.1% (2/2056) partnerships, both men had both male and female partners. No assortative relationship was found on the sexual mixing by bisexuality in male-male partnerships due to the low assortativity coefficient (r = 0.006, 95% CI: -0.004 to 0.016). Conclusion. One in 20male-male partnerships had at least one man who had both male and female partners within the preceding year. Individuals were not selective by bisexuality, suggesting that partnerships of bisexual individuals are mixed proportionately to the distribution of their characteristics. Still, these sexual mixing practices may affect STI transmission dynamics. [ABSTRACT FROM AUTHOR]

This Virtual Special Issue explores emerging topics in reproductive health in the Australian and New Zealand context. The included manuscripts cover pregnancy and termination of pregnancy, priority populations for sexual and reproductive health, digital technology and its impact on reproductive health, and perspectives from clinicians. [ABSTRACT FROM AUTHOR]

The use of touchscreen applications for the iPad(®) allows children with disabilities to improve their personal autonomy and quality of life. In light of this emerging literature and our clinical experience with toddlers and children with Fragile X syndrome (FXS), a randomized clinical trial pilot study was conducted of whether an interactive iPad(®)-based parent training program was efficacious for both individuals with FXS and autism spectrum disorder aged 2-to-12 compared to wait-listed controls. As a second goal, we assessed the difference between direct person-to-person therapy vs. online therapy sessions through telehealth. In this case series report it is presented preliminary results of four individuals with FXS enrolled in the study and described the innovative experience including qualitative and quantitative data analysis. Furthermore, we provide professionals with specific guidelines about the use of touchscreen devices as in-home learning tools and parent training strategies to actively involve families in educational treatments in conjunction with clinical guidance.