Main topics

Title and first author

Summary

Sexual health, STIs, older adults, methods

The Sex, Age, and Me study: recruitment and sampling for a large mixed-methods study of sexual health and relationships in an older Australian population. A. Lyons.

What they did: The Sex, Age, and Me project explored sexual behaviour, relationship/dating patterns, sexual health literacy, and sexual practices of Australians over the age of 60.

What they found: The study found online means to be the best method of recruitment; with an original intention of recruiting 600 participants, the study received a total of 2137 participants over half of which were recruited through Facebook.

Policy and practice implications: The study identified a need for increased response to the rising rates of STIs among the over-60 population. The study also found that far more participants were willing to participate in a qualitative interview than originally anticipated.

Sexual health, young people, CALD, migrants

Drawing them in: professional perspectives on the complexities of engaging ‘culturally diverse’ young people with sexual and reproductive health promotion and care in Sydney, Australia. J. Botfield.

What they did: Examined how professionals working across multiple sexual heath contexts viewed engaging with young people from minority ethnic, migrant and refugee backgrounds.

What they found:  Professionals identified five key themes as crucial to working effectively with young people from diverse backgrounds: appreciating the complexities of cultural diversity; recognising structural barriers and disincentives to engagement; normalising sexual health; balancing ‘youth-friendly’ and ‘culturally-competent’ priorities; and going beyond simple translation.

Policy and practice implications: In response to continuing diversification of the Australian population, an integrated, national approach to the delivery of sexual health promotion is required.

Young people, sexual health, heath literacy, relationships, service delivery

Friendship, sexual intimacy and young people’s negotiations of sexual health. P. Byron.

What they did: By interviewing young people and examining Australian sexual health websites for young people, the author sought to gain insight into the ways in which friendship discourse informs the practice, promotion, and study of young people’s sexual health.

What they found:  The interview data indicated that friendship can support young people’s sexual health and experiences by offering non-judgemental, caring, and affectionate support through an open dialogue which they may not experience within formal or professional health care settings.

Policy and practice implications: In order to improve engagement with young people both professionally and via social media, sexual health promoters need to acknowledge the role of friendship in negotiating sexual health and relationships.

Main topics

Title and first author

Summary

Young people, PWID, harm reduction

Perceptions of a drug prevention public service announcement campaign among street-involved youth in Vancouver, Canada: a qualitative study. L. Ti.

What they did: Conducted qualitative interviews with 25 individuals enrolled in an ongoing At-Risk Youth study to evaluate the efficacy of the Canadian Government’s DrugsNot4Me public awareness campaign.

What they found: Participants reported feelings of stigmatisation due to the campaigns simplistic approach, which espoused a message of ‘just say no’. They also found the messages to be uninformative and felt the resources used to develop the campaign would be better suited to mental health, public housing, or harm reduction programs.

Policy and practice implications: Rather than relying solely upon fear-based appeals, public awareness campaigns require the inclusion of the social, environmental, and structural contexts that shape the issue being addressed.

PWID, HIV, harm reduction, NSP, methods

Coverage of harm reduction services and HIV infection: a multilevel analysis of five Chinese cities. Q. Wu.

What they did: Conducted a serological and behavioural survey of PWID across five different cities in China to assess the efficacy of harm reduction programs.

What they found: Participants who reported using needle and syringe programs or methadone maintenance treatment services were approximately 50% less likely to be infected with HIV than those who reported not accessing the services.

Policy and practice implications: The study reflects the need for the linking of biological and behavioural data in order to accurately track program progress and effectively distribute program activities.

PWID, HIV, harm reduction, education, methods

The acceptability and feasibility of a brief psychosocial intervention to reduce blood-borne virus risk behaviours among people who inject drugs: a randomised control feasibility trial of a psychosocial intervention (the PROTECT study) versus treatment as usual. G. Gilchrist.

What they did: Explored the feasibility of a three-session, gender-specific psychosocial group intervention to reduce BBV transmission behaviours among PWID which included skills to improve injecting techniques and thus vein care, and strategies to avoid and plan for risk situations that PWID had themselves identified.

What they found: The intervention was acceptable to both facilitators and participants. Follow-up attendance was associated with fewer days of injecting in the last month and fewer injections of cocaine.

Policy and practice implications: High non-attendance highlights the need for flexible delivery of the intervention content to ensure wider reach.

SIFs, PWID

Willingness to use a supervised injection facility among young adults who use prescription opioids non-medically: a cross-sectional study. B. A. Bouvier.

What they did: Supervised injection facilities (SIFs) are legally sanctioned environments for people to inject drugs under medical supervision. This study evaluated willingness to use a SIF among youth who report non-medical prescription opioid use in the US.

What they found: Among young adults who use prescription opioids non-medically and inject drugs or are at risk of initiating injection drug use, more than six in ten reported willingness to use a SIF. Established risk factors for overdose, including homelessness, history of overdose, daily injection drug use, heroin use, and fentanyl misuse, were associated with higher SIF acceptability.

Policy and practice implications: Findings indicate that in the US young people at the highest risk of overdose might ultimately be the same individuals to use the facility.

Main topics

Title and first author

Summary

HIV, health literacy

A Systematic Review of Health Literacy Interventions for People Living with HIV. J. Perazzo.

What they did: Systematically reviewed current literature on health literacy interventions for people living with HIV.

What they found: Several health literacy intervention studies demonstrated trends toward improvement in medication adherence, but most did not achieve statistical significance. Significant improvements in knowledge, behavioural skills, and e-Health literacy were found following interventions.

Policy and practice implications: Health literacy interventions have the potential to promote HIV-related knowledge, behavioural skills, and self-management practices.

HIV, social capital, treatment, testing

Neighborhood Social Capital in Relation to Late HIV Diagnosis, Linkage to HIV Care, and HIV Care Engagement. Y. Ransome.

What they did: Examined whether social capital was associated with lower 5-year average prevalence of late HIV diagnosis; linked to HIV care; and engaged in HIV care within Philadelphia.

What they found: Higher average neighbourhood social participation was associated with higher prevalence of late HIV diagnosis, linked to HIV care and lower prevalence of engaged in HIV care. Higher collective engagement was associated with lower prevalence of linked to HIV care.

Policy and practice implications: Neighbourhood social capital is ecologically associated with population level HIV/AIDS outcomes along the care cascade in Philadelphia.

Young people, safe sex, HIV, homelessness

Condomless Sex Among Homeless Youth: The Role of Multidimensional Social Norms and Gender. A. Barman-Adhikari.

What they did: This study explored how different types of relationships contributed to norms about condomless sex and whether such norms were associated with engagement in condomless sex among homeless youth.

What they found: The perception of peer condom use and communication with sexual partners were significantly associated with not engaging in condomless sex. These relationships, however, varied by gender.

Policy and practice implications: There is a need for innovative network-level interventions, particularly those that include street-based peers and sex partner dyads, as well tailored gender-responsive programs, as such approaches may hold the greatest promise for reducing HIV incidence among homeless youth.

Main topics

Title and first author

Summary

Indigenous, testing, cervical cancer

Time to clinical investigation for Indigenous and non-Indigenous Queensland women after a high grade abnormal Pap smear, 2000–2009. L. J. Whop.

What they did: Investigated time to a follow-up clinical investigation (histology test or cancer diagnosis date) for Indigenous and non-Indigenous women in Queensland after a high grade abnormality being detected by Pap smear.

What they found: The proportion of women who had a clinical investigation within two months of a high grade abnormality finding was lower for Indigenous than for non-Indigenous women.

Policy and practice implications: Prompt follow-up after a high grade abnormality Pap smear finding needs to improve for Indigenous women. Nevertheless, slow follow-up is a smaller contributor to their higher cervical cancer incidence and mortality than their lower participation in cervical screening.

Drugs, policy

Beyond ice: rethinking Australia's approach to illicit drugs. M. Y. Frei.

What they did: A perspective piece that argues that harsh approaches to drugs are not just ineffective, they are often counter-productive. 

What they found: Many argue that Australia cannot arrest and imprison its way out of its illicit drug problem. Current evidence indicates that the problem is demand for drugs; while this demand remains strong, there will always be a supply.  Attracting and maintaining severely dependent and treatment-refractory users in alcohol and other drug therapy programs would be expected to reduce the size and demand of the market for ice.

Policy and practice implications: Redefining drug use as a health and social issue within a harm reduction framework will require progressive policy.

HPV, Indigenous, surveillance

Human papillomavirus vaccination and genital warts in young Indigenous Australians: national sentinel surveillance data. H. Ali.  

What they did: Examined the impact of the national human papillomavirus (HPV) vaccination program on the number of diagnoses of genital warts in Australian Aboriginal and Torres Strait Islander (Indigenous) people.

What they found: There were marked declines in the proportions of diagnoses of genital warts in young Indigenous women and men attending sexual health clinics after the introduction of the HPV vaccination program.

Policy and practice implications: If high levels of HPV vaccine coverage are sustained, HPV-related cancer rates should also decline.

Main topics

Title and first author

Summary

HIV, ART, treatment, methods

Patient Use of Electronic Prescription Refill and Secure Messaging and Its Association With Undetectable HIV Viral Load: A Retrospective Cohort Study. D. K. McInnes.

What they did: Investigated whether there are associations between the use of electronic personal health records (electronic prescription refill and secure messaging with providers) and HIV viral load in United States veterans.

What they found: There was a positive association between use of electronic prescription refill and change in HIV viral load status from detectable to undetectable. There was a similar association between secure messaging use and viral load status, but without achieving statistical significance.

Policy and practice implications: The use of electronic prescription refill, was associated with greater control of HIV in United States veterans.

Child sexual exploitation, service delivery, online

Screening for Child Sexual Exploitation in Online Sexual Health Services: An Exploratory Study of Expert Views. V. Spencer-Hughes.

What they did: Explored expert practitioner views on safeguarding child sexual exploitation in the context of an online sexual health service.

What they found: Participants described two different approaches to safeguarding. The “information-providing” approach considers that young people experiencing child sexual exploitation will ask for help when they are ready. This approach values online services as an anonymous space to test out disclosure without commitment. The “information-gathering” approach considers that young people may withhold information about exploitation. This approach values face-to-face opportunities for individualised questioning and immediate referral.

Policy and practice implications: Some elements of online sexual health services may facilitate disclosure of child sexual exploitation.  Effective transition from online to clinic services after disclosure is required.

Sexual health, drugs, methods, GBM

Feasibility of Ecological Momentary Assessment of Daily Sexting and Substance Use Among Young Adult African American Gay and Bisexual Men: A Pilot Study. S. L. Smiley. 

What they did: The objective of this pilot study was to assess the feasibility of a Ecological Momentary Assessment (EMA) (a mobile health method that involves text message based sampling of an individual's behaviour in real-time) as a method of prospectively studying sexting, marijuana, and alcohol use among a sample of young adult African American gay and bisexual men (GBM).

What they found: A total of 949 random prompt surveys were texted to the sample’s phones and a total of 544 surveys were completed, resulting in an overall compliance rate of 57.3%.

Policy and practice implications: The use of an EMA protocol has the potential to be a very useful research tool for understanding episodic behaviours  such as sexting and substance use in young adult African American GBM.

Main topics

Title and first author

Summary

STI, treatment

Antiseptic mouthwash against pharyngeal Neisseria gonorrhoeae: a randomised controlled trial and an in vitro study. E. P. F. Chow.

What they did: Tested whether Listerine, a commercial mouthwash product, has an inhibitory effect against Neisseria gonorrhoeae in a randomised controlled trial and an in vitro study, and therefore may be a potentially useful agent for gonorrhoea control.

What they found: Listerine significantly reduces the amount of N. gonorrhoeae on the pharyngeal surface.

Policy and practice implications: With daily use it may increase gonococcal clearance and have important implications for prevention strategies.

HIV, testing

An effective strategy to diagnose HIV infection: findings from a national audit of HIV partner notification outcomes in sexual health and infectious disease clinics in the UK. M. Rayment.

What they did: Audited HIV partner notification outcomes across the UK.

What they found: HIV partner notification is a highly effective diagnostic strategy. Non-completion of partner notification thus represents a missed opportunity to diagnose HIV in at-risk populations.

Policy and practice implications: Vigorous efforts should be made to pursue partner notification to identify people living with, and at risk of HIV infection.

HIV, testing

Diagnosing acute HIV infection at point of care: a retrospective analysis of the sensitivity and specificity of a fourth-generation point-of-care test for detection of HIV core protein. N. Fitzgerald.

What they did: Assessed the sensitivity of the new Alere HIV Combo point-of-care testing to detect acute HIV infection.

What they found: This new point-of-care testing shows improved sensitivity for detection of p24 antigen and may be of value for clinical use in detecting acute HIV infection.

Policy and practice implications: Further evaluation of its use in a clinical setting is still required.

HIV, treatment, service delivery

A discrete choice experiment to assess people living with HIV's (PLWHIV's) preferences for GP or HIV clinic appointments. A. H. Miners.

What they did: Investigated which aspects of GP and HIV clinic appointments people living with HIV (PLWHIV) most value when seeking advice for new health problems.

What they found: 59% preferred GP to HIV clinic appointments and particularly valued ‘being seen quickly’. 41% also valued shorter waiting times, but they had a strong general preference for HIV clinic rather than GP appointments.

Policy and practice implications: PLWHIV value many aspects of care for new health problems, particularly short appointment waiting times.

Main topics

Title and first author

Summary

Education, mobile technology

How well are health information websites displayed on mobile phones? Implications for the readability of health information. C. Cheng.

What they did: Examined how health information from health related webpages is displayed on mobile phones and its implications for readability.

What they found: The results showed that 71% of webpages were mobile-friendly but only 16% were mobile-friendly webpages designed in a way to optimise readability.

Policy and practice implications: Building mobile-responsive websites should be a priority for health information providers and policy-makers.

Main topics

Title and first author

Summary

Sexual health, education

Exploring discursive barriers to sexual health and social justice in the New Zealand sexuality education curriculum. S. Garland-Levett.

What they did: Examined New Zealand’s sex education curriculum in order to identify discursive possibilities and constraints.

What they found: The current curriculum fails to meet the needs of young people as it does not adequately address aspects of pleasure, bodies, contexts, and power.

Policy and practice implications: There is a need for sex education which addresses the circumstances which perpetuate social and sexual inequalities.

Safe sex, education

Condom Carnival: feasibility of a novel group intervention for decreasing sexual risk. M. B. Anderson. 

What they did: Explored the impact of young people attending Condom Carnival, an interactive, peer-led, culturally tailored, sexual risk reduction group intervention.

What they found: Condom Carnival increased lubricant safety awareness and condom-related behavioural intentions.

Policy and practice implications: There is a need to explore the gap between intentions to use and carry condoms and to develop effective strategies to increase condom carrying among young people.

Older adults, sex education

Learning about sex in later life: sources of education and older Australian adults. B. Fileborn.

What they did: Examined the preferred sexuality education sources of older Australian adults in later life.

What they found: Preferred sources of information include the Internet, the media, health care providers, books and workshops or discussion groups. A substantial number of participants did not actively seek information on sex. For those who had, these educational endeavours could profoundly shape their sexual practices.

Policy and practice implications: Learning about sex should be viewed as a lifelong endeavour.

Homophopic, transphobic, bullying

Homophobic and transphobic bullying: barriers and supports to school intervention. K. O’Donoghue.

What they did: Explored the perceived barriers and supports identified by school staff in tackling homophobic and transphobic bullying in Ireland.

What they found: The main barriers included students’ perceived discomfort in discussing their sexuality with teachers, teachers’ discomfort in discussing issues, a lack of priority given to these types of bullying, and parental views on homosexuality. Perceived supports included consistency in dealing with these types of bullying, appropriate training, and support from management.

Policy and practice implications: It is essential that schools develop inclusive policies and ethos. Training may increase teachers’ comfort discussing or dealing with topics such as homophobic and transphobic bullying. 

Main topics

Title and first author

Summary

HCV, access to care, service delivery

Multidisciplinary managed care networks—Life-saving interventions for hepatitis C patients. J.M. Tait.

What they did: Between 1994 and 2014, all adults who received a positive Hepatitis C antibody test in the region of Tayside, Scotland were monitored throughout their treatment in order to determine the efficacy of a managed care network model for the diagnosis and treatment of HCV.

What they found: The adoption of managed care network led to 97.5% of cases being referred to specialist services and a significant reduction in the time period from diagnosis to sustained viral response. Findings showed that involving services within the healthcare network can increase rates of HCV testing, diagnosis, and treatment.

Policy and practice implications: The introduction of an integrated, managed care network can improve treatment accessibility, patient retention, and reduce all-cause mortality.

HCV, HIV, treatment

Chronic hepatitis C infection and liver disease in HIV-coinfected patients in Asia. N. Durier.

What they did: Study the prevalence of chronic infection, genotype distribution, and extent of liver disease in HIV-positive patients in South-East Asia with known positive HCV antibody.

What they found: 85.8% of participants were found to be chronically infected with HCV. Of this GT1 was the most common (59%), with GT3 infections making up 26% and GT6 11%. 62% had previously undiagnosed liver disease.

Policy and practice implications: As HCV treatment is not usually available to HIV-positive patients undergoing routine care in South-East Asia, HIV-positive patients with positive ACV antibodies should be considered chronically infected until proven otherwise.

HCV, treatment

NS5A inhibitors for the treatment of hepatitis C infection. S. Gitto.

What they did: Conducted a review of the current understanding of NS5A protease complex inhibitors, with a focus on clinical efficacy and the development of viral resistance.

What they found: The NS5A inhibitors were well tolerated in patients with renal and hepatic impairment as well as in a transplant setting. Patients with GT 3 HCV showed increased rates of steatosis, fibrosis progression, and onset of hepatocellular carcinoma.

Policy and practice implications: The author recommends that future studies are dedicated to HCV eradication among the difficult to treat populations.

HCV, treatment

Prevention of allograft HCV recurrence with peri-transplant human monoclonal antibody MBL-HCV1 combined with a single oral direct-acting antiviral: A proof-of-concept study. H. L. Smith.

What they did: Conducted a proof-of-concept study in order to evaluate peri-transplant combination treatment of MBL-HCV1 with direct-acting antiretrovirals.

What they found: 12 week treatment with human monoclonal antibody MBL-HCV1 initiated on the day of transplantation can achieve SVR when combined with a single oral direct-acting antiretroviral.

Policy and practice implications: The study found peri-transplant immunoprophylaxis with the neutralizing human monoclonal antibody MBL-HCV1 in combination with direct-acting antiretrovirals to be a feasible approach to achieving a sustained virologic response post-transplantation.

HCV, cognition, mental health

Functional connectivity alterations in patients with chronic hepatitis C virus infection: A multimodal MRI study. S. Kharabian Masouleh 

What they did: Tested the associations of 3T-neuroimaging-derived grey matter volume and functional connectivity alterations with chronic HCV in order to assess the incidence of fatigue, depression, and cognitive impairments in HCV-positive patients.

What they found: HCV-positive patients had higher levels of fatigue and depression. Neither the grade of liver disease or the viral replication rate was associated with psychometric measures. No significant differences were found in grey matter volume between the HCV-positive patients and the healthy controls. Increased functional connectivity in right posterior parietal regions were found.

Policy and practice implications: The results indicate a compensatory mechanism in order to provide additional resources for better memory performance, further study is needed.

HCV, treatment

Effectiveness and safety of ombitasvir, paritaprevir, ritonavir ± dasabuvir ± ribavirin: An early access programme for Spanish patients with genotype 1/4 chronic hepatitis C virus infection. C. Perelló. 

What they did: Assessed the effectiveness and safety of ombitasvir/paritaprevir/ritonavir±dasabuvir in an early access program.

What they found: Sustained virologic response at 12 weeks post treatment was 96%. No statistical differences in virological response according to genotype or liver fibrosis were found.

Policy and practice implications: This combination therapy proved to be highly effective and safe in clinical practice with an acceptable safety profile and low rates of treatment discontinuation. However, larger studies are needed.

HBV, treatment, methods

Usefulness of albumin-bilirubin grade for evaluation of long-term prognosis for hepatitis B-related cirrhosis. R. C. Chen. 

What they did: Patients who were diagnosed with HBV-associated cirrhosis in China were followed up every 3 months in order to assess the applicability of albumin-bilirubin (ALBI), Child-Pugh and model for end-stage liver disease (MELD) scores to the long-term prognosis prediction of HBV-related cirrhosis.

What they found: A time-dependent receiver operating characteristic curve indicated that the ALBI score was superior to both the MELD and Child-Pugh scores. Additionally, a decision curve also indicated similar results.

Policy and practice implications: The ALBI score was effective in predicting the long-term prognosis for patients with HBV-related cirrhosis and more accurate than Child-Pugh and MELD scores.

HBV, treatment, transmission

Lamivudine therapy during the second vs the third trimester for preventing transmission of chronic hepatitis B. C. Q. Pan.

What they did: Retrospectively compared mothers who received lamivudine during pregnancy to untreated mothers.

What they found: At 28 weeks vertical transmission rates in lamivudine treated mothers were significantly lower than untreated mothers. Maternal HBV DNA levels were significantly lower at delivery in mothers who received lamivudine.

Policy and practice implications: Lamivudine treatment is an effective and safe measure to prevent vertical transmission. However, treatment should be deferred until the third trimester in order to minimise foetal exposure and drug resistance.

HBV, thrombocytopenia

Hepatitis B infection is associated with an increased incidence of thrombocytopenia in healthy adults without cirrhosis. E. J. Joo. 

What they did: Conducted a study of Korean men and women in order to determine the association between HBV infection and the development of thrombocytopenia.

What they found: Patients with the presence of hepatitis B surface antigens had a higher incidence of thrombocytopenia then healthy controls. Strong associations were consistently observed across the additional subgroups.

Policy and practice implications: There was a strong association between HBV infection and thrombocytopenia. Further research is needed across a larger population.

Main topics

Title and first author

Summary

MSM, HCV, HIV, PWID

Sexual transmission of hepatitis C virus among gay and bisexual men: a systematic review. F. Jin.

What they did: A systematic review was conducted in order to surmise evidence published since the year 2000 on the risk of HCV transmission in GBM (gay and bisexual men).

What they found: While there is yet to be a marked increase in HCV incidence among HIV-negative GBM there have been cases reported of acute HCV infection within this population. There is potential for this incidence to increase should individuals taking PrEP decide not to use condoms with a male of partner of the opposite HIV status.

Policy and practice implications:  HCV status should be determined prior to and monitored throughout PrEP use.

HIV, MSM

HIV incidence among gay men and other men who have sex with men in 2020: where is the epidemic heading? S. Stahlman.

What they did: Reviewed the factors that increased the incidence of HIV amongst MSM.

What they found: HIV incidence among MSM is increasing in many low- and high-income settings, with young, adolescent, and racial/ethnic minority MSM being among those at highest risk. Potentiating HIV risk factors include stigma and lack of access to PrEP and antiretroviral treatment as prevention.

Policy and practice implications:  Universal HIV treatment, increased access to HIV testing, and daily oral PrEP are integral to the prevention of HIV transmission, and should be expanded for MSM and other populations disproportionately affected by HIV. Respect for human rights and efforts to combat stigma and improve access to prevention services are needed to change the trajectory of the HIV pandemic among MSM.

MSM, STIs, epidemiology, LGBTIQ

As through a glass, darkly: the future of sexually transmissible infections among gay, bisexual and other men who have sex with men. M. R. Stenger.

What they did: Reviewed epidemiological data to in order to forecast the future outlook for STI prevention among MSM.

What they found: Syphilis transmission is likely to increase in both magnitude and geographic distribution. Additionally incidences of gonorrhoea and chlamydial infections are also likely to continue to increase. STI transmission is expected to continue to be prevalent in densely populated, urban populations. Routine management procedures for those using PrEP could potentially reduce STI transmission, in addition to the uptake of HPV vaccinations.

Policy and practice implications:  Continued and increased effort is required to reach MSM not routinely accessing sexual health services.

MSM, PWID, AOD, STIs, sexual health, LGBTQI

The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men. K. Race.

What they did: Outlined some of the conditions most likely to mediate the effect of drugs on the sexual health of gay and MSM.

What they found: Given that the causal nature between recreation drug use and STI transmission is uncertain, it is not yet possible to predict the future of the impact of recreational drug use on sexual health.

Policy and practice implications:  Public funding for LGBTQ drug issues should not remain restricted to questions of HIV prevention and sexual health. It should be expanded to equip sexual health and AOD service providers with the cultural and sexual literacy to mitigate stigma and allow them to respond constructively to drug problems among sexual and gender minorities as a matter of priority.

MSM, STIs, sexual health, HIV

Global travel and HIV/STI epidemics among men who have sex with men: what does the future hold? V. C. Lee.

What they did: Examined the HIV and STI transmission risk among the MSM population in the context of increasing population mobility. 

What they found: The mixing of populations of HIV-positive people presents opportunity for the mixing of HIV sub-types, increasing of HIV and STI transmissions, and the exposure to HIV resistant strains.

Policy and practice implications:  Public health services need to adapt in response to the increasing mobility of the population. The introduction of prevention tools such as mobile apps linking users to clinics providing PrEP and PEP would assist in mitigating the risk of transmission.

HIV, MSM

Stigma, gay men and biomedical prevention: the challenges and opportunities of a rapidly changing HIV prevention landscape.
G. Brown.

What they did: Examined how structural stigma and developments in biomedical technology effect MSM’s access to and use of new HIV prevention technologies.

What they found: Combination preventative methods often focus on behavioural and biomedical interventions and do not adequately emphasise the importance of structural interventions.

Policy and practice implications:  Investment is needed across HIV research, policy, and programs in order to prevent transmission, respond to structural stigma, increase health promotion and health services, and enhance participation of PLHIV and MSM in new approaches to prevent transmission.

HIV, MSM, PrEP

Dealing with pre-exposure prophylaxis-associated condom migration: changing the paradigm for men who have sex with men. R. A. Crosby.

What they did: Questioned some of the challenges of PrEP including the impact on rates of STIs and condom use.

What they found: PrEP and condom use can be equally effective against HIV transmission. However, low levels of PrEP-associated condom migration can substantially increase the risk of STI transmission. Prevention efforts overly focused on PrEP may inadvertently widen the already existing racial, ethnic and economic disparities in HIV incidence.

Policy and practice implications:  It is essential that PrEP is conceptualised as a tool to complementary preventative tool, rather than the only preventative tool. Until PrEP is widely accepted and available, the prevention of HIV transmission will continue to be reliant on the correct and regular use of male condoms.

MSM, STI, HIV, prevention, treatment

Mental health in 2020 for men who have sex with men in the United States. A. W. Batchelder.

What they did: The authors described the mental health challenges facing MSM related to HIV and STI prevention and across the HIV care cascade and disparities among MSM.

What they found/Policy and practice implications: Moving forward towards 2020, resources will be needed to assess and implement scalable intervention strategies to address psychological and social barriers to HIV and STI risk reduction and treatment for MSM, with a particular focus on the most vulnerable subpopulations. As access to prevention and treatment strategies expand, and new breakthroughs continue to emerge, behavioural strategies will continue to be needed to reduce risk and increase uptake and engagement among MSM most at risk through 2020 and beyond.

GBM, HIV, PrEP, safe sex, surveillance

Adapting behavioural surveillance to antiretroviral-based HIV prevention: reviewing and anticipating trends in the Australian Gay Community Periodic Surveys. M. Holt.

What they did: The Gay Community Periodic Surveys (2000–15), were reviewed to monitor the uptake and effect of new prevention strategies in GBM.

What they found: Between 2000 and 2015, there were significant increases in annual HIV testing, condomless sex with casual partners and the proportion of HIV-positive men on HIV treatment and with an undetectable viral load. The proportion of casual partners who were HIV negative, not on PrEP and who engaged in receptive condomless sex also increased.

Policy and practice implications: Behavioural surveillance can be successfully adapted to follow the effect of antiretroviral-based prevention. It is anticipated that HIV testing and HIV treatment will continue to increase among Australian GBM, but to prevent new infections, intervention in the growing proportion of GBM who have condomless sex with casual partners is needed. For PrEP to have its desired effect, condom use needs to be sustained.

HIV, testing, MSM

HIV testing intervention development among men who have sex with men in the developed world. P. Flowers.

What they did: This paper highlights the need for better ways of conceptualising testing in order to capitalise on the health benefits of diverse HIV testing interventions.

What they found: A multidimensional framework is proposed to capture ongoing developments in HIV testing among MSM and focus on the intersection of: (1) the growing variety of HIV testing technologies and the associated diversification of their pathways into care; (2) psychosocial insights into HIV testing; and (3) better appreciation of population factors associated with heterogeneity and concomitant inequities. By considering these three aspects of HIV testing in parallel, limitations and opportunities in future HIV testing-related interventions can be identified.

Policy and practice implications: Only a holistic and dynamic framework that captures the increasing complexity of HIV testing is fit for purpose to deliver the maximum public health benefit.

PrEP, HIV, MSM

Likely impact of pre-exposure prophylaxis on HIV epidemics among men who have sex with men. I. B. Zablotska.

What they did: This review evaluated studies, which modelled the impact of PrEP on HIV diagnoses, and discusses the progress towards PrEP implementation.

What they found: None of the published models showed that PrEP alone can reduce HIV diagnoses to zero and eliminate HIV transmission by 2030. However, PrEP in combination with other biomedical interventions can reduce HIV diagnoses on the population level by ~95%.

Policy and practice implications: Modelling studies can assist governments with decision-making about PrEP implementation and add urgency to the implementation of PrEP.

HIV, MSM, phylogenetics

Enhanced use of phylogenetic data to inform public health approaches to HIV among men who have sex with men. D. German.

What they did: The authors argue that viral phylogentics shows strong promise for informing innovative responses to the HIV epidemic among MSM.

What they found: HIV phylogenetic insights are providing new understandings of characteristics of HIV epidemics involving MSM, social networks influencing transmission, characteristics of HIV transmission clusters involving MSM, targets for antiretroviral and other prevention strategies and dynamics of emergent epidemics.

Policy and practice implications: Enhanced and integrated use of HIV surveillance, sociobehavioural and phylogenetic data resources are becoming increasingly critical for informing public health approaches to HIV among MSM.

HPV, vaccination, MSM

Human papillomavirus vaccination in men who have sex with men – what will be required by 2020 for the same dramatic changes seen in heterosexuals. C. K. Fairley.

What they did: Explores whether MSM will share the spectacular reductions in HPV infection and its associated neoplasia that is occurring in heterosexuals.

What they found: Findings indicate that the reproductive rate for HPV will be higher in MSM and hence the critical vaccination threshold will also be higher. The efficacy of the HPV vaccine is much lower when sexually active MSM are vaccinated rather than boys.

Policy and practice implications: If MSM are to have the same benefit from the HPV vaccine that heterosexuals had, boys and not adult MSM will need to be vaccinated.

STI, MSM, treatment, prevention

Sexually transmissible infection control programs for men who have sex with men – what will they look like in 2020? O. N. Refugio.

What they did: The authors examined current barriers to STI control, as well as the anticipation of new challenges that may arise, to give insight into what STI control may look like in 2020.

What they found: The resurgence of sexually transmissible infections among MSM is a concern for sexual health. Traditional strategies have relied on the promotion of condom use, regular testing, treatment, and partner management.

Policy and practice implications: Future sexually transmissible infection control programs must combine current prevention methods with novel approaches that target the providers, patients, and mechanisms of health care delivery.

MSM, HIV/AIDS, treatment, prevention, testing

Emerging models of clinical services for men who have sex with men: focused versus comprehensive approaches. K. H. Mayer.

What they did: The authors discuss historical and emerging models of clinical services for MSM.

What they found: In resource-rich countries, the development of clinical infrastructure to address the AIDS epidemic led to the creation of clinics that provided services for large numbers of MSM. During the same time period, other health centres were created that were community-focused, providing comprehensive behavioural health and medical services for all sexual and gender minority patients.

Policy and practice implications: Over the next few years, multiple models for MSM sexual health will evolve, ranging from centres that embed STI care in primary care, to more focused centres that can use new technology to provide an efficient assessment for at-risk MSM desiring quick screening services.