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Objective: Passive surveillance indicates a clear increase in infectious syphilis cases in Victoria, but trends are likely to be influenced by changes in testing. We therefore used testing data from two Melbourne clinics with a high caseload of men who have sex with men to examine infectious syphilis prevalence, time trends and risk factors for infection. Methods: We extracted laboratory testing data on all males tested for syphilis at the clinics between 2000 and 2004, including demographic information, syphilis test results and laboratory information used to assign HIV status (a HIV positive diagnosis or HIV positive clinical monitoring data). Results: Of 7,906 syphilis tests conducted at the two clinics, overall 1.4% resulted in a diagnosis of infectious syphilis, significantly increasing from 0.5% in 2000 to 2.5% in 2004, p Conclusions and Implications: The increase in infectious syphilis notifications appears unrelated to the observed increased in testing and is more likely to be attributed to increased transmission, highlighting the need for urgent prevention interventions. Key words: Syphilis; HIV infection; sexually transmitted diseases; men who have sex with men; disease transmission.

Objective: To investigate the feasibility of recruiting young men from rural football clubs for screening for sexually transmitted infections (STIs). Methods: Young men aged 16 to 29 were recruited from four football clubs outside of metropolitan areas in Victoria, Australia, and completed a questionnaire about sexual activity, knowledge and history of STIs, and alcohol and drug use, and provided a urine sample for STI testing. Results: One hundred and eight participants completed the questionnaire and 92 (85.2%) also provided a urine sample. More than 90% of eligible players present at the clubs on the night of the study participated. Eighty-seven participants (80.6%) had ever had penetrative sex, with 33 (39.3%) reporting a new sexual partner in the past three months. Among those who had ever had sex, the prevalence of chlamydia was 3.9% (95% Cl 0.8-11.0). While the majority of participants visited their doctor in the past year (78.7%) and were comfortable with the idea of an annual STI screen, few had ever discussed sex or STIs with their doctor or had a previous STI test. Conclusion: Young men from rural areas may be at considerable risk of STIs and many have not been previously tested. However, most are willing to participate in screening programs and the high participation rate achieved in this pilot project demonstrates the potential for screening to be successfully extended into non-medical settings such as sporting clubs. Implications: Young people at risk of STIs can be successfully recruited for STI screening from community settings. Key words: Sexually transmitted diseases, rural health, men.

Objective: To measure the prevalence and determinants of blood-borne virus (BBV) transmission in ethnic Vietnamese injecting drug users (IDUs). Methods: The study was conducted in Melbourne, Australia, in 2003. It was a cross-sectional design with participants recruited from street-based illicit drug markets predominately using a snowball technique. One hundred and twenty-seven participants completed a questionnaire that asked about illicit drug use and participants' blood samples were tested for HIV, HCV and HBV. Results: One hundred and three (81.1%) ethnic Vietnamese IDU study participants were HCV positive and three (2.4%) were HIV positive. More than 60% had evidence of being infected with HBV (either in the past, acute infection or chronic infection). Almost 60% had injected daily over the past 12 months. Fifty-nine participants had recently travelled to Vietnam; 24 (41%) had injected drugs in Vietnam; and three (12.5%) reported sharing injecting equipment in Vietnam. Conclusion: The prevalence of BBVs was higher in this study's IDU population compared with IDUs in Australia generally, despite the fact that the injecting risk behaviours were similar to IDUs more generally. Implications: Culturally sensitive drug treatment and education programs need to be developed in Australia for both ethnic Vietnamese IDUs and their families to reduce this group's risk of contracting a BBV.

Objective: To provide recent data regarding the epidemiology of community-based respiratory infections in Australia. Methods: A longitudinal study between 1997-99 involving collection of a health diary from 600 families in Melbourne. Results: More than 80% of study participants reported at least one respiratory episode over 15 months. An average of 2.2 respiratory episodes per person per year was reported, with a mean episode duration of 6.3 days. On average, subjects were symptomatic for 4.2% of the study days. Compared with other age groups, children aged less than two years were most likely to have at least one respiratory episode, a greater number of episodes per person and the longest episode duration (6.8 days). Approximately one in three (287%) respiratory episodes were associated with a doctor's visit, and one in four (23%) necessitated time off school or work. Exposure to other people with respiratory symptoms was commonly reported. Conclusions: Respiratory infections are common, cause a significant amount of morbidity, and are major contributors to the total community health burden. Implications: The direct and indirect costs of respiratory infections to the community are substantial.