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Background We aimed to examine the impact of lockdown on sexually transmitted infection (STI) diagnoses and access to a public sexual health service during the coronavirus disease 2019 (COVID-19) pandemic in Melbourne, Australia. Methods The operating hours of Melbourne Sexual Health Centre (MSHC) remained the same during the lockdown. We examined the number of consultations and STIs at MSHC between January and June 2020 and stratified the data into prelockdown (February 3 to March 22), lockdown (March 23 to May 10), and postlockdown (May 11 to June 28), with 7 weeks in each period. Incidence rate ratios (IRRs) and their 95% confidence intervals (CI) were estimated using Poisson regression models. Results The total number of consultations dropped from 7818 in prelockdown to 4652 during lockdown (IRR, 0.60; 95% CI, 0.57–0.62) but increased to 5347 in the postlockdown period (IRR, 1.15; 95% CI, 1.11–1.20). There was a 68% reduction in asymptomatic screening during lockdown (IRR, 0.32; 95% CI, 0.30–0.35), but it gradually increased during the postlockdown period (IRR, 1.59; 95% CI, 1.46–1.74). Conditions with milder symptoms showed a marked reduction, including nongonococcal urethritis (IRR, 0.60; 95% CI, 0.51–0.72) and candidiasis (IRR, 0.61; 95% CI, 0.49–0.76), during lockdown compared with prelockdown. STIs with more marked symptoms did not change significantly, including pelvic inflammatory disease (IRR, 0.95; 95% CI, 0.61–1.47) and infectious syphilis (IRR, 1.14; 95% CI, 0.73–1.77). There was no significant change in STI diagnoses during postlockdown compared with lockdown. Conclusions The public appeared to be prioritizing their attendance for sexual health services based on the urgency of their clinical conditions. This suggests that the effectiveness of clinical services in detecting, treating, and preventing onward transmission of important symptomatic conditions is being mainly preserved despite large falls in absolute numbers of attendees. [ABSTRACT FROM AUTHOR]

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

Background The kissing practices of heterosexual men are not well understood, despite the potential of kissing to be a significant risk factor for gonorrhoea transmission. This study aimed to explore kissing and sex practices among heterosexual men.Methods: A cross-sectional survey among heterosexual men attending the Melbourne Sexual Health Centre in 2016-2017 was conducted. Men were asked to report their number of kissing-only (in the absence of sex), sex-only (in the absence of kissing) and kissing-with-sex partners in the last 3 months. The mean number of each partner type was calculated, and multivariable negative binomial regression was used to investigate associations between the number of different types of partners and demographic characteristics.Results: Of the 2351 heterosexual men, men reported a mean of 2.98 kissing-only, 0.54 sex-only and 2.64 kissing-with-sex partners in the last 3 months. Younger men had a mean higher number of kissing-only partners than older men (4.52 partners among men aged ≤24 years compared with 1.75 partners among men ≥35 years, P < 0.001). Men born in Europe had the most kissing-only partners (mean: 5.16 partners) and men born in Asia had the fewest kissing-only partners (mean: 1.61 partners). Men recently arrived in Australia, including travellers from overseas, had significantly more kissing-only partners (adjusted incidence rate ratio (aIRR): 1.53; 95% CI: 1.31-1.80) than local men.Conclusions: This study provides novel data about kissing practices of heterosexual men. Studies assessing oropharyngeal gonorrhoea should include measurements of kissing until studies can clarify its contribution to transmission risk. [ABSTRACT FROM AUTHOR]

Background. We have undertaken a cross-sectional study that investigates the association between bacterial vaginosis (BV) and sexual practices in sexually experienced and inexperienced women. Methods. Participants were 17-21-year-old females who attend Melbourne University, Australia. Study kits that contained an information and consent form, questionnaire, swab, and slide were distributed. Information regarding demographic characteristics and a broad range of sexual practices were collected. Gram-stained, selfcollected vaginal smears were scored with the Nugent method. Associations between BV and behaviors were examined by univariate and multivariate analysis. Results. BV was diagnosed in 25 (4.7%) of 528 women (95% confidence interval [CI], 3.1%-6.9%). Importantly, BV was not detected in women (n=83) without a history of coital or noncoital sexual contact (0%; 95% CI, 0%-4.3%). BV was detected in 3 (3.8%) of 78 women (95% CI, 0.8%-10.8%) with noncoital sexual experience only and in 22 (6.0%) of 367 women (95% CI, 3.8%-8.9%) who reported penile-vaginal sex. BV was associated with a history of any genital contact with a sexual partner (P=.02). BV was strongly associated with >3 penilevaginal sex partners in the prior year (adjusted odds ratio, 7.1; 95% CI, 2.7-18.4) by multivariable analysis. Conclusions. This study shows a strong association between BV and penile-vaginal sex with multiple partners but found no BV in sexually inexperienced women, once a history of noncoital sexual practices was elicited. Our findings indicate that BV is not present in truly sexually inexperienced women. [ABSTRACT FROM AUTHOR]

Background: Targeted chlamydia screening has been advocated to reduce chlamydia associated reproductive sequelae. General practitioners are well positioned to play a major role in chlamydia control. The primary aim of this pilot study was to measure the effect of offering an online sexual health assessment tool, Youth Check Your Risk, on chlamydia testing rates among young people attending general practices. The secondary aim was to test the acceptability of the tool among general practitioners and young people. Methods: General practitioners at three practices in Melbourne, Australia, referred patients aged 16 to 24 years to Youth Check Your Risk http://www.checkyourrisk.org.au for use post-consultation between March to October 2007. The proportion of young people tested for chlamydia before and during the implementation of the tool was compared. Acceptability was assessed through a structured interviewer-administered questionnaire with general practitioners, and anonymous online data provided by Youth Check Your Risk users. Results: The intervention did not result in any significant increases in the proportion of 16 to 24 year old males (2.7% to 3.0%) or females (6.3% to 6.4%) tested for chlamydia. A small increase in the proportion of 16 to 19 year old females tested was seen (4.1% to 7.2%). Of the 2997 patients seen during the intervention phase, 871 (29.1%) were referred to Youth Check Your Risk and 120 used it (13.8%). Major reasons for low referral rates reported by practitioners included lack of time, discomfort with raising the issue of testing, and difficulty in remembering to refer patients. Conclusion: Offering an online sexual risk assessment tool in general practice did not significantly increase the proportion of young people tested for chlamydia, with GPs identifying a number of barriers to referring young people to Youth Check Your Risk. Future interventions aimed at increasing chlamydia screening in general practice with the aid of an online risk assessment tool need to identify and overcome barriers to testing. [ABSTRACT FROM AUTHOR]

The article discusses a study which determined whether pelvic examinations change clinical management of women with asymptomatic chlamydia infection. The study analyzed records for women with asymptomatic chlamydia who underwent a pelvic examination at a sexual health clinic in Melbourne, Victoria from January 2006 to June 2007. Findings showed that of the 91 cases examined, 31 warranted examination, one woman had muco-purulent cervicitis and mild tenderness, and was treated for possible pelvic inflammatory disease. The study also suggested that pelvic examination will lead to changes in treatment for very few women diagnosed with asymptomatic chlamydia infection.

The article discusses the research which aimed at determining the trends in chlamydia positivity from 2003 to 2007 among women in Melbourne, Victoria. It says that any possible change in chlamydia positivity over time following adjustment to demographic, clinical and sexual risk factors. It states that the study has provided evidence of that prevalence of chlamydia is rising in Australia.