STIs In Gay Men Action Group

About the STI in Gay Men Action Group

At February 2007

Role

To provide leadership and strategic direction for reducing and preventing sexually transmissible infections (STIs) among

gay men living in inner-city Sydney

Functions

In relation to STIs in gay men:

Monitor patterns and trends in infection and disease.
Coordinate responses to changes in epidemiology.
Plan, implement, coordinate and evaluate prevention and health promotion strategies.
Provide advice to relevant committees and personnel on health promotion and other prevention strategies.
Advise on role of health promotion and prevention activities in clinical practice (including testing, treatment and immunisation)
Foster and conduct Public Health research into STIs among gay men.
Make recommendations regarding allocation of resources (in reducing and preventing STIs among gay men).

Membership

Membership includes the following people or nominees from the following organisations:

From each of the South Eastern Sydney Illawarra Area Health Service, Sydney South West Area Health Service and Northern Sydney Central Coast Area Health Service.

Director, Public Health Unit
Director, Sexual Health Services
Manager, HIV/Sexual Health promotion
Manager, HIV/AIDS/Sexual health program

Director and a Manager, AIDS Council of NSW
General Practitioners, Division of General Practice representatives
General Practitioner, HIV GP Study Group
National Centre in HIV Social Research
National Centre in HIV Epidemiology and Clinical Research
Manager, People Living with HIV/AIDS (NSW)
AIDS/Infectious Diseases Branch, New South Wales Health Department

Chairperson

The current committee Chair is Dr Chris Bourne, Senior Staff Specialist and Clinical Service Manager at Sydney Sexual Health Centre, Sydney/Sydney Eye Hospital.

The History of STIGMA

Syphilis in gay men

Prior to 2000 there had been outbreaks of syphilis amongst gay men in Manchester and Brighton in the UK, Southern California & Seattle in USA and Amsterdam in the Netherlands. Syphilis had been well controlled and uncommon in these countries before this time. During 2000, Dr Chris Bourne from Sydney Sexual Health Centre (SSHC) was concerned that an outbreak may be replicated in Sydney’s gay population. SSHC and inner city general practitioners (GPs) had identified a small number of cases of syphilis in homosexually active men who had sexual contacts from the east coast of USA. There was also a concern that public health laboratory notifications of syphilis sent to the public health unit (PHU) didn’t differentiate between old and new cases and there was no active follow-up of notified cases. Surveillance at this time would therefore not identify an emerging problem with infectious syphilis amongst gay men.

SSHC began working with the former South Eastern Sydney Area Health Service (SESAHS) (now South Eastern Sydney Illawarra Area Health Service) PHU to ensure that new cases of syphilis were being correctly identified. The NSW HIV General Practice study group members and the Eastern Sydney Division of General Practice were alerted to these new cases. SSHC and SESAHS PHU also sent a letter to GPs in the area to make them aware of the problem, as well as what tests to conduct and their responsibilities around notification. Along with other PHUs in NSW, the SESAHS PHU began enhanced surveillance of positive syphilis serology by calling or writing to notifying doctors to define the clinical stage of syphilis disease.

STIGMA is formed

Once the groundwork for strengthened syphilis surveillance was complete, it was agreed that this partnership should be expanded to include other organisations and other STIs in gay men. Health promotion work over the prior 5 years had focussed on outbreak responses to STI’s (particularly hepatitis A, gonorrhoea and shigella). While there had been efforts to raise the health literacy of gay men, there was little focus on health seeking behaviours, such as the regularity with which gay men have testing for STIs. The inaugural meeting of the “Surveillance and Prevention of Sexually Transmissible Infections in Gay Men Action Group” (STIGMA) chaired by SESAHS Director of Public Health Dr Mark Ferson was held on 15th December 2000. STIGMA has grown from 10 members at this first meeting to 20 members in 2007.

STIGMA Initiatives

STI testing guidelines for MSM

Members of this group developed clinical guidelines on regular STI testing for men who have sex with men (MSM). This involved the collection of research on regularity of STI testing. The well researched guidelines from King County, Washington State, USA (subsequently published in Sexually Transmitted Diseases August 2001 and reinforced in the CDC STD treatment guidelines 2002) were used as a discussion point for GPs and sexual health doctors. They were then adapted for Sydney and distributed widely for comment. The guidelines have been endorsed by the Australasian Chapter of Sexual Health Medicine. The STIGMA testing guidelines for MSM can be found at: www.racp.edu.au/public/sexualhealth.htm

STIGMA health promotion initiatives

Since the formation of STIGMA, a number of working groups have focused on developing and implementing important health promotion initiatives. The promotion of regular STI testing to gay men and their health care providers has been a major focus and has included the development of the website www.whytest.org.

The “Party Play Test” social marketing campaign was released during Mardi Gras 2006 and included the launch of new electronic technologies on the website. This initiative provides free reminders to gay men regarding their next STI test via SMS or email. In addition, an electronic partner notification system has been developed to enable gay men diagnosed with an STI to inform their sexual partners via SMS or email.

A number of related resources have also been developed for gay men including the STI booklet, “Last night I picked up someone… and something! A guide to sexually transmissible infections for gay men.” A GP bookmark for patient files was also developed to remind GPs about regular STI testing for their gay male clients.

A social marketing campaign in 2004 encouraged gay men to get vaccinated for Hepatitis A and B and included the distribution of vouchers for free vaccinations at sexual health clinics. A training session for GPs on gay men and sexual health was provided as part of this project.

Another working group has explored the issues around sexual risk taking and alcohol and other drug use and included a forum for health care workers. A separate working group is currently addressing issues for MSM from culturally and linguistically diverse backgrounds.

This page reformatted 23 July 2008