Objectives: To report on sexual behaviors and sexually transmitted infections (STIs) among men who have sex with men (MSM) in their teens, when many MSM engage in their first sexual experiences.Methods: MSM aged 16 to 20 years were recruited via community and other sources. Men completed a questionnaire about their sexual behaviors and were screened for gonorrhea, chlamydia, syphilis, and HIV.Results: Two hundred men were included. The median age was 19 years. The median age at first insertive or receptive anal intercourse was 17 years. Half of men reported sex with mainly older men: these men were more likely to engage in receptive anal intercourse (48% vs. 25%, p<.001) than other men. Most men had engaged in insertive (87%) and receptive (85%) anal intercourse in the prior 12 months with 60% and 53% reporting inconsistent condom use with insertive and receptive anal intercourse partners, respectively. The median number of insertive anal intercourse partners was 3 and 1.5 (p<.001) among men reporting inconsistent and consistent condom use with insertive anal intercourse over the prior 12 months. The median number of receptive anal intercourse partners was 3 and 2 (p=.006) among men reporting inconsistent and consistent condom use with receptive anal intercourse over the prior 12 months. Pharyngeal gonorrhea, rectal gonorrhea, urethral chlamydia, rectal chlamydia, and syphilis were detected in 3.0%, 5.5%, 3.0%, 4%, and 2.0% of men, respectively. All men were HIV negative.Conclusion: Many of the teenage MSM in this study were at risk for STI. Preventative messages and STI screening interventions that are age appropriate need to be developed to reduce HIV and STI risk in this under-recognized group. (C) 2014 Society for Adolescent Health and Medicine. All rights reserved.

BACKGROUND: Guidelines recommend frequent screening of men who have sex with men (MSM) for sexually transmissible infections (STIs) but few interventions have demonstrated increased testing and detection of bacterial STIs among MSM in controlled studies. METHODS: We used automated text message and email reminders generated by computer assisted self-interview (CASI) to remind MSM to retest for syphilis. We compared clinic visits, STI testing and detection rates over 12 month between men receiving reminders (reminder group) and men not offered the reminders (concurrent control group). RESULTS: Men who chose 3-monthly reminders had more clinic visits (median 3 vs 1) and higher testing rates for pharyngeal gonorrhoea (67.0% vs 33.6%), rectal gonorrhoea (62.7% vs 31.1%), urethral chlamydia (67.3% vs 39.3%), rectal chlamydia (62.9% vs 31.3%), syphilis (67.0% vs 39.3%) and HIV (64.9% vs 36.7%) (all p<0.001) than concurrent controls, within 12 months after their first visit. Also, men receiving reminders had a higher combined testing rate for all the aforementioned STIs at a same visit (55.7% vs 25.5%, p<0.001) compared with concurrent controls. This association remained after adjusting for differences in characteristics between the two groups (adjusted odds ratio:1.77, 95% confidence interval:1.51-2.08). Men receiving reminders also had a higher detection rate of: rectal gonorrhoea (3.7% vs 1.2%, p = 0.001), urethral chlamydia (3.1% vs 1.4%, p = 0.027), rectal chlamydia (6.6% vs 2.8%, p<0.001), and early, latent syphilis (1.7% vs 0.4%, p = 0.008) compared with concurrent controls. CONCLUSION: This is the first study to demonstate that a fully automated reminder system using CASI was associated with increased detection of bacterial STIs among MSM.

Background Data on testing and detection of sexually transmissible infections (STIs) in younger MSM are scarce and no specific study focusing on teenage MSM has been published. In this study we report on sexual risk behaviours and STI testing and detection in teenage MSM aged 15–20 attending a sexual health service. Methods Data were extracted from Melbourne Sexual Health Centre’s computerised medical records system on self-reported sexual behaviours and test results between July 2008 and June 2012. Results for MSM aged 15–20 were compared with those of older MSM. Results 445 MSM aged 15–20 and 4313 MSM aged 20 or older were included. The median number of casual male partners in the past 12 months was 4 and 5 (p = 0.015) for teenage and older MSM, respectively. Compared to older MSM, Teenage MSM were less likely to participate in insertive anal sex (91.9% vs 86.8%, p = 0.002) and more likely to participate in receptive anal sex (86.3% vs 92.4%, p = 0.002) with casual male partners. Teenage MSM were more likely to consistently use a condom in insertive anal sex (39.0% vs 32.7%, p = 0.024) with regular partners but less likely to consistently use a condom inwith receptive anal sex with casual male partners (45.5% vs 56.6%, p = 0.001). The prevalence of rectal gonorrhoea (2.8% vs 3.5%, p = 0.472), rectal chlamydia (5.9% vs 6.8%, p = 0.496) and early syphilis (1.5% vs 2.2%, p = 0.346) were similar in the two age groups. More teenage MSM had pharyngeal gonorrhoea (4.8% vs 2.0%, p < 0.001) but more older MSM were diagnosed for urethral chlamydia (0.7% vs 3.3%, p = 0.004) and HIV (0.3% vs 1.8%, p = 0.021). Conclusion A high level of sexual risk was seen among teenage MSM together with a high prevalence of STIs. More innovative and age-specific measures should be adopted to promote sexual health messages to younger gay men.

Let Them Know (www.letthemknow.org.au) is an Australian internet based service designed to support individuals diagnosed with an STI to notify sexual partners using anonymous or personal text messages. A review of user activity and acceptability of the website was performed. Between 17 March 2010 and 31 March 2011, of 13?024 website visits, 4863 (37%) visits resulted in a text message being sent. From 3 December 2010, of 1383 consecutive users, 963 (70%) indicated they were more likely to contact a partner because of the website. A short period of misuse was identified and controlled, and additional measures to monitor for and prevent misuse were subsequently implemented. Web-based notification systems such as the Let Them Know website can help to facilitate partner notification for individuals who may be reluctant to do this in person.

Background: Our aim was to describe the use of and responses to a self-management website, ‘Health Map’, established to address the key chronic health issues of HIV-positive people. Methods: Health Map assessed health issues against current recommendations for: treatment adherence, monitoring CD4 counts and viral load, psychological health and physical activity, vaccination, cholesterol, fasting blood sugar, blood pressure, alcohol consumption, smoking, body mass index, and cervical screening for women and sexually transmissible infection (STI) screening for men who have sex with men (MSM). Results: A total of 552 people, with a mean age of 37 years, completed the full ‘Health Map’ program, of whom 536 (97%) were Australian, 425 (77%) were male, including 268 (63%) MSM. Online responses to several health indices were of concern: 49% missed at least one dose of antiretroviral therapy per month and only 41% had had an HIV viral load test in the 4 months prior. Only 43% reported regular physical activity, and 49% and 61% reported vaccination for hepatitis A and B. The proportion tested within the recommended periods for fasting cholesterol (40%), fasting blood sugar (35%) and cervical screening (43%) in women or STI screening for MSM (53%) were low. Conclusions: A substantial proportion of individuals completing the online survey reported information that would suggest their HIV and more general health care is suboptimal. These data are consistent with community surveys and indicate the need for improvement in the chronic management of HIV.

Background: This review describes the published information on what constitutes the elements of a core sexual history and the use of computer-assisted self interviewing (CASI) within sexually transmitted disease clinics. Methods: We searched OVID Medline from 1990 to February 2010 using the terms “computer assisted interviewing” and “sex,” and to identify published articles on a core sexual history, we used the term “core sexual history.” Results: Since 1990, 3 published articles used a combination of expert consensus, formal clinician surveys, and the Delphi technique to decide on what questions form a core sexual health history. Sexual health histories from 4 countries mostly ask about the sex of the partners, the number of partners (although the time period varies), the types of sex (oral, anal, and vaginal) and condom use, pregnancy intent, and contraceptive methods. Five published studies in the United States, Australia, and the United Kingdom compared CASI with in person interviews in sexually transmitted disease clinics. In general, CASI identified higher risk behavior more commonly than clinician interviews, although there were substantial differences between studies. CASI was found to be highly acceptable and individuals felt it allowed more honest reporting. Currently, there are insufficient data to determine whether CASI results in differences in sexually transmitted infection testing, diagnosis, or treatment or if CASI improves the quality of sexual health care or its efficiency. Conclusions: The potential public health advantages of the widespread use of CASI are discussed.

This study evaluated Let Them Know (www.letthemknow.org.au), an online partner notification website offering e-mail and text message notification services to individuals diagnosed with chlamydia. A substantial and increasing number of text messages were sent, pointing to the potential for improved partner notification rates.

BACKGROUND:The present study aimed to determine the sexual risk profile of people using an automated, internet-based service that allows internet users to receive recommendations on sexually transmissible infection screening ('Check your risk' (CYR), http://www.checkyourrisk.org.au/), and to compare this with that of patients attending the Melbourne Sexual Health Centre (MSHC) for the first time over the same 6-month period: January-June 2006.METHODS:The characteristics of those who used CYR and those who attended MSHC were compared using a chi(2)-test for categorical variables and the Mann-Whitney U-test for non-parametric data.RESULTS:There were 2492 users who accessed CYR and 2735 who attended MSHC over the period. The age of CYR users was similar to that of MSHC patients when compared according to risk groups. The median number of recent sexual partners reported by CYR users was similar to and not significantly lower than that reported by MSHC patients. Of the 309 CYR users who provided a rating for the CYR site, 215 (70%) rated it as being 'useful' to 'very useful'.CONCLUSIONS:Individuals who accessed an automated, internet-based sexual risk assessment service were at substantial risk for sexually transmitted infections, similar to those attending a sexual health service.

Objective: It may be difficult for young people to know if they need testing for sexually transmitted infections and some primary care physicians may be unsure about what tests to order for patients with different risk profiles. Our aim was to help overcome these barriers by implementing an automated, internet based service that allowed internet users to receive specific recommendations for STI screening based on their online responses to a series of questions relating to their recent sexual practices ('Check Your Risk' (CYR), available at: www.mshc.org.au). This study evaluated this service and compared the risk profile of individuals using CYR with that of patients attending a sexual health centre in the same city over the same time period. Methods: An automated and individualised web based algorithm was developed using current recommendations for STI testing. The characteristics of individuals visiting CYR were compared to those attending the Melbourne Sexual Health Centre (MSHC) for the first time over the same 6 month period, from January to June 2006. Results: There were 2492 (59% men, 41% women) who visited the CYR online service and 2735 (59% men, 41% women) who attended the MSHC over the period. 513 (22%) of the men visiting CYR and 467 (18%) of the men visiting MSHC reported sex with other men, with a median of 6 (SD 26.4) and 6 (SD 29.4) partners in the previous 12 months respectively (p=0.9). 43 (1.8%) of the women visiting CYR and 54 (2.1%) of the women visiting MSHC reported sex with other women, with a median of 1 (SD 9.3) and 1 (SD 2.1) partners in the previous 12 months respectively (p=0.5). Among men reporting sex with women only, the median number of female sex partners in the preceding 12 months was 2 (SD 10.6) and 3 (SD 5.8) for those visiting CYR and MSHC respectively (p=0.8). For women reporting sex with men only, the median number of male partners was 2 (SD 11.1) and 2 (SD 4) for those visiting CYR and MSHC respectively (p=0.03). Participants responded favourably to the CYR online service, with 70% rating it as 'useful'; or 'very useful'. Conclusions: This internet based sexual risk assessment tool was accessed frequently by individuals with a high risk profile that was similar to those who attended the sexual health service in the same city. The CYR service cost A$4000 to set up. CYR effectively increased the outreach of the centre's services substantially, via the internet and was given a positive rating by the majority of its users.