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British Medical Journal & Medical
Journal of Australia Nov 2015 - Mar
2016
BMJ - Impact factor of 17.4 (June 2015) and is ...
BMJ November 2015 - News
• India’s HIV prevention programme is running
out of condoms, Sophie Cousins
BMJ 2015 (Published ...
BMJ November 2015 - News
• HIV pre-exposure prophylaxis could help 1.2
million in US, Michael McCarthy
BMJ 2015 (Published...
Jacqui Wise BMJ 2015;351:bmj.h6419
©2015 by British Medical Journal Publishing Group
New cases of HIV in Europe reach high...
Countries in the EU and EEA
The European Union (EU) is an economic and political union of 28 countries.
It operates an int...
BMJ December 2015 - News
• Mobile dating apps could be driving HIV
epidemic among adolescents in Asia Pacific,
report says...
BMJ January 2016 - Research
• Patient choice in opt-in, active choice, and
opt-out HIV screening: randomized clinical
tria...
Fig 2 HIV test acceptance percentage by risk of infection: unadjusted results.
Juan Carlos C Montoy et al. BMJ 2016;352:bm...
BMJ March 2016 - Feature
• How Cuba eliminated mother-to-child
transmission of HIV and syphilis, Jeanne
Lenzer
BMJ 2016; 3...
MJA February 2016 - Research
• A survey of Sydney general practitioners’ management of
patients with chronic hepatitis B
Z...
A survey of Sydney general practitioners’
management of patients with chronic hepatitis B
• In NSW SLHD and SWSLHD highest...
MJA March 2016 – Short Report
• HPV vaccine impact in Australian women: ready for an HPV-
based screening program
Julia ML...
MJA March 2016 - Research
• Impact of HPV sample self-collection for underscreened
women in the renewed Cervical Screening...
Impact of HPV sample self-collection for underscreened
women in the renewed Cervical Screening Program
• Single round of H...
Socio-demographic and structural barriers to being tested for
chlamydia in general practice Andrew Lau, Simone Spark, et a...
Socio-demographic and structural barriers to
being tested for chlamydia in general practice
Methods
•All CT test requests ...
Socio-demographic and structural barriers to
being tested for chlamydia in general practice
Results
•Overall annual testin...
Socio-demographic and structural barriers to
being tested for chlamydia in general practice
• 2545 no test (19.2%, CI 16.5...
Socio-demographic and structural barriers to
being tested for chlamydia in general practice
Discussion
•1 in 5 young peopl...
Finally
• The author’s acknowledged there were a number of
limitations
why test was ordered?
mostly rural settings, genera...
SSHC Journal Club presentation on the British Medical Journal and the Medical Journal of Australia Nov 2015 - Mar 2016
SSHC Journal Club presentation on the British Medical Journal and the Medical Journal of Australia Nov 2015 - Mar 2016
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SSHC Journal Club presentation on the British Medical Journal and the Medical Journal of Australia Nov 2015 - Mar 2016

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Sydney Sexual Health Centre Journal Club presentation by Cherie Desreaux on the British Medical Journal and the Medical Journal of Australia editions published between November 2015 and March 2016.

The Sydney Sexual Health Centre Journal Club allows our team to stay up-to-date with what is being published in the field of sexual health. Staff members take turns to read, review and share the contents of an allocated journal. Journal Club encourages knowledge sharing and discussion about topics raised.

Veröffentlicht in: Gesundheit & Medizin
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SSHC Journal Club presentation on the British Medical Journal and the Medical Journal of Australia Nov 2015 - Mar 2016

  1. 1. British Medical Journal & Medical Journal of Australia Nov 2015 - Mar 2016 BMJ - Impact factor of 17.4 (June 2015) and is ranked fifth among general medical journals. 4 or 5 editions a month each year. MJA - Australia’s leading peer-reviewed general medical journal. It has been delivering ground- breaking research to the medical community since 1914
  2. 2. BMJ November 2015 - News • India’s HIV prevention programme is running out of condoms, Sophie Cousins BMJ 2015 (Published 10 November 2015) Cite this as: BMJ 2015;351:h6066 • Incidence of sexually transmitted infections jumps in US, CDC reports, Michael McCarthy BMJ 2015 (Published 19 November 2015) Cite this as: BMJ 2015;351:h6263
  3. 3. BMJ November 2015 - News • HIV pre-exposure prophylaxis could help 1.2 million in US, Michael McCarthy BMJ 2015 (Published 25 November 2015) Cite this as: BMJ 2015;351:h6384
  4. 4. Jacqui Wise BMJ 2015;351:bmj.h6419 ©2015 by British Medical Journal Publishing Group New cases of HIV in Europe reach highest level since 1980s, Jacqui Wise BMJ 2015;351:h6419
  5. 5. Countries in the EU and EEA The European Union (EU) is an economic and political union of 28 countries. It operates an internal (or single) market which allows free movement of goods, capital, services and people between member states. EU countries The EU countries are: Austria, Belgium, Bulgaria, Croatia, Republic of Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and the UK. The European Economic Area (EEA) The EEA includes EU countries and also Iceland, Liechtenstein and Norway. It allows them to be part of the EU’s single market. Switzerland is neither an EU nor EEA member but is part of the single market - this means Swiss nationals have the same rights to live and work in the UK as other EEA nationals.
  6. 6. BMJ December 2015 - News • Mobile dating apps could be driving HIV epidemic among adolescents in Asia Pacific, report says, Jocalyn Clark BMJ 2015(Published 02 December 2015) Cite this as: BMJ 2015;351:h6493 • US lifts 30 year ban and allows some gay men to donate blood, Michael McCarthy BMJ 2015(Published 23 December 2015) Cite this as: BMJ 2015;351:h6982
  7. 7. BMJ January 2016 - Research • Patient choice in opt-in, active choice, and opt-out HIV screening: randomized clinical trial, Juan Carlos C Montoy, resident1, William H Dow, professor2, Beth C Kaplan, professor3 BMJ 2016; (Published 19 January 2016) Cite this as: BMJ 2016;352:h6895 • 2006 CDC HIV Testing Guidelines : Opt-out testing • ED well placed to identify est. 20% undiagnosed HIV • RCT in urban teaching hospital and regional trauma centre ED • Opt-in, opt-out and active choice
  8. 8. Fig 2 HIV test acceptance percentage by risk of infection: unadjusted results. Juan Carlos C Montoy et al. BMJ 2016;352:bmj.h6895 ©2016 by British Medical Journal Publishing Group
  9. 9. BMJ March 2016 - Feature • How Cuba eliminated mother-to-child transmission of HIV and syphilis, Jeanne Lenzer BMJ 2016; 352 doi: http://dx.doi.org/10.1136/bmj.i1619 (Published 21 March 2016) Cite this as: BMJ 2016;352:i1619 • WHO announced Cuba to be first to virtually eliminate MTC transmission HIV and syphilis • <50 cases per 100 000 live births • 2013 2 babies HIV and 3 babies syphilis • ARVs versus public health initiatives
  10. 10. MJA February 2016 - Research • A survey of Sydney general practitioners’ management of patients with chronic hepatitis B Zeina Najjar, Leena Gupta, Janice Pritchard-Jones, Simone I Strasser, Miriam T Levy, Siaw-Teng Liaw and Benjamin C Cowie Med J Aust 2016; 204 (2): 74. • Estimated 218 000 living with CHB • 44% undiagnosed • 2 – 13 % receiving adequate treatment • Annual number of deaths from CHB expected to rise - 450 in 2008 to 1550 in 2017 • Objective – examine GP methods of assessment and management CHB
  11. 11. A survey of Sydney general practitioners’ management of patients with chronic hepatitis B • In NSW SLHD and SWSLHD highest prevalence of CHB • GPs identified via PHU notifications 2012 – 2013 • Survey posted to 218 GPs, 58% responded • 79% GPs expressed “reasonable” confidence at managing CHB • The greater the number of patients cared for with CHB • The greater the confidence • Liver specialist input preferred model of care • Dependence remains a barrier • Increased GP support programs needed.
  12. 12. MJA March 2016 – Short Report • HPV vaccine impact in Australian women: ready for an HPV- based screening program Julia ML Brotherton, Dorota M Gertig, Cathryn May, Genevieve Chappell and Marion Saville Med J Aust 2016; 204 (5): 184. • 2017 Australia moving to HPV DNA testing • HPV screening to commence at 25 • Possible due to HPV vaccination • Prevalence in young women dramatic decline
  13. 13. MJA March 2016 - Research • Impact of HPV sample self-collection for underscreened women in the renewed Cervical Screening Program Megan Smith, Jie Bin Lew, Kate Simms and Karen Canfell Med J Aust 2016; 204 (5): 194. • 2017 National screening program moves to 5-yearly primary HPV screening • Outcome measures were how many cancer diagnoses and deaths would be averted. • Dynamic model of HPV transmission and vaccination • Cohort model of HPV natural history and cervical screening • 3 choices for unscreened women
  14. 14. Impact of HPV sample self-collection for underscreened women in the renewed Cervical Screening Program • Single round of HPV testing on a self-collected sample • Single round of HPV testing on a clinician-collected sample • Joining the mainstream screening program (5-yearly) • The comparator – remaining unscreened • Age 30 and one self-collected sample estimated 908/100 000 cancer diagnoses averted, NNT 5.8 • Age 30 and joined the mainstream program diagnoses averted would more than double 2002/100 000, NNT 4.9 • Previously unscreened women to be encouraged to join
  15. 15. Socio-demographic and structural barriers to being tested for chlamydia in general practice Andrew Lau, Simone Spark, et al Med J Aust 2016; 204 (3): 112. Objectives To investigate socio-demographic and structural factors associated with not providing a specimen for chlamydia testing following a request by a general practitioner Design, setting and participants: Cross-sectional analysis of chlamydia testing data for men and women aged 16–29 years attending general practice clinics participating in a cluster randomised controlled trial evaluating the effectiveness of a chlamydia testing intervention (ACCEPt). Data extrapolated for the study period the 2013 calendar year. Outcome: The proportion of chlamydia test requests for which the patient did not provide a specimen for testing.
  16. 16. Socio-demographic and structural barriers to being tested for chlamydia in general practice Methods •All CT test requests from 1 January – 31 December 2013 •Factors associated with “no test performed” outcome explored using logistic regression •Univariate ORs, multivariate ORs, and 95% CI were calculated •Intervention arm of the ACCEPt study only used for this analysis •Total of 63 intervention clinics
  17. 17. Socio-demographic and structural barriers to being tested for chlamydia in general practice Results •Overall annual testing rate 19.2% (CI 16.8-21.8%) •13 225 CT tests requested •73% were for women •29% were for 16-19 year olds •21% requested at Melbourne clinics •55% at inner regional clinics •22% at outer regional settings •2% in remote settings •31% were bulk-billing & 92% onsite specimen collection
  18. 18. Socio-demographic and structural barriers to being tested for chlamydia in general practice • 2545 no test (19.2%, CI 16.5-22.3%) • Univariate analysis, most likely to not have test if: – Male – 16 – 19 years old – Greater socio-economic disadvantage area Multivariate analysis also found – No onsite specimen collection No association with “No Test” – geographic location, bulk-billing or ATSI
  19. 19. Socio-demographic and structural barriers to being tested for chlamydia in general practice Discussion •1 in 5 young people •Men and 16-19 year olds •Living in areas of greater socio-economic disadvantage •Attending clinics with no onsite specimen collection (likelihood of no test 40% greater in this group) All predictors for not providing a specimen for CT testing Important fact Younger age and socio-economic disadvantage risk factors for CT infection.
  20. 20. Finally • The author’s acknowledged there were a number of limitations why test was ordered? mostly rural settings, generalisable?? unable to look at clinic specifics patient symptomatic/asymptomatic • Strengths Large sample Considered area, clinic, and patient level factors

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