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Bradshaw C, Murray G, Vodstrcil L, Garland S, Plummer E, Tan A, Twin J, Law M, Hocking J, Bulach D, Phillips G, Fairley C, Tabrizi S. P2.08 Microbiological factors that contribute to the development of bacterial vaginosis:a longitudinal study. Clin Sci (Lond) 2017. [DOI: 10.1136/sextrans-2017-053264.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bilardi J, Walker S, Temple-Smith M, Mcnair R, Mooney-Somers J, Vodstrcil L, Bellhouse C, Fairley C, Bradshaw C. Women View Key Sexual Behaviours As the Trigger for the Onset and Recurrence of Bacterial Vaginosis. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.04.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chow E, Priest D, Walker S, Cornelisse V, Chen M, Bradshaw C, Phillips T, Fairley C. Kissing Is Association With the Source for Meeting Casual Partners in Men Who Have Sex With Men. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.04.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Chow E, Chen M, Bradshaw C, Fairley C. Vaccinating Against Human Papillomavirus Is not Associated With Risky Sexual Behaviours Among Men Who Have Sex With Men. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.04.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Konovalenko L, Bradshaw C, Andersson E, Kautsky U. Application of an ecosystem model to evaluate the importance of different processes and food web structure for transfer of 13 elements in a shallow lake. JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2017; 169-170:85-97. [PMID: 28110115 DOI: 10.1016/j.jenvrad.2016.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 12/25/2016] [Accepted: 12/29/2016] [Indexed: 06/06/2023]
Abstract
In environmental risk assessments of nuclear waste, there is need to estimate the potential risks of a large number of radionuclides over a long time period during which the environment is likely to change. Usually concentration ratios (CRs) are used to calculate the activity concentrations in organisms. However, CRs are not available for all radionuclides and they are not easily scalable to the varying environment. Here, an ecosystem transport model of elements, which estimates concentrations in organisms using carbon flows and food transfer instead of CR is presented. It is a stochastic compartment model developed for Lake Eckarfjärden at Forsmark in Sweden. The model was based on available data on carbon circulation, physical and biological processes from the site and identifies 11 functional groups of organisms. The ecosystem model was used to estimate the environmental transfer of 13 elements (Al, Ca, Cd, Cl, Cs, I, Ni, Nb, Pb, Se, Sr, Th, U) to various aquatic organisms, using element-specific distribution coefficients for suspended particles (Kd PM) and upper sediment (Kd sed), and subsequent transfer in the foodweb. The modelled CRs for different organism groups were compared with measured CRs from the lake and literature data, and showed good agreement for many elements and organisms, particularly for lower trophic levels. The model is, therefore, proposed as an alternative to measured CR, though it is suggested to further explore active uptake, assimilation and elimination processes to get better correspondence for some of the elements. The benthic organisms (i.e. bacteria, microphytobenthos and macroalgae) were identified as more important than pelagic organisms for transfer of elements to top predators. The element transfer model revealed that most of the radionuclides were channelled through the microbial loop, despite the fact that macroalgae dominated the carbon fluxes in this lake. Thus, element-specific adsorption of elements to the surface of aquatic species, that may be food sources for organisms at higher trophic levels, needs to be considered in combination with generic processes described by carbon fluxes.
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Lau A, Kong F, Fairley CK, Donovan B, Chen M, Bradshaw C, Boyd M, Amin J, Timms P, Tabrizi S, Regan DG, Lewis DA, McNulty A, Hocking JS. Treatment efficacy of azithromycin 1 g single dose versus doxycycline 100 mg twice daily for 7 days for the treatment of rectal chlamydia among men who have sex with men - a double-blind randomised controlled trial protocol. BMC Infect Dis 2017; 17:35. [PMID: 28061753 PMCID: PMC5217553 DOI: 10.1186/s12879-016-2125-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 12/14/2016] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Rectal infection with Chlamydia trachomatis is one of the most common bacterial sexually transmissible infections among men who have sex with men (MSM) with diagnosis rates continuing to rise. Current treatment guidelines recommend either azithromycin 1 g single dose or doxycycline 100 mg twice daily for 7 days. However, there are increasing concerns about treatment failure with azithromycin. We are conducting the first randomised controlled trial (RCT) to compare treatment efficacy of azithromycin versus doxycycline for the treatment of rectal chlamydia in MSM. METHODS/DESIGN The Rectal Treatment Study will recruit 700 MSM attending Australian sexual health clinics for the treatment of rectal chlamydia. Participants will be asked to provide rectal swabs and will be randomised to either azithromycin 1 g single dose or doxycycline 100 mg twice daily for 7 days. Participants will be asked to complete questionnaires about adverse drug reactions, sexual behaviour and drug adherence via short message service and online survey. The primary outcome is the treatment efficacy as determined by a negative chlamydia nucleic acid amplification test at 4 weeks post treatment. Secondary outcomes will utilise whole genome sequencing and mRNA assay to differentiate between treatment failure, reinfection or false positive results. DISCUSSION Rectal chlamydia is an increasing public health concern as use of pre-exposure prophylaxis against HIV becomes commonplace. Optimal, evidence-based treatment is critical to halting ongoing transmission. This study will provide the first RCT evidence comparing azithromycin and doxycycline for the treatment of rectal chlamydia. The results of this trial will establish which treatment is more efficacious and inform international management guidelines. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12614001125617.
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Read T, Bradshaw C. Managing Mycoplasma genitalium infections during a rapid upsurge in antibiotic resistance. MLO: MEDICAL LABORATORY OBSERVER 2016; 48:28-30. [PMID: 30047665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Konovalenko L, Bradshaw C, Andersson E, Lindqvist D, Kautsky U. Evaluation of factors influencing accumulation of stable Sr and Cs in lake and coastal fish. JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2016; 160:64-79. [PMID: 27153476 DOI: 10.1016/j.jenvrad.2016.04.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 04/06/2016] [Accepted: 04/18/2016] [Indexed: 06/05/2023]
Abstract
As a result of nuclear accidents and weapons tests, the radionuclides Cs-137 and Sr-90 are common contaminants in aquatic ecosystems. Concentration ratios (CR) based on concentrations of stable Cs and Sr in biota and media are used for the estimation of transfer of their radioisotopes for radiation dose calculations in environmental and human safety assessments. Available element-specific CRs vary by over an order of magnitude for similar organisms, thus affecting the dose estimates proportionally. The variation could be reduced if they were based on a better understanding of the influence of the underlying data and how that affects accumulation and potential biomagnification of stable Cs and Sr in aquatic organisms. For fish, relationships have been identified between water concentrations of K and CR of Cs-137, and between water concentrations of Ca and CR of Sr-90. This has not been confirmed for stable Cs and Sr in European waters. In this study, we analysed an existing dataset for stable Cs and Sr, as well as K and Ca, in four Swedish lakes and three Baltic Sea coastal areas, in order to understand the behaviour of these elements and their radioisotopes in these ecosystems. We found significant seasonal variations in the water concentrations of Cs, Sr, K and Ca, and in electrical conductivity (EC), especially in the lakes. CR values based on measurements taken at single or few time points may, therefore, be inaccurate or introduce unnecessarily large variation into risk assessments. Instead, we recommend incorporating information about the underlying variation in water concentrations into the CR calculations, for example by using the variation of the mean. The inverse relationships between fish CR(Cs)-[K]water and fish CR(Sr)-[Ca]water, confirmed that stable Cs and Sr follow the same trends as their radioisotopes. Thus, they can be used as proxies when radioisotope data are lacking. EC was also strongly correlated with K and Ca concentrations in the water and could potentially be used as a quick and cost-effective method to estimate water chemistry to obtain less variable CR. We also recommend some simple improvements to data collection that would greatly enhance our ability to understand Cs and Sr uptake by fish.
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Sunderland T, Tan LY, Walker S, Su J, Bradshaw C, Fairley C, Garland S, Mokany E, Tabrizi S. O033 A qPCR assay that simultaneously detects Mycoplasma genitaliumand mutations associated with macrolide resistance has the potential to improve patient management. Br J Vener Dis 2016. [DOI: 10.1136/sextrans-2016-052718.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chow E, Howden B, Stevens K, Walker S, Lee D, Snow A, Cook S, Fehler G, Bradshaw C, Chen M, Fairley C. O004 Inhibitory effect of an antiseptic mouthwash against Neisseria gonorrhoeaein the pharynx (GONE) among men who have sex with men: a randomised control trial. Br J Vener Dis 2016. [DOI: 10.1136/sextrans-2016-052718.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bilardi J, Walker S, Mooney-Somers J, McNair R, Temple-Smith M, Bellhouse C, Fairley C, Chen M, Bradshaw C. P088 Sexual contact is the trigger! Women’s views and experiences of the triggers for the onset of bacterial vaginosis and exacerbating factors associated with recurrence. Br J Vener Dis 2016. [DOI: 10.1136/sextrans-2016-052718.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chow E, Machalek D, Tabrizi S, Danielewski J, Fehler G, Bradshaw C, Garland S, Chen M, Fairley C, Walker S. O027 Rapid fall in quadrivalent vaccine targeted human papillomavirus genotypes in heterosexual men following the Australian female HPV vaccination programme: an observational study from 2004 to 2015. Br J Vener Dis 2016. [DOI: 10.1136/sextrans-2016-052718.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Cornelisse V, Sherman C, Zhang L, Chen M, Bradshaw C, Bellhouse C, Fairley C, Chow E. P096 Concordance of chlamydia infections of the rectum and urethra in same-sex male partnerships: A cross-sectional analysis: Abstract P096 Table 1. Br J Vener Dis 2016. [DOI: 10.1136/sextrans-2016-052718.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ong J, Morton A, Henzel H, Berzins K, Druce J, Fairley C, Bradshaw C, Hocking J, Chen M. P024 Clinical characteristics of herpes simplex virus urethritis compaerd with chlamydia urethritis among men: a case control study. Br J Vener Dis 2016. [DOI: 10.1136/sextrans-2016-052718.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chow E, Tabrizi S, Phillips S, Lee D, Bradshaw C, Chen M, Fairley C. P089 Detection of Neisseria gonorrhoeaebacterial loads in the pharynx and saliva among men who have sex with men. Br J Vener Dis 2016. [DOI: 10.1136/sextrans-2016-052718.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bellhouse C, Walker S, Fairley C, Vodstrcil L, Bradshaw C, Chen M, Chow E. P149 Patterns of sexual behaviour among transgender individuals in Melbourne, Australia 2011–2014. Br J Vener Dis 2016. [DOI: 10.1136/sextrans-2016-052718.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chow E, Read T, Law M, Chen M, Bradshaw C, Fairley C. P090 Assortative sexual mixing patterns in male-female and male-male partnerships in Melbourne, Australia: implications for HIV and STI transmission. Br J Vener Dis 2016. [DOI: 10.1136/sextrans-2016-052718.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Cornelisse V, Fairley C, Walker S, Young T, Lee D, Chen M, Bradshaw C, Chow E. P098 Adherence to and acceptability of mouthwash as a potential preventive intervention for pharyngeal gonorrhoea among men who have sex with men in Australia – an observational study. Br J Vener Dis 2016. [DOI: 10.1136/sextrans-2016-052718.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bilardi J, Walker S, McNair R, Mooney-Somers J, Temple-Smith M, Bellhouse C, Fairley C, Chen M, Bradshaw C. Women's Management of Recurrent Bacterial Vaginosis and Experiences of Clinical Care: A Qualitative Study. PLoS One 2016; 11:e0151794. [PMID: 27010725 PMCID: PMC4807032 DOI: 10.1371/journal.pone.0151794] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 02/17/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Few data are available on how women manage recurring bacterial vaginosis (BV) and their experiences of the clinical care of this condition. This study aimed to explore women's recurrent BV management approaches and clinical care experiences, with a view to informing and improving the clinical management of BV. METHODS A descriptive, social constructionist approach was chosen as the framework for the study. Thirty-five women of varying sexual orientation who had experienced recurrent BV in the past 5 years took part in semi-structured interviews. RESULTS The majority of women reported frustration and dissatisfaction with current treatment regimens and low levels of satisfaction with the clinical management of BV. Overall, women disliked taking antibiotics regularly, commonly experienced adverse side effects from treatment and felt frustrated at having symptoms recur quite quickly after treatment. Issues in clinical care included inconsistency in advice, misdiagnosis and inappropriate diagnostic approaches and insensitive or dismissive attitudes. Women were more inclined to report positive clinical experiences with sexual health physicians than primary care providers. Women's frustrations led most to try their own self-help remedies and lifestyle modifications in an attempt to treat symptoms and prevent recurrences, including well-known risk practices such as douching. CONCLUSION In the face of considerable uncertainty about the cause of BV, high rates of recurrence, unacceptable treatment options and often insensitive and inconsistent clinical management, women are trying their own self-help remedies and lifestyle modifications to prevent recurrences, often with little effect. Clinical management of BV could be improved through the use of standardised diagnostic approaches, increased sensitivity and understanding of the impact of BV, and the provision of evidence based advice about known BV related risk factors.
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Bilardi J, Walker S, Mooney-Somers J, Temple-Smith M, McNair R, Bellhouse C, Fairley C, Chen M, Bradshaw C. Women's Views and Experiences of the Triggers for Onset of Bacterial Vaginosis and Exacerbating Factors Associated with Recurrence. PLoS One 2016; 11:e0150272. [PMID: 26930414 PMCID: PMC4773144 DOI: 10.1371/journal.pone.0150272] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 02/11/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Bacterial vaginosis (BV) is the most common vaginal infection affecting women of childbearing age. While the aetiology and transmissibility of BV remain unclear, there is strong evidence to suggest an association between BV and sexual activity. This study explored women's views and experiences of the triggers for BV onset and factors associated with recurrence. METHODS A descriptive, social constructionist approach was chosen as the framework for the study. Thirty five women of varying sexual orientation who had experienced recurrent BV in the past five years took part in semi-structured interviews. RESULTS The majority of women predominantly reported sexual contact triggered the onset of BV and sexual and non-sexual factors precipitated recurrence. Recurrence was most commonly referred to in terms of a 'flare-up' of symptoms. The majority of women did not think BV was a sexually transmitted infection however many reported being informed this by their clinician. Single women who attributed BV onset to sex with casual partners were most likely to display self-blame tendencies and to consider changing their future sexual behaviour. Women who have sex with women (WSW) were more inclined to believe their partner was responsible for the transmission of or reinfection with BV and seek partner treatment or change their sexual practices. CONCLUSION Findings from this study strongly suggest women believe that BV onset is associated with sexual activity, concurring with epidemiological data which increasingly suggest BV may be sexually transmitted. Exacerbating factors associated with recurrence were largely heterogeneous and may reflect the fact it is difficult to determine whether recurrence is due to persistent BV or a new infection in women. There was however evidence to suggest possible transmission and reinfection among WSW, reinforcing the need for new approaches to treatment and management strategies including male and female partner treatment trials.
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Ong JJ, Grulich A, Walker S, Hoy J, Read T, Bradshaw C, Garland SM, Hillman R, Templeton D, Hocking J, Eu B, Tee BK, Fairley CK. Baseline findings from the Anal Cancer Examination (ACE) study: screening using digital ano-rectal examination in HIV-positive men who have sex with men. J Med Screen 2015; 23:70-6. [PMID: 26462726 DOI: 10.1177/0969141315604658] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 08/10/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Cytological screening for anal cancer precursors is not always possible. We investigated digital ano-rectal examination (DARE) as a means of early anal cancer detection in HIV-positive men who have sex with men (MSM). METHODS We recruited 327 HIV-positive MSM aged 35 and over from clinics with HIV physicians in Melbourne, Australia, to receive an annual DARE. We analyzed baseline data from patient questionnaires regarding general, anal and sexual health, adverse effects from the anal examination, cancer worry, and quality of life. RESULTS The majority of men (82%, 95% CI:78-87) felt relaxed during the DARE, 1% (95% CI:0-3) complained of pain, and 1% (95% CI:0-4) reported bleeding after the examination. Nearly all men (99%, 95% CI:96-100) were willing to continue with an annual DARE. Quality of life was unaffected with utility scores of 0.76 before examination vs. 0.77 two weeks after examination, (p = 0.41). An anal abnormality was detected in 86 men (27%, 95% CI:22-31), with one anal cancer identified. The specialist referral rate following DARE was 5% (95% CI:3-8). Recruitment rates were significantly associated with the clinic setting (sexual health centre 78%, general practice 13%, hospital 14%, p = 0.002) and specialty (sexual health physician 67%, general practitioner 20%, infectious disease physician 14%, p = 0.031). CONCLUSION Annual DARE to detect anal cancer in HIV-positive MSM was acceptable for patients, with minimal side effects. Strategies to increase HIV physician's patient recruitment would be needed if DARE were to be implemented in anal cancer screening.
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Hocking JS, Vodstrcil L, Huston W, Timms P, Chen M, Bradshaw C, Worthington K, Lawrence A, McIver R, Phillips S, Tabrizi SN. O15.4 Azithromycin treatment failure in women infected with genital chlamydia infection. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ong J, Fairley CK, Carroll S, Walker S, Chen M, Read T, Bradshaw C, Grulich A, Kaldor J, Clarke P. P10.05 Cost-effectiveness of screening for anal cancer using regular digital ano-rectal examinations in hiv-positive men who have sex with men. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Zou H, Tabrizi S, Grulich A, Hocking J, Garland S, Bradshaw C, Fairley C, Chen M. P10.11 Serum antibody responses following anal and penile infection with human papillomavirus in teenage men who have sex with men. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bilardi J, Walker S, Temple-Smith M, McNair R, Mooney-Somers J, Bellhouse C, Fairley C, Chen M, Bradshaw C. P14.05 Sexual contact is the trigger! women’s views and experience of the causes and triggers of bacterial vaginosis. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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