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
- Make recommendations regarding allocation of resources (in reducing and preventing STIs among gay men)
- South Eastern Sydney Local Health District(Sydney Sexual Health Centre, The Albion Centre, HARP Unit, Public Health Unit)
- Sydney Local Health District (RPA Sexual Health, HARP Health Promotion, Public Health Unit)
- Northern Sydney Local Health District (Clinic 16, HARP Unit, Public Health Unit)
- ACON (AIDS Council of NSW)
- Positive Life NSW
- Centre for Social Research in Health
- Kirby Institute
- NSW Ministry of Health
- Central and Eastern Sydney PHN
- Sydney North Primary Health Network
- Australian Federation of AIDS Organisations (AFAO)
- Australasian Society for HIV, Viral Hepatitis, and Sexual Health Medicine (ASHM)
Prior to 2000 there had been outbreaks of syphilis amongst gay men in Manchester and Brighton in the UK, Southern California & Seattle in the USA, and Amsterdam in the Netherlands. Syphilis had been well controlled and uncommon in these countries before this time. During 2000, Sydney Sexual Health Centre (SSHC), Sydney Hospital was concerned that an outbreak may be replicated in Sydney’s gay community. 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 among gay men.
SSHC began work with the South East Sydney Area Health Service (SESAHS) PHU (now called the South Eastern Sydney Local Health District PHU) to ensure that new cases were being correctly identified. The NSW HIV GP study group members and 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 a potential syphilis increase, what tests to do and their responsibilities around notification.
Along with other NSW PHUs the SESAHS PHU began enhanced surveillance of positive syphilis serology by calling or writing to testing/notifying doctors to define the clinical stage of syphilis disease.
STIs in Gay Men Action Group is formed
Once the groundwork for strengthened syphilis surveillance was complete, this early partnership was expanded to include other organisations and cover other STIs in gay men. Health promotion work over the prior 5 years had focussed on outbreak responses to single STIs (particularly hepatitis A, gonorrhoea and shigella). For example, there had been an inner city cross-Area Health Service committee when managing a Hepatitis A outbreak.
These efforts had produced some short term outcomes but had not always produced sustained strategies to reduce the background prevalence of these diseases. Similarly, while there had been efforts to raise the health literacy of gay men, there was little focus on health seeking behaviours, like the regularity of STI testing for gay men.
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.
The member organisations then were:
- General Practitioners (GP S100 Prescriber, Eastern Sydney Division of General Practice)
- National Centres for HIV epidemiology and Clinical Research (NCHECR) and Social Research (NCHSR)
From (former) South East Sydney Area Health Service (SESAHS):
- Sydney Sexual Health Centre
- HIV/AIDS & Related Diseases Unit
- St George Hospital Sexual Health Service (Short Street Clinic)
From (former) Central Sydney Area Health Service (CSAHS):
- Sexual Health Promotion
- Livingstone Road Sexual Health Centre