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Sexual Health - STI's, bacterial vaginosis, Chlamydia, Genital herpes, Gonorrhea. HIV/AIDS, Human papillomavirus, safer sex, syphilis, Trichomonas vaginitis, Birth Control

Herpes study putting poor women at risk

December 2006 Women's Health Watch

A study on valacyclovir, a herpes medication, was trialled on poor pregnant women in the US. The trial is to see if the drug can help prevent outbreaks of herpes simplex virus (HSV) while in labour. When HSV is present a caesarean delivery is generally preferred as HSV transmission to the baby during delivery can sometimes be fatal. The intervention group of 170 women received valacyclovir while the control group of 168 largely indigent women were given dummy pills. Despite the publication of a study midway through the trial that concluded giving women drug intervention could reduce the caesarean intervention rate, the trial continued putting women at risk by giving half of them placebos....Read More

Can lemons stop AIDS?

November 2005 Women's Health Update

An affordable widely obtainable prophylactic to prevent HIV infection? No not a condom, try a lemon. Dr. Roger Short of the University of Melbourne has been researching the potential of lemon juice for preventing HIV transmission. Lemon juice which has been used traditionally to avoid pregnancy has been shown to immobilize human sperm and kill HIV in the laboratory. Lemon juice maybe natures own microbicide - according to Dr. Short.

Lemon juice was once widely used in the Mediterranean as a contraceptive, and remains in use in parts of African and South East Asia as a disease preventative and contraceptive device. It is proposed that lemon or lime juice could be used as a natural microbicide by using the juice either as a douche (or wash) directly after sex or by using it directly in the vagina during sex. Approximately a teaspoon of lemon juice in a saturated cotton ball or sea sponge inserted into the vagina and removed after sex could be all that is needed. Laboratory experiments have shown that a 20% concentration of lemon juice inactivates 80% of HIV in as little as two minutes. ...Read More

Chlamydia Screening for New Zealand?

December 2006 Women's Health Watch

In response to calls from sexual health professionals for a national Chlamydia screening programme for New Zealand, the National Screening Unit released a surprise report in December.

Chlamydia is now the most common treatable sexually transmitted infection amongst young adults in New Zealand and the rates seem to be rising...The incidence appears to be increasing in New Zealand and growing attention has focused on a chlamydia "epidemic". However clear and reliable figures on the prevalence are hard to come by. Various studies have reported prevalence in New Zealand between 2 and 12%.

This discussion paper puts forth a robust argument for the introduction of a screening programme but does not recommend proceeding at this stage. The paper assesses the introduction of a screening programme against the eight screening assessment criteria developed by the National Health Committee. It concludes that chlamydia meets most of the criteria as it is a suitable candidate for screening, with a suitable test available; and an effective and accessible treatment for early intervention; evidence that early intervention is effective; testing and treatment is easy and has few physical or psychological harms; the social and ethical issues relate to inequalities of provision which are already present with opportunistic screening and treatment; and it is cost-effective - especially for young and/or pregnant women. The potential barriers to an effective screening are health system barriers - the chlamydia test is not yet standard in all laboratories and elements of the screening pathway need some attention. The discussion paper recommends that, instead of a screening programme, measures are introduced within current primary care structures to increase surveillance and early intervention....Read More

Chlamydia Screening for New Zealand?

January 2007 Women's Health Update

Brief article: In December the National Screening Unit produced a discussion paper on Chlamydia screening in New Zealand. The paper is in response to the fact that chlamydia is now the most common treatable sexually transmitted infection amongst young adults. Clear and reliable data on rates and incidence are not available in New Zealand but there is serious concern amongst Family Planning and Sexual Health clinics about the rising rates of infection amongst the youth population. Many of these organizations have called for the introduction of a formal chlamydia screening programme...Read More (pdf)

Chlamydia in New Zealand

September 2005 Women's Health Watch

The latest NZ Medical Journal summarises the studies and reports on the incidence of Chlamydia in New Zealand. It points out that most studies have been carried out on specific groups such as attendees at sexual health, university, student youth health and family planning clinics. Most of these studies have been done with women although a study of 200 asymptomatic male army recruits in 2001 showed a prevalence of 4%.
Despite changes in population groups and testing methods, it appears that rates are dropping but still remain reasonably high. An early study of 2034 attendees at the Christchurch Family Planning Clinic had a rate of 17.5%. Rates in a smaller population at the same clinic ten years later have dropped to around 6%. Rates vary with age and ethnicity. Younger women tend to have higher rates and the highest rates are found in Maori (12 -15.2%) and Pacific populations (12-18%) Much of the drop has been attributed to education and health promotion campaigns and aggressive opportunistic screening.
Chlamydia is asymptomatic but has serious health consequences such as neonatal conjunctivitis and pneumonia, pelvic inflammatory disease, infertility and ectopic pregnancy. Testing has got better and treatment "of a stat dose of two tablets of azithromycin could not be easier." says the article.
The author describes Chlamydia as the "problem that just wont go away" and suggests that a community prevalence study might be a timely way to help decide where to target both health promotion activity and screening.
Ref:The NZ Medical Journal. 12th August 2005, Vol 118. No 1220

Sex patches for women

May 2005 Women's Health Watch

Proctor & Gamble have come up with a testosterone patch (Intrinsa) for use in treating women's 'sexual dysfunction' - ie women deemed to have a low sex drive. As part of the process of seeking FDA approval for their new product the company submitted the results of two studies involving almost 1100 women who had had their ovaries and uterus removed for medical reasons. The women were taking oestrogen and were experiencing a problem with lack of desire for sex. One study found that, compared to women on placebo, women using Intrinsa experienced a 56% rise in sexual desire and a 74% rise in satisfying sexual encounters - working out to about one additional sexual episode per woman per month.
Fortunately, the FDA panel voted unanimously against approval for Intrinsa citing concerns about the safety of long-term use and its use by groups of women not yet adequately tested....Read More

Women and HIV/AIDs in New Zealand

September 2001 Women's Health Watch

  • A total of 45 women in New Zealand have been diagnosed with AIDS since 1986 (6 per cent of total cases)
  • Of these, 24 were European, 3 Maori, 4 Pacific, and 14 other ethnicities
  • 202 females (10 girls and 192 women) have been diagnosed with HIV infection since 1986 (14 per cent of total cases)
  • Of the 113 new cases of HIV in females since 1996, 19 were in European women, 5 Maori, 7 Pacific, and 70 other ethnicities
  • 70 per cent of females with new HIV infections were members of ethnic groups other than European, Maori and Pacific
  • Of the new HIV cases in women, 80 percent arose from heterosexual transmission, 4 were acquired before birth, 1 case arose from intravenous drug use, 1 from blood transfusion
  • 93 of the new cases of HIV infections in females were thought to be have been acquired overseas, with 51 acquired in Africa and 22 acquired in Asia
  • Of the 20 females whose infections occurred in NZ, 19 were infected by heterosexual means and 1 was infected perinatally
  • Seven of the women infected heterosexually in NZ had partners from high prevalence countries, while 7 had partners with other HIV risk factors
  • There is an increase in HIV among women with 32 per cent of HIV cases being in women in 2000.

These statistics are from AIDS- New Zealand Issue 48 August 2001

Sexual and reproductive health strategy

July 2001 Women's Health Update

A document outlining the overall strategic direction for sexual and reproductive health will be released by the Ministry of Health at the end of August. The strategy will include:

  • sexual and reproductive health services as a public health service
  • provision of a comprehensive free specialist sexual health service close to the community
  • sexually transmitted disease control to ensure that at-risk groups have access to effective education
  • disease control of HIV/AIDS as a sexually transmitted disease
  • an emphasis on effective and available services for Maori, Pacific and young people.
Ministry manager for Personal and Family Health Judy Glackin says the document will also outline a process for developing detailed action plans covering key areas of concern. Ms Glackin says the Ministry is putting a lot of effort into consulting across the health sector and a sector reference group with a broad representation has been set up to provide expert advice and assist with consultation.
Members are: Dr Pippa MacKay; Dr Rick Franklin ; Kevin Hague; Pania Ellison; Ingi Hayward; Fuimaono Karl Pulotu-Endemann; Olivia Tusa ; Alan Flemming; Gillian Tasker; Catherine Healey; Nigel Dickson; Gill Greer and Kitty Flannery.

So far the group has held three meetings. As part of the development of the strategy, the Ministry has embarked on a stocktake of existing services, a literature review of programme effectiveness for sexual health services and a summary of service evaluations undertaken within the previous five years.
A new Ministry appointee, who will lead the sexual health policy, is due to take up the position later this month.

Upsurge in chlamydia

January 2000 Women's Health Update

Sue Bagshaw looks at a recent Ministry of Health report, highlighting the high incidence of chlamydia amongst teenage girls living in the Waikato and Bay of Plenty.

The report, prepared by Environmental Science and Research, found that in the year ending June 1999, 3367 per 100,000 15 to 19-year-old girls in Waikato and Bay of Plenty were diagnosed with chlamydia. Women were three times more likely than men to be diagnosed with chlamydia.

The overall population-based incidence of chlamydia was 379 cases per 100,000, compared to Canada with 115 and USA with 322 cases per 100,000...Read More

Chlamydia screening

September 1998 Women's Health Watch

Sexually active teenage girls should be screened every six months for Chlamydia trachomatis infection, according a US study.

A team from the Johns Hopkins University studied 3200 sexually active girls aged 12-19 years and found that overall nearly 30% of the girls had at least one positive test result. Chlamydial infection was found in 24% of first visits and 14% of repeat visits, with very few of the girls experiencing any symptoms.

The researchers recommended testing every six months because most teenagers become infected or re-infected in about six months.  They say younger girls are at greater risk of infection because of the immaturity of the cervix and lack of knowledge about preventing Chlamydia infections.

Screening adolescent boys is just as important as screening girls because male partners often won't believe they're infected and don't get treated, according to the researchers.
Ref: BMJ 1998; 317:432

Subsidy for new chlamydia treatment

November 1998 Women's Health Update

Pharmac has agreed to fully subsidise azithromycin, a one-dose cure for chlamydia, even though it is more expensive than other subsidised treatments. It is hoped that more cures will result from the one-dose treatment, as treatment with the alternative doxycycline requires twice daily treatment for a week. Chlamydia has potentially serious effects, such as infertility and chronic pelvic inflammatory disease.

New test for chlamydia

November 1998 Women's Health Update

A new test for chlamydia promises more accuracy in detecting this maiming infection, but it is expensive. Sue Bagshaw discusses how the test might be used.

Infection with chlamydia trachomatis is one of the commonest sexually trans-mitted diseases. It can infect the urethra in both men and women, as well as the cervix and the epididymal tubes in the testis. It is easily treated with antibiotics but because there are often very few symptoms, if any, the infection often goes untreated. The result is scarring, which can lead to difficulty conceiving or complete infertility.

A new test has been developed using molecular biology which can detect chlamydia and other infections. It is expensive but more and more studies are showing that it is much more sensitive than existing tests. In recent studies in both Auckland and Christchurch, the new LCR (Ligase Chain Reaction) Test has been able to double the detection rate of chlamydia. Among the 812 people in the Christchurch study, 3% were found to have chlamydia using the routinely used test. Using the LCR test the incidence was 6%...Read More

Teens targeted in free campaign

January 1998 Women's Health Update

Eye-catching postcards on display in cafes throughout Auckland and Northland announce new free sexual health services for young people.

North Health has funded the Family Planning Association to provide the new programme to the tune of $300,000 as part of the Sexual and Reproductive Health Strategy announced by Jenny Shipley when Minister of Health in 1996.

The new service gives under-20-year-olds free sexual health consultations at Family Planning Association clinics and for those aged 20 to 24 the first visit is free. Women of any age who have had a termination of pregnancy can have free visits for a year.

As well as the free postcards and posters, an advertising campaign run through cinemas and on the backs of buses informs young people about the scheme. Clients can ring an 0800 FAM PLAN line which diverts callers to one of twelve centres or six outreach clinics provided by FPA in the Auckland and Northland regions. These facilities offer a wide range of opening times with after hours emergency service....Read More

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