Papers by Hennie Williams
International Journal of Environmental Research and Public Health, Mar 25, 2022
Culture, Health & Sexuality
Oxford Handbook of Tropical Medicine 5e
Why are sexually-transmitted infections important??, Syndromic management of sexually-transmitted... more Why are sexually-transmitted infections important??, Syndromic management of sexually-transmitted infections?, Syphilis?, Gonorrhoea?, Chlamydial infections?, Chancroid?, Granuloma inguinale donovanosis?, Trichomoniasis?, Bacterial vaginosis?, Genital herpes?, Candida vaginitis?, Human papillomavirus and genital warts?
Sexual Health
Background During 2020, the State of Victoria (Australia) experienced two COVID-19 waves. Both re... more Background During 2020, the State of Victoria (Australia) experienced two COVID-19 waves. Both resulted in community lockdowns followed by eased restrictions. We examined variation of sexual behaviour in Victorians over time during COVID-19. Methods We conducted a repeated online survey at four timepoints corresponding with two lockdown (LD1, LD2) and two reduced restriction (RR1, RR2) periods in Victoria. A convenience sample of participants aged ≥18 years was recruited via social media and asked about their recent (past 4 weeks) sexual behaviour. Using multivariable logistic regression, we investigated variation in sexual behaviour between surveys. Results A total of 1828 surveys were completed; 72% identified as female, 69% were aged 18–29 years, 90% were metropolitan residents. The proportion reporting recent partnered sex ranged from 54.9% (LD2) to 70.2% (RR1). Across all timepoints, the most common sexual partners were regular (81.5%, n = 842) and 10.8% (n = 111) reported casu...
Adolescents and Sex - The Handbook for Professionals Working With Young People, 2018
Poster presentations, 2021
Background The residents of Victoria (Australia’s second most populous state), were subject to a ... more Background The residents of Victoria (Australia’s second most populous state), were subject to a hard lockdown for several months as they experienced a second wave of COVID-19. Victorians could only leave their homes for essential activities, were required to wear facemasks, remain within 5km of their homes and were subject to a nightly curfew. Elsewhere in Australia, COVID numbers remained low with no lockdown in place. We examined the impact of the lockdown on the sexual behaviour of Victorians compared with elsewhere in Australia. Methods Our online survey was open for 2.5 weeks during the lockdown (August 13th to 31st). Participants aged 18+ were recruited via social media and asked to report on their current sexual practices. Logistic regression was used to calculate the difference in the proportion of practices between Victorians and non-Victorians. Results 976 people completed the survey: 71% identified as female, 75% were aged 18–29 years, 61% resided in Victoria. Compared w...
Australian Journal of Primary Health, 2021
Long-acting reversible contraceptives (LARC) are the most effective contraceptive methods availab... more Long-acting reversible contraceptives (LARC) are the most effective contraceptive methods available in Australia and are effective for between 3 and 8 years. Early LARC removal (<12 months of use) can lead to gaps in contraceptive cover, exposing women to the risk of unplanned pregnancy. This study explored the experiences of doctors working in primary care (GPs and sexual health physicians) when asked to remove LARC earlier than expected. From May to July 2020, 13 doctors in Melbourne, Australia, were interviewed. Overall, participants felt conflicted about early LARC removal requests; participants highlighted the importance of respecting patient autonomy, but many felt that patients should ideally persist with LARC longer. Participants found balancing a desire to respect patients’ autonomy with their clinical responsibility challenging. Doctors used reassurance, delaying tactics and treatment of side effects to try and prolong LARC use. However, this balancing act led many doct...
Sexually Transmitted Infections, 2011
engaged in substance abuse and sexual behaviours that increase their risk of HIV transmission, an... more engaged in substance abuse and sexual behaviours that increase their risk of HIV transmission, and STD transmission and acquisition. Such patients were more likely to want to discuss their mental health concerns than those who did not engage in these behaviours. These findings underscore the importance of interventions to decrease risky sexual behaviour and to promote clinical assessment of mental health needs for this patient population. A mental health assessment can identify patients who might need greater psychosocial support or referral for treatment of substance abuse and underlying mental illness.
Improving access to sexual health services is critical in light of rising sexually transmitted in... more Improving access to sexual health services is critical in light of rising sexually transmitted infections (STIs). We evaluated a Hub and Spoke model for improving access to sexual health services in three general practices in Victoria, Australia. The primary outcome was the impact on HIV and STI (chlamydia, gonorrhoea, syphilis) testing. Segmented linear regression analysis was conducted to examine the trends in the total HIV/STI tests before (from January 2019 to June 2020) and post-implementation (from July 2020 to July 2021). We evaluated the feasibility and acceptability of integrating this model into the general practices using semi-structured individual interviews. There was a statistically significant rise in testing for HIV and STIs in all general practices: post-implementation, there was an increase of an average of 11.2 chlamydia tests per month (p=0.026), 10.5 gonorrhoea tests per month (p=0.001), 4.3 syphilis tests per month (p=0.010), and 5.6 HIV tests per month (p=0.01...
Sexually Transmitted Infections, 2008
The clinical diagnosis of pelvic inflammatory disease (PID) is subjective. Our aim was to determi... more The clinical diagnosis of pelvic inflammatory disease (PID) is subjective. Our aim was to determine if the pattern of diagnosis of PID among experienced clinicians varied compared with the diagnosis of genital warts. We conducted a retrospective study of 325 PID diagnoses made by experienced clinicians at Melbourne Sexual Health Centre, Australia (2002-2006), where doctors saw 21 785 unselected female patients in a walk-in service. We compared the proportion of female patients diagnosed as having PID and genital warts between doctors and then compared doctors above (high diagnosing) and below (low diagnosing) the mean rate of PID diagnosis. There were significant and clinically important differences in the proportion of women diagnosed with having PID (0-5.7%) across 23 doctors investigated. Estimated standard deviation in the frequency of PID diagnosis (logit scale) was 1.26 (95% CI 0.81 to 1.95)--approximately four times greater than for warts. Patients seen by high (n = 4673) and low (n = 16 787) diagnosing doctors had similar epidemiological risk profiles suggesting true distribution of PID cases across doctors was similar (p&amp;amp;gt;0.13). Women diagnosed with having PID by high diagnosing doctors compared with low diagnosing doctors were younger (odds ratio 1.7; 95% CI 1.1 to 2.8, p = 0.013) but otherwise had similar epidemiological and clinical features. Differences in diagnostic rates for PID between doctors are substantial and may be because of PID cases being missed by some doctors.
The European Journal of Contraception & Reproductive Health Care
Sexually Transmitted Infections
IntroductionAustralia recorded its first case of COVID-19 in late January 2020. On 22P March 2020... more IntroductionAustralia recorded its first case of COVID-19 in late January 2020. On 22P March 2020, amid increasing daily case numbers, the Australian Government implemented lockdown restrictions to help ‘flatten the curve’. Our study aimed to understand the impact of lockdown restrictions on sexual and reproductive health. Here we focus on sexual practices.MethodsAn online survey was open from the 23PP April 2020 to 11P May 2020. Participants were recruited online via social media and other networks and were asked to report on their sexual practices in 2019 and during lockdown. Logistic regression was used to calculate the difference (diff) (including 95% CIs) in the proportion of sex practices between time periods.ResultsOf the 1187 who commenced the survey, 965 (81.3%) completed it. Overall, 70% were female and 66.3% were aged 18–29 years. Most (53.5%) reported less sex during lockdown than in 2019. Compared with 2019, participants were more likely to report sex with a spouse (35....
Culture, Health & Sexuality
ABSTRACTIntroductionAustralia recorded its first case of COVID-19 in late January 2020. On 22nd M... more ABSTRACTIntroductionAustralia recorded its first case of COVID-19 in late January 2020. On 22nd March 2020, amid increasing daily case numbers, the Australian Government implemented lockdown restrictions to help ‘flatten the curve’. Our study aimed to understand the impact of lockdown restrictions on sexual and reproductive health. Here we focus on sexual practices.MethodsAn online survey was open from the 23rd April 2020 to the 11th May 2020. Participants were recruited online via social media and other networks and were asked to report on their sexual practices in 2019 and during lockdown. Logistic regression was used to calculate the difference (including 95% confidence intervals) in the proportion of sex practices between time periods.ResultsOf the 1187 who commenced the survey, 965 (81.3%) completed it. Overall 70% were female and 66.3% were aged 18 to 29 years. Most (53.5%) reported less sex during lockdown than in 2019. Compared with 2019, participants were more likely to rep...
Sexual Health
Background:Dual condom and long-acting reversible contraceptive (LARC) or non-LARC hormonal contr... more Background:Dual condom and long-acting reversible contraceptive (LARC) or non-LARC hormonal contraceptive use is the most effective way to protect against unwanted pregnancy and sexually transmissible infections (STIs). This study aimed to determine whether condom use varied between users of LARC and non-LARC hormonal contraceptives and explore their motivations for condom use. Methods: Women aged 16–24 years attending a sexual and reproductive health centre in Melbourne, Australia, completed a survey about contraceptives and sexual practices. The proportion of LARC and non-LARC hormonal contraceptive users using condoms was calculated and logistic regression compared condom use between the two groups. Condom use was based on frequency of use and coded as a binary variable ‘never, not usually or sometimes’ versus ‘usually or always’. Results: In all, 294 (97%) women participated in the study; 23.8% (95% confidence interval (CI) 19.0–29.1%) used LARC and 41.7% (95% CI 36.0–47.6%) use...
Introduction: Australia introduced lockdown measures to control COVID-19 on 22 March 2020. For tw... more Introduction: Australia introduced lockdown measures to control COVID-19 on 22 March 2020. For two months, Australians were asked to remain at home and only leave for essential activities. We investigate the impact this had on sexual and reproductive health (SRH). Methods: Australians aged 18+ were eligible to participate in an online survey from 23 April-11 May 2020. Questions included contraceptive use, pregnancy intentions and access to SRH services. We report on the experiences of 518 female participants aged <50 years. Pregnancy intentions and contraceptive use were analysed using descriptive statistics. Odds ratios and 95% confidence intervals were calculated to investigate difficulty accessing SRH products and services. Qualitative data were analysed using descriptive thematic analysis. Results: Most participants (55.4%, 287/518) were aged 18-24 years. Most (76.1%, 379/498) indicated they were trying to avoid pregnancy. The oral contraceptive pill was the most common singl...
Sexual Health
Background Dual condom and long-acting reversible contraceptive (LARC) or non-LARC hormonal contr... more Background Dual condom and long-acting reversible contraceptive (LARC) or non-LARC hormonal contraceptive use is the most effective way to protect against unwanted pregnancy and sexually transmissible infections (STIs). This study aimed to determine whether condom use varied between users of LARC and non-LARC hormonal contraceptives and explore their motivations for condom use. Methods: Women aged 16–24 years attending a sexual and reproductive health centre in Melbourne, Australia, completed a survey about contraceptives and sexual practices. The proportion of LARC and non-LARC hormonal contraceptive users using condoms was calculated and logistic regression compared condom use between the two groups. Condom use was based on frequency of use and coded as a binary variable ‘never, not usually or sometimes’ versus ‘usually or always’. Results: In all, 294 (97%) women participated in the study; 23.8% (95% confidence interval (CI) 19.0–29.1%) used LARC and 41.7% (95% CI 36.0–47.6%) use...
BMC infectious diseases, Jan 5, 2017
Our study aimed to describe the concordance of chlamydia infections of the rectum and urethra in ... more Our study aimed to describe the concordance of chlamydia infections of the rectum and urethra in men who have sex with men (MSM) and their male partners. This was a cross-sectional study of chlamydia in MSM and their male sexual partners both attending Melbourne Sexual Health Centre (MSHC), Australia, between February 2011 and March 2015. We excluded partnerships where testing for chlamydia at both the rectum and urethra were not undertaken. Our study included 473 partnerships (946 men). 30 men had urethral chlamydia, of whom 14 (47%, 95% CI 28 to 66) had a partner with rectal chlamydia. 46 men had rectal chlamydia, of whom 14 (30%, 95% CI 18 to 46) had a partner with urethral chlamydia. The proportion of men with rectal chlamydia when their partner had urethral chlamydia was significantly higher than the proportion of men with urethral chlamydia when their partner had rectal chlamydia (McNemar's p = 0.02). This is the first study of chlamydia concordance in male sexual partners...
JMIR mHealth and uHealth, 2016
Smartphone apps provide a new platform for entertainment, information distribution, and health pr... more Smartphone apps provide a new platform for entertainment, information distribution, and health promotion activities, as well as for dating and casual sexual encounters. Previous research has shown high acceptability of sexual health interventions via smartphone apps; however, sexual health promotion apps were infrequently downloaded and underused. Integrating sexual health promotion into established apps might be a more effective method. The objective of our study was to critically review popular sex-related apps and dating apps, in order to ascertain whether they contain any sexual health content. Part 1: In January 2015, we used the term &amp;amp;amp;amp;amp;amp;quot;sexual&amp;amp;amp;amp;amp;amp;quot; to search for free apps in the Apple iTunes store and Android Google Play store, and categorized the sexual health content of the 137 apps identified. Part 2: We used the term &amp;amp;amp;amp;amp;amp;quot;dating&amp;amp;amp;amp;amp;amp;quot; to search for free geosocial-networking apps in the Apple iTunes and Android Google Play stores. The apps were downloaded to test functionality and to determine whether they included sexual health content. Part 1: Of the 137 apps identified, 15 (11.0%) had sexual health content and 15 (11.0%) contained messages about sexual assault or violence. The majority of the apps did not contain any sexual health content. Part 2: We reviewed 60 dating apps: 44 (73%) targeting heterosexual users, 9 (15%) targeting men who have sex with men (MSM), 3 (5%) targeting lesbian women, and 4 (7%) for group dating. Only 9 dating apps contained sexual health content, of which 7 targeted MSM. The majority of sex-related apps and dating apps contained no sexual health content that could educate users about and remind them of their sexual risks. Sexual health practitioners and public health departments will need to work with app developers to promote sexual health within existing popular apps. For those apps that already contain sexual health messages, further study to investigate the effectiveness of the content is needed.
Uploads
Papers by Hennie Williams