ANNUAL REPORT 2012 THE KIRBY INSTITUTE for infection and immunity in society ANNUAL REPORT 2012

CONTENTS

Kirby Institute programs 2012 3 Research activities: Aboriginal and Torres Strait Islander Health Program 10 Biostatistics and Databases Program 11 HIV Epidemiology and Prevention Program 13 Immunovirology and Pathogenesis Program 15 Justice Health Research Program 19 Public Health Interventions Research Group 20 Sexual Health Program 25 Surveillance and Evaluation Program 30 Therapeutic and Vaccine Research Program 32 Viral Hepatitis Clinical Research Program 36 Viral Hepatitis Epidemiology and Prevention Program 40

Kirby Institute advisory committees 45 External boards, committees and advisory groups 47 Staff and affiliated researchers 51 Students and student supervision 54 Collaborating organisations 57 Funding and research grants 63 Publications 66 n KIRBY INSTITUTE PROGRAMS 2012

THE ABORIGINAL AND TORRES STRAIT ISLANDER in SHIMMER, a quality improvement project in Aboriginal HEALTH PROGRAM Community Controlled Health Services in NSW with State government support. REACCH, a Centre for Clinical Research The Aboriginal and Torres Strait Islander Health Program was Excellence in Aboriginal Community Controlled Health taking established in 2007. The program works collaboratively to place at four community controlled services across the country, close the gap in health between Aboriginal and Torres Strait collected comprehensive data on uptake and outcome of testing Islander and non-Indigenous people, with a central focus upon for sexually transmissible infections and hepatitis B. The ARC- sexual health and blood borne viruses. In doing so, the program funded project GOANNA, the first national survey of young engages in strategies that are designed to enhance the capacity Aboriginal and Torres Strait Islander people regarding sexual of Aboriginal and Torres Strait Islander communities in health and injecting related knowledge, risk behaviour and health improvement. service access, completed its second full year of data collection, through a variety of community events across the country. The program has four main domains of activity that it conducts Ongoing projects in which the program played in major role in partnership within Aboriginal and Torres Strait Islander in 2012 were NHMRC-funded studies of point-of-care testing communities: for sexually transmissible infections in remote communities • Research aimed at increasing knowledge about ways (TTANGO) and a large cluster randomised trial of chlamydia to prevent and manage blood-borne viral and sexually screening (ACCEPt). transmissible infections in Aboriginal and Torres Strait Islander communities; • Surveillance to support programs and policy related to the control of these infections in Aboriginal and Torres Strait THE BIOSTATISTICS AND DATABASES PROGRAM Islander communities; • Capacity building, to ensure that there is a strong workforce in The Biostatistics and Databases Program has a collaborative research and service delivery in Aboriginal and Torres Strait biostatistical research role across many of the Kirby Institute’s Islander communities; programs and activities. A key activity in this area in 2012 was • Information dissemination to and from Aboriginal and Torres extensive statistical analyses of the ENCORE and SECONDLINE Strait Islander communities about key new developments clinical trials (TVRP), for DSMB activities and final reporting. and best practice in the control of blood-borne and sexually The final statistical analyses of the PREDICT study (HIVNAT) transmitted infections. were conducted and published. Study databases were developed for trachoma surveillance (SEPHH) and the REACT study The program works closely with the National Aboriginal (SHP). The program also started a new role to provide training Community Controlled Health Organisation, its State for, and coordination of, NHMRC and ARC grant applications. and Territory-based affiliate organisations and Aboriginal Community Controlled Health Services to make a difference to During 2012 groundwork was laid for the development of a the health of indigenous communities. number of new collaborative studies. A case-control study of TB diagnosis in HIV-positive adults in Asia, examining socio- James Ward, who founded the program, moved to a senior economic risk factors for infection, was commenced. A case- position in Alice Springs with Baker IDI but has maintained control study of risk factors for suicide in HIV-positive adults in strong collaboration with the program and ongoing leadership Australia was also begun. A trial of scabies treatment in Fiji was of a number of its projects. The program published the initiated. Finally, the extensive approvals required for a linkage annual surveillance report on blood-borne viral and sexually study of the Health in Men and Positive Health studies with the transmitted infections in Aboriginal and Torres Strait Islander National Death Index and hospitalisation databases was put in people, which is designed to provide a comprehensive update place. All these studies are expected to provide exciting research to meet the planning and evaluation needs of communities. outputs in 2013 and beyond. Australia’s largest randomised cluster trial ever conducted in Aboriginal health, named STRIVE and funded by the NHMRC, 2012 was an active year for research outputs in a number of completed its first year of activity and transitioned into the areas. Methodological work included an adaptive Markov second year, undertaking quality improvement for sexual chain Monte Carlo for epidemic modelling of HPV; the use of health clinical services in nearly 70 remote communities across semiparametric regression models in HIV prevention research; central and northern Australia. Work progressed through 2012 and reclassification metrics to evaluate survival prediction

ANNUAL REPORT 2012 3 equations in HIV-positive patients. Analyses of observational Professor Andrew Grulich heads the HIV Epidemiology and cohort data showed that in HIV-positive adults successfully Prevention Program with a focus on cohort studies in at risk treated with antiretrovirals, life expectancy approached that of populations linked to behavioural and biomedical prevention the general population, and that long-term CD4 count responses of HIV and sexually transmitted infections. These types of showed no evidence of declining in older patients. A diabetes research are central to the evaluation of biomedical preventions risk prediction model was also developed for HIV-positive strategies such as vaccines, microbicides and chemoprophylaxis. patients that should aid identification and patient management Professor Grulich is also a world authority on the serious of pre-diabetes. Predictors of lost to follow-up were examined in emerging issue of cancer in HIV. Andrew has been at the Kirby HIV-positive patients receiving treatment in Asia, and found the Institute for 20 years. optimal definition of lost to follow-up was no clinical contact for 180 days. Advanced statistical analysis of HIV surveillance data indicated a reduced impact of antiretroviral treatment among injecting drug users. Finally, hepatitis C treatment outcomes in THE IMMUNOVIROLOGY AND PATHOGENESIS routine care in Australian clinics were evaluated. PROGRAM Professor Matthew Law, head of the Biostatistics Program, The activities of the IVPP during 2012 can be divided into has been at the Kirby Institute for almost twenty years. His three categories. All involve substantial, daily interaction with group plays a key support role to other academic programs the Immunovirology group at St Vincent’s Centre for Applied but has also independent research activities in cohort studies, Medical Research, which is collocated with IVPP. mathematical modelling, linkage studies and complex statistical analyses. A substantial proportion of laboratory-based activity involved provision of routine or semi-routine laboratory support, essential for the successful conduct of clinical trials and epidemiological studies conducted by the Kirby Institute. This section of the THE HIV EPIDEMIOLOGY AND PREVENTION laboratory continued to perform well in external QA programs. The laboratory acted as the central global laboratory for flagship PROGRAM Kirby Institute studies such as SECOND-LINE, ENCORE, MARCH, The HIV Epidemiology and Prevention Program (HEPP) and ATAHC II. Collaborative strategies were further developed conducts research into the transmission and prevention of to streamline the conduct of the laboratory aspects of these large HIV and sexually transmissible infections (STIs), and on complex trials. The laboratory completed extensive optimisation the natural history of HIV. We work in partnership with and verification studies of DNA-based viral tropism assay which communities most affected by HIV, particularly the gay was then successfully transferred to the NSW State HIV Reference community and those people living with HIV. HEPP works Laboratory at St Vincent’s. The laboratory played a substantial across the spectrum of biomedical, behavioural and structural role in the development of an external QA program for viral prevention, because effective HIV prevention acknowledges tropism that was used to qualify laboratories both in Australia the complexities of everyday life for at-risk communities. and overseas for conduct of assays for the MARCH Study. The Their work includes behavioural risk surveillance, studies of laboratory also completed all the central resistance and viral risk behaviour, and studies of use of biomedical preventive load testing for the SECOND-LINE study and has commenced interventions. Researchers in HEPP conduct a range of work on performing similar assays for ENCORE. the intersection of infection, immunity and cancer to inform our knowledge of how we might prevent cancer in people with HIV. The second critical component of the program was the A particular focus is the prevention of anal cancer in gay men. continued conduct of clinical trials and natural history studies in pathogenically informative populations of patients with Highlights of 2012 for the HIV Epidemiology and Prevention HIV-infection such as those with primary infection and long Program include the commencement of enrolment into the term non-progressors. These cohorts continued to provide NHMRC funded Opposites Attract project. Opposites Attract is a valuable material for productive collaborations particularly five year cohort study of HIV transmission in HIV serodiscordant with Stephen Kent’s group at the University of Melbourne gay couples. The study is examining the effect of HIV treatment and Martyn French’s group at Royal Perth Hospital. Further, and HIV viral load on sexual risk behaviour and the rate of HIV the primary infection database continued to provide data to transmission. Data from the study will be critical in informing the European collaborative effort CASCADE. Each of these the development of biomedical HIV prevention policies in collaborations resulted in several peer reviewed publications in Australia. Complementing Opposites Attract is the TAXI-KAB 2012. In addition, these cohorts were used for a range of studies study which is collecting baseline information about gay men’s conducted within the program including studies providing knowledge, attitudes and beliefs about recent changes in insight into new regulatory pathways of T-cell function biomedical prevention of HIV and in HIV testing procedures and involving micro-RNAs which in turn appear to impact on rates technologies. These data will be key to assessing any changes of progression of HIV-infection. This work was accepted for in understanding of these issues over coming years. The first publication during 2012 and attracted editorial commentary in three year funding period of the national HIV Seroconversion the European Journal of Immunology. Study was completed in June, with nearly 500 recently diagnosed individuals having been enrolled into the study. The Senior scientists and academics within the program were study report was launched in Melbourne at the annual ASHM responsible for their own research projects on pathogenesis and conference. The next funding period will commence at the development of therapeutics. In 2012, a paper demonstrating start of 2013. Recruitment for the NHMRC-funded Study of the the utility of a patented, simple T cell assay as assisting the Prevention of Anal Cancer neared completion, and baseline diagnosis of latent TB was published. These results were data were presented at the 28th International Papillomavirus derived from twin studies conducted in Sydney and Bangkok, Conference in Puerto Rico. in collaboration with HIV-NAT. In addition, the initial analyses

4 ANNUAL REPORT 2012 of the first year of the PINT study, which provided new insights Dr Stuart Turville into dynamics of establishment and maintenance of the Dr Turville’s research career started with a BSc Hons (First viral reservoir, were published in two separate manuscripts. class and John Elliot Prize for Best Thesis in Animal Biology) Samples from this trial were a major focus of on going work in and followed with an Australian Postgraduate Award for PhD the laboratory in 2012. Further, insights into the mechanisms studies at the University of Sydney on the mechanism of HIV underlying the maintenance of the viral reservoir were sought transmission in dendritic cells. from the elucidation of the relative infection rates of various T-cell subsets and their turnover rates. Developmental work for the characterisation of viral DNA load and phylogenetic profiles of virus-infected, antigen-specific CD4+ T-cells was carried out. JUSTICE HEALTH RESEARCH PROGRAM This sophisticated work is only possible using a combination of molecular and cellular assays developed within the laboratory. The Justice Health Research Program was established at the These and other studies involving identification of lymphocyte Kirby Institute in January 2011. Designed to complement the subsets were aided by an upgrade of our flow cytometer KI approach to health and human rights, particularly among to a 3 laser machine capable of analysing 15 parameters marginalised populations, the program has a particular focus simultaneously. This was achieved through the award of an on Australia’s offender population. The Justice Health Research equipment grant, allowing a machine purchased in 2003 to Program undertakes research into a broad range of health remain state of the art. issues affecting offender populations including communicable diseases, access to hepatitis C treatment in prison, Aboriginal During 2012 the first in vivo testing of our unique siRNAs that health, mental health, sexual health, tobacco smoking, induce prolonged transcriptional gene silencing of HIV-1 in impulsivity, and alcohol use. a Hu-SCID mouse model were completed with our Japanese collaborators. These experiments provided very encouraging 2012 saw the Justice Health Research program grow in terms data regarding the ability of these constructs to suppress viral of projects and staff joining the team. The program received replication when delivered by retroviral constructs. Further, NHMRC funding to look at the sexual health, attitudes to sex the results of elegant molecular and confocal microscopy and reproductive health of young offenders in the community demonstrating that these constructs work in the nucleus in and custody (the JOSH study). The JOSH study complements concert with Ago1 were published. The proposed development the highly productive Sexual Health and Attitudes of Australian of these constructs was supported through the award of an Prisoners (SHAAP) survey of adult offenders. Funding was received NHMRC project grant to commence in 2013. in 2012 from the Lowitja Institute to examine the community’s attitudes to the treatment of offenders using a Citizen’s Juries In 2012 Dr Stuart Turville and his HIV Biology Group had their approach pioneered by the late Professor Gavin Mooney. work on the visualisation of the mechanisms of viral interaction with filopodia on dendritic cells and how this allows increased The program continues to hosts the NHMRC capacity building infection of CD4+ T cells was published in Plos Pathogens. The grant in Indigenous offender health, which has a cohort of further development of this work was supported by the NHMRC Aboriginal researchers across Australia examining a range with the funding of a project grant lead by Stuart to commence of issues including justice reinvestment, alcohol programs in 2013. Stuart was also successful in attracting funding for the for Aboriginal men in custody, youth trajectories into crime, upgrading of the DeltaVision Elite microscope housed within the health needs of Aboriginal prisoners, and the role of the St Vincent’s AMR PC3 laboratory. This upgrade, which social support and families in post-release integration. Paul will occur early in 2013, will allow high through-put, and high Simpson joined the team as the Indigenous Offender Health resolution imaging of the interactions between virus and sub- Capacity Building Group (IOHR-CBG) coordinator, and has also cellular compartments in live cells in real time. commenced working on collaborative projects looking at justice reinvestment and transgender prisoner policies. At the end of 2012, the laboratory took delivery of sophisticated confocal endo-microscope from Optiscan. It will be used with Other NHMRC funded projects that continued during 2012 collaborators at the Garvan Institute of Medical Research and St included the Hepatitis C, Prisons and Treatment Opportunities Vincent’s Hospital to visualise dynamic changes in the integrity (HePATO)’ study, and the AusAID funded study ‘Strengthening of mucosal surfaces and for the monitoring real time of mucosal China’s response to HIV, TB and HIV/TB co-infection in immune responses in vivo. labour camps (lao jiao suo) in Guangxi Autonomous Region: developing a prevention model to inform national policy’. The overall quality of the work generated by the program and its ability to collaborate effectively to produce high Joanne Reekie also joined the program working on a range of quality clinically important results was recognised through projects as support statistician. the awarding of a highly prestigious NHMRC program grant to commence in 2014 through to a group of investigators, Professor Tony Butler is the inaugural head of the Justice including the head of the IVPP. Health Research Program. He has researched health issues in the criminal justice system for more than a decade. Professor Professor Tony Kelleher is head of the Immunovirology and Butler’s research focus includes the surveillance of blood- Pathogenesis Program, and works closely at a laboratory level borne viruses and sexually transmissible infection among with colleagues from SVH. The program provides lab support prison entrants nationally, work on establishing the National across the organisation, as well as conducting world-class Prisoner Health Indictor Project, conducting Australia’s largest research, presently focussed on the design and development epidemiological survey of prisoners’ mental health and research of novel assays, and the study of micro RNAs, fine mapping of into traumatic brain injury among prisoners. He is a key T-cell function, and the transcriptional gene silencing of HIV by member of a group undertaking research into smoking cessation siRNA. among prisoners.

ANNUAL REPORT 2012 5 THE PUBLIC HEALTH INTERVENTIONS This was another busy and productive year. In 2012 several RESEARCH GROUP new joint projects were developed with the Sydney Sexual Health Centre. Methodologies used by the program range from The Public Health Interventions Research Group (PHIRG) descriptive epidemiology with novel analytical techniques, undertakes a diverse range of projects that focus on the evaluation molecular epidemiology, enhanced surveillance strategies, data of strategies to prevent infectious disease. The program linkage studies, social and behavioural research, test evaluations, collaborates extensively, both within the Kirby Institute and detecting antimicrobial resistance, evaluating and improving externally, and emphasises research that benefits the health health care delivery, legal and policy research, anthropology, and of disadvantaged populations in Australia and the Asia-Pacific biomedical prevention trials. Region. Much of their work also has a strong capacity-building component. The group is currently involved in projects related to In March, the program launched a report called The Sex Industry the control of HIV, sexually transmissible infections, viral hepatitis, in New South Wales, commissioned by the NSW Ministry of tuberculosis, scabies and trachoma. Countries of activity include Health. The report favourably evaluated the long-term impact of Australia, Papua New Guinea, Indonesia, Cambodia and Fiji. the decriminalisation of sex work and made recommendations to inform future policy development. In 2012, Bette Liu undertook and published a linkage study that demonstrated a strong downward trend in chronic hepatitis B In conjunction with the Burnet Institute, the Sexual Health infection among pregnant women in the Northern Territory, Program continues to steer the Australian Collaboration for where the neonatal vaccination program was commenced more Chlamydia Enhanced Sentinel Surveillance (ACCESS), which than twenty years ago. The program also completed the largest uses routine clinical data to complement routine notification study ever undertaken of hepatitis B infection in New South Wales data and evaluate clinical service strategies. Over 100 clinical by country of birth. Also completed, as part of a collaboration with sites participate in ACCESS, each providing a core set of the Royal Women’s Hospital in Melbourne, was the first survey routinely collected data in de-identified line-record format in the world to demonstrate a decline in human papillomavirus which are extracted on a six-monthly basis. The ACCESS infection following the implementation of the national vaccination network provided the first reliable means of interpreting program. In conjunction with the other Kirby Institute programs, trends in national rates of chlamydia diagnoses. Plans are well PHIRG continued work on national trachoma surveillance and; advanced to expand the range of STIs and risk behaviours its second annual surveillance report from was also released. captured by ACCESS. In addition, the program’s national Andrew Vallely, on secondment to the Papua New Guinea genital warts surveillance system documented a dramatic Institute of Medical Research, continued to build the research population-level reduction in warts as a result of the national program on male circumcision in Papua New Guinea and its link HPV vaccination program. to sexual health, culminating in several published reports. He also embarked on new projects in sexually transmitted infection and The Sexual Health Program also continued its involvement in the control of human papillomavirus and its complications. The the Australian Chlamydia Control Effectiveness Pilot (ACCEPt), project, evaluating interferon gamma release assay for diagnosis led by Associate Professor Jane Hocking at the University of of children with suspected tuberculosis in PNG, was published Melbourne. ACCEPt is the first study to assess the population in 2012. Through a successful competitive application, AusAID impact of annual chlamydia screening in primary care on the provided renewed funding for the Field Research Training prevalence of chlamydia using a randomised controlled study Program (FRTP) in Indonesia and Cambodia, which is designed design. to assist emerging public health researchers to develop skills and experience in longitudinal health studies. Bradley Mathers was Continuing the program’s commitment to innovative research awarded a NHMRC early career fellowship, to commence in 2013. aimed at improving testing for STIs, the chlamydia re-test trial (REACT), funded by the NHMRC STI Program Grant, uses Professor John Kaldor is an NHMRC Senior Principal Research a randomised controlled design to assess the effectiveness Fellow and Professor of Epidemiology. of coupling SMS reminders with home-based self-collected samples in improving the uptake of chlamydia re-testing. Regular testing and re-testing for HIV and other STIs in high risk populations is recognised as a key control strategy. NSW THE SEXUAL HEALTH PROGRAM Health has funded the eTEST intervention which is designed to increase the frequency of HIV/STI screening in ‘high risk’ The Sexual Health Program leads and supports research into the MSM through a novel multi-faceted intervention using decision epidemiology, surveillance, microbiology, clinical management support software coupled with other evidence-based strategies. and prevention of sexually transmissible infections (STIs). The This project involves 10-12 general practice clinics in Sydney program is also involved in research into the behaviour and sexual and Melbourne that see a high case load of MSM. health of priority populations for STI control such as youth, men who have sex with men (MSM), sex workers, Aboriginal and Rebecca Guy leads the NHMRC-funded Test, Treat and Go Torres Strait Islander people, prisoners and travellers. (TTANGO) Project: a trial of a novel nucleic acid amplification point-of-care test for chlamydia and gonorrhoea (GeneXpert®). The program works closely with several programs within the The trial uses a cross-over, cluster-randomised design in 12 Kirby Institute. Other collaborators include: a national network remote Aboriginal communities in northern Queensland, of 25 specialist sexual health services; research laboratories in Western Australia and South Australia. During 2012, the Sydney, Melbourne, Brisbane and Papua New Guinea; the School laboratory evaluation of the testing system was successfully of Population Health at the University of Melbourne; the Burnet completed and field evaluations began. The Sexual Health Institute in Melbourne; the National Aboriginal Community Program was also involved in the multi-centre (Sydney, Controlled Health Organisation; BakerIDI in Alice Springs; and Melbourne and Goroka) laboratory-based evaluation of six the Menzies School of Health Research in Darwin. rapid point-of-care tests for syphilis.

6 ANNUAL REPORT 2012 The program continued to provide clinical and technical support SEPPH advanced its international expertise, working in to several large trials of sexual health care quality improvement in collaboration with the World Bank Group, to commence Aboriginal medical services, including the STRIVE Project (WA, a project to contribute to the improvement of the NT, and Qld), the NHMRC Centre for Clinical Research Excellence effectiveness and efficiency of HIV prevention responses in Aboriginal sexual health (NSW, SA, Qld, and Vic), and the in Asia’s concentrated HIV epidemic settings. Extensions SHIMMER Project (NSW). of this work involve studies around evaluation, health economics, efficiency and financing for informing Ministries The program had a strong presence at the IUSTI World STI & of Health and Ministries of Finance in many countries. HIV Congress in Melbourne in October with 18 presentations. SEPPH currently conducts analyses in: Malaysia, Myanmar, Program staff also accepted invitations to present their research Nepal, Thailand, China, Philippines, Cambodia, Indonesia, in Brazil, Canada, Turkey, the UK and Chile. Vietnam, Jamaica, Malawi, Nigeria, Swaziland, Zimbabwe, Ukraine, Moldova, Armenia, Belarus, Tajikistan, Estonia, Georgia, Kazakhstan, and Russia.

THE SURVEILLANCE AND EVALUATION PROGRAM Associate Professor David Wilson, head of the Surveillance and Epidemiology Program for Public Health, has presided FOR PUBLIC HEALTH over a restructure and expansion of our surveillance work in the The Surveillance and Evaluation Program for Public Health few short years since he joined the Kirby Institute. His program (SEPPH) monitors the pattern of transmission of HIV, viral has extended its standing monitoring of HIV, viral hepatitis, and hepatitis, specific sexually transmissible infections, transfusion specific sexually transmissible infections to other surveillance transmissible infections, and trachoma in Australia. The activities as well as to the assessment of past and expected program assesses past and expected epidemic trends, and epidemic trends, and more recently to impact evaluation, cost- evaluates the epidemiological impact and cost-effectiveness effectiveness and efficiency studies of HIV programs. of public health intervention strategies through various trial designs and retrospective analyses. SEPPH also conducts efficiency studies of HIV programs and informs national strategic planning, including optimal resource allocation and THE THERAPEUTIC AND VACCINE RESEARCH financing with primary focus in Asia and Eastern Europe. PROGRAM Blood-borne viral and sexually transmissible infections (STIs) The Therapeutic and Vaccine Research Program (TVRP) surveillance activities are conducted in collaboration with conducts a range of clinical trials designed to assess the the Australian Commonwealth Government Department of effectiveness of new HIV therapies and therapeutic strategies. Health and Ageing, State and Territory health authorities and These studies provide data that have an impact on policy and collaborating networks. Analyses and interpretation of recent clinical practice, in both resource-rich and resource-limited trends in new diagnoses of HIV, viral hepatitis and STIs, and settings. The TVRP provides leadership through the program’s estimates of prevalence and incidence in key population subgroups role as an international co-ordinating centre for the INSIGHT are published in our Annual Surveillance Report. Publicly released network, a major international collaboration for the conduct datasets on new HIV and AIDS diagnoses are also available of large clinical endpoint strategic trials in HIV disease which for download. SEPPH, is a collaborating unit of the Australian has more than 300 sites in 30 countries. In parallel, the TVRP Institute of Health and Welfare. The program collaborates with co-ordinates the activities and operations of an international the Australian Red Cross to conduct surveillance of transfusion network in over 20 countries on seven continents in which transmissible infections among blood donors in Australia. In investigator-initiated research is performed. collaboration with the Office of Aboriginal and Torres Strait Islander Health of the Department of Health and Ageing and other Investigator-initiated research Kirby Institute Programs, SEPPH coordinates national surveillance The SECOND-LINE study completed enrolment in September and reporting of trachoma among Aboriginal communities. 2011 and 48 week follow-up concluded in September 2012. This clinical trial was designed to compare the safety and efficacy In 2012, SEPPH released a number of Surveillance Reports, of ritonavir-boosted lopinavir (r/LPV) + 2-3N(t)RTI with r/ including the sixteenth annual review of available surveillance LPV + raltegravir in participants virologically failing first-line data pertaining to the occurrence of ‘HIV, viral hepatitis and therapy. Preliminary results were presented at CROI 2013. The sexually transmissible infections in Australia’, and the sixth experimental regimen was non-inferior to the standard of care annual ‘Blood-borne viral and sexually transmitted infections regimen. Follow-up of the cohort with additional and ongoing in Aboriginal and Torres Strait Islander people: Surveillance analyses will further illuminate the care of people who have and Evaluation Report’. Surveillance activities and analyses failed first line therapy. of transfusion transmissible infections in Australia were once again conducted, which led to the second-annual ‘Transfusion The ENCORE1 study commenced recruitment in 2011, with all Transmissible Infections in Australia Surveillance Report’. sites opening for recruitment in the period between August and Cross-program contributions resulted in advancement of December. A total of 636 patients were randomised in a period the National Trachoma Surveillance and Reporting Unit at of approximately nine months. Results from the first 48 weeks UNSW and the production of the second UNSW trachoma of this study will be available in mid-2013. report ‘Australian Trachoma Surveillance Report 2011’, due for publication in 2013. Further cross-program collaboration The MARCH study continued to recruit during 2012 through resulted in the release of the National BBV and STI Surveillance a network of 63 clinical centres. The first patients were and Monitoring Plan which will be followed by SEPPH in the randomised in September 2011. Results of the QA/QC program production of an annual report for monitoring progress against have been accepted for publication and recruitment will be the latest blood-borne viral and STI national strategies. completed in August 2013.

ANNUAL REPORT 2012 7 INSIGHT research Several new projects commenced or were funded in 2012. VHRCP The START study has now recruited close to 4000 subjects was awarded funding from Janssen to conduct DARE-C, a study with final participants to be recruited by December 2013 evaluating the feasibility of response guided triple therapy of based on a re-estimation of sample size to 4600. This large telaprevir, pegylated interferon 2b and ribavirin in recently study with seven nested substudies addresses the question acquired genotype 1 infection. The ATAHC Recall study, which of when to start antiretroviral therapy based on CD4+ cell aims to examine the long term outcomes of participants enrolled count. The TVRP co-ordinates this trial at more than 40 in the original Australian Trial in Acute Hepatitis C study (NIH centres in nine countries. The estimated completion date for funded 2004-2009), commenced at three Australian sites. The the trial is 2016. ETHOS study completed recruitment with a total of 440 subjects enrolled from nine opiate substitution clinics and primary care The FLU studies (002, 003 and 004) have continued to clinics in NSW. The ACTIVATE study, a clinical trial of response recruit patients with, initially, pandemic H5N1 swine variant guided treatment for chronic hepatitis C genotype 2/3 infection in influenza, but more recently with all seasonal influenza-like current injection drug users, commenced recruitment in Canada illnesses. The TVRP coordinates these studies in six countries and Australia. The study will also enrol patients through sites that have recruited approximately 2000 subjects. in five European countries and 2012 was focussed on obtaining ethical and regulatory approval in these countries. Professor Sean Emery is head of the Therapeutic and Vaccine Research Program. He has been at The Kirby Institute In 2012 Professor Greg Dore was elected to the NHMRC Council for 20 years and is a recognised expert in HIV therapeutic and was also awarded a five-year NHMRC Program Grant. research and the design, conduct and reporting of clinical trials. Dr Gail Matthews was awarded a four-year NHMRC Career He is a recognised leader in clinical trial research providing Development Fellowship. expert advice to UK NHS/MRC, US NIH, NSW Cancer Institute and NHMRC. Professor Greg Dore heads the Viral Hepatitis Clinical Research Program which investigates therapeutic strategies for people infected with hepatitis B or C and particularly those for acute and chronic hepatitis C among people who inject drugs. THE VIRAL HEPATITIS CLINICAL RESEARCH He has been at the Kirby Institute for more than 18 years. PROGRAM HCV therapeutic development continued in 2012 with the first THE VIRAL HEPATITIS EPIDEMIOLOGY AND phase III interferon-free trials with new direct-acting antiviral (DAA) agents for the treatment of chronic hepatitis C infection PREVENTION PROGRAM commencing. The rapidly changing HCV therapeutic landscape The Viral Hepatitis Epidemiology and Prevention Program should provide considerable opportunity for phase IV clinical (VHEPP) aims to conduct rigorous research that is ethical, trials over the next two-to-five years, particularly in specific innovative and makes a difference. The program is committed sub-populations and indications not addressed in phase II/III to working in partnership with affected communities in development. The Viral Hepatitis Clinical Research Program, Australia and internationally to achieve key goals. Program was established in 2003 and continues to demonstrate national objectives are to: and international leadership in HCV research, particularly in · Conduct epidemiological, social and behavioural research key affected communities such as people who inject drugs and examining viral hepatitis and other infections in vulnerable HIV coinfected populations. populations, including people who inject drugs (PWID) and female sex workers (FSW) The program has three main areas. Clinical research including · Develop and trial interventions designed to prevent infectious clinical trials forms the main part of the program’s work. The diseases in vulnerable populations second component is molecular virology and host genetic · Initiate and support surveillance activities including research utilising samples from HepBank, the program’s monitoring trends in anti-HIV and anti-HCV prevalence and viral hepatitis sample repository. The third component is risk behaviour among PWID epidemiological research through data linkage studies and · Translate research outcomes into public health policy and practice mathematical modelling. · Build capacity for research, surveillance and harm reduction within Australia and the region through the provision of In addition to chronic HCV research, the program, also has training and technical assistance. interest in the natural history of newly acquired HCV and treatment of acute and chronic HCV, particularly in the Highlights of 2012 included completion of the first-ever trial of setting of injecting drug use and a strong interest in HIV/ a brief intervention designed to increase clinical trial literacy HBV coinfection. The program’s laboratory research focuses and willingness to participate in future candidate hepatitis C on superinfection / mixed infection, protective immunity, vaccine trials among people PWID. Conducted as part of the host genetics, phylogenetics and transmission dynamics and NHMRC-funded program of HCV vaccine preparedness studies, the incidence and prevalence of viral mutations that impart early results indicate an improvement in clinical trial literacy, resistance to the new therapies. The Viral Hepatitis Clinical with a significant increase in the mean number of correct Research Program liaises with all other programs within responses 24 weeks post-intervention. Other VHEPP projects the Kirby Institute, as well as with hepatologists, infectious completed in 2012 included the Young Women’s Health Study, disease physicians and primary care networks nationwide. The a collaboration between UCSF, the Kirby Institute, NCHADS ACTIVATE study, which is evaluating the safety and efficacy and the Cambodian Women’s Development Association; and of individualised treatment with pegylated interferon and a cluster randomised trial of non-pharmaceutical protection ribavirin, commenced recruitment through a newly established against influenza in Vietnam in collaboration with the School of international network. Public Health and Community Medicine at UNSW.

8 ANNUAL REPORT 2012 In 2012 a new NIH subcontract for the Cambodia Integrated HIV and Drug Prevention Implementation Program. Using a randomised cluster trial, this study will examine the impact of conditional cash transfer and microfinance interventions on HIV risk and ATS use among FSWs in ten provinces in Cambodia. Other new projects included an NIH-funded collaboration with the British Columbia Centre for Excellence in HIV/AIDS to evaluate the impact of social, structural and environmental factors on HIV risk, incidence and treatment outcomes among PWID and FSW. Also in 2012, VHEPP NHMRC post-doctoral fellow Jo Kimber, and Lisa Maher received funding from the Centre for Research Excellence into Injecting Drug Use (CREIDU) to conduct a ten year mortality follow-up of the HCV cohort using linkage to the National Death Index to determine causes of death and mortality risk factors in this group. Recruitment and follow-up for the Hepatitis Incidence and Transmission Study – community (HITS-c) also continued during 2012 with more than 180 anti-HCV negative PWID enrolled and 25 incident cases observed to date (8.45/100 person years).

Among the 53 papers published (and in press) by VHEPP staff and students in 2012 were the first published report of the epidemiology of human papillomavirus infection among young FSWs in Cambodia in BMC Infectious Diseases, a paper by Anna Olsen examining the health beliefs and behaviours of women living with hepatitis C in the International Journal of Drug Policy, a report by Bethany White in the Australian and New Zealand Journal of Public Health on the epidemiology of hepatitis B virus in PWID, and a study by Ju Park examining factors influencing willingness to participate in candidate HCV vaccine trials among PWID in Drug and Alcohol Dependence. Also in 2012, Lisa Maher and Nick Walsh co-edited a special issue of Current Opinion in HIV and AIDS on injecting drug use and HIV, and Rachael Green (National Drug Research Institute co- supervision) was awarded a PhD for her thesis An ethnographic study of recreational drug use and identity management among a network of electronic dance music enthusiasts in Perth, Western Australia.

Professor Lisa Maher is head of the Viral Hepatitis Epidemiology and Prevention Program and an NHMRC Senior Research Fellow. She conducts ethnographic, epidemiological and clinical research with a focus on interventions designed to prevent infectious diseases in vulnerable populations, including people who inject drugs and female sex workers.

ANNUAL REPORT 2012 9 n RESEARCH ACTIVITIES

ABORIGINAL AND TORRES been developed and the first round of STRAIT ISLANDER HEALTH incentive payments have been sent to GOANNA health services based on their progress PROGRAM 2012 STUDIES towards best practice targets. The first Australian study assessing Personnel: John Kaldor, James Ward, knowledge, risk behaviours and health Alice Rumbold, Rebecca Guy, Robyn service access in relation to sexually STRIVE McDermott , Lisa Maher, Basil Donovan, transmissible infections and blood borne Linda Garton, Christopher Fairley, viruses of young Indigenous people. This study is a cluster randomised Bronwyn Silver, Janet Knox, Belinda This is the first-ever Australian study trial with an intervention of a sexual Hengel, David Glance, Skye McGregor, describing levels of knowledge, risk health quality improvement program Donna Ah Chee, John Boffa, Steven practice and access to health services (SHQIP) aimed at reaching best-practice Skov, Debbie Taylor-Thomson in relation to sexually transmissible targets in STI control. It is located in Funding: NHMRC Project Grant infections (STIs) and blood borne viruses 68 remote communities, comprised (BBVs) of young Aboriginal and Torres of 23 clusters of communities, in the Strait Islander people aged 16 to 30 years. Northern Territory, Western Australia REACCH: Research Excellence in Status: Currently underway; 40 survey and Far North Queensland. Baseline Aboriginal Community Controlled collections sites completed prevalence data for chlamydia, Personnel: James Ward, Heather Worth, gonorrhoea and trichomonas has been Health Donna Ah Chee, John Kaldor, Smith A, collected from 64 of 68 health services REACCH is a collaborative project led Marion Pitts, Joanne Bryant that are participating in the trial and by the Kirby Institute and NACCHO Funding: Australian Research Council prevalence assessment reports have working with four Aboriginal (ARC) Linkage Grant been fed back to health services. Community Controlled Health Services STRIVE coordinators have completed a in urban and regional areas. REACCH baseline systems assessment for health works with services to conduct Australian Chlamydia control services that were randomised to year community-driven clinical research with effectiveness pilot (ACCEPt) study one of the SHQIP and implemented the potential to lead to improved health sexual health action plans with goals outcomes, foster training of clinical Current national guidelines for general set to improve sexual health service researchers working within Aboriginal practitioners (GPs) recommend all delivery. Coordinators have conducted Community Controlled Health Services sexually active people aged 15-29 years three and six month visits of randomised and ensure effective translation of old receive annual testing for chlamydia. health services with reports of STI research outcomes into clinical practice. More than 80% of 15-29 year-olds attend testing activity derived from lab data Status: A group quality improvement a GP each year however less than 10% presented to services. project is underway with six monthly are being tested for chlamydia by their Status: All participating sites will reporting of STI and BBV testing and GP. ACCEPt involves a multifaceted receive the intervention and the trial outcomes with CQI visits underway in intervention in the GP setting to is currently in the second year of the several services. Service-led projects maximise testing rates and annual testing activated arm. Year three sites are are under way or under development in sexually active 16-29 year-olds to see if due to commence the intervention in three services and two Aboriginal it can reduce the prevalence of chlamydia from May 2013 onwards. STRIVE researchers have been appointed with infections and associated complications field coordinators are conducting site REACCH funding to lead these projects. such as pelvic inflammatory disease visits to provide feedback on STRIVE Personnel: John Kaldor, James Ward, (PID). This is the first trial of this best practice target activity prior to Dea Delaney Thiele, Sophie Couzos, nature in Australia and is being led the intervention and since the sexual David Scrimgeour, Jenny Hunt, Greg by the Centre for Women’s Health, health quality improvement program Dore, Basil Donovan, Mary Ellen Gender and Society at the University commenced. Modifications have Harrod, Mark Saunders, Sid Williams, of Melbourne in collaboration with a been made to patient information Peter Waples-Crowe, Julie Mooney- large consortium of experts including a systems with the inclusion of STI Somers number of researchers from the Kirby templates, STI clinic reports are under Funding: NHMRC Centre for Clinical Institute. In addition, the Kirby Institute development, tailored action plans have Research Excellence (CCRE) has been contracted to develop the

10 ANNUAL REPORT 2012 protocol for program evaluation, conduct Service; Biripi Aboriginal Corporation Status: Linkage complete; data analysis mathematical modelling, and assist with Medical Centre Taree; Coomealla Health and interpretation underway implementation. Aboriginal Corporation; Coonamble Personnel: Jeremy McAnulty, James Status: 48 postcodes have been recruited. Aboriginal Health Service; Griffith Ward, Amalie Dyda, Paula Spokes, Jenny Personnel: Rebecca Guy, John Kaldor, Aboriginal Medical Service; AMS Hunt, Mark Bartlett Basil Donovan, David Regan, David Western Sydney; Hunter New England Funding: NSW Health Wilson, Matthew Law, Rebecca Lorch, Health; National Centre in HIV and Lisa Edward, James Ward, Belinda Ford Social Research Collaborators: Jane Hocking, Meredith Funding: NSW Health Temple-Smith, Jenny Walker, Simone BIOSTATISTICS AND DATABASE Poznanski, Alaina Vaisey, Dyani Lewis, PROGRAM 2012 STUDIES Jane Gunn, Christopher Fairley, Nicola SHIMMER: NSW Aboriginal Health Low, Marian Pitts, Marion Saville, Dorota Research Program Gertig, Sepehr Tabrizi, Margaret Hellard The Australian HIV Observational Funding: Australian Government This project is trialling a sexual health Database (AHOD) Department of Health and Ageing and quality improvement program Chlamydia Pilot Program. Further funding designed to improve STI/BBV testing Observational cohort study of patients from NHMRC Project grant from 2011. and management at four Aboriginal with HIV. Demographic, clinical and Co-location: Sexual Health Program, Community Controlled Health Services treatment data are aggregated twice each Public Heath Interventions Research in NSW. The project aims to increase year via electronic data transfer. Group, Biostatistics and Databases STI/BBV testing, re-testing and follow-up. Status: The study commenced in Program, Aboriginal and Torres Strait Another aim is to improve the clinical December 1999 and currently has 26 Islander Health Program management and ongoing monitoring of active sites contributing data twice yearly patients diagnosed with chronic hepatitis on a total of >3500 enrolled patients. B and hepatitis C. The overall aim of Personnel: Hamish McManus, Stephen An Evaluation of Aboriginal Sexual SHIMMER is to incorporate sustainable Wright, Courtney Bendall, Kathy and Reproductive Health and Viral sexual health testing and management Petoumenos, Matthew Law processes in each participating ACCHS, Collaborators: Network of clinical sites Hepatitis Program in selected irrespective of staff turnover. (GPs, hospitals and sexual health clinics) Aboriginal Community Controlled Status: Since March 2012, SHIMMER throughout Australia Health Services researchers have been visiting the Funding: Foundation for AIDS Research This evaluation program seeks to participating ACCHS and meeting with (amfAR) via a US National Institutes of examine changes in service delivery clinic staff who have been developing Health grant through the International within selected Aboriginal Community long term sustainable STI testing Epidemiologic Databases to Evaluate Controlled Health Services (ACCHS) and management strategies for their AIDS collaboration; consortium of throughout NSW. Sexually transmissible ACCHS and communities. Overall, the pharmaceutical companies. infections (STIs) for Aboriginal youths proportion of 15-29 year-olds tested aged 16-25 years of age and blood-borne for chlamydia and gonorrhoea has viral (BBV) infections for patients aged increased. SHIMMER will be conducting The Data Collection on the Adverse 16-54 years will be monitored over time a second audit in March 2013 to examine Events of Anti-HIV Drugs Study (DAD) by examining the number of diagnostics STI and hepatitis C management. tests conducted in relation to occasion of Personnel: James Ward, Basil Donovan, This large, international, collaborative service, rate of positive test results and Rebecca Guy, Simon Graham, Janet study is aimed at assessing the medium care and management of diagnosis (with Knox, Handan Wand, John Kaldor to long-term effects of antiviral treatment particular regards to viral hepatitis). Funding: NSW Health of people with HIV in terms of possible A further component of this program increased risk of cardiovascular events. will be to examine demographic and Status: The study combines data behavioural correlates of sexual and Increasing completeness of from 11 cohorts, including more than reproductive health knowledge and ‘Aboriginality’ in infectious diseases 33,000 patients. Australia contributes risk behaviours. This evaluation aims 706 patients from the Australian HIV to determine if a continuous quality data through record linkage – a Observational Database. improvement program can improve STI/ feasibility study Personnel: Hamish McManus, Stephen BBV testing and management practices in The aim of this project is to link notifiable Wright, Kathy Petoumenos, Matthew Law Aboriginal Community Controlled Health diseases database with other health data Collaborators: Network of clinical sites Services throughout NSW. and provide availability and validity (GPs, hospitals and sexual health clinics) Status: Evaluation updates have been of epidemiological data on notifiable throughout Australia; Copenhagen HIV presented at several national conferences. diseases in Aboriginal people in NSW, Programme, Hvidovre University Hospital Personnel: John Kaldor, Handan Wand, so that incidence and prevalence of Funding: European Agency for the Rebecca Guy, Brigitte Gerstl, Amalie these diseases can be more accurately Evaluation of Medicinal Products (EMEA) Dyda, Andrew Nakhla, Mary Ellen estimated. The objective of this project Harrod, Stephen Anthony, James Ward is to link records from the Notifiable (Baker IDI), Douglas Boyle (Melbourne Diseases Database (NDD) with other The Australian HIV Observational University) routinely collected population health Database (AHOD) STI project Collaborating centres: Family Planning databases to prepare a de-identified NSW; AH&MRC; Bulgarr Ngaru ‘snapshot’ dataset, with improved Sexual health clinics in AHOD will Aboriginal Community Controlled Health completeness of Aboriginal status. contribute data on sexually transmissibly

ANNUAL REPORT 2012 11 infections and treatment in patients cervical intraepithelial neoplasia and Status: At the data transfer in March recruited to AHOD. cervical cancer). New methodology has 2011, baseline and retrospective data Status: Protocol agreed with 11 sites been developed to facilitate the calibration from some 5000 patients from 19 sites involving around 900 patients. Protocol of the model in a Bayesian framework. were aggregated. It is expected that is under review by ethics committees. Individual-based models have been follow-up will continue for at least a First data transfer and analysis in March developed to investigate the potential further three years. 2011. impact of HPV vaccination on non-vaccine Personnel: Jialun Zhou, Awachana Personnel: Kathy Petoumenos, Hamish types and to assess the implications of Jiamsakul, Matthew Law, David Cooper McManus, Stephen Wright, Courtney changes in HPV ecology for surveillance. Collaborators: Network of 19 clinical Bendall, Matthew Law Personnel: David Regan, Matthew sites at countries throughout the Asia- Collaborators: Network of 11 Australian Law, Andrew Grulich, John Kaldor, Igor Pacific region sexual health clinics Korostil, Edward Waters Funding: American Foundation for AIDS Funding: National Health and Medical Collaborators: CSL Limited, Victorian Research (amfAR) via a US National Research Council, NIH, EMEA and Cytology Service Incorporated, University Institutes of Health grant through the pharmaceutical consortium of Melbourne, La Trobe University International Epidemiologic Databases Funding: Australian Research Council, Evaluating AIDS collaboration CSL Limited, Victorian Cytology Service The Australian HIV Observational Incorporated Database Temporary Residents TREAT Asia Studies Evaluating Access Study Resistance (TASER) Mathematical modelling of bacterial An AHOD sub-study recruiting 180 STIs in Australian sub-populations There are two studies: First, a HIV-positive legal temporary residents surveillance study (TASER-S) examining who are ineligible for Medicare and This research involves the design, rates of transmitted HIV-resistance in providing free antiretroviral for a implementation and analysis of newly diagnosed HIV-infected subjects maximum of four years. Recruitment to mathematical models for assessing not previously treated with antiretroviral this study commenced November 2011. the health economic impact of public drugs. Second, a monitoring study Antiretrovirals are provided by all seven health interventions for the control and (TASER-M) assessing rates of developing pharmaceutical companies with licensed prevention of chlamydia, gonorrhoea, HIV-resistance in patients starting anti-HIV drugs in Australia. syphilis and trichomaniasis in different antiretroviral treatments. Status: Ongoing populations in Australia. The models Status: Approximately 2000 naive and Personnel: Hamish McManus, Stephen will address the STIs that are of most experienced patients had been recruited Wright, Courtney Bendall, Kathy importance in heterosexual, MSM, and to TASER-M. Enrolment and follow up Petoumenos indigenous populations, respectively. have ceased. The TASER-M cohort will be Collaborators: National Association of Status: A range of compartmental and terminated in December 2011 with some people living with HIV/AIDS (NAPWA) individual-based models have been of the patients being transferred into developed to evaluate a wide range of TAHOD for future follow-up. screening and intervention strategies for TASER-S: Approximately 480 patients Mathematical modelling of human the control and prevention of bacterial have been recruited from five sites. papillomavirus transmission STIs in remote individual communities Recruitment has ceased for this study. and to assess the potential importance of Personnel: Awachana Jiamsakul, Jialun This research involves the design, community mobility in sustaining high Zhou, Matthew Law implementation and analysis of prevalence of STIs in these communities. Collaborators: Network of 12 sites in mathematical models for assessing the A model of gonorrhoea transmission, South East Asia health-economic impact of Human incorporating infection at different Funding: American Foundation for AIDS papillomavirus (HPV) vaccination, anatomical sites, is in development to Research (amfAR) via a grant from the screening and testing policies in Australia. assess the potential impact of moving government of the Netherlands Status: A general HPV modelling from culture to NAAT as the primary framework has been completed allowing diagnostic test. for the transmission of multiple HPV Personnel: David Regan, David Wilson, TREAT Asia Paediatric HIV types to be modelled. The model has been Ben Hui, Matthew Law, Rebecca Guy, Observational Database (TApHOD) used to estimate the long-term impact Basil Donovan, John Kaldor of the current female-only vaccination Collaborators: University of Melbourne, TREAT Asia Paediatric HIV Observational programme, and a theoretical male + La Trobe University, Deakin University Database (TApHOD) is a collaborative female vaccination programme, on the Funding: National Health and Medical cohort of HIV-infected children in incidence of genital warts due to HPV Research Council the Asia-Pacific region. The study types 6 and 11 as well as the incidence of participants are recruited from TREAT infection due to HPV types 6, 11, 16, and Asia clinical sites. Demographic, clinical 18. The results of this work were reported TREAT Asia HIV Observational and treatment data are aggregated twice in a Technical Report and formed part Database (TAHOD) each year via electronic data transfer. of a submission to the Pharmaceutical Currently, 18 sites in six countries have Benefits Advisory Committee for males Observational cohort study of patients agreed to participate and transferred to be included in the National HPV with HIV at 19 sites throughout the Asia- their data to the Kirby Institute. Immunisation Programme. The model is Pacific region. Demographic, clinical and Status: Up to March 2011, 4045 children being further developed to incorporate treatment data are aggregated twice each were recruited into TApHOD. Of these, progression to HPV-related disease (e.g., year via electronic data transfer. 3277 (81%) children have received

12 ANNUAL REPORT 2012 antiretroviral treatment. There have been 345 (8.5%) deaths, 490 (12.1%) lost to The Opposites Attract study Risk factors for HIV seroconversion follow-up, and 416 (10.3%) transfers to (The Seroconversion Study) other clinics. A four-year cohort study to examine the Personnel: Azar Kariminia, Matthew effect of HIV treatment and HIV viral A study of risk factors for HIV infection Law load on the rate of HIV transmission in among people recently diagnosed with Collaborators: Network of 18 sites 240 HIV serodiscordant gay couples. HIV infection. The findings from this initially throughout the Asia-Pacific region Status: The study started recruitment in study inform HIV organisations and state Funding: TApHOD is funded by The early 2012. health departments about the contexts of Foundation for AIDS Research (amfAR), Personnel: Andrew Grulich (PI), risk behaviours and motivations for these the Austrian AIDS Life Association, and Garrett Prestage, Iryna Zablotska, Jeff behaviours. The study also considers the US National Institute of Child Health Jin, Ben Bavinton, Lara Cassar, David current gaps in policy and program and Human Development (NICHD). Cooper, Anthony Kelleher, David Wilson, development and implementation, Kersten Koelsch, Christopher Fairley, including in the research base, by Kathy Triffitt, Sean Emery, Kate Merlin, interviewing individuals who have HIV EPIDEMIOLOGY AND Jennifer Hoy, Darren Russell, Ban Kiem recently been diagnosed with HIV about Tee, Nick Doong, David Baker, Robert the factors they believe led to their HIV PREVENTION PROGRAM 2012 McFarlane, David Orth, Mark Bloch, seroconversion and their experiences STUDIES Richard Moore, William Donohue, Norm since receiving their diagnosis. Roth, David Templeton, Anna McNulty, Status: By January 2013, 484 individuals HIV vaccine preparedness cohort Emanuel Vlahakis, Mark Kelly. who had recently seroconverted had study (Health in Men study) Collaborators: The Alfred Hospital, participated in the survey and 92 had Cairns Sexual Health Service, Centre been interviewed. The study continues to The HIM study was conducted as a HIV Clinic, Dr Doong’s Surgery, East Sydney recruit participants vaccine preparedness study, to describe Doctors, Gladstone Road Medical Personnel: Garrett Prestage, Ian Down, HIV and STI incidence and associated Centre, Holdsworth House Medical Jack Bradley, Andrew Grulich, Jeanne risk behaviours, and attitudes towards Practice, Melbourne Sexual Health Ellard, Kathy Triffitt, Graham Brown HIV prevention technologies, in a Centre, Northside Clinic, O’Brien Street Collaborators: National Centre in HIV community-based sample of HIV negative General Practice, Prahran Market Social Research; Australian Research homosexual men. Men were interviewed Clinic, Royal Prince Alfred Hospital, Centre in Sex, Health and Society; Curtin twice yearly about a wider range of HIV St Vincent’s Hospital Immunology B University; State AIDS Councils, State and STI risk behaviours, and about their Ambulatory Clinic, Sydney Sexual PLWHA organisations, and State Health attitudes towards HIV prevention. They Health Centre, Taylor Square Private Departments. were tested annually for HIV, syphilis, Clinic, Sexual Health and HIV Service Funding: Queensland Health; Victorian gonorrhoea and chlamydia, and consent Clinic 2 Department of Health; NSW Health was collected for later testing of stored Funding: NHMRC Project grant Department; Western Australian specimens. By 2011, stored samples from Health Department; South Australian consenting participants had been tested Department of Health; Tasmanian for antibodies to hepatitis C, herpes Modelling interventions to prevent Department of Health; Health simplex types 1 and 2, Helicobacter HIV infection and their acceptability Department of the ACT pylori and human papillomavirus. In a substudy, around 300 men also among gay men in NSW underwent an anal pap smear. Those This study uses mathematical modelling PEP users in Sydney, NSW: with an abnormality on pap smear also to estimate the likely impact of a range pilot cohort underwent a high resolution anoscopy. of interventions designed to reduce Chlamydia positive tests underwent rates of HIV infection among gay A cohort of PEP users at St. Vincent’s further testing to examine whether men, and uses both quantitative and Hospital, Sydney, with quantitative lymphogranuloma venereum was present qualitative research methods to assess behavioural data collection at in this population. how acceptable such interventions would enrolment when men request PEP, Status: By the end of the study 1427 men be to the target population. The study at the completion of PEP course and had been followed for over 5000 person- recruited 600 gay men to answer specific six months after completing the years. questions about their attitudes toward a PEP course. The aims were to assess Personnel: Andrew Grulich , Garrett range of possible interventions through ability to enrol and maintain a cohort Prestage, Jeff Jin, Mary Poynten, David an online survey and were then invited to of PEP users and to compare sexual Templeton, Brian Acraman, Patrick participate in five focus groups in Sydney. practices of participants before, McGrath, Jack Bradley, Harry Smith, Data from mathematical models were during and after their PEP course. Leon Botes, Daniel O’Neill, Paul Kelly, considered alongside the findings from As a pilot study, this cohort prepared Kim Scholey, Lara Cassar, Hédimo the acceptability study. and tested the methodology of Santana, Matthew Hua, Joanne Holden, Status: Data collection completed; data recruitment and data collection in a Suzanne Kippax, Limin Mao, John Imrie analysis and reporting is ongoing pilot cohort of NPEP users. Collaborating centres: National Personnel: Garrett Prestage, Jack Status: Enrolment complete. Centre in HIV Social Research; Royal Bradley, Ian Down, David Wilson, Personnel: Iryna Zablotska, John Women’s Hospital, Melbourne; Sexually Richard Gray McAllister Transmitted Infections Research Centre, Collaborators: Australian Research Collaborators: St Vincent’s Hospital University of Sydney Centre in Sex Health and Society PEP clinic Funding: NHMRC; NSW Health Funding: NSW Health Funding: Kirby Institute

ANNUAL REPORT 2012 13 people with HIV. Recently, epidemics Funding: State and Territory Health The PASH (Pleasure and Sexual of acute HCV among HIV-infected men Departments Health) Study: understandings of risk who have sex with men (MSM) have been reported in UK, Europe, USA and among gay men Australia. All of these cohorts report Predictors of PEP awareness and A study of beliefs and attitudes about permucosal, including high-risk sexual, use in Australian Gay Community risks and consequences of HIV infection rather than parenteral, usually injecting in Australian gay men. Data collection drug use (IDU), risk associated with (Australian Gay Community Periodic is completed: In total, 4125 men were HCV transmission. This study of HCV Surveys) referred to the survey, of whom 2306 transmission and its risk factors among A quantitative study of trends in PEP provided sufficiently complete survey homosexual men recruited HIV-positive awareness and use among gay men questionnaires for inclusion in analysis. gay men recently diagnosed with in Australia. In 2011, all behavioural 40 men were interviewed in depth. hepatitis C to answer specific questions questionnaires completed by the The aims of the PASH Study were to about their knowledge of hepatitis C and participants in Sydney, Melbourne, iInterview gay men about their current their beliefs about its transmission. and Brisbane Gay Community Periodic beliefs and understandings of HIV, and Status: Data collection will continue Surveys were analysed in parallel with the risk of HIV transmission, and the with an overseas component (London). the analyses of data from the PEP clinic relations between these and pleasure; Australian data collection was completed in St. Vincent’s hospital. Analyses of PEP inform HIV organisations and state in December 2011. use were published in the Journal of health departments about the contexts Personnel: Garrett Prestage, Ian Acquired Immune Deficiency Syndromes. of risk behaviours and motivations for Down, Jack Bradley, Mark Danta, Gail Status: The team is conducting data these behaviours; and consider current Matthews, Tanya Applegate, Margaret analyses of PEP awareness and will be gaps in policy and program development Hellard, Joseph Sasadeusz working on the preparation of the report and implementation, including in the Funding: NHMRC in 2013. research base.. Personnel: Iryna Zablotska, John Status: In the five months of recruitment, McAllister 2306 online responses were collected, Monogamy: meanings and practices Collaborators: National Centre in HIV while 40 men were interviewed. among gay men Social Research; State AIDS Councils; Personnel: Pól Dominic McCann, Garrett State PLWHA organisations; State Health Prestage, Ian Down, Jack Bradley, This is a study of gay men’s attitudes Departments Michael Hurley, Graham Brown toward and beliefs about monogamy, Funding: State and Territory Health Collaborating centre: Australian and how that affects the kinds of Departments Research Centre in Sex, Health and relationships they form. Gay men are Society, La Trobe University being interviewed in depth about the Funding: State health departments. concept of monogamy and their own Social norms regarding HIV/STI risk relationships. and risk reduction behaviours among Status: Data collection is complete. men who have sex with men in Sexually adventurous men’s study Personnel: Garrett Prestage Australia (CONNECT study) (SAMS) Collaborators: Australian Research Centre in Sex Health and Society HIV/STI risk reduction is more likely to A study to document and record the Funding: NHMRC occur if community norms regarding risk work of the Sexually Adventurous Men’s reduction are supportive and are shared Projects of the Victorian AIDS Council in the community. There is a lack of and PLWHA Victoria, and to investigate Periodic surveys of HIV risk behaviour research on the social norms regarding the beliefs and behaviours among gay (The Gay Community Periodic Surveys) HIV/STI related behaviours among men in sexually adventurous networks in MSM. The CONNECT Study investigated Melbourne. A repeated cross-sectional survey norms and acceptability of risk reduction Status: Processes and record-keeping conducted annually in each participating strategies in Australian gay communities. documentation have been established, state of sexual risk behaviour, HIV and This cross-sectional quantitative study and data collection is ongoing. Interview STI testing, and illicit drug use among used respondent-driven sampling to schedules have been developed. gay men in Australia. In 2011, more than recruit homosexual men in Sydney, Personnel: Garrett Prestage. 9000 behavioural questionnaires surveys Melbourne and Perth to investigate Collaborators: Australian Research were completed in Sydney, Melbourne, norms regarding sexual practices across Centre in Sex Health and Society; Adelaide, Perth, Canberra and Brisbane, different social/sexual networks. Victorian AIDS Council; PLWHA Victoria. as well as in certain regional areas of Status: Recruitment was completed in Funding: Victorian Health Department Queensland. 2012. The research team is currently Status: Ongoing annual surveillance, conducting data analyses for publication. with about 8000-9000 men participating Personnel: Iryna Zablotska, Garrett Defining risk and mechanisms of each year. Prestage, Michelle McKechnie, Ben permucosal transmission of acute Personnel: Garrett Prestage, Iryna Bavinton, Matthew O’Dwyer, John De Zablotska, Andrew Grulich, Martin Holt, Wit, Graham Brown, Bruce Maycock, HCV infection within high-risk John de Wit, Limin Mao Alden Klovdahl, Christopher Fairley, populations (RAMPT-C Study) Collaborators: National Centre in HIV Jeffery Grierson. Hepatitis C (HCV)-related liver disease Social Research; State AIDS Councils; Collaborators: Curtin University, Aids has emerged as a major contributor State PLWHA organisations; State Health Council of New South Wales (ACON), to morbidity and mortality among Departments Positive Life NSW, Australian Federation

14 ANNUAL REPORT 2012 of AIDS Organisations (AFAO), New the relative priority this understanding South Wales Department of Health, takes with respect to other aspects of International pooled analysis of Victorian AIDS Council (VAC), People understanding and knowledge which immune risk factors for lymphoma Living with HIV/AIDS (PLWHA), Western may change or be influenced over time by Australian AIDS Council (WAAC) and prevailing healthcare policy, educational A pooled analysis of case-control studies Western Australia Department of Health. efforts, or personal and anecdotal of immune risk factors for lymphoma. Funding: NHMRC experiences. The responses will provide All twelve member studies sent data on a data that can be analysed to identify key pooled total of 12,982 cases and 16,441 patterns regarding beliefs and attitudes controls, and results on auto-immune Mapping gay community networks in toward HIV, and which will lend itself to disease as a risk factor for non-Hodgkin Sydney, NSW close analysis. lymphoma (NHL) were reported. Status: Recruitment completed, Status: Analyses on infectious conditions No formal research has been undertaken preliminary analysis completed, report and NHL risk were reported. to map the various groups within underway and expected to be published Personnel: Andrew Grulich Sydney’s gay community, or to locate in March 2013. Collaborators: UNSW Cancer Research them geographically and culturally, Personnel: Garrett Prestage, Andrew Centre; University of Southern and to describe their characteristics, Grulich, Jack Bradley, Martin Holt, Mary California; German Cancer Research interconnections and the best ways of Poynten, Ben Bavinton, Kathy Triffit, Centre; Feinberg School of Medicine, accessing them. This mixed-method Graham Brown, Phillip Keen, Geoff Northwest University; Centre for Study cross-sectional study involved interviews Honnor, Colin Batrouney, Dean Murphy, and Prevention of Cancer; Aviano Cancer of opinion leaders representing different Lance Schema. Centre; Catalan Institute of Oncology; networks and organisations of gay men Collaborating centres: NCHSR, University of California, San Francisco; in Sydney to describe the structure PositiveLife NSW, La Trobe University, David Geffen School of Medicine, and functioning of the Sydney gay NAPWA, ACON, AFAO University of California, Los Angeles; community. The protocol and data Funding: NHMRC University of York; British Columbia collection instrument were developed. Cancer Registry; School of Medicine, Data collection has commenced and 130 Yale University gay community groups and networks The SPANC study (Study of the Funding: Leukaemia Foundation of have been interviewed by the end of 2011. prevention of anal cancer) Australia Status: 200 groups have been identified and 183 interviews conducted.. Gay men are at greatly increased risk of Personnel: Iryna Zablotska, Garrett human papillomavirus (HPV)-related Serological studies of HPV in gay Prestage, Michelle McKechnie, Matt anal cancer. This study tracks the Australian men O’Dwyer precursors of anal cancer in a cohort Collaborating centres: The Australian of HIV negative and HIV positive gay A sero-epidemiological study of the Research Centre in Sex Health and men. This cohort study examines the prevalence, incidence and predictors of Society at La Trobe University and prevalence, incidence and risk factors infection with a number of different HPV the gay community organisations and for progression of human papillomavirus types. partners (particularly, the AIDS Council infection and anal cancer precursors Status: In 2011, over 5000 serological of NSW and Positive Life NSW). in HIV positive and HIV negative samples from the Health in Men study Funding: NSW Health homosexual men aged 35 and older. were analysed for antibodies to 10 HPV Status: By the end of 2011, 190 types at the German Cancer Research participants were recruited. Initial Centre (DKFZ) in Heidelberg, Germany. TAXI KAB Study analyses were reported on safety and Analyses of the data were completed. adverse effects of anal cancer screening Two papers have been published. Knowledge Attitudes, and Beliefs (KAB) were presented. Personnel: Mary Poynten, Andrew of gay men in Australia when they Think Personnel: Andrew Grulich, Jeff Jin, Grulich, Jeff Jin, Dave Templeton, About eXposure to Infection (TAXI) to HIV. David Templeton, Garrett Prestage Garrett Prestage, Tim Waterboer, Michael This project describes understandings Andrew Grulich, Richard Hillman, Jeff Pawlita, Christopher Fairley, Basil of HIV risk by gay men in the context of Jin, Mary Poynten, David Templeton, Donovan, Suzanne Garland knowledge, attitude and behaviour. The Brian Acraman, Patrick McGrath, Collaborators: German Cancer Research study aims to describe patterns of belief Matthew O’Dwyer, Dorothy Machalek, Centre (DKFZ), Heidelberg, Germany about HIV transmission and relative Garrett Prestage, Winnie Tong, Funding: STI Program Grant, NHMRC risk; assess the attitudes these men have Kate Thompson, Suzanne Garland, Post-doctoral Training Scholarship (M. developed; and describe the behaviour Christopher Fairley, Jennifer Roberts, Poynten) of these men in those contexts. The Annabelle Farnsworth, Adele Richards, study aims to explore the knowledge, Sepehr Tabrizi, Alyssa Cornwall, Andrew attitudes and beliefs around HIV among Carr, Kirsten McAffery, Kirsten Howard. IMMUNOVIROLOGY AND gay and bisexual men in a single research Collaborating centres: St Vincent’s project that uses quantitative methods. Hospital Immunology B Ambulatory PATHOGENESIS PROGRAM This study would: 1. Measure current Clinic; Sexually Transmitted Infections 2012 STUDIES attitudes, knowledge levels, and beliefs Research Centre, University of Sydney; about HIV among gay men; and 2. School of Public Health, University of Randomised trial in primary HIV Explore these beliefs about relative risk, Sydney; Douglas Hanly Moir Pathology; infection looking at three forms of both in terms of their understandings Royal Women’s Hospital, Melbourne. of the relative risk of transmission and Funding: NHMRC Program Grant intervention (SPARTAC)

ANNUAL REPORT 2012 15 SPARTAC (short pulse antiretroviral and repository provided basis for several the overall smooth running of clinical treatment at seroconversion) looks publications and ongoing and new trials and natural history studies. at the effect on CD4 T-cells of three collaborations Status: Ongoing interventions at primary HIV infection, Personnel: Pat Grey, Ansari Shaik, David Personnel: Anthony Kelleher either treating with antiretroviral therapy Cooper, Anthony Kelleher. Collaborators: Kate Merlin, Julie for 12 or 48 weeks or not treating at Collaborators: Robert Finlayson, Yeung, Maria Piperias, Bertha Fsadni (St all until CD4 declines to <350 cells. Mark Bloch, Cassy Workman, Robert Vincent’s Hospital, Sydney) Enrolment ceased in June 2007, by which McFarlane, Dr B.K. Tee, Norman Roth, Funding: Project-specific grants time 37 patients had been screened, and Phillip Cunningham, John Zaunders, Co-located: Viral Hepatitis Clinical 31 patients continue to be followed up. Tim Read, John Murray (School of Research Program and Immunovirology Status: Study completed, primary Mathematics) and Pathogenesis Program manuscript accepted for publication in Funding: NHMRC Program Grant NEJM. Personnel: Anthony Kelleher, Pat Grey RESTORE Collaborators: Jonathon Weber, Sarah Australian Long-Term Non-progressor An observational study to explore Fidler, Robert Finlayson, Mark Bloch, Study reconstitution of immunity in patients Robert McFarlane, Cassy Workman, with advanced HIV-1-infection Nick Doong, David Cooper, Mark Kelly, The Australian long-term non-progressor commencing combination antiretroviral Norman Roth, Dr BK Tee, Richard Moore, cohort study was established in 1994 therapy Philip Cunningham, Kate McGhie, Julie and is ongoing. Studies focussing on Target: 50 patients recruited and in Yeung identifying the reason this rare group follow-up Funding: Wellcome Trust of people with prolonged HIV infection Status: week 48 follow up completed remain healthy, with virtually no damage Sites: one site in Thailand to their immune system, are extremely Personnel: Denise Hsu, Sarah Pett, Sean Laboratory surveillance of incident important for understanding the Emery, Anthony Kelleher, HIV infection pathogenesis of HIV and for developing Collaborators: Jintanat Ananworanich, new antiretroviral therapy and Sasiwimol Ubolyam, Anchalee Laboratory markers are used to preventative vaccines. Avihingsanon, Kiat Ruxrungtham, determine incident from established Status: Of the 163 participants recruited Praphan Phanuphak, HIV-NAT Bangkok HIV infection to monitor the trends in to this cohort 42 individuals (sustained Funding: NHMRC, UNSW newly acquired infections, providing an non-progressors) are still treatment- important sentinel surveillance tool. BED naïve. Four new patients were recruited ELISAs, and analysis of other routine in 2012. Provided basis for a several Dynamic trafficking of HIV spread laboratory markers used in the diagnosis publications. of HIV infection, are used in monitoring Personnel:Anthony Kelleher, Pat Grey, HIV as a cell-free viral entity is new infections. Ansari Shaik, John Kaldor, David Cooper vulnerable to many attacks by the innate Status: All newly identified cases of HIV Collaborators: Long-Term Non- and acquired immune system. To get infection at the NSW State Reference progressor Study Group, including around these often hostile conditions, Laboratory for HIV at St Vincent’s clinical sites in Sydney, Port Kembla, HIV predominately spreads from one Hospital were analysed on BED assays. Canberra, Brisbane and Melbourne; cell to the next when they are intimately Protocols were further developed Kat Marks, St Vincent’s Hospital, contacting each other in a structure towards a goal of deriving viral sequence Sydney; Stephen Kent and Ivan Stratov, referred to as a synapse. Whilst the for RT protease and integrase genes University of Melbourne. International main objective for virus to move across from dried blood spots. This would allow collaboration includes Elite Controller a synapse is evasion, it may also be seen sophisticated molecular epidemiology Collaborative Project and the as a form of synchronised infection. For to be performed even in resource-poor International AIDS Vaccine Initiative instance, once an infected cell makes settings. (IAVI). contact with a future HIV target, the Personnel: Anthony Kelleher Funding: NHMRC virus actively promotes release of many Collaborators: Philip Cunningham, virions towards this neighbouring target. St Vincent’s Hospital, Sydney; Sara This effectively overwhelms the new Evans, Celine Yang, Kazuo Suzuki, Jane Specimen receipt and processing cell with virus, making it difficult for Cornwall for clinical trials and natural history natural defences and also antiretroviral Funding: NSW Health Department drugs to stop and/or control. This project studies represents a study only currently capable The laboratory provides a service in a few laboratories worldwide, as it Primary HIV and early disease to other Kirby Institute programs has taken years to develop appropriate research – Australian cohort encompassing the separation of blood HIV constructs that could be used to components including but not limited visualise in primary infected cells. The (PHAEDRA) Extension to; cryopreservation of serum, plasma major aim of this project is to track live A systematic mechanism to follow-up the and PBMC, archiving and on shipping infectious HIV moving from cell to cell PHAEDRA and Core01 cohorts in Sydney of samples. The service also includes and delineate key cellular pathways the and Melbourne with acute and early HIV- database management of the storage of virus corrupts in this process. 1 infection. these samples. Staff also have experience Status: For the first time, we have Status: Good follow-up of patients with the implementation of assays identified HIV using long acting-based already enrolled and some patients which are not offered by local diagnostic structures to co-ordinate spread to new rolled over from SPARTAC. Database laboratories. This service contributes to targets. The virus does so by embedding

16 ANNUAL REPORT 2012 in the tips of long finger-like projections system are resistant to gene therapy, will Collaborators: John Zaunders, called filopodia. In doing so, the virus help in increasing the efficacy of this type Mahila Namasivayam, Tony Walls, has hijacked a probing structure that is of treatment. John Ziegler, Nabila Seddiki, Stephen otherwise used by cells of the immune Status: Using lentiviral vectors that can Kent, Bob Anderson, Jason Tye-Din, system to initiate communication of the package the related monkey virus protein Jintanat Ananworanich, Sasiwimol immune response. VPX, we and others have been able to Ubolyam, Anchalee Avihingsanon, Kiat Personnel: Stuart Turville, Anupriya introduce genes into highly resistant Ruxrungtham, Praphan Phanuphak Aggarwal, Tina Iemma, Ivy Shih cells (macrophages and dendritic cells) Funding: NHMRC, St Vincent’s Hospital, Collaborators: Thomas Hope, Timothy at efficiencies of greater than 60%. Coeliac Foundation Newsome Presently, we are targeting resting Co-located: Viral Hepatitis Clinical Funding: NHMRC primary CD4 T cells, with the aim of Research Program and Immunovirology raising gene transduction to similar and Pathogenesis Program levels. In doing so we wish later to create Novel inhibitors of HIV entry cells of the immune system that are resistant to future HIV infection. RNA inducing viral latency The site where HIV fuses to the cellular Personnel: Stuart Turville, Sam membrane has remained one of McAllery, Anupriya Aggarwal, Tina This project is related to siRNA gene the most controversial areas in HIV Iemma silencing for HIV-1 and SIV infection. biology. As HIV can fuse with cellular Collaborators: Nathaniel R. Landau siRNAs targeting viral promoter DNA membranes in a pH independent Funding: NHMRC region induce transcriptional gene manner, it is already assumed that silencing (TGS) of viral genes in infected the virus can directly fuse with the cells. The study has been extended to plasma membrane. However, recent Assays of T-cell function, proliferation two major objectives: delivery system of studies knocking down both Dynamin and cytotoxicity, and identification of siRNA and mechanism of gene silencing. and Clathrin proteins, has highlighted To develop and evaluate delivery HIV may favour entry via endosomal antigen-specific T-cells systems including lentiviral and non- membranes. Through a collaborative A range of flow cytometric assays for viral systems for use in a humanised venture with Professor Philip Robinson assessing CD4+ and CD8+ T-cell mouse HIV-1 infection model; and to at the Children’s Medical Research function are worked up in the laboratory. define the pathways by which dsRNAs Institute, we are currently testing a The measures of antigen-specific T-cells targeting the promoter regions of HIV-1 portfolio of Dynamin and Clathrin include T-cell proliferation, activation and SIV. Silencing constructs applicable specific set of compounds and their and cytokine secretion. Such assays for use in HIV-1 infection have been impact on HIV entry. are important for understanding HIV development. These constructs have Status: We have developed an imaging pathogenesis and in responses to been incorporated into a lentiviral platform of uniquely labelled virions, to vaccines, and therefore are included in delivery system, which will be assessed map the entry, fusion and uncoating of the protocols of clinical trials and natural in vitro. Epigenetic changes induced the virus under normal conditions and in history studies carried out by the Kirby by siRNAs targeting HIV-LTR will also the presence of inhibitors. In conjunction Institute. Assays were performed as be defined. We also investigated the with high throughput assays, we have part the PINT trial of therapy with the subcellular localisation of Argonaute identified a novel block to HIV entry integrase inhibitor, Raltegravir and the proteins (Ago) during the TGS process using Dynamin and Clathrin specific Restore and PrIRIS studies in Bangkok and recently reported the presence of compounds, but not at the level of viral and Sydney respectively. Other studies Ago1 in the nucleus and Ago2 in the fusion as expected. Rather, the block is were conducted as part of the PHIIDO nuclear membrane as demonstrated by at the time of reverse transcription, with observational study of primary HIV confocal microscope using tagged Ago1/ little to no block at the time of entry/ infection. These assays were validated Ago2 and fluorescently labelled siRNA. fusion. in the context of two competed clinical We also demonstrated colocalisation Personnel: Stuart Turville, Tina Iemma, studies assessing latent TB infection in between Ago1 or Ago2 and F-actin and Anupriya Aggarwal Bangkok and Sydney; in a clinical study are currently following up of this novel Collaborators: Philip Robinson of CMV re-activation and Adenovirus finding to potentially link transport of Funding: Australian Centre for HIV and infection following paediatric bone the molecules from the cytoplasm into Hepatitis Virology Research (ACH2) marrow transplantation, and in following the nucleus where they would then act Location: Immunovirology and immune responses with gluten induced on the HIV-1 promoter to initiate gene Pathogenesis Program flares of Coeliac disease. Assays were also silencing. conducted to elucidate the generation of Status: successful completion of in vivo CD4+ T-cell responses during primary proof of principle experiments using Lentiviral vectors and gene therapy vaccinia vaccination. SCID-Hu mouse model of HIV-1 infection Status: Continued analysis of samples with Japanese collaborators The quest for a HIV cure is top on the from PHAEDRA and the long-term Personnel: Anthony Kelleher, Chantelle list of objectives worldwide in the fight non-progressor cohorts, TB studies Hood, Sanjay Swaminathan against this disease and therapy by completed, studies of CMV disease Collaborators: Kazuo Suzuki, Takaomi lentiviral vectors is one means to attack completed in 2011 and coeliac study Ishida, Makoto Ymamagisi, Toshiki the virus potentially at multiple levels. commenced. Watanebe One of the key limitations to the use of Personnel: Susanna Ip, Laura Cook, Funding: NHMRC gene therapy is the natural resistance Mee-Ling Munier, Michelle Bailey, Yin Co-located: Viral Hepatitis Clinical of immune cells to this procedure. Thus Xu, Chansavath Phetsouphanh, Celine Research Program and Immunovirology understanding why cells of the immune Yan, Anthony Kelleher, Denise Hsu and Pathogenesis Program

ANNUAL REPORT 2012 17 different subsets, which will provide HIV drug resistance and viral In vivo visualisation of epithelial hints on coreceptor usage. Ethics tropism surfaces by confocal endomicroscopy approval has obtained to collect tonsilar tissues from healthy donors by Dr. This project involves the development This project intends to combine Richard Harvey. Cells will be isolated for of expertise in the application of the development of laser scanning real-time phenotyping and functional a number of methods of detecting endomicroscopy with antibody reagents assays, and stored for later studies. antiretroviral drug resistance and fluorophores as tools for detection Personnel: Yin Xu, Chris Weatherall, through genotypic testing of HIV of disease markers in the gastrointestinal Michelle Bailey, Kazuo Suzuki, John isolates. The program has three tract. This will provide us with tools to Zaunders, Anthony Kelleher. major projects: evaluation and visualise biological processes in the real Collaborators: Rob de Rose, Rob Center, conducting commercially available time and enable instant diagnosis for Stephen Kent, Brigette Autran, Richard genotype testing for protease, reverse diseases such as inflammatory bowel Harvey. transcriptase regions; development disease. Funding: NHMRC Program Grant of a new, cheap in-house genotyping Status: Preliminary studies in ex- method from blood dry-spots as a vivo tissue have been conducted. starting material; and development of Standardised protocols were Primary HIV Infection Data assays for the determination of CCR5 established for the in vivo assessment Observational (PHIIDO) tropism of patient’s HIV isolates. More of mucosal barrier function by confocal than 700 HIV-1 resistance genotypes endomicroscopy. Fluorescent labelling This is a study of untreated individuals, have been performed based on the of ex vivo tissue has been optimised and designed to recruit and follow up a cohort commercial based resistant assays. a mouse model has been established for of people with documented acute and early Validation of new in-house genotyping intravital imaging of the mucosal lining HIV infection, not going onto antiretroviral method is close to completion.. The of the small intestine. therapy, although patients may initiate CCR5 tropism assay for RNA has been Personnel: Tri Phan, Mehreen Arshi, antiretroviral therapy at any stage in transferred to the NSW State reference Mark Danta, Anthony Kelleher consultation with their treating clinicians laboratory at St Vincent’s and is being Collaborators: Daniel Christ, Peter in accordance with current standard used for routine care. The validation of Delaney. of care guidelines. There is also an aim the DNA version of this assay is complete Funding: ARC Linkage Grant to provide the clinical and laboratory and has been used for routine patient framework to characterise immunological care since January 2012. responses/viral events that occur early in Status: In routine use Characterisation of infection of the course of HIV infection in untreated Personnel: Anthony Kelleher, Celine follicular T helper cells during subjects with a focus on factors that Yan, Kerstin Koelsch, Yong Pan determine natural viral control. Subjects Collaborators: Kazuo Suzuki, Kat Marks, pathogenic SIV infection and HIV-1 are adults identified with acute or early Nick Rismanto Philip Cunningham, Leon Infection HIV infection, who do not intend to go on McNally, Alexander Carrera The aim of this project is to understand treatment at present. Analysis of factors Funding: NSW Health Department, ViiV the fate and role of T follicular helper associated with disease progression will be Co-located: Viral Hepatitis Clinical cells, a subset of memory CD4+ T cells undertaken on an annual basis including, Research Program and Immunovirology which helps B cells to make high affinity, CD4 decline to <350 cells/mm, plasma and Pathogenesis Program class-switched antibodies and to develop levels of HIV-1 RNA, serial CD4/CD8 memory, during pathogenic SIV infection counts, meeting the criteria for initiation of

or HIV infection. Macaque TFH cells ARV therapy, progression to AIDS or death. PINT were phenotypically characterised from Status: Study commenced in May 2009; lymphoid tissues and sorted into pure 16 patients screened A study of the effects of the integrase population for SIV DNA quantification. Personnel: Pat Grey

inhibitor, raltegravir, on viral reservoirs Result shows that TFH cells were infected Collaborating centres: St Vincent’s in those treated at primary HIV-infection with SIV at similar levels as other Hospital, AIDS Research Initiative, East compared to those treated during chronic memory CD4+ T cells, and despite Sydney Doctors, Holdsworth House infection. infection, they accumulated during the Medical Practice, Taylor Square Private Status: Two publications in 2012; further chronic stage. Current focus is on the Clinic and Albion St Clinic

modelling of viral turnover in T-cell mechanisms for viral entry and TFH cell subsets commenced; extension phase accumulation. Collaboration was also set analysis commenced. up with a French group lead by Professor Role of miRNA in disease progression Personnel: Anthony Kelleher, Linda Brigette Autran. TFH cells and other Gelgor, Pat Grey, Kersten Koelsch, CD4+ T cell subsets were sorted in Paris miRNAs are a relatively recently described Christophe Boesecke, Sean Emery, and shipped to Sydney for confirmation mechanism of regulating and fine-tuning

Wendy Lee, Janaki Amin, David Cooper. of TFH cell infection with HIV in humans. mRNA and protein production. Their Collaborators: Robert Finlayson, Mark Mechanism work will also be performed role in determining outcomes of HIV

Bloch, Robert McFarlane, John Zaunders, on TFH cells from healthy donors. infection is poorly understood. This study Kat Marks, Kate McGhie, Julie Yeung, Status: Characterisation of infection of is designed to identify new targets for

John Murray TFH cells in pathogenic SIV infection in therapeutic intervention and to determine Funding: Merck & Co Inc. pigtail macaques has completed with one profiles of miRNAs in groups of patients

Co-location: Therapeutic and Vaccine publication in 2013. TFH cell infection with disparate clinical outcome Research Program and Immunovirology with HIV-1 has been confirmed. We are Status: Ongoing and Pathogenesis now sequencing envelope gp120 from Personnel: Sanjay Swaminathan,

18 ANNUAL REPORT 2012 Chansavath Phetsouphan, Yin Xu, Laura Collaborating centre: St Vincent’s (SA Prison Health Service); Chris Cook, Daniel Murray, Chantelle Hood, Hospital, Sydney Wake and Deborah Siddall (Tasmania Nabila Seddiki, Kazuo Suzuki, John Funding: Project-specific grants Correctional Primary Health Services); Zaunders Fiona MacFarlane and Michele Gardner Collaborating centres: Long-Term Non- (Justice Health Victoria); and Holly progressor Study Group; Faculté Créteil Immunopathogenesis of immune Beasley (WA Corrective Services). Henri Mondor, Créteil France; University reconstitution disease Collaborating centres: ACT Corrections of Canberra; St Vincent’s Hospital, Health; Justice Health NSW; NT Sydney; Garvan Institute Studies of the immunopathogenesis of Correctional Services; Queensland Funding: NHMRC immune reconstitution disease (IRD) Health; SA Prison Health Service; based on the samples studied ex vivo Tasmania Correctional Primary Health from patients suffering this disease. Services; Justice Health Victoria; WA Role of ADCC in disease progression This study is exploring the causes of this Corrective Services. dysregulation, with particular focus on Funding: State and Territories Antibody dependent cytotoxicity is a the role of T regulatory cells. Studies governments contributions. mechanism by which natural killer cells commenced in 2006 and were formalised kill infected cells. Its role in control of to recruit all patient-commencing CART HIV-infection and in preventing HIV late in the disease with a natural history REINVEST: Reducing impulsive infection post vaccination is unclear. It is study called PrIRIS. Analysis of assays behaviour in repeat violent offenders mediated by certain isotypes of IgG. This performed real time elucidating the study will define quantity and quality phenotype (eight flow cytometry panels) using a Selective Serotonin Reuptake of ADCC responses in various patient at intracellular cytokine secretion and at Inhibitor (the REINVEST study) groups and look for correlations with antigen-specific regulatory and effector Serotonergic dysfunction in the control. Studies are being undertaken T-cells. brain has been linked to impulsivity with collaborators in Melbourne Status: Data analysis is ongoing and and impulsive behaviour has been and Perth to determine correlates of cryopreserved samples are being used for linked to offending behaviour, progression and unique epitopes. immunopathogenesis studies. particularly violent offending. This Status: Samples on all LTNP and Personnel: Anthony Kelleher, randomised control trial examines untreated patients at primary infection Chansavath Phetsouphanh, Denise Hsu, whether treatment with a class of with varying rates of progression have Mee-Ling Munier, David van Bockel, antidepressant medication know as a been transferred to Melbourne and Sarah Pett, Nabila Seddiki selective serotonin reuptake inhibitor Perth for conduct of assays. Manuscript Collaborating centres: St Vincent’s (SSRI) is effective in reducing reporting results in LTNPs and rapid Hospital, Sydney; Faculté Créteil Henri impulsivity, and hence offending progressors has been submitted for Mondor, Créteil behaviour, in repeat-violent offenders publication. Funding: NHMRC in New South Wales. Personnel: Anthony Kelleher, Pat Grey, Status: planning underway Ansari Shaik, David Cooper, Kat Marks. Personnel: Tony Butler, Lee Knight; Collaborating centres: Long-Term JUSTICE HEALTH RESEARCH Peter Schofield (Hunter New England Non-progressor Study Group, including Health), David Greenberg (Justice clinical sites in Sydney, Port Kembla, PROGRAM 2012 STUDIES Health NSW), Don Weatherburn Canberra, Brisbane and Melbourne; St (NSW Bureau of Crime Statistics and Vincent’s Hospital, Sydney; Department National Prison Entrants’ Bloodborne Research), Kay Wilhelm (St Vincent’s of Immunology and Infectious Diseases, Virus Survey (NPEBBVS) 2010 Hospital), Vaughan Carr (Schizophrenia Melbourne University; Department of Research Institute), Catherine D’Este Immunology, Royal Perth Hospital. The NPEBBVS is conducted triennially (Newcastle University), Phil Mitchell and involves screening a consecutive (University of New South Wales), Alison national sample of prisoners entering Jones (University of Wollongong); Tony Immuno-phenotyping of T-cell subsets the correctional system in Australia. Keech (Sydney University), Val Gebski The survey screens for HIV, hepatitis B, (University of Sydney); Rodney Scott Many of Kirby Institute’s clinical trial hepatitis C, chlamydia, gonorrhoea, and (University of Newcastle); Jocelyn Jones and natural history protocols involve syphilis. A short behavioural risk factor (National Drug Research Institute), immunological sub-studies. The questionnaire collects information on Luke Grant (Corrective Services NSW), laboratory supports these sub-studies demographic characteristics, drug use, Carolynn Dixon (Justice Health NSW), as a semi-routine service. Performance injecting practices, tattooing, tobacco Alison Churchill (CRC Justice Support), of intensive assays has been undertaken smoking, and sexual health. Steven Allnutt (Justice Health NSW), as part of the PINT and CORAL studies, Status: Completed latest iteration in Andrew Ellis (Justice Health NSW) including analysis of stem cells. Several 2010; 2013 version being planned. Collaborating centres: Corrective novel assays have been developed with Personnel: Tony Butler Services NSW; Justice Health NSW; new insights into pathogenesis. Project steering committee: Tony Butler Hunter New England Health; UNSW Status: The CORAL study was completed (Kirby Institute), Michael Levy (ACT Psychiatry; Schizophrenia Research in 2010. Corrections Health); Devon Indig Institute; Newcastle University; NHMRC Personnel: Mee-Ling Munier, Michelle (Justice Health NSW); Kiah McGregor, Clinical Trials Centre; Bureau of Crime Bailey, Chansavath Phetsouphanh, Yin Simon Stafford, and Robyn Hopkins (NT Statistics and Research; University of Xu, Anthony Kelleher, Denise Hsu, Laura Correctional Services); Alun Richards Wollongong. Cook, Will Hey-Cunningham, Kersten and Stacy Kambouris (Queensland Funding: NHMRC Partnership Grant; Koelsch, John Murray, John Zaunders. Health); Peter Frost and Karen Harlin NSW Health Department Funding.

ANNUAL REPORT 2012 19 health burden compared with the general to their health in the 12 months prior HePaTO: Hepatitis C, Prison, and community, there is a need to develop to their imprisonment. Alcohol has also Treatment Opportunities knowledge in this area, particularly in been implicated as a major contributing relation to Indigenous incarceration. factor to the high levels of Indigenous Few prisoners report receiving treatment This project sees indigenous and non- imprisonment, with Indigenous for hepatitis C in prison. The aims of Indigenous academics from Western Australians only comprising about 2.5% HePaTO are to identify cultural and Australia, the ACT, New South Wales and of the general population but around systemic barriers to providing treatment Victoria develop offender health research 20% of the prison population nationally. for Indigenous and non-Indigenous capacity within a team of indigenous This project investigated what alcohol prisoners during incarceration in Australia, and non-Indigenous investigators. and other drug rehabilitative programs to estimate the potential number of Investigators work on collaborative exist in Australian prisons for Indigenous prisoners who could be treated for chronic projects in the areas of mental health, men. This research explored gaps in hepatitis C in prisons in Australia, and to substance use, blood-borne viruses, services provision and it is hoped that evaluate the potential economic impact of impact of incarceration on indigenous further work will look at how these gaps treating chronic hepatitis C in prison. communities, and models of care for can be addressed. Status: Qualitative interview completed. indigenous offenders. Status: Complete. Modelling component underway Status: Ongoing. Personnel: Michael Doyle, Colleen Personnel: Tony Butler, Lorraine Yap; Personnel: Tony Butler, John Kaldor, Fishers, Sherry Saggers, Tony Butler Susan Carruthers (National Drug Kay Wilhelm, Michael Doyle,. Megan Collaborating centres: The University of Research Institute, Curtin University); Williams, Paul Simpson, Lise Lafferty Western Australia’s School of Population Wendy Cheng (Royal Perth Hospital); Collaborating centres: National Centre Health, National Drug Research Institute Sandra Thompson (Combined for Indigenous Studies (Australian (Curtin University) Universities Centre for Rural Health, National University); National Drug Funding: This project was funded as part University of Western Australia); Jocelyn and Alcohol Research Institute (Curtin of the NHMRC capacity building grant Jones (National Drug Research Institute, University); Winnunga Nimmityjah Curtin University) Aboriginal Health Service (ACT) Funding: NHMRC Project Grant Other investigators: Michael Levy, Mick Reducing Australia’s Aboriginal Dodson, Fadwa Al-Yaman, Dennis Gray, prisoner population through ‘Justice Steve Allsop, Jocelyn Jones, Jill Guthrie, Reinvestment’: assessing the public’s Does traumatic brain injury (TBI) lead Nerelle Poroch, Dina Saulo views on imprisonment versus to offending behaviour? Funding: NHMRC non-imprisonment alternatives for Rates of reported past TBI within offenders using Citizens’ Juries offender and prisoner populations are Strengthening China’s response to Justice Reinvestment has been gaining extraordinarily high and it has been HIV, TB and HIV/TB co-infection attention among Indigenous, health and suggested that TBI may be responsible offender advocates and is touted as a for up to half of all crimes leading to in labour camps (lao jiao suo) in a possible solution to Indigenous over- incarceration. Our study is designed to southwestern China region representation in Australia’s criminal rigorously examine this question using The aim of the study is to describe the justice system. This project seeks to high quality linked data, adopting a health status of detainees in re-education- determine, through ‘Citizens’ Juries’, whole of life-time approach. Should a through-labour-camp and identify through the opinions and views of a critically relationship between TBI and subsequent self-reported questionnaires their level of informed public towards alternatives to offending be established, this will open HIV and TB knowledge, risk behaviours, incarceration. It also examines whether up the possibility of developing effective and health management of men and policy makers are influenced by the interventions to prevent this trajectory. women in labour camp settings. opinions and views of the Citizens’ Juries. Status: Analysis underway Personnel: Lorraine Yap, Tony Butler, Status: Ongoing. Personnel: Tony Butler, Basil Donovan, Zunyou Wu (China National Center in Personnel: Tony Butler, Paul Simpson, Lorraine Yap, Juliet Richters (SPHCM); AIDS and STD Control and Prevention), Michael Doyle, Jill Guthrie, Jocelyn Jones Luke Grant (Corrective Services NSW); Liu Wei (Guangxi CDC), Chen Yi (Guangxi Collaborating centres: National Centre Alun Richards (Queensland Health) CDC); Lei Zhang, Joanne Reekie for Indigenous Studies (Australian National Collaborating centres: Justice Health Collaborating centres: China National University); National Drug and Alcohol NSW; Corrective Services NSW; Center in AIDS and STD Control and Research Institute (Curtin University) Queensland Health; National Centre in Prevention, Guangxi Provincial Centre Project Funding: Lowitja Institute HIV Social Research for Disease Control (Department of AIDS Funding: NHMRC Project Grant Control and Prevention), Re-education- Through-Labour Administration in the PUBLIC HEALTH region INTERVENTIONS RESEARCH Broome to Berrima: building capacity Funding: AusAID Development Research Australia wide in Indigenous offender Award GROUP 2012 STUDIES health research Young Women’s Reproductive Health Australia has one of the highest Alcohol and other drug interventions in Study Indigenous incarceration rates in the Australian prisons for Indigenous men OECD which impacts profoundly on This is a nationally representative survey indigenous communities. With offender 73% of Indigenous people entering of young women designed to obtain populations known to endure a greater prison had used alcohol at levels harmful population-based information on human

20 ANNUAL REPORT 2012 papillomavirus vaccination coverage, developing country partners. While there Collaborating centres: National Centre prevalence of genital warts and genital is no standard approach to measuring for HIV/AIDS, Dermatology and STD chlamydia and other issues pertinent to research capacity, bibliometrics has been (NCHADS), Phnom Penh, Cambodia; young women’s reproductive health such used in a number of developing country School of Public Health, Udayana as pregnancy and contraception. settings. We aimed to assess the change University (UU), Bali, Indonesia; Faculty Status: Recruitment underway and in research capacity over time, through a of Medicine, Universitas Gadjah Mada, analysis underway. ten year analysis of trends in authorship (UGM), Yogyakarta, Indonesia Personnel: Bette Liu, John Kaldor, Basil positions and predictors of authorship. Funding: AusAID Donovan, Julia Brotherton, Marion Saville Status: analysis underway Collaborating centres: Victorian Personnel: Skye McGregor, John Kaldor, Cytology Service; National HPV Klara Henderson Scabies - Factors associated Vaccination Register Funding: Nil with scabies in a highly endemic Funding: NHMRC Program Grant, Victorian Cytology Service population Predictors of research involvement Scabies is a major cause of morbidity for developing country UNSW Public in many developing countries, leading to economic disadvantage and reduced Notifiable Diseases and Reproductive Health research graduates Health quality of life. This project addresses Research in Masters and Doctoral the problem of scabies control in high This project uses data linkage in NSW to degrees are pathways to understanding prevalence countries, through the examine the effects of commonly notified methods and the role of research. As investigation of the efficacy of two diseases including sexually transmitted a consequence of limited graduate alternative mass drug administration infections and blood borne viruses on education opportunities in developing (MDA) regimens in Fiji compared to the reproductive health outcomes in women. countries, students in these countries current standard of care, which centres Status: Recruitment completed and tend to complete studies overseas. The on treatment of asymptomatic cases analysis underway. question is whether these students go and their direct contacts. This study has Personnel: Bette Liu, Louisa Jorm, on to have careers in research, and three main objectives: to characterise the Christine Roberts, John Kaldor, Rebecca contribute to the research capacity of participants in a Fiji community survey Guy, Basil Donovan, Joanne Reekie their countries. Our aim is to describe the of scabies; to identify environmental Collaborating centres: University characteristics of UNSW public health and demographic risk factors for scabies of Western Sydney; Kolling Institute research graduates, to measure their in Fiji; and to provide information on University of Sydney research output and to analyse predictors possible preventative measures for scabies. Funding: NHMRC Post-doctoral of research involvement. Status: currently recruiting fellowship; NHMRC Program Grant Status: Ongoing Personnel: John Kaldor, Lucia Romani, Co-located: Public Health Interventions Personnel: Skye McGregor, John Kaldor, Handan Wand, Andrew Steer, Margot Research Group and Sexual Health Program Klara Henderson, Joanne Travaglia Whitfield, Ross Andrews, Hla Hla Thein, Collaborating centre: School of Public Josefa Koroivueta, Lisi Tikoduadua, Health and Community Medicine Timothy Furlong, Apisolome Identifying predisposing factors for, Funding: Nil Nakolinivalu, Eric Rafai,Meciusela and the consequences of, common Tuicakau Collaborating centres: Murdoch and emerging infectious diseases Field Research Training Program, HIV Children’s Research Institute, Menzies This project will involve using the 45 and Consortium for Partnerships in Asia School of Health Research, Fiji Ministry Up Prospective cohort study and data of Health, St Vincent’s Hospital linkage to examine what factors may and the Pacific Funding: NHMRC Project Grant predispose adults to certain infections The Field Research Training Programme and what the longer term consequences (FRTP) aims to build clinical and of infections are on health outcomes and epidemiological HIV research capacity Women’s and men’s experiences health service utilisation. in Cambodia and Indonesia through of preventing mother-to-child Status: Analyses underway. training of researchers in the following Personnel: Bette Liu, John Kaldor, Emily areas: longitudinal research design, transmission (PMTCT) in Papua New Banks conduct and analysis; engagement with Guinea: a gendered socio-cultural Collaborators: Sax Institute; Australian government and affected communities analysis of barriers and facilitators for National University as research partners; research funding program engagement Funding: Ramaciotti Foundation submissions; and the dissemination of research findings to inform policy. The PNG is experiencing an expanding content and structure of the FRTP are heterosexual HIV epidemic, placing an A bibliometric analysis of research flexible and tailored to suit trainees, their increasing number of newborns at risk capacity building in HIV in low- institutions and country needs. The FRTP of acquiring infection. This research was established as part of the AusAID- seeks to understand the gendered socio- income countries funded HIV Consortium for Partnerships cultural aspects influencing the uptake Many international health research in Asia and the Pacific. and outcomes of PMTCT programs from programs aspire to the twin goals of Status: Ongoing the perspectives of antenatal women, acquiring new scientific knowledge Personnel: Louise Causer, John Kaldor, their partners, and health care workers. and the building of research capacity Bradley Mathers, Skye McGregor, Janaki It seeks to: undertake an assessment of in the institutions and workforce of Amin, Kathy Petoumenos PMTCT programs; examine knowledge,

ANNUAL REPORT 2012 21 attitudes and decision-making processes future policy on wide scale roll-out of MC Highlands Province commenced regarding PMTCT; test enablers of for HIV prevention in PNG be informed February 2012 and is on-going. Photo- return for safe delivery and post-natal by a combination of (a) data from MC voice activity conducted in December care; examine experiences of consent, intervention pilot programs and (b) 2012 is expected to lead to an interactive counselling and confidentiality; determine formative research on the potential photographic exhibition in-country and gender-specific barriers/facilitators to protective effect of other forms of penile in Australia in 2013. accessing PMTCT programs; and develop cutting. The MCAIS group has been Personnel: Andrew Vallely, John Kaldor, recommendations for improved PMTCT asked to take a lead role in these future Angela Kelly, Lee Wilson, Lisa Fitzgerald, programs. research activities and will be leading Peter Siba, Maxine Whittaker, Agnes Status: 168 interviews were conducted these new activities from 2013 onwards. Mek, Herick Aeno, John Millan, Joyce with women, men and key informants. Status: Complete. Sauk, Richard Naketrumb, Zure Kombati. Seventy-eight HIV-positive women took Personnel: Andrew Vallely, John Collaborators: PNG Institute of Medical part in in-depth interviews (IDIs). Of Kaldor, John Murray, David Wilson, Research, University of Queensland. these, twenty-four were interviewed Richard Gray, Peter Siba, Angela Kelly, Funding: National AIDS Council three times, sixteen twice and thirty- Claire Ryan, Martha Kupul, Herick Secretariat, Papua New Guinea (NACS) eight once. Twelve HIV-negative women Aeno, Voletta Fiya, James Neo, Richard underwent one IDI. Eighteen men Naketrumb, Greg Law, Petronia Kaima, whose wives had undergone HIV testing Zure Kombati, Joyce Sauk, Joyce Allan, The epidemiology of sexually were interviewed. Of these, one was Pamela Toliman, Liza Fitzgerald, Peter transmitted infections, including interviewed three times, nine twice and Hill, Anna Tynan, John Millan. seven once. Twenty-eight Key Informant Collaborators: PNG Institute of Medical human papillomavirus, among Interviews (KIIs) were also conducted. Research; Mt Hagen General Hospital, pregnant women attending antenatal Personnel: John Kaldor, Heather Worth, PNG; HOPE Worldwide, PNG; University clinics at four sites in Papua New Angela Kelly, Martha Kupul, Lisa Vallely, of Queensland, Australia; The Burnet Guinea (STIs in Pregnancy Study, PNG) Ruthy Neo, Voletta Fiya, Grace Karawiga, Institute, Melbourne. Glen Mola Funding: AusAID Australian An estimated 1500 women die every year Collaborating centres: PNG Institute of Development Research Award (ADRA) in PNG due to cervical cancer. Despite this Medical Research; University of Papua disease burden, no large-scale surveys New Guinea; Port Moresby General have been conducted to establish the Hospital; UNICEF PNG; International Qualitative longitudinal study prevalence of HPV among general or at- HIV Research Group, UNSW to investigate constructions of risk populations of women. This study will Funding: AusAID Australian investigate the epidemiology of sexually Development Research Award masculinity, sexuality and agency transmitted infections, including human among male youth in Papua New papillomavirus (HPV), HIV and herpes Guinea (NACS Masculinities Study, simplex type-2 (HSV-2) among 1000 MCAIS: Male Circumcision PNG) women attending antenatal clinics in four Acceptability & Impact Study, PNG provinces in PNG. It will provide the first This two-year multi-disciplinary general population level estimates of HPV This four-year multi-disciplinary community-based research program type prevalence and is expected to inform community-based research program will investigate the role that individual, future policy on HPV vaccination and is investigating the potential of male community and cultural constructs of cervical cancer prevention in PNG. circumcision for HIV prevention in Papua masculinity, male sexuality and sexual Status: Ethical clearance and clinical site New Guinea and has four principal agency have in determining sexual preparation completed December 2011; components: ethnographic research; behaviour among young men in PNG, study recruitment started February 2012. mathematical modelling; health systems and specifically, their role in promoting At the end of 2012, 227 study participants research; and longitudinal clinical cohort behaviours known to increase the risk of had been recruited at two sites. studies. The study is being carried out HIV and STIs among men and women. The Personnel: Andrew Vallely, Claire Ryan, among a combination of general and study will be conducted in Eastern and John Kaldor, Handan Wand, Peter Siba, at-risk population cohorts at multiple Western Highlands Provinces, PNG where Greg Law, Petronia Kaima, Zure Kombati, sites in PNG. A sub-study to investigate 50 to 60 in-school and out-of school male Joyce Sauk, Sandra Yamuwe, Lisa Vallely, the notional acceptability of a vaginal youth aged 16-17 years will be recruited Glen Mola, Nola N’drewei, Sepehr Tabrizi microbicide surrogate for HIV prevention into a qualitative longitudinal research Collaborators: PNG Institute of Medical among women and men attending a study and followed up every three months Research; National Department of sexual health clinic in Port Moresby for up to 18 months. This research Health, PNG; The Burnet Institute, was completed in 2010. MCAIS jointly addresses a clear gap in current knowledge Melbourne; Royal Women’s Hospital, organised a national policy forum on about masculinities and male sexuality Melbourne. male circumcision for HIV prevention in in the context of the HIV epidemic in Funding: PNGIMR ICRAS Program / PNG, which was held in Port Moresby PNG. It will provide information vital AusAID PNG in November 2011 with the purpose of to evidence-based public health policy translating research evidence into public development. The study is also expected to health policy and practice. The forum directly inform the implementation of new Human papillomavirus infection made three key recommendations: (1) national programs designed specifically among women attending sexual the formation of a joint NDoH/NACS to address male sexual and reproductive Policy Committee on Male Circumcision; health health clinics in Mt Hagen, Goroka (2) the establishment of an integrated Status: Qualitative longitudinal study and Port Moresby, Papua New harm reduction program; and (3) that among male youth in rural Eastern Guinea (HPV Study PNG)

22 ANNUAL REPORT 2012 This study will investigate the Funding: U.S. President’s Emergency epidemiology of human papillomavirus Meanings and beliefs of cervical Plan for AIDS Relief (HPV) and other sexually transmitted cancer, its causation, prevention and infections among women attending sexual treatment in Papua New Guinea health clinics in three provinces in PNG. It A survey and follow-up study to will provide the first estimates of HPV type Cervical cancer is the most common cancer assess research capacity building prevalence among women at increased among women in PNG and a leading risk of HIV/STI acquisition in PNG and cause of premature death. Despite this of developing country attendees of is expected to inform future policy on disease burden, no research to date has the 2012 International Microbicides cervical cancer screening and prevention. been conducted to investigate traditional Conference (M2012) Status: Currently recruiting. and contemporary socio-cultural contexts, It is commonly accepted that attendance Personnel: Andrew Vallely, Claire Ryan, meanings and understandings of cervical at international research conferences John Kaldor, Handan Wand, Peter Siba, cancer causation, prevention and facilitates exposure to new research Greg Law, Petronia Kaima, Zure Kombati, treatment in PNG. This mixed-method ideas, methodologies, and researchers. Joyce Sauk, Sandra Yamuwe, Glen Mol, qualitative study will investigate socio- For developing country attendees, it Nola N’derewei, Sepehr Tabrizi cultural contexts of cervical cancer in could reasonably be assumed that this Collaborators: PNG Institute of Medical Papua New Guinea in order to inform would contribute to the development of Research; National Department of future national prevention and care research capacity of individuals. Surveys Health, PNG; HOPE Worldwide, PNG; strategies, including HPV vaccination and of research attendees are common, Mt Hagen General Hospital; Save the cervical screening programs. but largely relate to the assessment of Children in PNG; The Burnet Institute, Status: Study conducted in Unggai quality of the conference. A web based Melbourne; Royal Women’s Hospital, Bena District, August-October 2012 with survey distributed to developing country Melbourne remaining sites to be completed by July attendees of M2012. Data is collected on Funding: AusAID PNG 2013. education, current research involvement, Personnel: Andrew Vallely, John Kaldor, and research activity in the twelve Angela Kelly, Voletta Fiya, Priscilla Ofi, months following M2012. Cervical cancer screening using visual Herick Aeno, Glen Mola, Antonia Kumbia, Status: Ethics approval was granted inspection with acetic acid (VIA) and Benny Kombuk, Alex Golpak, Lisa Vallely, in March 2012, the first survey was Jane Jones, David Wood, Peter Siba. distributed in May 2012, the first follow its relationship to cervical cytology Collaborators: PNG Institute of Medical up in October 2013, with the final survey and high-risk human papillomavirus Research, National Department of to be distributed in April 2013 (HR-HPV) infection among women Health, PNG, Mt Hagen General Hospital, Personnel: Skye McGregor, John Kaldor, attending Well Woman Clinics in Goroka General Hospital, Kimbe Hospital Klara Henderson Papua New Guinea (VIA Study PNG) Funding: AusAID PNG Funding: n/a This study will investigate: the prevalence of VIA-detectable cervical HIV prevalence, predictors of Mobile men with money: the role of abnormalities; cervical intraepithelial infection, and effective interventions mining development on sexual health dysplasia; high-risk human papillomavirus (HR-HPV) infection; for female sex workers in Vietnam risks among landowners and the behavioural and biological Recent increases in prevalence among key A qualitative study to examine the role determinants associated with risk, risk populations in Vietnam, particularly of mining development on sexual health among women attending Well Woman FSW, have prompted the government risks among landowners, their sexual clinics in Eastern and Western Highlands and HIV donor community to launch partners and others affected by resource Provinces, PNG. The study will determine new initiatives, but in a period of donor extraction development, in order to the acceptability and operational funding decline for HIV programs in improve the health outcomes of Papua feasibility of VIA plus cryotherapy (‘test Vietnam. Evidence-based planning is New Guineans. This study will examine and treat’) as an intervention for cervical critically needed at this transitory stage the impact of development, mobility, cancer screening and treatment among of HIV prevention programming. This and income remittance on sexual health urban and rural populations in PNG, and research helps fill the epidemiologic risk and vulnerability for Papua New is being conducted in order to inform data gap on FSW, investigates barriers Guineans, particularly landowners and future national policy on cervical cancer and incentives for FSW enrolment their sexual partners in the selected screening. and retention in longitudinal studies, LNG project affected areas, and identify Status: Currently recruiting. and evaluates the effectiveness of new strategies and points of entry for sexual Personnel: Andrew Vallely, Claire interventions in reducing HIV risks health impact mitigation. Ryan, John Kaldor, Glen Mola, Antonia among FSW.This is a combination of Status: Currently recruiting Kumbia, Benny Kombuk, Handan Wand, cross-sectional, prospective cohort and Personnel: Andrew Vallely, Angela Lisa Vallely, Angela Kelly, Joanne Goyen, ethnographic studies characterising the Kelly, Roselyn Siki, Richard Naketrumb, Phillip Baird, Greg Law, Peter Siba HIV epidemic among female sex workers Priscilla Ofi, Michael Moses, Heather Collaborating centres: PNG Institute of (FSW) in Vietnam and evaluating HIV Worth, Richard Eves Medical Research, National Department interventions for FSW in Ho Chi Minh City. Collaborating centres: PNG Institute of Health, PNG, Mt Hagen General Status: ongoing of Medical Research; International HIV Hospital, Goroka General Hospital, Personnel: Linh-Vi Le, John Kaldor, Lisa Research Group, University of New South MeriPath PNG; The Burnet Institute, Maher, Keith Sabin Wales, Sydney; Australian National Melbourne Collaborating centres: World Health University, Canberra Funding: AusAID PNG Organization, UNAIDS, CDC Vietnam Funding: PNGIMR ICRAS Program

ANNUAL REPORT 2012 23 infertility and pelvic inflammatory correlates of protection it will be HIV, tuberculosis, sexually disease in women, eye infection in conducted as part of a male circumcision transmitted infections and blood neonates, and has been reported to intervention being provided on-campus potentiate the transmission of HIV. to students enrolled at Pacific Adventist borne viruses in prison populations in Standard treatment for gonorrhoea in University in Port Moresby. Papua New Guinea PNG is amoxicillin-clavunate, however Status: Currently recruiting A longitudinal clinical cohort study Ng strains that are resistant to this Personnel: Andrew Vallely, John to investigate the prevalence and risk and other antibiotics are becoming Kaldor, Stuart Turville, John McBride, factors associated with HIV, tuberculosis, increasingly prevalent in the Asia-Pacific Mangalasiri Jayathunge, Tom Hope, sexually transmitted infections and blood region, raising concern that resistant Minh Dinh, David MacLaren, Peter Siba, borne viruses in prison populations strains may also be circulating in PNG. Claire Ryan, Paul Horwood, Rachael in Papua New Guinea. This study Status: currently recruiting Tommbe will estimate the prevalence of HIV, Personnel: Andrew Vallely, Johanna Collaborating centres: PNG Institute of tuberculosis (TB), sexually transmitted Wapling, Mition Yohannes, Pamela Medical Research; National Department infections (STIs), and blood borne Toliman, Sylvia Soso, Matthew David, of Health, Waigani; Pacific Adventist viruses (BBVs) among new prisoners on Claire Ryan, Andrew Greenhill, Zure University, Port Moresby; James Cook admission to Bomana Prison, National Kombati, Greg Law, David Whiley University, Cairns; The Burnet Institute, Capital District, Papua New Guinea; and Collaborating centres: PNG Institute Melbourne; Feinberg School of Medicine, determine the behavioural and socio- of Medical Research; Mt Hagen General Northwestern University, Chicago cultural factors associated with risk of Hospital; National Department of Health, Funding: National AIDS Council, PNG infection. Waigani; Burnet Institute, Melbourne; Status: Currently recruiting Monash University, Melbourne; Personnel: Andrew Vallely, Bradley University of Queensland, Brisbane The protective effect of dorsal Mathers,Tony Butler, John Kaldor Funding: PNGIMR ICRAS Program longitudinal slit of the foreskin Collaborating centres: PNG Institute of Medical Research; National Department against HIV acquisition in men in Papua New Guinea of Health, Waigani; Department of Genital infections in Papua New Correctional Services, Boroko; The Guinea This prospective study will investigate Burnet Institute, Melbourne; University the protective effect of dorsal of Western Australia, Perth To determining the contribution of longitudinal slit of the foreskin against Funding: PNGIMR ICRAS Program bacterial vaginosis and Candida albicans HIV acquisition in men in Papua New to vaginal discharge syndrome and Guinea. Male circumcision (MC) has vulval irritation in women attending a been shown in large-scale clinical trials Drugs and HIV risk in prisons in PNG sexual health clinic in Goroka, Papua in Africa to have a protective efficacy New Guinea. The aim of this study is to of around 60% in preventing HIV An assessment of HIV risk in relation to determine the contribution of bacterial acquisition in heterosexual men, alcohol and other drugs (particularly vaginosis and C. albicans to vaginal confirming earlier observational injecting) and HIV risk in prisons and discharge syndrome and vulva irritation and ecological studies, and resulting access to prevention, treatment and care. in PNG women attending a sexual health in a recommendation by WHO/ This study investigated the risks for HIV clinic in Goroka. UNAIDS in 2007 that MC be associated with illegal drugs, particularly Status: Ethical approvals obtained July considered an essential component injecting drugs and in closed settings, 2012; specialist training for study PI of comprehensive HIV prevention HIV risk and access to HIV prevention, completed in Melbourne, September in high prevalence settings. Dorsal treatment and care. 2012; participant enrolment to start April longitudinal slit of the foreskin (‘dorsal Status: Currently recruiting 2013. slit’) appears to be the most common Personnel: Bradley Mathers, Andrew Personnel: Andrew Vallely, Nola form of contemporary penile cutting Vallely, Angela Kelly, Thomas Kawage N’Drewei, Claire Ryan, Johanna Wapling, in PNG and was reported by 47% of Collaborating centres: PNG Institute of Alson Akege’e, Catriona Bradshaw men in a large cross-sectional survey Medical Research Collaborating centres: PNG Institute of conducted in four provinces in 2010-11. Funding: UNAIDS/UNODC Medical Research; Michael Alpers Clinic, Personnel: Andrew Vallely, John Goroka Provincial Hospital; Burnet Kaldor, Handan Wand, David Institute, Melbourne; Melbourne Sexual MacLaren, Rachael Tommbe, Angela Gonococcal resistance in Papua New Health Centre, Melbourne Kelly, Claire Ryan, John McBride, Guinea Funding: PNGIMR ICRAS Program Peter Siba, Lalen Simeon, Clement Manineng, Kel Browne, Petronia The prevalence and mechanisms of Kaima, Zure Kombati, Greg Law, John gonococcal resistance to antimicrobial Immuno-Histological correlates of Millan, Peter Hill compounds in Papua New Guinea. protection from HIV transmission by Collaborating centres: PNG Institute of Gonorrhoea is a sexually transmitted Medical Research; National Department infection (STI) caused by the bacteria male circumcision and other forms of of Health, Waigani; Pacific Adventist Neisseria gonorrhoeae (Ng). Gonorrhoea penile cutting University, Port Moresby; Divine World is an important public health issue for This study will test the hypothesis that University, Madang; James Cook PNG, as reported infection rates are high alternative forms of penile cutting may University, Cairns; The Burnet Institute, (131 per 100,000), and infection can be protective against HIV infection Melbourne; University of Queensland, result in a range of pathologies including among men in Papua New Guinea Brisbane urethritis in men, endocervicitis, and investigate immuno-histological Funding: National AIDS Council, PNG

24 ANNUAL REPORT 2012 Personnel: Andrew Vallely, Lisa Vallely, in sexually active 16–29- year-olds to An investigation of health workers Primrose Homiehombo, Julie Liviko, see if it can reduce the prevalence of understanding of syphilis testing in Angela Kelly, Voletta Fiya, Andrew chlamydia infections and its associated Whittaker, Caroline Homer complications such as PID. This is the PNG Collaborating centres: PNG Institute first trial of this nature in Australia and Knowledge, attitudes and practices of Medical Research; Eastern Highlands is being led by the Centre for Women’s (KAP) survey among health workers Provincial Department of Health, PNG; Health, Gender and Society at University in government, non-government and University of Queensland, Brisbane; of Melbourne in collaboration with a faith-based health care facilities in 10 University of Technology, Sydney large consortium of experts including a provinces in PNG. Informants completed Funding: PNGIMR ICRAS Program number of researchers from the Kirby short interview based questionnaire to Institute. In addition, the Kirby Institute assess their understanding of syphilis has been contracted to develop the testing, diagnosis and treatment. STIs among pregnant women in protocol for program evaluation, conduct Information also captured on the level Papua New Guinea mathematical modelling, and assist with of training health workers received implementation. regarding the performance of syphilis The epidemiology of sexually Status: 52 Postcodes recruited and rapid tests and the interpretation of transmitted infections, including human randomised. Intervention is underway. results. The PNG Safe Motherhood/ papillomavirus (HPV), among pregnant Personnel: Rebecca Guy, John Kaldor, Obstetrics Group has approved the use women attending antenatal clinics at four Basil Donovan, David Regan, David of a TPHA syphilis rapid test in rural sites in Papua New Guinea. Papua New Wilson, Matthew Law, Rebecca Lorch, antenatal clinics (ANCs). Informal Guinea (PNG) has one of the highest rates Lisa Edward, James Ward, Belinda Ford interviews indicate that health care of cervical cancer in the world with an Collaborators: Jane Hocking, Meredith workers (HCWs) have not been trained estimated age-standardised incidence of Temple-Smith, Jenny Walker, Simone in the use of TPHA rapid tests, that there 23.7/100,000 compared to 5.0/100,000 Poznanski, Alaina Vaisey, Dyani Lewis, are differences in how much blood is in Australia and New Zealand. Cervical Jane Gunn, Christopher Fairley, Nicola used, and how long before results are cancer is the most common cancer Low, Marian Pitts, Marion Saville, Dorota being read. among women in PNG and a leading Gertig, Sepehr Tabrizi, Margaret Hellard Status: Ethical approval obtain January cause of premature death. An estimated Funding: Australian Government 2012. Interviews with over 50 health 1500 women die every year in PNG due Department of Health and Ageing workers conducted in 11 provinces April to cervical cancer. Despite this disease Chlamydia Pilot Program. Further funding – November 2012 burden, no large-scale surveys have been from NHMRC Project grant from 2011. Personnel: Andrew Vallely, Claire Ryan, conducted to establish the prevalence Co-location: Sexual Health Program, Tawarot Kurumop, Justin Pulford, Jimmy of human papillomavirus (HPV) among Public Heath Interventions Research Elliot, Greg Law general or at-risk populations of women. Group, Biostatistics and Databases Collaborating centres: PNG Institute Status: currently recruiting Program, Aboriginal and Torres Strait of Medical Research; Burnet Institute, Personnel: Andrew Vallely, John Kaldor, Islander Health Program Melbourne; National Department of Handan Wand, Claire Ryan, Lisa Vallely, Health, PNG Suparat Phuanukoonon, Peter Siba, Glen Funding: PNGIMR ICRAS Program Mola, Greg Law, John Millan, Glennis Australian Collaboration on Rai, Sepehr Tabrizi Chlamydia Enhanced Sentinel Collaborating centres: PNG Institute of Surveillance (ACCESS) Women’s experiences of pregnancy Medical Research; National Department and childbirth in Upper Bena, Unggai of Health, PNG; The Burnet Institute, Chlamydia is the most commonly Melbourne; Royal Women’s Hospital, notified infection in Australia and is an Bena District, Eastern Highlands Melbourne important cause of pelvic inflammatory Province, Papua New Guinea. Funding: Papua New Guinea Partnership disease, ectopic pregnancy and tubal PNG has one of the highest maternal in Health Program (PNG PiHP) infertility in women. Chlamydia mortality ratios (MMR) in the world. This notifications have been increasing for study will investigate the epidemiology over a decade. However, the basis of of sexually transmitted infections, SEXUAL HEALTH PROGRAM the increase is not well understood. The including human papillomavirus (HPV), ACCESS program determines chlamydia HIV and herpes simplex type-2 (HSV-2) STUDIES 2012 testing and positivity rates in priority among 1000 women attending antenatal populations nationally also maintains clinics in four provinces in PNG. It will Australian Chlamydia control an ongoing surveillance system. provide the first general population effectiveness pilot (ACCEPt) study Populations of interest include young level estimates of HPV type prevalence heterosexuals, men who have sex with and is expected to inform future policy Current national guidelines for general men, sex workers, pregnant women, and on HPV vaccination and cervical cancer practitioners (GPs) recommend all Indigenous people. The program involves prevention in PNG. sexually active people aged 15–29 years national collaborative networks of Status: Key informant interviews old receive annual testing for chlamydia. selected services including sexual health (KIIs) and recruitment of women into More than 80% of 15–29-year-olds attend clinics, antenatal clinics, Aboriginal a longitudinal cohort started Jan 2012. a GP each year less however less than Community Controlled Health Services, Collection of health facility data relating 10% are being tested for chlamydia by family planning clinics, general practices to maternal health activities, follow-up their GP. ACCEPt involves a multifaceted and laboratories. interviews for women in the longitudinal intervention in the GP setting to Status: A number of peer-reviewed cohort, and KIIs completed in May 2012. maximise testing rates and annual testing reports published.

ANNUAL REPORT 2012 25 Personnel: Basil Donovan, Rebecca Collaborators: Jane Hocking, Jenny chlamydia prevention. This study was Guy, Hammad Ali, John Kaldor, Andrew Walker, Christopher Fairley, Marcus conducted at Family Planning Clinics in Grulich, James Ward, Handan Wand, Chen, Jane Gunn, Marie Pirotta, all states and territories of Australia and David Wilson Veerakathy Harindra, Lyle Gurrin involved an online survey of clinicians’ Collaborators: Margaret Hellard, L, Kathy McNamee, Hudson Birden chlamydia testing and management Caroline Van Gemert, Mark Stoove, (University of Sydney); Frank Bowden, practices. Following the survey, focus Isabel Bergeri, Jane Goller, Fabian Kong, Sepehr Tabrizi, Suzanne Garland groups among family planning clinics’ Anna Bowring, Elizabeth Sullivan, Funding: Australian Government clinicians will be conducted to determine Zhuoyang Li, Wayne Dimech, Marcus Department of Health and Ageing enablers and barriers to the testing and Chen, Christopher Fairley, Catherine Chlamydia Pilot Program; NHMRC management of patients for chlamydia. O’Connor, Bridget Dickson, Lewis Co-location: Sexual Health Program and Status: The study survey closed at the end Marshall, Tony Merritt, Jane Hocking, Public Heath Interventions Research Group of June, 2012 with an overall response Marie Pirotta, Phyllis Lau Douglas Boyle, rate of 79%. All of the focus groups (11 in Helena Britt, Clare Heal, Tom Brett, total) have been completed. Preliminary Caroline Harvey, Robyn Wardle, Kathy Chlamydia re-test review data has been fed back to Family Planning McNamee, Lynne Jordan, Anne Stephens, Australia and individual clinic feedback is Christine Read, Deborah Bateson, Repeat infection with chlamydia being put together. Deborah Wright, Mick Adams, Mark trachomatis following treatment is Personnel: Joanne Micallef, Rebecca Saunders, Sophie Couzos, Jenny Hunt, common and increases the risk of Guy, Larissa Lewis Peter Waples-Crowe, David Scrimgeour, sequelae. Despite clinical guidelines Collaborators: Deborah Bateson (Family Sid Williams, Ana Herceg, Liz Moore, recommending re-screening within Planning New South Wales); Caroline Michael Beckmann, Julie MacPhail, three months of treatment, re-screening Harvey (Family Planning Queensland); Marian Currie, Zena Robinson, Trent rates remains low. We undertook a Julie Mooney-Somers (University of Miller, Megan Halliday, Paul Goldwater systematic review to identify studies Sydney); Caroline Van Gemert (Burnet Funding: Funding is currently being which compared rates of re-screening Institute) sought from States and Territories’ for repeat chlamydial infection between Co-location: Sexual Health Program and Health Departments and from the patients receiving and not receiving an Public Health Interventions Research Group Department of Health and Ageing. intervention. Co-location: Sexual Health Program, Status: Review accepted for publication Public Heath Interventions Research in Sexually Transmitted Infections Cost analysis of rapid HIV testing in Group, Surveillance and Evaluation Personnel: Rebecca Guy, Hammad Al, sexual health clinics Program for Public Health, Biostatistics Basil Donovan, John Kaldor and Databases Program Collaborators: Jane Hocking (University This analysis will assess the costs of of Melbourne); Low Nicola (University both conventional and rapid HIV testing of Bern, Switzerland); Bauer Heidi in terms of test kits and laboratory Chlamydia incidence and re-infection (California Department of Public Health); equipment, staff time and other ancillary study (CIRIS): a longitudinal cohort Jenny Walker (University of Melbourne) costs to allow a direct comparison. A Jeffrey Klausner (University of California). decision tree analysis will be used to study of young Australian women Funding: Nil assess the possible impact of provision Chlamydia incidence and re-infection Location: Sexual Health Program of conventional HIV results by telephone rates have never been studied in and avoiding a second clinic visit through Australian women. We aimed to rapid HIV testing on the costs of HIV determine the incidence of chlamydia Chlamydia testing and management testing for MSM. The study is designed in a cohort of young women who practices in Australian family to assess whether rapid HIV testing can initially screen negative, along with be shown to be cost saving compared to determining the re-infection rate of planning clinics conventional serology testing. women who initially screen positive, Chlamydia is the most common Status: Ongoing. in order to inform future population reportable infection in Australia with Personnel: Damian Conway, screening programs. This study involved over 80,000 cases reported in 2011. Rebecca Guy the establishment of a cohort of young Chlamydia infection is associated with Funding: NHMRC program grant women attending a range of primary adverse health outcomes including Co-location: Sexual Health Program health care services who agreed to pelvic inflammatory disease (PID), and Biostatistics, HIV Epidemiology and complete questionnaires and return self- ectopic pregnancy, and tubal infertility. Prevention Program, Surveillance and collected vaginal swabs for testing. This Chlamydia testing, contact tracing Evaluation Program for Public Health study is lead by the Centre for Women’s and retesting practices of clinicians Health and Society at University of are important foundations for early Melbourne. detection and prevention of chlamydia Evaluation of sexual health services for Further funding was obtained from the infections. The aims of this study are: men who have sex with men in Perth National Health and Medical Research to assess chlamydia testing, partner Council extending this project to notification and retesting practices of Review of sexual health services for gay, investigate the incidence of Bacterial clinicians at family planning clinics in bisexual and other men who have sex Vaginosis (BV) and Mycoplasma Australia; to determine enablers and with men (MSM). genitalium within this cohort of women. barriers to chlamydia testing, contact The Western Australian AIDS Council Status Final report published in PLoS tracing and retesting; and to identify (WAAC) provides a peer (or community) one in 2012. opportunities for training and support based sexual health services for gay, Personnel: Basil Donovan, John Kaldor of clinicians and future interventions for bisexual, and other (MSM) clients at

26 ANNUAL REPORT 2012 two sites. This model is a relatively new rates in general practice. eTEST will Garland (Royal Women’s and Royal approach to HIV/STI service delivery take place in Sydney among 10-15 GP Children’s Hospitals, Melbourne) among MSM in Western Australia. clinics with the aim of increasing HIV/ Funding: NHMRC Project Grant This study will describe the approach STI testing to at least two times per year Co-location: Sexual Health Program and compare it with two other service in high-risk gay men, four times per year delivery models (general practice and in HIV positive men, and re-testing after sexual health clinic). It will describe a chlamydia and gonorrhoea infection. Rapid HIV testing in men who have the clinic (funding, staffing, location), These aims are in accordance with the sex with men in sexual health clinics the MSM clients attending (numbers, testing guidelines for men who have sex demographics, testing patterns, reasons with men. in Sydney for attending) and the clients perceptions Status: Recruitment for eTEST finished, This is the first study to use rapid HIV of the services. Multiple data collections with interventions designed for eight tests in a clinical setting in NSW. The will take place. clinics in NSW and one in VIC; The study will be undertaken at four public Status: Data collection for patient survey collection of testing and positivity sexual health clinics in Sydney: Sydney complete with 373 participants. HIV and surveillance data was organised for each Sexual Health Centre, Albion Street STI lab testing data pending. Report in site and audit reports were presented Centre, Clinic 16 Royal North Shore preparation with manuscript for journal to several clinics; Ongoing support to Hospital and Parramatta Sexual Health submission to follow during 2013. participating clinics and regular data Clinic. The rapid HIV test used in the Personnel: Damian Conway, Rebecca reporting will continue into 2013 study is the Alere Determine HIV 1&2 Guy, Denton Callander Personnel: Rebecca Guy, Denton Antigen/Antibody Combo assay which Collaborators: Martin Holt, Lewis Callander, Larissa Lewis, Handan Wand, gives a result in 21 minutes. Men who Marshall, Trish Langdon, Michael John Kaldor, Basil Donovan have sex with men and who attend the Atkinson, Jenny McCloskey, Ric Chaney Collaborators: Chris Bourne study sites for HIV screening will be Funding: NHMRC Program grant (Sydney Sexual Health Centre); Vijay offered rapid HIV testing. Participants Location: Sexual Health Program Ramanathan (Central Sydney GP will undergo usual care in relation to Network); Jane Hocking (University sexually transmissible infection screening of Melbourne); Mark Stoove (Burnet and conventional HIV serology testing. Genital Warts Surveillance Network Institute); John de Wit, (National Centre The participants’ rapid HIV test results will in HIV Social Research); Cathy Pell, be provided during their visit, and if the A national program of human (Taylor Square Private Clinic); Liza result is reactive they will be referred to papilloma virus (HPV) vaccination Doyle, (Australasian Society for HIV the counsellor for support. The evaluation of Australian teenage girls and Medicine); Geoff Honnor (ACON); Barry will assess acceptability of the rapid HIV young women requires systems that Edwards (NSW Health); Sonny Williams testing process among clients and clinic can provide long-term surveillance (Positive Life) staff, barriers to HIV testing, the impact for trends in HPV-related diseases. Funding: NSW Ministry of Health of rapid HIV testing on client flow, the Genital warts can only be prevented Co-location: Sexual Health Program, performance of the rapid test compared to by quadrivalent vaccine that also Biostatistics and Databases Program and conventional laboratory HIV serology, and covers HPV types 6 and 11. We Public Heath Interventions Research Group the cost of rapid HIV testing in a sexual established a network for enhanced health clinic settings, compared with sentinel surveillance of genital warts standard of care. in eight larger sexual health clinics A longitudinal study of bacterial Status: Ethics and site-specific approvals across Australia. vaginosis and Mycoplasma and staff training completed. Staff were Status: Two further reports trained in rapid HIV testing as part of a submitted for publication. genitalium in young Australian formal training workshop conducted in Personnel: Basil Donovan, Rebecca women partnership with the National Serology Guy, Hammad Ali, David Regan, Little is known about the epidemiology Reference Laboratory and the St Vincent’s Andrew Grulich, Handan Wand and natural history of bacterial vaginosis Centre for Applied Medical Research. Collaborator: Christopher Fairley (BV) and nothing is known about M By the end of 2012, 1672 men had 1981 Funding: CSL Biotherapies Ltd genitalium (MG) infection in Australian rapid tests performed at the four clinic Co-location: Sexual Health Program, women. We seek to determine the sites. Initially funded through NHMRC Biostatistics and Databases Program and prevalence, incidence and persistence STI program grant, NSW Health awarded HIV Epidemiology and Prevention Program of BV and MG in a general population funding for expansion of the study to of Australian women using the cohort more sites around NSW. There were 1111 established by the CIRIS study. This study participants in the patient acceptability eTEST An initiative to enhance STI is lead by the Centre for Women’s Health survey and 68 participants in the staff Testing in gay men and Society at University of Melbourne. acceptability survey. Three manuscripts Status: Two reports have been published are in preparation for journal submission Regular testing of sexually active gay in PLoS one and Clinical Infectious in 2013. men is required to prevent ongoing Diseases. Personnel: Damian Conway, Rebecca transmission of STIs. This project Personnel: Basil Donovan Guy, Andrew Grulich assesses whether a multi-faceted Collaborators: Jane Hocking, Jenny Collaborators: Martin Holt, Philip intervention which involves software Walker, Christopher Fairley, Marcus Cunningham, Don Smith, Phillip Keen, designed to encourage clinicians to test Chen, Catriona Bradshaw, Jane Gunn, Stephen Davies, Deborah Couldwell, through passive prompts, SMS recall Marie Pirotta, Veerakathy Harindra, Lyle Anna McNulty messaging, audit tools, education and Gurrin L, Kathy McNamee (University Funding: NHMRC incentives for testing can increase testing of Melbourne); Sepehr Tabrizi, Suzanne Location: Sexual Health Program

ANNUAL REPORT 2012 27 GeneXpert, a new point-of-care diagnostic REACT: Chlamydia re-test trial Syphilis testing in HIV positive men: a device based on molecular detection of multi-site review infections. The GeneXpert performs on par Chlamydia re-infection is common with routine laboratory based tests and in women and men. Chlamydia Clinical guidelines recommend has the potential to revolutionise point-of- re-infections increase the risk of three-monthly syphilis testing in HIV- care testing for chlamydia and gonorrhoea, chlamydia-related sequelae such as positive men who have sex with men previously reliant on poor performing pelvic inflammatory disease (PID) and (MSM) as part of quarterly routine lateral flow devices. infertility, when compared to initial HIV management checks. However, Status: Ethical approval obtained in QLD infection, and in men who have sex not all men are having quarterly HIV and WA; with men (MSM) has been associated management checks, particularly if they Sites identified, with signing of with an increased HIV seroconversion have been clinically stable for a number participation agreements underway; risk. Clinical guidelines in Australia of years. This study aims to assess the Operational group active and meeting recommend that all people treated for syphilis testing frequency in HIV positive fortnightly; Reference group established chlamydia undergo a repeat test three men against the frequency of HIV with first meeting held. months after initial treatment. This management checks at seven clinical Personnel: Rebecca Guy, James Ward, randomised controlled trial will assess sites in Melbourne and Sydney, Australia. Basil Donovan, John Kaldor, David the effectiveness of a SMS reminder Status: Final report published in Sexually Wilson, David Regan, Handan Wand, and home-based self-collected samples Transmitted Diseases. Louise Causer. (home group) to increase the proportion Personnel: Rebecca Guy, Handan Wand Collaborators: Lisa Natoli, David of patients re-tested after a chlamydia Collaborators: Andrew Carr, John Anderson, Belinda Hengel, David Whiley, infection, compared to an SMS reminder McAllister, Karl Hesse (St Vincent’s Sepehr Tabrizi (Royal Women’s Hospital); and clinic testing (clinic group). Hospital, Sydney); Marcus Chen, Christopher Fairley, Mark Shephard, Lisa Approximately 600 patients diagnosed Christopher Fairley (Melbourne Sexual Bastian, Sharon Clews, Jarran Heywood with chlamydia across two sexual health Health Centre/University of Melbourne); Funding: NHMRC project grant clinics will be randomised to the home Anna McNulty, Chris Bourne (Sydney Co-located: Sexual Health Program, group or the clinic group. Sexual Health Centre); David Baker (East Aboriginal and Torres Strait Islander Status: Recruitment completed in Sydney Doctors); Norm Roth (Prahran Health Program, Public Health September 2012. Follow-up to continue Market Clinic); BK Tee (The Centre Interventions Research Group, Biostatistics until February 2013 Clinic); Jenny Hoy, Kerry Watson (The and Databases Program and Surveillance Personnel: Kirsty Smith, Rebecca Guy, Alfred Hospital); Mark Stoove, Carol El- and Evaluation Program for Public Health Handan Wand, Basil Donovan, John Hayek (Burnet Institute) Kaldor Co-location: Sexual Health Program and Collaborators: Christopher Fairley, Biostatistics and Databases Program Uptake and outcomes of chlamydia or Marcus Chen, Catriona Bradshaw, Karen gonorrhoea testing programs in non- Worthington, Jane Hocking, Anna clinical settings: a systematic review McNulty, Phillip Read, Simon Wright, Test, Treat ANd GO, the TTANGO and meta-analysis Samantha Morgan, Sepehr Tabrizi, Trial: a randomised trial of rapid Suzanne Garland, Bill Rawlinson, Marion Primary care clinics play an important Saville, Gary Rickard point-of-care tests for chlamydia role in the prevention and management Funding: NHMRC STI Program Grant and gonorrhoea infections in remote of sexually transmissible infections Co-location: Sexual Health Program, Aboriginal communities (STIs). A large proportion of young Public Heath Interventions Research Group Many remote and isolated communities people attend primary care clinics each and Biostatistics and Databases Program in Australia continue to experience year for one reason or another and most higher rates of chlamydia and chlamydial infections are diagnosed gonorrhoea despite focused efforts at in this setting. However, despite the Report on the sex industry in New STI prevention and control. In order central role of primary care in chlamydia South Wales to interrupt disease transmission and management, the proportion of sexually reduce the risk of complications, early active young people attending these This is a state-specific report of the sex diagnosis and treatment is important. clinics who are offered screening at the industry in New South Wales that was However in many remote communities, time of their visit is suboptimal in many commissioned by the NSW Ministry of there are long delays between clinical developed countries. This systematic Health. testing and the provision of treatment, review aims to examine the participation Status: Final report launch February due to both distance from laboratories rate and outcomes of chlamydia and/ 2012. and difficulties in recalling patients or gonorrhoea testing programs among Personnel: Basil Donovan, Chris when results arrive. This study will be young people outside of clinical services. Harcourt, John Kaldor, Handan Wand, the first to trial the addition of point- Status: Final report published in BMC Lucy Watchirs Smith of-care testing to standard diagnostic public health. Collaborators: Sandra Egger (Faculty procedures with aims of improving the Personnel: Rebecca Guy, Muhammad of Law, UNSW); Sepehr Tabrizi (Royal interval time to treatment and decreasing Shahid Jamil, Hammad Ali, Basil Women’s and Royal Children’s Hospitals, rates of persistent chlamydia and Donovan, John Kaldor. Melbourne); Christopher Fairley gonorrhoea infections (many of which Collaborators: Jane Hocking (University (Melbourne Sexual Health Centre/ are due to re-infection). The randomised of Melbourne); Heidi Bauer (Program University of Melbourne) controlled study will take place in remote Development and Evaluation, STD Funding: NSW Health communities in Queensland and Western Control Branch, California Department Location: Sexual Health Program Australia. The study will utilise the of Public Health); Jennifer Walker

28 ANNUAL REPORT 2012 (Melbourne Sexual Health Centre/ to improve re-testing rates for HIV and University of Melbourne) sexually transmissible infections (STIs) New Xpress STI screening clinic Funding: Nil in men who have sex with men (MSM); improves patient journey and clinic Co-location: Sexual Health Program and three-to-six monthly SMS reminders Biostatistics, Public Heath Interventions were recommended for high-risk MSM. capacity at a large sexual health clinic Research Group and Biostatistics and We evaluated the impact of the SMS In December 2010 a new ‘express’ testing Databases Program reminder system on HIV/STI testing re- service (Xpress) was implemented testing rates in MSM attending Sydney alongside routine clinics at a large sexual Sexual Health Clinic. A controlled health clinic. Xpress involved a computer COLLABORATIVE PROJECTS observational study design was used. The assisted self interview (CASI), self- evaluation demonstrated re-testing was collected samples, and enrolled nurse WITH SYDNEY SEXUAL HEALTH 4.4 times more likely (95% CI 3.5 to 5.5) staffing. The evaluation demonstrated the CENTRE in the SMS group than the comparison Xpress clinic improved the patient journey group. in regards to waiting times and length Do SMS reminders improve retesting Status: Final report published in Sexually of stay at the clinic, and even though the rates after chlamydia infection in Transmitted Infections Xpress clinics was not fully utilised, more Personnel: Rebecca Guy, Handan Wand patients were seen overall in the clinic heterosexuals? Collaborations: Chris Bourne, Vickie with minimal additional costs. Chlamydia re-infection is common in Knight, Heng Lu, Anna McNulty (Sydney Status: Manuscript published in Sex women and men. By 12 months, re- Sexual health Centre) Transm Dis. infection rates have been reported to Funding: Nil Personnel: Handan Wand, Rebecca Guy, be as high as 22% in a chlamydia re- Co-location: Sexual Health Program and Basil Donovan infection prospective cohort of young Biostatistics and Databases Program Collaborators: Phillip Read, Vickie Knight, women in Australia 2008-2009. In light Heng Lu, Anna McNulty (Sydney Sexual of the high re-infection rates, clinical Health Centre); Nathan Ryder, (Sexual guidelines in Australia recommend that The use of SMS reminders to Health and Blood Borne Virus Unit, any people diagnosed with chlamydia increase completion of Hepatitis Department of Health and Families, NT) should be re-tested in three months to Funding: Nil detect chlamydia re-infections. Despite A and B vaccination courses in a Co-location: Sexual Health Program and this, a recent analysis of heterosexuals Sydney sexual health clinic Biostatistics and Databases Program attending 19 sexual health clinics Hepatitis B virus (HBV) is a major public found that the proportion of patients health problem worldwide. Prevention with chlamydia infection who were is widely acknowledged to be the most Seasonal trends in STI diagnoses: an re-tested in one-to-four months was effective approach to the problem. A investigation 11.9% in heterosexual males and vaccine has been available since 1982, 17.8% in heterosexual females. In late and the standard immunisation schedule Local, state-wide and national 2008, Sydney Sexual Health Centre consists of three injections, at zero, one notification data for STIs appears to show implemented a SMS reminder system to and six months. There are also Hepatitis consistent variation at specific times improve the frequency of the re-testing A/B combinations vaccinations which during the year. The aim of the study is to within three months of a chlamydia follow the same schedule. Noncompliance identify seasonal trends in STI diagnoses, infection. We evaluated the impact of with vaccination schedules undermines and to correlate this to trends in sexual the SMS reminder system on chlamydia the potential benefits of immunisation. behaviour, alcohol and drug use. Data re-testing within three months of initial Despite this, the completion rates among from the Sydney Sexual Health Centre infection in heterosexuals attending sexual health clinic attendees have been database will be used for this analysis. Sydney Sexual Health Clinic. A reported to be suboptimal in many clinics. Status: Analysis complete. Manuscript controlled observational study design In 2008, Sydney Sexual health Centre being prepared. was used. implemented a SMS reminder system to Project members: Handan Wand, Basil Status: Manuscript published. The improve compliance with HBV vaccine Donovan, Rebecca Guy project informed the design of a schedule. The purpose of this study Collaborators: Phillip Read, Aurelie randomised controlled trial of home was to evaluate whether a reminder of Kenigsberg, Vickie Knight, Anna McNulty collection combined with SMS reminders the next vaccine dose sent by (SMS to (Sydney Sexual Health Centre) (REACT). the vaccinee’s mobile phone increases Funding: Nil Personnel: Rebecca Guy, Handan Wand compliance with hepatitis B vaccination Co-location: Sexual Health Program and Collaborators: Phillip Read, Aurelie schedule. A secondary objective was Biostatistics and Databases Program Kenigsberg, Vickie Knight, Anna McNulty to identify differences in completion (Sydney Sexual health Centre) between patient sub-groups eligible for Co-location: Sexual Health Program and HBV vaccination. Culturally and linguistically diverse Biostatistics and Databases Program Status: Analysis complete. MSM at SSHC: diagnostic and Personnel: Handan Wand, Rebecca Guy, Amalie Dyda, Ruth McIver behavioural trends Do SMS reminders improve STI Collaborators: Phillip Read, Vickie People of culturally and linguistically testing frequency in men who have Knight, Anna McNulty (Sydney Sexual diverse backgrounds (CALD) and health Centre) men who have sex with men (MSM) sex with men (MSM)? Funding: Nil are recognised as potential priority In late 2008, Sydney Sexual health Co-location: Sexual Health Program and populations in the 6th National HIV Centre implemented a reminder system Biostatistics and Databases Program Strategy. The Sydney Sexual Health

ANNUAL REPORT 2012 29 Centre (SSHC) sees a range of MSM from understand drivers of epidemic trends, morbidities and mortality and estimate different CALD backgrounds, particularly project future epidemic trajectories, the current burden of disease. The Asian. Differences may exist in both and assess the potential impact of project also aims to evaluate the STI risk behaviour, testing patterns public health strategies. It also extends epidemiological and economic impact of and prevalence of HIV and sexually impact evaluations to assess what the prevention and treatment strategies for transmissible infections (STIs) between investments in programs have brought, reducing the burden of viral hepatitis. CALD and non-CALD MSM, and the at what cost, and whether the past or Status: Ongoing information can inform health promotion future return on investment warrants Personnel: David Wilson, Rosie Thein, programs. The analysis demonstrated the shifts in funding. In addition to broad Lisa Maher, Greg Dore, Tony Butler, annual proportion of MSM who were born quantitative evaluation aims, national Shamin Kinathil in Asia increased over time, and compared and jurisdiction-specific mathematical Collaborator: Murray Krahn, Ahmed to non-Asian MSM, Asian MSM were more models of HIV transmission are Bayoumi (University of Toronto); Chris likely to be younger, less likely to report developed to represent clinical care Bauch (University of Guelph); Marina sexual risk behaviour and ever injected and access, relevant biological factors, Klein (Canadian Institutes of Health drugs, less likely to have presented with heterogeneity of sexual behaviour and Research) genital symptoms, less likely to report a epidemiology. The models are used to Funding: National Health and Medical previous HIV testing, and more likely to be understand past epidemic trends and Research Council (NHMRC); Canadian diagnosed with chlamydia. to simulate the expected population Institutes of Health Research Status: The analysis is completed and incidence and prevalence of HIV in Co-location: Surveillance and Evaluation was presented at ASHM conference 2011; disease and clinical burdens according Program for Public Health; Viral Hepatitis manuscript is in preparation. to a number of future scenarios of Epidemiology and Prevention Program; Personnel: Rebecca Guy, Handan Wand, specific programmatic and/or policy Viral Hepatitis Clinical Research Program; Basil Donovan changes. HIV clinical service supply is Public Health Interventions Research Collaborators: Chris Bourne (NSW also monitored through surveys sent Group; Justice Health Research Program. Health); Phillip Read (Sydney Sexual to hospital departments, sexual health Health Centre) services and general practices with Funding: Nil expertise in HIV management Australia- Modelling and Health Economic Co-location: Sexual Health Program and wide. This project is ongoing to address Evaluation of STI Epidemics & Biostatistics and Databases Program current policy, program and research questions nationally, sub-nationally Prevention Programs in Australia and inform global HIV prevention Surveillance systems to monitor the Unprotected oral sex and sex workers discussions. The results from this project extent, characteristics, and trends of at Sydney Sexual Health Centre provide insight into reasons for observed transmission and burden of disease of surveillance trends and a stronger STIs in Australia may not reflect the Unprotected fellatio at work may evidence-base for designing effective true epidemics due to dependencies represent a risk for STI acquisition in the HIV policies and programs locally and on testing rates among populations at oropharynx, and subsequent onwards abroad. higher risk or other biases in healthcare- transmission. This study seeks to identify Status: Ongoing seeking subpopulations. This project the determinants of unprotected fellatio, Personnel: David Wilson, Richard develops and applies tools to adjust and where possible correlate this to the Gray, Alex Hoare, Ann McDonald, routinely collected surveillance data presence of gonorrhoea in the oropharynx. James Jansson, Kylie-Ann Mallitt, Kathy to provide better estimates of the Sex workers attending Sydney Sexual Petoumenos prevalence and incidence of new Health Centre were asked about their use Collaborators: Levinia Crooks STI infections and morbidities. This of condoms for fellatio at work, and swabs (Australasian Society for HIV Medicine project also evaluates the past impact were taken for gonorrhoea testing. (ASHM)); Jo Watson (National of programs and the potential future Status: Final report published in STI in Association of People Living with epidemiological and economic impact 2012 HIV/AIDS (NAPWA)); NSW Health; of new strategies. The methods used Personnel: Basil Donovan, Rebecca Guy, Australian Research Centre in Sex involve a combination of data synthesis, Handan Wand Health and Society, La Trobe University, literature review, new epidemiological Collaborators: Phillip Read, Anna Melbourne and statistical analyses from existing data McNulty (Sydney Sexual Health Centre) Funding: Department of Health and sources, and mathematical modelling. Co-location: Sexual Health Program and Ageing (DoHA); NSW Health; Australian Mathematical models which describe the Biostatistics and Databases Program Research Council (ARC); National transmission of STIs are powerful tools Association of People Living with HIV/ that can facilitate our understanding AIDS (NAPWA); National Health and of the transmission dynamics and the SURVEILLANCE AND Medical Research Council (NHMRC). epidemiology of an STI in a population. Importantly, this can also help to identify EVALUATION PROGRAM FOR the most effective interventions for PUBLIC HEALTH 2012 STUDIES Modelling & Health Economic lowering STI prevalence in a population. Evaluation of Hepatitis Epidemics & The output from these models can link with economic models to examine issues Modelling and Health Economic Prevention Programs in Australia Evaluation of HIV Epidemics and of allocative and technical efficiency This project aims to conduct estimates (whether to invest and if so, how). In Prevention Programs in Australia and projections of hepatitis B and view of the marked increases in STIs and This project carries out rigorous hepatitis C epidemics in Australia the National STI Strategy, there is an evaluations of public health programs to including incidence of infection, immediate need for tools to help explore

30 ANNUAL REPORT 2012 the potential of, and inform the design a large national technical efficiency registries, and develops new initiatives of interventions aimed at reducing STIs. study, and a series of modelling and in surveillance, such as monitoring The findings from this project will inform economic based post-hoc evaluation, incident HIV infection through the use of the development of public health policy projection, cost-effectiveness, return specialised laboratory tests, and carries on the most effective and cost-effective on investment and allocative efficiency out quality control studies of surveillance strategies for reducing the incidence of studies. data. The surveillance reports: HIV, STIs and their sequellae in Australian Status: Ongoing viral hepatitis and sexually transmissible populations. Personnel: David Wilson, Klara infections in Australia Annual Surveillance Status: Ongoing Henderson, Lei Zhang, Richard Gray, Report; Bloodborne viral and sexually Personnel: David Wilson, Richard Gray, Cliff Kerr, Karina Razali, Rosie Thein, transmitted infections in Aboriginal and Gordana Popovic, Matthew Law, John Alexander Hoare, Josephine Reyes, Eric Torres Strait Islander people: Surveillance Kaldor, Andrew Grulich, Basil Donovan, Chow, Quang Pham, Corrine Iu, Dam and Evaluation Report, the Australian David Regan, David Philp, Ben Hui. Anh Tran, Kelly-Jean Heymer, Amy HIV Surveillance Report; and the Collaborators: Jane Hocking (University Kwon, Karen Schneider, Andrew Craig, National Blood-borne virus and Sexually of Melbourne); Anthony Smith (La Megan Tapia. Transmissible Infections Surveillance Trobe University); Rob Carter (Deakin Collaborators: World Bank Global and Monitoring Report, are compiled University); Queensland University of HIV/AIDS Program; National Center annually as part of this surveillance Technology; Papua New Guinea Institute for AIDS Prevention and Control; project. The program also provides the of Medical Research; James Ward (The Nantong University; Tsinghua secretariat supporting the activities Baker IDI Institute) University; University of Indonesia; of the National Blood Borne Virus Funding: National Health and Medical Indonesia National AIDS Commission; and Sexually Transmissible Infections Research Council (NHMRC) Indonesian Ministry of Health; Surveillance Committee and other ad hoc Co-location: Surveillance and Evaluation University of Malaya; Malaysian sub-committees established to develop Program for Public Health; Biostatistics Ministry of Health; Malaysian AIDS new data sources and standardised and Databases Program; Public Health Council; Malaysia National Anti-Drug procedures for data collection across Interventions Research Group; Sexual Agency; Royal Malaysian Police; State and Territory health jurisdictions Health Program; Aboriginal and Torres Malaysian Prison Department; in Australia, to support this project. The Strait Islander Health Program; HIV National Epidemiology Center, Surveillance and Evaluation Program Epidemiology and Prevention Program. Department of Health, Philippines; for Public Health at the Kirby Institute World Health Organization; HIV-NAT is a research associate of the Australian (HIV-Netherlands-Australia-Thailand) Institute of Health and Welfare. Evaluation & Cost Effectiveness of Research Collaboration; Thai Ministry of In addition to the production of the above- HIV Prevention in Asia Health; Viet Nam Administration of HIV/ named reports, activities conducted within AIDS Control; UNAIDS; Pasteur Institute; this project, in 2012 included: In Asia, HIV epidemics are concentrated, National Drug and Alcohol Research • Monitoring perinatal exposure to HIV driven by the prevalence of risky Centre, UNSW; School of Public • Monitoring long-term outcomes of practices such as injecting drug use Health and Community Medicine, chronic hepatitis B and C (IDU) and unprotected sex among UNSW; HART Consulting; Yale • Monitoring long-term outcome of men who have sex with men (MSM), University; Philippines National AIDS newly acquired HIV infection and sex workers and their sexual Council; AIDS Projects Management • Monitoring HIV transmission through contacts. Drawing from data and Group; Hanoi School of Public specialised tests for incident HIV experiences from countries in East Health; Mai Hoa Do Consulting; infection Asia and Pacific, Europe and central China National Centre for AIDS/ • Monitoring HIV prevalence and Asia and the South Asia Region, this STD Control and Prevention; USAID; incidence through sexual health clinics study contributes to the improvement Alliance Ukraine; Department for • Monitoring HIV antibody prevalence of the effectiveness and efficiency of International Development; Family among prison entrants in Australia HIV prevention responses in Asia’s Health International (FHI) • Monitoring cases of newly diagnosed concentrated HIV epidemic settings. Funding: The World Bank Group; viral hepatitis HIV/AIDS effectiveness evaluation Department for International • Monitoring diagnoses of newly and cost-effectiveness studies Development (DFID) acquired HIV infection have become important analytical • Monitoring cases of newly diagnosed tools to understand what HIV HIV infection investments have bought, whether the National Surveillance of BBV&STIs • Monitoring cases of AIDS interventions averted new infections • Australian HIV Surveillance Report and AIDS deaths, and at what cost. The Surveillance and Evaluation • Merging National HIV and AIDS They can support decision-making Program for public health monitors registries and prioritisation of intervention the pattern of transmission of HIV, • Community-based behavioural and strategies and target groups within viral hepatitis and specific sexually epidemiological surveillance among the HIV/AIDS response with its transmissible infections in Australia, culturally and linguistically diverse overall goals of minimising the in collaboration with the Australian populations burden of disease and maximising Government Department of Health Status: Ongoing health outcomes. and Ageing, State and Territory Personnel: Ann McDonald, Melanie This project involves the conduct health authorities and collaborating Middleton, David Wilson, Elizabeth of numerous large-scale empirical networks. The program coordinates Mlambo, Megan Tapia, Rebecca Guy, evaluation trials across multiple national surveillance for HIV, Jenny Iverson, Mihaela Ivan, Hammad countries in Asia and Eastern Europe, managing the national HIV/AIDS Ali, Stephen Wright, James Jansson,

ANNUAL REPORT 2012 31 Basil Donovan, John Kaldor, Tony Butler, Aboriginal Medical Services Alliance of declining koala population levels. This David Cooper, Gregory Dore, Sean the Northern Territory; Aboriginal Health study aims to discover the essential Emery, Andrew Grulich, Lisa Maher, Council of South Australia; Country correlates of chlamydial infection of the Joanne Micallef, Kathy Petoumenos, Health South Australia; Department of human reproductive tract, to determine Garrett Prestage Health, Western Australia; The University the most effective vaccination strategy Collaborators: State and Territory of Melbourne; Western Australia Country against Chlamydia in koalas given the health authorities; Australian Health Service; National Trachoma practical and financial restrains on vaccine Government Department of Health Reference Group; James Ward (The Baker distribution, and to gain qualitative and Ageing; State and Territory IDI Institute); Tom Snelling (Sydney and quantitative insight into the innate Departments of Corrections; Australian Children’s Hospital) immune response to Chlamydia infection. Paediatric Surveillance Unit; Australian Funding: Commonwealth Department of In 2012, this project contributed a book Institute of Health and Welfare; NSW Health and Ageing (DoHA) chapter titled ‘Biomathematical Modeling State Reference Laboratory for HIV; Co-location: Surveillance and Evaluation of Chlamydia Infection and Disease’ to Australia and New Zealand Liver Program for Public Health; Public Health the American Society for Microbiology Transplant Register; networks involved Interventions Research Group; Aboriginal publication ‘Intracellular Pathogens in surveillance for HIV, viral hepatitis and and Torres Strait Islander People Program I: Chlamydiales’ (Tan and Bavoil) and sexually transmissible infections, James neared completion of an evaluation Ward (The Baker IDI Institute) of koala vaccination strategies. Data Funding: Commonwealth Department of National Surveillance of Transfusion- collation is also near completion for Health and Ageing transmissible Infections assessing correlates of infection of the human reproductive tract. This project collects and analyses national Status: Ongoing National Surveillance of Trachoma donation testing data on Australian blood Personnel: David Wilson, Andrew Craig donors. It is designed to be a core evidence Collaborators: Patrik Bavoil, Jacques This project is contained within the resource to inform further revision and Ravel, Anthony Maurelli, Garry Myers responsibility of the National Trachoma evaluation of donor selection guidelines (University of Maryland, Baltimore); Surveillance and Reporting Unit and donation testing algorithms in Peter Timms, Ken Beagley (Queensland (NTSRU) which is based at the Kirby Australia. In addition, a large blood University of Technology); Roger Rank Institute. The NTSRU is responsible donor survey has been conducted and (Arkansas Children’s Hospital Research for trachoma data collation, analysis calculations of risk of infections in the Institute) and reporting related to the ongoing blood supply to provide important Funding: National Institutes of Health evaluation of trachoma control strategies evidence for decisions around exclusion (NIH); Australian Research Council (ARC) in Australia. The unit was particularly criteria of donors to ensure continued established due to recent action by the maintenance of a safe blood supply. Commonwealth Department of Health Surveillance activities and analyses of THERAPEUTIC AND VACCINE and Ageing in response to trachoma transfusion transmissible infections in levels. Australia is the only developed Australia were once again conducted in RESEARCH PROGRAM 2012 country where trachoma is still endemic. 2012 which led to the second-annual STUDIES It occurs primarily in remote and very ‘Transfusion transmissible infections in remote Aboriginal communities in Australia Surveillance Report’, being PHIDISA Ia the NT, SA and WA. The Australian published in December of that year. Government, in accordance with GET Status: The second annual report on A prospective epidemiological cohort 2020 initiative and the Closing the Gap Australian blood donors’ surveillance study of HIV and risk-related co- initiative, through the Improving Eye was published in December 2012. infections in the South African National and Ear Health Services for Indigenous Personnel: Tarana Lucky, David Wilson, Defence Force (SANDF). Australians for Better Education and Ann McDonald, Handan Wand, Status: Recruitment opened January 2004. Employment Outcomes measure, Collaborators: Clive Seed, Sue Ismay, Sites: Six military medical sites in committed $16 million over a four-year Stephen Wroth, June Lee, Anthony Republic of South Africa period towards eliminating trachoma in Keller, Claire Styles, Hung-Sing Yang Enrolled/target: 8,439/unlimited Australia. The funding is to be used for Funding: Australian Red Cross Blood Personnel: Sean Emery improving and expanding screening and Service, Australian Research Council Funding: US National Institutes of control activities, as well as establishing (ARC), Commonwealth Department of Health; US Department of Defense; a strong framework for monitoring and Health and Ageing South African National Defence Force evaluation. Status: The second annual National Trachoma Surveillance Report, edited by Modelling Cellular & Intercellular ENCORE1 the NTSRU, was produced in 2012, due Dynamics of Chlamydia Infections for release in 2013. Encore1 (NCT01011413) is an ongoing Personnel: Carleigh Cowling, John Chlamydia trachomatis is the most investigator-initiated, international, Kaldor, David Wilson, Bette Liu, Gordana commonly notified sexually transmitted multicentre, randomised, double blind, Popovic, Andrew Shattock disease in Australia, and in women placebo-controlled, 96 week non- Collaborators: Office for Aboriginal and even asymptomatic infections can cause inferiority trial to determine whether a Torres Strait Islander Health (OATSIH), infertility. Chlamydial infections are dose reduction of the antiretroviral drug Department of Health and Ageing; not restricted to humans: Chlamydia (ARV) efavirenz (EFV) provides safe Aboriginal Community Controlled pecorum infects koalas, and is considered and effective viral suppression as part of Health Services in the NT, WA and SA; to be an important driver behind initial combination antiretroviral therapy

32 ANNUAL REPORT 2012 (cART) compared with the currently proximal femur as measured by DXA scan licensed EFV dose. EFV, a non-nucleoside ENCORE1 Neurocognitive Sub-study between the two study arms in a sub-set reverse transcriptase inhibitor, is of the SECOND-LINE cohort. recommended in current treatment This randomised, double-blind, placebo- Status: Closed to enrolment. guidelines and used globally in first-line controlled clinical trial will compare the Sites: 40 antiretroviral regimens. Worldwide it is neurocognitve (NC) function of standard Target: 212 estimated that 7.4 million people receive (600 mg) versus reduced (400 mg) dose Personnel: Mark Boyd, Alli Humphries, cART. Positive outcomes for reduced dose efavirenz (EFV) to determine its safety Nisha Seneviratne, Paddy Mallon, EFV in Encore1 will change treatment and efficacy as part of combination Jennifer Hoy, Waldo Belloso, Samuel guidelines, with particular relevance to therapy in treatment naive individuals Ferret developing countries where HIV is most with HIV infection. Seven clinical sites Funding: UNSW, Merck, Abbott, amfAR prevalent and resources more scarce. In are participating in the sub-study; one in these settings, publicly funded roll-out each of Thailand, South Africa, Mexico, programs could save money by reducing Malaysia and two sites in Argentina. Strategic Timing of Antiretroviral dosages of key ARVs. Eligible participants will complete a Therapy (START) Status: The study is fully recruited at computerised battery of NC tests, the 38 sites in Argentina, Australia, Chile, Cogstate™ tests at weeks 0,4,24 and 48. An open-label randomised multicentre Germany, Hong Kong, Israel, Malaysia, Data from the sub-study will be combined trial to examine the safety and efficacy of Mexico, Nigeria, Singapore, South Africa, with plasma sampling data from the main commencing combination antiretroviral

Thailand and the United Kingdom. The study to examine the association between therapy at a CD4+ cell count of > scheduled week 48 primary endpoint week 4 plasma EFV levels and change from 500 cells/mm3 versus commencing analysis will take place in May 2013. baseline NC function to week 4 and 24. at a CD4+ cell count of <350 cells/ Target: 630 Status: recruitment underway mm3. This initiative includes several Personnel: Rebekah Puls, Dianne Sites: 17 sites in 11 countries substantial substudies (see below for Carey, Enmoore Lin, Carlo Dazo, Anna Target: 126 details) designed to determine the effects Donaldson, Janaki Amin, Kate Merlin, Personnel: Amanda Clarke, Rebekah of treatment with ART on neurological Julie Yeung, Bertha Fsadni, Ansari Shaik Puls, Anna Donaldson, Stephen Kerr manifestations of HIV disease, Funding: Bill & Melinda Gates Foundation Funding: UNSW cardiovascular complications, bone mineral metabolism, chronic obstructive pulmonary disease, liver fibrosis ENCORE1 CNS Sub-study SECONDLINE progression and abbreviated forms of informed consent documentation. A randomised, double-blind, placebo- A randomised open-label study comparing Status: Recruitment underway controlled clinical trial to determine the safety and efficacy of ritonavir boosted Sites: 100 in the pilot phase with 17 the safety and efficacy of reduced dose lopinavir and 2-3N(t)RTI backbone versus sites co-ordinated by the Kirby Institute), efavirenz (400mg qd) versus standard ritonavir boosted lopinavir and raltegravir expanding in the definitive phase with dose efavirenz (600mg qd) as part of in participants virologically failing first- a further 30 sites co-ordinated by KI (in combination therapy in treatment naive line NNRTI/2N(t)RTI therapy. Argentina, Chile, Mexico, Israel, Thailand, individuals with HIV infection: EFV central Status: Closed to enrolment Nigeria, India, Malaysia and Australia). nervous system exposure sub-study. Sites: 40 Target: pilot phase enrolment 1200 Status: Recruitment is underway. Target: 558 recruited patients with 220 from sites coordinated Sites: Five sites in four countries Personnel: Mark Boyd, Alli Humphries, by the Kirby Institute; enrolment in Target: Approximately 40 Natalie Espinosa, Nisha Seneviratne, the definitive phase will be 4000, Personnel: Rebekah Puls, Enmoore Lin, Maria Arriaga, Rosemary Robson with approximately 1000 from sites Jessica Taylor, Carlo Dazo, Janaki Amin Funding: UNSW, Merck, Abbott, amfAR coordinated by the Kirby Institute Funding: UNSW Personnel: Cate Carey, Megan Evans, Simone Jacoby, Sally Hough (maternity SECONDLINE Dried Blood Spot leave), Joseph Levitt, Sean Emery, Lara ENCORE1 Intensive Pharmacokinetics sub-study Cassar, Sarah Pett Sub-study Funding: Division of AIDS (DAIDS), The To test concordance between dried blood National Institute of Allergy and Infectious A randomised, double-blind, placebo- spots to assess viral load and genotypes as Diseases (NIAID), National Institutes of controlled clinical trial to determine compared to centrally tested stored samples. Health (NIH); Australian National Health the safety and efficacy of reduced dose Status: Closed to enrolment and Medical Research Council (NHMRC); efavirenz (400mg qd) versus standard Sites: 40 Agence Nationale de Recherches sur dose efavirenz (600mg qd) as part of Target: 150 le SIDA et les Hépatites Virales (ANRS, combination therapy in treatment naive Personnel: Mark Boyd, Alli Humphries, France); Bundesministerium für Bildung individuals with HIV infection: intensive Natalie Espinosa und Forschung (BMBF, Germany); NEAT 24 hour pharmacokinetic analysis. Funding: UNSW, Merck, Abbott, amfAR - European AIDS Treatment Network; Status: Recruitment is underway. Department of Bioethics, The Clinical Sites: Four sites in four countries Center, NIH; Division of Clinical Research, Target: approximately 40 SECONDLINE Body Composition NIAID, NIH; National Cancer Institute Personnel: Rebekah Puls, Dianne Carey, sub-study (NCI), NIH; National Heart, Lung, and Enmoore Lin, Jessica Taylor, Carlo Dazo, Blood Institute (NHLBI), NIH; National Janaki Amin To determine the difference in mean Institute of Mental Health (NIMH), Funding: UNSW limb fat changes and BMD changes at the NIH; National Institute of Neurological

ANNUAL REPORT 2012 33 Disorders and Stroke (NINDS), NIH; The pulmonary substudy will determine National Institute for Arthritis and Neurology: A substudy of Strategic if early initiation of ART is superior to Multiple Sclerosis (NIAMS), NIH Timing of AntiRetroviral Treatment deferred ART in with regards to pulmonary function as assessed by annual spirometry (START) and respiratory health questionnaire. Informed Consent Substudy: A The purpose of the substudy is to Status: 263/1000 enrolled, with 38 co- substudy of Strategic Timing of determine whether immediate initiation ordinated by KI. of antiretroviral therapy (ART) in ART- Sites: 45 in the pilot phase with 7 sites in AntiRetroviral Treatment (START) naïve persons with a CD4+ count > the Sydney region; a further 40 sites will This substudy is evaluating 500 cells/mm3 is superior, with respect be added for the definitive phase including understanding of study information to neurocognitive function, compared another 17 sites co-ordinated by KI. and satisfaction with the consent to deferring ART initiation until CD4+ Target: n=1000 process among research participants counts decline to 350 cells/mm3. Personnel: Cate Carey, Megan Evans, of the START protocol, after receiving Status: Recruitment opened April 2009. Simone Jacoby, Sally Hough, Joseph information from one of two different To date 468/600 enrolled, with 158 in Levitt, Sean Emery, Sarah Pett types of consent form: a standard or a the Sydney region. Funding: DAIDS; NHMRC; ANRS, concise consent. Sites: 30 in the pilot phase (11 in Sydney France; BMBF, Germany; NEAT - Status: Recruitment underway region) expanding to a total of 33 sites European AIDS Treatment Network and Sites: 75 in the pilot phase with 15 sites Target: n=600 NHLBI, NIH in the Sydney region; the definitive Personnel: Cate Carey, Megan Evans, Location: Therapeutic and Vaccine phase (from October 2010) with a Simone Jacoby, Sally Hough (maternity Research Program further 19 sites in the Sydney Region. leave), Joseph Levitt, Sean Emery, Sarah Target: n=2000. Pett Personnel: Cate Carey, Megan Funding: DAIDS; NHMRC; ANRS, Bone Mineral Density: A substudy Evans, Simone Jacoby, Sally Hough France; BMBF, Germany; NEAT - of Strategic Timing of AntiRetroviral (maternity leave), Joseph Levitt, Sean European AIDS Treatment Network; Emery, Lara Cassar, Sarah Pett NIMH, NIH; NINDS, NIH Treatment (START) Funding: DAIDS; NHMRC; ANRS, Location: Therapeutic and Vaccine The bone mineral density substudy will France; BMBF, Germany; NEAT - Research Program determine if early initiation of ART is European AIDS Treatment Network; superior to deferred ART with regards to Department of Bioethics, The Clinical bone health as measured by annual bone Center, NIH Arterial Elasticity: A substudy of mineral density. Location: Therapeutic and Vaccine Strategic Timing of AntiRetroviral Status: Recruitment opened March 2011. Research Program To date 13/400 enrolled, with 11 at sites Treatment (START) co-ordinated by KI. The arterial elasticity substudy will Sites: 44 with 18 sites co-ordinated by Genomics: A substudy of Strategic determine if early initiation of ART is KI (includes pilot sites already open and Timing of AntiRetroviral Treatment superior to deferred ART in increasing definitive phase sites) large artery elasticity (LAE) and small Target: n=400 (START) artery elasticity (SAE) (i.e., in reducing Personnel: Simone Jacoby, Megan Evans, The purpose of this substudy is to arterial stiffness) as measured by pulse Sally Hough, Joseph Levitt, Sean Emery, obtain a whole blood sample from wave tonometry. Cate Carey, Lara Cassar, Sarah Pett which DNA will be extracted to study Status: Recruitment open Funding: DAIDS; NHMRC; ANRS, validated (present and future) genetic Sites: 17 sites in the pilot phase (5 sites France; BMBF, Germany; NEAT - variants that determine the risk of co-ordinated by KI), expanding to 21 sites, European AIDS Treatment Network and the various primary and secondary with one additional site co-ordinated by The National Institute of Arthritis and outcomes assessed in START. KI (in India), and six sites in Australia, Musculoskeletal and Skin Diseases, NIH. Status: Since April 2009, 1156/4000 Thailand and Argentina contributing Location: Therapeutic and Vaccine enrolled, with 172 in the Sydney patients utilising tonometers located at Research Program region. other sites in the same city. Sites: As many of the START sites as Target: n=300 possible to be involved; to date 125 Personnel: Joseph Levitt, Cate Carey, Liver Fibrosis Progression: A substudy sites are registered with 17 in the Sydney Megan Evans, Simone Jacoby, Sally of Strategic Timing of AntiRetroviral region Hough (maternity leave), Sean Emery, Target: As many of the overall cohort of Sarah Pett Treatment (START) 4000 START patients as possible. Funding: DAIDS; NHMRC; ANRS, France; The liver fibrosis progression (LFP) Personnel: Cate Carey, Megan Evans, BMBF, Germany; NEAT - European AIDS substudy will use fibroscan technology to Simone Jacoby, Sally Hough (maternity Treatment Network and NHLBI, NIH examine the effect of HIV, hepatitis C virus leave), Joseph Levitt, Sean Emery, Sarah Location: Therapeutic and Vaccine (HCV) and ART on the rates of LFP among Pett Research Program ART naive HIV-infected individuals with Funding: DAIDS; NHMRC; ANRS, and without viral hepatitis with CD4+ France; BMBF, Germany; NEAT - counts above 500 cells/mm3. European AIDS Treatment Network; Pulmonary Substudy: A substudy of Status: Protocol release September 2011, Division of Clinical Research, NIAID, NIH Strategic Timing of AntiRetroviral recruitment expected to commence Location: Therapeutic and Vaccine towards the end 2011. Research Program Treatment (START) Sites: Approx. 40 with 13 sites in Sydney

34 ANNUAL REPORT 2012 region (includes pilot sites that are Personnel: Sarah Pett, David Cooper, setting of Chronic HIV-1 infection and already open and definitive phase sites) Dominic Dwyer, Richard Moore, Tuck ways to minimise this are currently Target: n=990 (900 HIV mono-infected Meng Soo, Norm Roth, Mark Bloch being pursued in many different and 90 HIV/HCV co-infected) Funding: NIAID settings. Maraviroc penetrates the CNS Personnel: Cate Carey, Megan Evans, and as almost all virus in the brain is Simone Jacoby, Joseph Levitt, Sean R5, the drug may have a potential role Emery, Lara Cassar. LASA in the treatment and/or prevention Funding: No additional funding of impairment of NC function. The A multicenter randomised study to randomised arms of MARCH offer an compare the efficacy and safety of opportunity to explore, in a pilot study, FLU002 lower dose atazanavir/ritonavir (ATV/r the effects of MVC either partnered with 200/100 mg OD) versus standard dose PI/r or NRTI on the CNS. An International Observational Study (ATV/r 300/100 mg OD) in combination Status: Currently recruiting. to Characterize Adults with Influenza with 2NRTIs in well virology suppressed Sites: 15 clinical centres in the Kirby A –Pandemic H1N1 (H1N1v) INSIGHT HIV-infected adults. Institute’s international network. Sites H1N1v Outpatient Study (FLU 002). Status: 199/560 located in Australia (n=7), Canada Note that version 3.0 broadens inclusion Sites: nine clinical centres in the Thai (n=1), France (n=1), Germany (n=2), to include all influenza subtypes not National Health Service network Israel (n=1), UK (n=3). just H1N1 and the protocol has been Target: 560 Target: 50 renamed An International Observational Personnel: Sean Emery Personnel: Nisha Seneviratne, Sarah Study to Characterize Adults with Influenza. Funding: Kirby Institute, HIVNAT, Thai Pett, Rose Robson Status: Ongoing, globally 2777 NHSO Funding: Kirby Institute participants enrolled Sites: 85 sites globally; in Sydney region: 23 sites (in Thailand, Argentina, Chile MARCH MARCH resistance substudy and Australia) Target: 1895/5000; enrolment in Sydney A randomised, controlled trial to evaluate A study to explore the prevalence and region n=968 the efficacy and safety of maraviroc as evolution of HIV drug-resistance using Personnel: Sarah Pett, Sean Emery, a switch for either nucleoside analogue cell associated HIV DNA: The MARCH David Courtney-Rodgers, David Cooper, reverse transcriptase inhibitors (N(t)RTI) Resistance Sub-study. Version 0.4, 12 Dominic Dwyer, Richard Moore, Tuck or boosted HIV protease inhibitors(r/ September 2011 Meng Soo, Norm Roth, Mark Bloch PI) in HIV infected patients with stable, Status: Recruitment is underway. Funding: NIAID well-controlled plasma HIV-RNA while Sites: All sites taking their first N(t)RTI + r/PI regimen Personnel: David Cooper, Sean Emery, of combination antiretroviral therapy Tony Kelleher, Sarah Pett, Elise Tu FLU003 (cART) – The MARCH study. Funding: Kirby Institute Status: 400 patients screened and 158 An International Observational Study to randomised. Expected date of completion Characterize Adults Who Are Hospitalized August 2015. MARCH –VE substudy with Complications of Influenza A – Sites: 70 clinical centres in the Kirby Pandemic H1N1 (H1N1v) INSIGHT international network including Maraviroc Switch vascular endothelium H1N1v Hospitalization Study (FLU 003) ). Argentina, Australia, Brazil, Canada, substudy: a randomised, open-label Note that version 2.0 broadens inclusion Chile, France, Germany, Ireland , Israel, study to evaluate the efficacy and safety to include all influenza subtypes not just Japan, Mexico, Peru, Spain, UK. of maraviroc (MVC) as a switch for H1N1 and the protocol has been renamed Target: 560 either nucleoside or nucleotide analogue An International Observational Study to Personnel: Sean Emery, Sarah Pett, reverse transcriptase inhibitors (N(t)RTI) Characterize Adults Who Are Hospitalized Nisha Seneviratne, Elise, Tu, Hila or boosted protease inhibitors (PI/r) in with Complications of Influenza Haskelberg, David Silk, Rose Robson, HIV-1 infected individuals with stable, Status: Ongoing with 810 participants Kymme-Courtney-Vega well-controlled plasma HIV-RNA while enrolled globally Funding: Pfizer/ViiV Healthcare taking their first N(t)RTI + PI/r regimen of Sites: 98 globally; 19 in Sydney region combination antiretroviral therapy (cART). (in Thailand, Argentina, Chile, Hong To explore changes in VE as measured by Kong and Australia) MARCH CNS substudy pulse wave tonometry in the MARCH study. Target: 580/1600; total enrolment; Status: Currently recruiting. enrolment in Sydney region n=116 A randomised, open-label study to Sites: St. Vincent’s Hospital and sites in Personnel: Sarah Pett, David Cooper, evaluate the efficacy and safety of Argentina, UK, Thailand and Germany, in Dominic Dwyer, John McBride, Jenny maraviroc (MVC) as a switch for either a total 11 sites. Hoy, Julian Elliott nucleoside or nucleotide analogue Target: 75 Funding: NIAID reverse transcriptase inhibitors (N(t)RTI) Personnel: Sarah Pett, Elise Tu, Janaki Amin or boosted protease inhibitors (PI/r) in Funding: Kirby Institute HIV-1 infected individuals with stable, FLU004 well-controlled plasma HIV-RNA while taking their first N(t)RTI + PI/r regimen MARCH renal substudy Status: globally 181 enrolled in FLU002 of combination antiretroviral therapy co-enrolled in FLU004; globally 36 (cART). Impairment of neurocognitive This substudy is a prospective, enrolled in FLU003 co-enrolled in FLU004 (NC) function is a major concern in the observational, open-label, randomised

ANNUAL REPORT 2012 35 study within the MARCH study exploring Germany, Switzerland, France, Belgium, changes in protein (UPCR) and albumin DARE-C: Direct Acting Antiviral (DAA) Norway and Finland. (UACR)excretion through the kidneys based therapy for recently acquired Status: Open to recruitment at 13 sites between the randomised and standard of in six countries. A further four sites to be care (control) arm of MARCH. Secondary hepatitis C opened in the first half of 2013. objectives are to evaluate the following Future therapy for the treatment of Enrolled: 11 patients at 31 December aspects of renal function at baseline and individuals with chronic HCV will 2012. The accrual target is 100 patients changes within and between study groups: involve directly acting antiviral agents, by 31 December 2013. Status: Recruiting. with or without pegylated interferon Personnel: Greg Dore, Pip Marks, John Sites: Site survey pending (PEG-IFN)/ribavirin (RBV). In early Morrison, Marianne Byrne Target: 150 chronic HCV infection (duration less Collaborating centres: St Vincent’s Personnel: Sarah Pett, David Silk, Janaki than 18 months) treatment responses Hospital, NSW, Burnet Institute, Alfred Amin David Cooper, Mark Bloch, David are generally very good and individuals Hospital, VIC Sowden, Mark Kelly, Dominic Dwyer often keen to be treated. The use of Royal Adelaide Hospital, SA, Hunter Funding: Kirby Institute short course triple therapy including Pharmacotherapy, John Hunter Hospital, telaprevir (TVR) in this setting warrants NSW, Nepean Hospital, NSW, Vancouver evaluation. ATAHC II study is examining Infectious Diseases Centre, Canada; VIRAL HEPATITIS CLINICAL a broad strategy of individualisation Centre Hospitalier de l’Universite de of duration of PEG-IFN/RBV therapy Montreal (CHUM), Canada; East Toronto RESEARCH PROGRAM 2012 based on early response in acute and Hepatitis C Program, Canada; ARUD, STUDIES early chronic HCV infection across Poliklinik Zokl 1, Zurich, Switzerland; all genotypes and HIV status. The Zentrum fur Suchtmedizin, Basel, ATAHC Recall: Long-term outcomes sub-study DARE-C aims to evaluate Switzerland; Koda Bern/Poliklinik following treatment of recently individualisation of therapy duration fur Infektiologe, Switzerland; ZNA using triple therapy (PEG-IFN/RBV/ Stuivenberg and Free Clinic, Antwerp, acquired hepatitis C virus infection TVR) in a subgroup of ATAHC II subjects Belgium; Ziekenhuis Oost Limburg and Hepatitis C virus (HCV) infection is a with genotype 1 infection and early MSOC, Genk, Belgium; Leppavaarankatu public health problem, however very little chronic HCV infection. 10 Espoo, Finland; Praxiszentrum Im Tal is known about the health of patients Status: Ethics and regulatory approval (PIT); Ludwig-Maximilians-Universitat years following therapy, and whether HCV for St Vincent’s Hospital are expected by Munich, Germany; CONCEPT Center for treatment at an early stage continues to be the end of 2012 and the first patient visit Addiction Treatment Munich, Germany; beneficial to people. The Australian Trial is expected for January 2013. Oslo University Hospital, Norway; Barts in Acute Hepatitis C (ATAHC) previously Personnel: Austin Butcher, Gail and the London Queen Mary’s School of enrolled 163 subjects with recent (ie Matthews, Sophie Quiene, Ineke Shaw, Medicine and Dentistry, United Kingdom; acute or early chronic) HCV infection Greg Dore, Pip Marks, Barbara Yeung, Nottingham University Hospital, United between 2004 and 2008. Uptake of Mahshid Tamaddoni Kingdom. treatment was high, with 79% initiating Collaborating centres: St Vincent’s Funding: Merck Sharpe and Dohme therapy. Follow-up was maintained for Hospital Sydney, The Alfred Hospital up to two years post SVR with continued and Royal Adelaide Hospital. specimen and data collection, with seven Funding: Janssen GP Pilot-Enhanced Treatment for reinfections observed during this time. Hepatitis C in Primary Care Settings The study closed in 2007 and the original subjects are now an average of 5.6 years ACTIVATE – Response Guided This is a prospective observational cohort from initial infection. The ATAHC study Treatment for Patients with Chronic study, aiming to evaluate the feasability, demonstrated the successful recruitment, safety and efficacy of a primary care engagement and early follow-up of one HCV Infection and Ongoing Injection based model for the delivery of HCV of the largest cohorts of individuals with Drug Use services, including initiation of anti-viral AHC and established an extensive serum, This is a phase IV, open-label, therapy. Those subjects that commence plasma and PBMC storage banks of AHC multicentre, international trial of treatment will be followed until 24 weeks worldwide. Longitudinal follow-up will response guided treatment with directly post treatment (SVR). The cohort will be allow for the first international, long-term observed pegylated interferon alfa 2b recruited through a network of primary assessment of clinical, social, behavioural, and self-administered ribavirin for care clinics undertaking HCV assessment, psychological and immunovirological patients with chronic HCV genotype 2 or treatment and monitoring. outcomes following recently acquired HCV. 3 infection and ongoing injection drug Status: All study sites open. Ongoing Status: Ongoing. use. The primary objective is to evaluate recruitment through five sites in New Personnel: Gail Matthews, Greg Dore, the proportion of patients with sustained South Wales Sofia Barlett, Amanda Erratt, Jason virological response at 24 weeks post end Enrolled: 39 patients enrolled. Grebely, Pip Marks, Francois Lamoury, of treatment (SVR24) following directly Personnel: Greg Dore, Pip Marks, Austin Butcher, Margaret Hellard, Joseph observed pegylated interferon alfa 2b Amanda Erratt Doyle, David Shaw and self-administered ribavirin for 12 Collaborating centres: Australasian Collaborating centres: St Vincent’s weeks in participants with undetectable Society for HIV Medicine (ASHM); Hospital, Sydney; The Alfred Hospital, HCV RNA at week four of therapy, National Centre in HIV Social Research Melbourne; Royal Adelaide Hospital, and for 24 weeks in participants with (NCHSR); East Sydney Doctors, Adelaide detectable HCV RNA at week four of Darlinghurst; Clinic 96, Orange; Hunter Funding: St Vincent’s Hospital Research therapy. The study will be conducted Pharmacotherapy Services, Newcastle; Foundation in Australia, Canada, United Kingdom, The Byrne Surgery, Redfern; Cowra

36 ANNUAL REPORT 2012 Medical Associates, Cowra; Asquith patient can participate in Part I only or Medical Centre, Asquith; Dr Doong’s Enhancing Treatment of Hepatitis all three parts. Surgery, Burwood. C in Opiate Substitution Settings Status: ongoing; Funding: Australasian Society for HIV Personnel: Gail Matthews, Greg Dore, Medicine (ASHM) (ETHOS) Pip Marks, Tanya Applegate, Amanda The Kirby Institute was awarded an Erratt, Dan Bradshaw. NHMRC Partnership Grant (partner Collaborating centres: Macfarlane Morbidity in people with hepatitis B organisations listed below) to address Burnet Institute for Medical Research and C in New South Wales the issue of HCV treatment in the opiate and Public Health, VIC; St Vincent’s pharmacotherapy setting. Among Hospital, NSW. Understanding hepatocellular carcinoma patients with a history of injection drug Funding: National Health and Medical (HCC) in NSW. This was a population- use, the specific objectives of this study Research Council Project Grant and St. based data linkage study. Notification are to examine: Vincent’s Clinic Foundation Research records for cases of hepatitis B and/or 1. Assessment and treatment of HCV in a Grant hepatitis C in New South Wales were prospective cohort study – the ETHOS linked to their hospital, death, and HIV/ Cohort. AIDS records by The Centre for Health 2. Patient and provider attitudes and The Healthy Liver Campaign Record Linkage (CHeReL). Statistical barriers towards the provision of methods to account for within patient services for assessment and treatment This study is to evaluate the impact clustering were employed of HCV infection. of a Healthy Liver Campaign on HCV Status: Analyses on the epidemiology 3. Peer based support as a strategy for knowledge, assessment and treatment and natural history (including morbidity enhancing knowledge and uptake of among people attending OST clinics. and mortality) of HCC and viral hepatitis treatment for HCV infection. Among people attending OST clinics, the are ongoing. 4. Cost effectiveness of providing aims of the study are to assess knowledge Personnel: Rosie Thein, Greg Dore, assessment and treatment for of liver disease and associated factors; Jason Grebely, Maryam Alavi, Janaki HCV infection in the opiate assess willingness and barriers to Amin, Heather Gidding, Matthew Law pharmacotherapy setting. receiving assessment for liver disease and Collaborating centres: Kate Ward (NSW Status: Closed to recruitment. There are associated factors; evaluate the impact of Health) currently 438 participants enrolled in a Healthy Liver Campaign on knowledge Funding: The Cancer Council NSW the ETHOS Cohort and 77 on treatment. of liver disease, liver disease assessment Follow-up of participants will continue and uptake of interventions; and develop until mid-2014 guidelines for liver disease and FibroScan Australian Trial in Acute Hepatitis C Target: 500 assessment in the OST setting. (ATAHC II) Personnel: Greg Dore, Jason Grebely, Status: Ongoing. Pip Marks, Michelle Micallef Target: 480 A prospective longitudinal study of Collaborating centres: National Centre Personnel: Greg Dore, Jason Grebely, natural history and treatment outcomes in HIV Social Research (NCHSR); NSW Pip Marks, Michelle Micallef following response guided treatment of Department of Health; Sydney Local Collaborating centres: National Centre recent hepatitis C infection. Health District; Hepatitis C Council of in HIV Social Research (NCHSR); Status: All study sites have received NSW; NSW Users and AIDS Association Centre for Health Initiatives, University ethics and research governance approval (NUAA); Discipline of Addiction of Wollongong; Australian Injecting and all open to recruitment. Medicine, The University of Sydney and and Illicit Drug Users League (AIVL); Enrollment target: 120 subjects Australian Injecting and Illicit Drug Hepatitis C Council of NSW and NSW Personnel: Gail Matthews, Greg Dore, Users League (AIVL). Users and AIDS Association (NUAA) Barbara Yeung, Pip Marks, Jason Grebely, Funding: Australian Government Funding: Schering Plough and Tanya Applegate, Margaret Hellard (the Department of Health and Ageing and University of NSW Major Research Burnet Institute and the Alfred Hospital), NSW Health Department. Equipment and Research Infrastructure David Shaw (Royal Adelaide Hospital), (MREII) grant Paul Haber (Royal Prince Alfred Hospital), Andrew Lloyd (UNSW), Alex Defining Risk and Mechanism of Thompson (St. Vincent’s Hospital, VIC), Permucosal Transmission for acute LABORATORY SERVICE AND David Iser (St. Vincent’s Hospital and the Alfred Hospital, VIC), Joe Sasadeusz HCV Infection within high-risk SUPPORT (Royal Melbourne Hospital), Silvana populations (RAMPT-C Study) Gaudieri (Royal Perth Hospital and The study aims to characterise HepBank Clinical Sample Repository Murdoch University, WA) permucosal transmission of HCV & Open Access Substudy database Collaborating centres: St. Vincent’s among HIV-positive and HIV- Hospital, Sydney, Royal Prince Alfred negative MSM, through clinical and (LabKey) Hospital, Kirketon Road Centre and molecular epidemiological analysis, Samples are stored in -80°C freezers Nepean Hospital in NSW, The Alfred with qualitative socio-behavioural (monitored by alarms 24/7) and Vapour Hospital, Royal Melbourne Hospital and and biological studies to explore Phase Tanks at St Vincent’s Centre for St. Vincent’s Hospital, Melbourne in the transmission mechanisms. The Applied Medical Research, Lowy Packer VIC, Royal Adelaide Hospital in SA and Study consists of three parts: Part I – Building in Darlinghurst. The repository Princess Alexandra Hospital in QLD. Phylogenetics analysis, Part II – semen stores serum, plasma, PBMC, DNA and Funding: US National Institutes of analysis, and Part III – Behavioural semen samples collected during HREC Health mechanism interview. An eligible VHCRP approved clinical trials, research

ANNUAL REPORT 2012 37 projects or clinic visits from patients with integrase inhibitor, Raltegravir and the of HIV isolates. There are three major hepatitis B or C including those co-infected Restore and PrIRIS studies in Bangkok projects: evaluation and conducting with HIV. Several processes determine and Sydney respectively. Other studies commercially available genotype testing the allocation of samples from Hepbank were conducted as part of the PHIIDO for protease, reverse transcriptase to be used for a laboratory research sub- observational study of primary HIV regions; development of a new, cheap study project, including a review of sample infection. These assays were validated in-house genotyping method from blood criteria availability, protocol steering in the context of two completed clinical dry-spots as a starting material, ; and committee (PSC) approval of investigator studies assessing latent TB infection in developing assays for the determination driven concept sheets, HREC approval for Bangkok and Sydney; in a clinical study of CCR5 tropism of patient’s HIV all sites participating in the study and a of CMV re-activation and Adenovirus isolates. More than 700 HIV-1 resistance Letter of Understanding (LOU) between infection following paediatric bone genotypes have been performed based on the PSC and the research site. The sample marrow transplantation, and in following the commercial based resistant assays. repository is managed by HIVIRL, an immune responses with gluten induced Validation of new in-house genotyping Oracle database developed by Tony flares of coeliac disease. Assays were also method is close to is close to completion.. Kelleher’s laboratory, which is interfaced conducted to elucidate the generation of The CCR5 tropism assay for RNA has with the LabKey database.The web-based CD4+ T-cell responses during primary been transferred to the NSW State LabKey database links existing clinical, vaccinia vaccination. reference laboratory at St Vincent’s and sample repository and laboratory data-sets Status: Continued analysis of samples is being used for routine care. to allow comprehensive analysis of clinical from PHAEDRA and the long-term Status: The validation of the DNA trial results. This provides an invaluable non-progressor cohorts, TB studies version of this assay is complete and is group of samples to be used for Hep C completed, Studies of CMV disease to being used for routine patient care from related laboratory research. be completed in 2011 and coeliac study January 2012. Status: Samples from new VHCRP trials commenced. Personnel: Anthony Kelleher, Celine are being added to the repository. The Personnel: Susanna Ip, Laura Cook, Yan, Kerstin Koelsch, Yong Pan Live Labkey site is now in official use Mee-Ling Munier, Michelle Bailey, Yin Collaborators: Kazuo Suzuki, Kat Marks, with several central laboratories using Xu, Chansavath Phetsouphanh, Celine Nick Rismanto, Philip Cunningham, Leon the offsite repository function to enter Yan, Anthony Kelleher, Denise Hsu McNally, Alexander Carrera specimen data for samples collected Collaborating centres: John Zaunders, Funding: NSW Health Department, ViiV from VHCRP clinical trials. This enables Mahila Namasivayam, Tony Walls, Co-located: Viral Hepatitis Clinical real time analysis of patient sample John Ziegler, Nabila Seddiki, Stephen Research Program and Immunovirology data and improves efficiency in data Kent, Bob Anderson, Jason Tye-Din, and Pathogenesis Program collection for both the central laboratory Jintanat Ananworanich, Sasiwimol and VHCRP. Ubolyam, Anchalee Avihingsanon, Kiat Personnel: Austin Butcher, Sofia Ruxrungtham, Praphan Phanuphak RNA inducing viral latency Bartlett, Ineke Shaw, Pip Marks, Funding: NHMRC, St Vincent’s Hospital, Trent Schafer, Brendan Jacka, Tanya Coeliac Foundation This project is related to siRNA gene Applegate, Ansari Shaik, Tony Kelleher Co-located: Viral Hepatitis Clinical silencing for HIV-1 and SIV infection. Funding: NHMRC Program Grant and Research Program and Immunovirology siRNAs targeting viral promoter DNA UNSW Major Equipment Research and Pathogenesis Program region induce transcriptional gene funding silencing (TGS) of viral genes in infected Co-located: Viral Hepatitis Clinical cells. The study has been extended to Research Program (laboratory program) Development of research tools to two major objectives: To develop and and Immunovirology and Pathogenesis assess host and viral genetic variations evaluate delivery systems including Program lentiviral and non-viral systems for use To develop affordable assays to support in a humanised mouse HIV-1 infection host genetic and viral phylogenetic studies. model; and to define the pathways by ASSAY DEVELOPMENT Status: Ongoing. which dsRNAs targeting the promoter Personnel: Francois Lamoury, Brendan regions of HIV-1 and SIV. Silencing Jacka, Sofia Bartlett, Tanya Applegate constructs applicable for use in HIV-1 Assays of T-cell function, proliferation Collaborating centres: Philip infection have been development. These and cytotoxicity, and identification of Cunningham, Alex Carrera constructs have been incorporated into Funding: NHMRC Program Grant a lentiviral delivery system, which will antigen-specific T-cells Co-located: Viral Hepatitis Clinical be assessed in vitro. Epigenetic changes A range of flow cytometric assays for Research Program (laboratory program) induced by siRNAs targeting HIV-LTR assessing CD4+ and CD8+ T-cell and Immunovirology and Pathogenesis will also be defined. We also investigated function are worked up in the laboratory. Program the subcellular localisation of Argonaute The measures of antigen-specific T-cells proteins (Ago) during the TGS process include T-cell proliferation, activation and recently reported the presence of and cytokine secretion. Such assays Development of new therapeutic Ago1 in the nucleus and Ago2 in the are important for understanding HIV modalities nuclear membrane as demonstrated by pathogenesis and in responses to confocal microscope using tagged Ago1/ vaccines, and therefore are included in HIV drug resistance and viral tropism Ago2 and fluorescently labelled siRNA. the protocols of clinical trials and natural This project involves the development of We also demonstrated colocalisation history studies carried out by the Kirby expertise in the application of a number between Ago1 or Ago2 and F-actin and Institute. Assays were performed as of methods of detecting antiretroviral are currently following up of this novel part the PINT trial of therapy with the drug resistance through genotypic testing finding to potentially link transport of the

38 ANNUAL REPORT 2012 molecules from the cytoplasm into the This study is designed to evaluate TRANSLATIONAL RESEARCH: nucleus where they would then act on the the association between the ITPA VIRAL HIV-1 promoter to initiate gene silencing. polymorphisms rs1127354 and Status: Ongoing rs7270101, and on-treatment anaemia, Personnel: Anthony Kelleher, Chantelle RBV dose reduction and rate of SVR in RADAR: Resistance Against Directly Hood, Sanjay Swaminathan the CHARIOT cohort. Acting Antivirals in Australian Trial in Collaborators: Kazuo Suzuki, Takaomi Status: Ongoing Ishida, Makoto Yamagisi, Toshiki Watanebe Personnel: Greg Dore, Gail Matthews, Acute Hepatitis C, (ATAHC) Funding: NHMRC Pip Marks, Sofia Bartlett. Identification of the prevalence of pre- Co-located: Viral Hepatitis Clinical Collaborating centres: Alex Thompson existing resistance mutations within the Research Program and Immunovirology (St Vincent’s Hospital, Melbourne) and ATAHC cohort in treatment naïve patients, and Pathogenesis Program CHARIOT PSC to Polymerase and Protease Inhibitors Funding: St Vincent’s Hospital Sydney, using Deep Sequencing analysis. Roche Products Pty Ltd Status: Ongoing TRANSLATIONAL RESEARCH: Co-located: Viral Hepatitis Clinical Research Personnel: Gail Matthews, Tanya Program (laboratory program) and Applegate, Greg Dore HOST Immunovirology and Pathogenesis Program Collaborating centres: Silvana Gaudieri Funding: NHMRC Project Grant, In-vivo hepatitis C virus adaptation to NHMRC Program grant host in recently acquired HCV (ATAHC) A study of the relationship between Co-located: Viral Hepatitis Clinical vitamin status and the severity Research Program (laboratory program) To characterise HCV adaptation to HLA- and Immunovirology and Pathogenesis restricted immune response and examine of liver disease and outcomes of Program the influence of HLA alleles on HCV the treatment with Pegylated sequence evolution and escape mutations. interferon alfal 2A plus Ribavirin Status: Ongoing in Hepatitis C Genotype 1 infected Characterisation of reinfection/mixed Personnel: Greg Dore, Gail Matthews patients HCV infection in recently acquired Collaborating centres: Simon Malal and Silvana Gaudieri (CCiBS, Perth) and This study is designed to evaluate serum HCV (ATAHC) Andrew Lloyd (UNSW) vitamin d levels and the relationship Analysis of the prevalence and impact Funding: National Institute of Health between vitamin d and histologic disease of HCV reinfection and mixed infection Co-located: Viral Hepatitis Clinical severity in hcv genotype 1 patients with using novel real time PCR (MNAzyme) Research Program (laboratory program) biopsy proven CHC from the CHARIOT technology, direct sequencing and and Immunovirology and Pathogenesis study. genotype specific PCR. Program Status: Ongoing Status: Ongoing Personnel: Greg Dore, Pip Marks, Sofia Personnel: Brendan Jacka, Tanya Bartlett. Applegate, Jason Grebely, Greg Dore, IP10, IL28B serum protein levels and Collaborating centres: Stuart Roberts, Gail Matthews T-cell responses in recently acquired Matthew Kitson. Collaborating centres: Sean Pham & Funding: The Alfred Hospital, Peter White (UNSW, Sydney), Alison HCV (ATAHC) Melbourne, Roche Products Pty Ltd Todd & Elisa Mokany (SpeeDx Pty Ltd, Analysing serum IP-10 and IL28B Co-located: Viral Hepatitis Clinical Sydney). protein levels (by ELISA) as a marker Research Program (laboratory program) Funding: National Institute of Health, of spontaneous and treatment-induced and Immunovirology and Pathogenesis NHMRC Program Grant, Australian clearance during early HCV infection. Program Postgraduate Award Status: Ongoing Co-located: Viral Hepatitis Clinical Personnel: Jason Grebely, Tanya Research Program (laboratory program) Applegate, Greg Dore, Gail Matthews Role of host genetics in chronic HCV and Immunovirology and Pathogenesis Collaborating centres: Jordan Feld combination treatment response Program (Toronto University, Canada), Andrew Lloyd (UNSW), Jacqueline Flynn and To identify a combination of baseline co- Rosemary Ffrench (Burnet Institute, variates, serum protein markers and host TRANSMISSION RESEARCH Victoria) genetic markers to develop a treatment Funding: National Institute of Health, algorithm to predict the response rate of NHMRC Program Grant each patient considering treatment for ITHACA: Investigating Transmission Co-located: Viral Hepatitis Clinical CHC. Dynamics of HCV Among injecting Research Program (laboratory program) Status: Ongoing and Immunovirology and Pathogenesis Personnel: Greg Dore, Pip Marks, Sofia drug users in Canada and Australia Program Bartlett, Tanya Applegate. Status: The goal of this project is to Collaborating centres: Jacob George, evaluate HCV transmission dynamics Stuart Roberts. among people who inject drugs (PWID). Investigation of the association Funding: Roche Products Pty Ltd First, we are interested in how HCV between ITPA polymorphism, on- Co-located: Viral Hepatitis Clinical is transmitted from older to younger Research Program (laboratory program) PWID and whether public health treatment anemia and treatment and Immunovirology and Pathogenesis initiatives have led to a reduction in outcome in the CHARIOT cohort Program transmission. Second, we are interested

ANNUAL REPORT 2012 39 in understanding how frequently concentration during the first 12 weeks Collaborating centres: St Vincent’s reinfection and mixed infections with of therapy in CHC genotype 1 patients Hospital, Sydney; St Vincent’s Hospital HCV occur and what characteristics treated within the CHARIOT study. Melbourne. are associated with reinfection/mixed Status: Ongoing Funding: Kirby Institute infections. We plan to conduct this study Personnel: Gail Matthews, Ineke Shaw, Co-located: Viral Hepatitis Clinical within well-established cohorts of PWID Rachel Ali, Greg Dore Research Program (laboratory program) in Vancouver, the Vancouver Injecting Collaborating centres: John Ray (St and Immunovirology and Pathogenesis Drug Users Study (VIDUS) and the At- Vincent’s Hospital) Program risk Youth Study (ARYS). Ethics approval Funding: St Vincent’s Hospital Sydney, is expected from the UBC Providence Roche Products Pty Ltd Health Care Ethics Committee in Canada Co-located: Viral Hepatitis Clinical VIRAL HEPATITIS during 2012. Ethics is currently being Research Program (laboratory program) sought for work to be done in Australia. and Immunovirology and Pathogenesis EPIDEMIOLOGY AND Status: Ongoing Program PREVENTION PROGRAM 2012 Personnel: Jason Grebely, Tanya STUDIES Applegate, Brendan Jacka, Greg Dore, Francois Lamoury, Gail Matthews RAMPT-C cohort Collaborating centres: Mel Krajden The Australian needle and syringe (British Columbia Centre for Disease Defining risk and mechanisms of program survey (ANSPS) Control), Evan Wood, Thomas Kerr, permucosal transmission for acute HCV Richard Harrigan, Art Poon (British infection MSM and IDUs within high- The Australian Needle and Syringe Columbia Centre for Excellence in risk populations. This includes analysis Program Survey (ANSPS) forms the HIV and AIDS), Zabrina Brumme of transmission events through HCV basis of Australia’s sentinel surveillance (Simon Fraser University), Jesse Raffa sequencing, biological and behavioural of HIV and hepatitis C virus (HCV) (University of Waterloo), Brandon mechanisms in incident cases. prevalence and behaviour indices of risk Marshall (Brown University), Silvana Personnel: Gail Matthews, Barbara among people who inject drugs (PWID). Gaudieri (University of Western Yeung, Amanda Erratt, Tanya Applegate, Since 1995, all clients attending selected Australia) Brendan Jacka, Greg Dore Needle and Syringe Program (NSP) Funding: The Canadian Institutes for Collaborating centres: Mark Danta, sites during a specified one to two week Health Research Margaret Hellard, Rose Ffrench, Kylie period are asked to complete a brief self- Co-located: Viral Hepatitis Clinical Goy administered questionnaire and to provide Research Program (laboratory program) Funding: NHMRC Project Grant a capillary blood sample for HIV and and Immunovirology and Pathogenesis Co-located: Viral Hepatitis Clinical hepatitis C antibody testing. Demographic Program Research Program (laboratory and behavioural data captured include program) and Immunovirology and injecting and sexual behaviour, blood Pathogenesis Program borne virus testing, drug treatment and Transmission networks in recently needle and syringe acquisition. A National acquired HCV in ATAHC Data Report, summarising national and SEARCH-C: surveillance for state/territory data is produced by VHEPP Explore clinical and molecular Antiviral Resistant variants in on an annual basis. epidemiology of HCV transmission Status: Ongoing networks in HIV+/- population and chronic hepatitis C patients Personnel: Jenny Iversen, Lisa Maher assess if networks bridging into HIV- There remains a number of critical Collaborators: Australian State communities through phylogenetic data gaps in understanding the and Territory health authorities; the and molecular clock analysis of HCV clinical significance of HCV resistance Collaboration of Australian Needle and sequences. associated variants: There has been no Syringe Programs; St Vincent’s Centre Status: Ongoing detailed deep sequencing analysis of for Applied Medical Research (AMR) Personnel: Gail Matthews, Tanya the association between baseline RAVs and NSW State Reference Laboratory for Applegate, Greg Dore, Jason Grebely and the outcomes of DAA-treatment HIV at St Vincent’s Hospital; Association Collaborating centres: Sean Pham, regimens; no “real world” data has for Prevention and Harm Reduction Fabio Luciani, Peter White, Lei Zhang investigated the relationship between Programs Australia (ANEX); Australian Funding: National Institute of Health, treatment adherence and selection Injecting and Illicit Drug Users’ League NHMRC Program Grant of RAVs; the data is very limited data (AIVL); National Drug Research Institute Co-located: Viral Hepatitis Clinical on the natural history / potential (NDRI); Drug and Alcohol Service, Research Program (laboratory program) pathogenicity of these RAVs that are St Vincent’s Hospital. and Immunovirology and Pathogenesis selected in patients who fail antiviral Funding: Australian Government Program therapy; and no data exist concerning Department of Health and Ageing whether the selection of HCV resistance-associated variants with first- THERAPEUTIC RESEARCH generation DAA-based regimens may Hepatitis acceptability and compromise future treatment options. vaccination incentives trial (HAVIT) Status: Ongoing; no enrolments to date. Ribavirin concentrations in subjects Personnel: Gail Matthews, Greg Dore, Injecting drug use is the leading with chronic HCV (CHARIOT) Amanda Erratt, Pip Marks, Francois exposure for newly acquired hepatitis B Lamoury, Sofia Bartlett, Austin virus (HBV) infection in Australia, yet Determinants of plasma ribavirin Butcher, Alex Thompson vaccination uptake and coverage among

40 ANNUAL REPORT 2012 people who inject drugs (PWID) remains enrolled and retention at 12 months completed in 2012. Data are currently low. The trial aimed to determine was 86%. A total of 17 incident cases being analysed. the efficacy of financial incentives in of HCV infection have been observed Personnel: Lisa Maher increasing hepatitis B vaccine completion (9.3/100py; 95% CI 5.8-14.9). Collaborating centres: School of Public among PWID. Secondary endpoints Status: By the end of September 2012, Health and Community Medicine, included cost effectiveness and correlates 176 PWID were enrolled and retention UNSW (lead); Imperial College London, of immunity. HAVIT was the first head- at 12 months was 85%. A total of 26 Faculty of Medicine; National Institute to-head comparison of incentives paid incident cases of HCV infection have of Hygiene and Epidemiology (NIHE), on a per-dose basis versus no incentives been observed. Hanoi; Westmead Hospital, Sydney. in increasing vaccination completion in Personnel: Anna Bates, Jarliene Funding: Australian Research Council the world. Results indicate that PWID Enriquez, Sammy Chow, Jessica Jia, Len allocated to the incentive condition Liao, Bethany White, Sarah Wright, Lisa were more than three times more likely Maher Staying safe: How do long-term to complete the schedule. Findings Collaborating centres: Academic injecting drug users avoid hepatitis C suggest that the provision of modest Medical Centre, University of financial incentives to PWID for hepatitis Amsterdam and Infectious Disease infection? B vaccination completion is a realistic Cluster, Amsterdam Public Health Building on data collected from established public health strategy with the potential Service; Australian Intravenous and longitudinal cohort of PWID, this project is to reduce the burden of HBV disease and, Injecting League (AIVL); Hepatitis focussed on developing hepatitis C virus potentially, other vaccine-preventable Australia; Hepatitis C Council of NSW; (HCV) prevention programs to assist both infections in this group. Inflammatory Diseases Research Unit, new and experienced PWID to develop and Status: 139 PWID completed the School of Medical Sciences, UNSW; implement strategies to remain uninfected experimental procedures; follow up data SEALS Microbiology, Prince of Wales with HCV. Through collaborations collection completed. Hospital; Burnet Institute; British with Harm Reduction Victoria and the Personnel: Rachel Deacon, Mofizul Columbia Centre for Excellence in HIV/ Centre for Population Health at Burnet Islam, Libby Topp, Lisa Maher AIDS; University of California San Institute, data collected from this project Collaborating centres: Kirketon Road Francisco. is also being used to assist people who Centre, South Eastern Sydney and Funding: NHMRC Project Grant are infected with HCV but who clear the Illawarra Area Health Service; Sydney virus to continue to inject to avoid re- South West Area Health Service; Redfern infection. In-depth interview data allows Drug Health Service, South West Economic, social and cross-cultural comparisons of PWID who have acquired Sydney Area Health Service; Discipline issues in non-pharmaceutical HCV and those who have not ensuring of Addiction Medicine, University of utility for all PWID. Sydney; National Drug and Alcohol protection of front line responders Status: Completed. Research Centre to pandemic influenza and Personnel: Peter Higgs, Lisa Maher Funding: NHMRC Project Grant emerging infections Collaborating centres: The Centres Non-pharmaceutical interventions for Population Health, Burnet Institute; such as face masks are one of the Harm Reduction Victoria. Hepatitis C vaccine preparedness few widely available strategies that Funding: NHMRC studies can be offered to front line health care workers (HCW) in outbreak This program of work, which commenced situations and that can be guaranteed Staying safe Sydney in 2010, continues and extends earlier to be available regardless of the type work conducted under the UNSW HCV of infection. The aims of this study are: This study aims to explore the social Vaccine Initiative. The project aims to to determine knowledge, attitudes and practices and conditions associated establish the feasibility of conducting practices of HCW related to infection with long term avoidance of hepatitis C efficacy trials of candidate HCV control and barriers to adherence virus infection. During 2011 a further 12 vaccines with PWID by answering key to mask use; to conduct a cluster participants from South West Sydney were scientific questions, building community randomised trial in frontline health care recruited into Stage Two. Initial interviews capacity and establishing the necessary workers in Hanoi in order to determine explored participants’ life histories, infrastructure to conduct future trials. the efficacy of surgical and cloth masks focussing on constructing a ‘timeline’ Specific aims are to 1) determine HCV against influenza and other respiratory which was later reproduced graphically incidence and spontaneous clearance viruses; to compare knowledge, using ‘Timeline Maker Professional’ in a prospective cohort of uninfected attitudes and practices of frontline HCW software. Follow-up interviews focused PWID; 2) identify associated risk factors; in Australia and Vietnam, and identify on drug use over time and place with the 3) evaluate retention strategies and both culturally specific and universal ‘timeline’ serving as a prompt. Data from factors associated with adherence to issues that may affect behaviour in the 23 completed interviews is being the study protocol; and 4) investigate an emergency; to model the cost- coded using ‘NVivo9’ software, using the immunisation acceptability, clinical trial effectiveness of surgical and N95 face coding frame constructed during Stage literacy and willingness to participate in masks; and to inform disease control One of the project. future vaccine trials in this group. The policy nationally and internationally Status: This study was completed in 2012 project includes the Hepatitis C Incidence on the use of face masks in the control Personnel: Lisa Maher, Carla Treloar, and Transmission Study – community of pandemic influenza, emerging Jake Rance, Magdalena Harris (HITS-c), an ongoing prospective infections or a bioterrorist attack. Collaborating centre: National Centre observational study of HCV antibody Status: Fifteen hospitals involving 1,606 for HIV Social Research. negative PWID. By 2011, 150 PWID were HCW were enrolled and the trial was Funding: UNSW

ANNUAL REPORT 2012 41 longitudinal perspective through annual (KRC) and to develop and evaluate an An ethno-epidemiological investigation follow-up of participants. intervention to prevent and treat IRID of social and environmental contexts of Status: Completed. in this group. A clinician-administered Personnel: Will Small, Lisa Maher screening tool was developed and HIV vulnerability among injection drug Collaborators: British Columbia Centre integrated into routine alcohol and other users for Excellence in HIV/AIDS, Vancouver drug assessment for PWID first attending By combining ethnographic and (lead) KRC. The intervention consisted of epidemiological methods this Funding: Canadian Institutes of Health specific safer injecting messages provided project seeks to develop an ethno- Research by clinicians at the point of venepuncture epidemiological model of HIV to screen for blood borne infections. vulnerability among PWID. Ethnographic A survey to assess baseline injecting methods are used to generate empirical Relative efficacy of cash versus knowledge and practices was conducted information regarding key transitional vouchers in engaging people who prior to, and following receipts of, the events and social contexts within the intervention. lives of PWID and how these shape HIV inject drugs (PWID) in research Status: Evaluation underway risks. These ethnographic research Ethical concerns around reimbursing Personnel: Mihaela Ivan, Lisa Maher activities are integrated with a broad PWID for research participation have Collaborators: Kirketon Road Centre, program of social epidemiology, focussed on the potential for cash South Eastern Sydney Local Health including ongoing epidemiological payments to precipitate drug use. In District. cohort studies. This design permits an effort to overcome perceived ethical Funding: NSW Ministry of Health identification of cohort participants complexities, some protocols instead Mental Health and Drug and Alcohol undergoing key transitions for reimburse participants with vouchers Office (MHDAO) targeted in-depth interviews, as rather than cash. This study employed well as examination of hypotheses a crossover design at two opioid Examination of injecting drug use life regarding the relationship between HIV substitution therapy (OST) clinics. At course and estimating prevalence and vulnerabilities and particular social Time 1, researchers located in each clinic contexts (e.g. street-based drug markets invited OST clients to participate in a health consequences of a dynamic and sex work environments). survey about alcohol use. Four months population Status: Completed in August 2012 later (Time 2), the same protocol was This project examines longitudinal Personnel: Will Small, Lisa Maher implemented in the same two clinics. datasets of injecting drug users from the Collaborators: Urban Health Research However, at Time 1, Clinic 1 offered $20 UK (e. g. Edinburgh Addiction Cohort Institute, British Columbia Centre for cash as reimbursement while Clinic 2 Study) and Australia (e. g. Hepatitis Excellence in HIV/AIDS. offered a $20 voucher. At Time 2, the Incidence and Transmission Study) Funding: Canadian Institutes of Health form of reimbursement was reversed, taking into account periods of injecting Research Post Doctoral Fellowship; with Clinic 1 offering the voucher, and non-injecting. This will allow for Michael Smith Foundation for Health and Clinic 2 offering cash. The main more valid projections of injecting drug Research Post Doctoral Fellowship outcome of interest in this study was use health consequences and associated the proportion of participants willing health impacts and costs of interventions. to participate for cash versus voucher Status: Completed Exploring the natural history of reimbursement. Results indicated that, Personnel: Lisa Maher injection drug use: A qualitative as expected, participation rates were Collaborators: University of Bristol; significantly higher when clients were MRC Biostatistics Unit, Cambridge; study of social and environmental offered cash than when they were offered Muirhouse Medical Group, Edinburgh; influences in the VIDUS cohort vouchers. London School of Hygiene and Tropical This study seeks to: (1) examine the Status: Round 1 data collection completed Medicine influence of social and environmental in July 2011; round 2 completed in Funding: NHMRC (Sidney Sax) Training factors on critical initiation and November 2011. Data entry, cleaning and Fellowship transitional events among street youth analysis completed in February 2012. and adults who inject drugs, including Personnel: Mofizul Islam, Rachel transitions in drug use, initiation into Deacon, Libby Topp, Carolyn Day The role of resiliency in responding drug scenes and sex work; (2) examine Collaborating centre: Discipline of to blood-borne viral and sexually the influence of social and physical Addiction Medicine, University of Sydney contexts within ‘drug scenes’ on HIV risk Funding: UNSW Faculty of Medicine transmitted infections in Indigenous behaviour; (3) refine and document an Faculty Research Grant communities evolving ethno-epidemiological approach A collaborative project between to investigating the natural history of Australia, Canada and New Zealand injection drug use. The study employs Assessment and prevention of to examine resilience to blood- observational ethnographic activities, in- injection-related injury and disease borne viruses (BBVs) and sexually depth interviews, mapping techniques, transmissible infections (STIs) in photography, and epidemiological (IRID) among people who inject drugs Indigenous communities. With a focus on data. Observational activities will be Injecting-related injury and disease adolescents and young adults in urban conducted in settings where illicit (IRID) is a significant health issue settings, the Australian component of drugs are consumed. Qualitative in- among PWID. This study aims to identify the study seeks to identify factors that depth interviews will be conducted prevalence (lifetime and recent) of IRID protect against acquisition of BBV/STI with individuals who are members of and associated risk factors among PWID and promote access to prevention and existing cohort studies, and will utilise a attending the Kirketon Road Centre treatment, and provide capacity building

42 ANNUAL REPORT 2012 opportunities for Indigenous researchers Margaret Hellard, Arthur Kim, Georg and Aboriginal Community Controlled The International Collaboration Lauer, Andrew Lloyd, Barbara McGovern, Health Services. In 2011, surveys data of Incident HIV and hepatitis C in Maria Prins, Stephen Shiboski, Naglaa were collated and analysis commenced. Shoukry Health services undertook data analysis Injecting Cohorts (InC3) Collaborative Collaborating centres: University of training. Group California San Francisco (lead); Burnet Status: Ongoing. While several prospective studies have Institute; Inflammation and Infection Personnel: Anna Olsen, Lisa Maher, been conducted worldwide over the last Research Centre UNSW; Johns Hopkins John Kaldor decade, knowledge of the epidemiology University; Massachusetts General Collaborators: Townsville Aboriginal of acute HIV and HCV infection in PWID Hospital; University of Amsterdam and and Islanders Health Service Ltd; The remains limited. Drawing on a merged Infectious Disease Cluster, Amsterdam Aboriginal Medical Service Coop Ltd, international multi-cohort project of Public Health Service; University of Redfern; Derbarl Yerrigan Health pooled data from well characterised Montreal Service, Perth; Centre for Infectious cohorts of people who inject drugs Funding: National Institutes of Health Disease Prevention and Control, (PWID), InC3 offers an unprecedented Co-location: Viral Hepatitis Epidemiology Health Canada; Canadian Aboriginal opportunity to overcome the limitations and Prevention Program and Viral AIDS Network; University of Ottawa; of current studies and address questions Hepatitis Clinical Research Program Ngã Pae o te Mãramatanga, University unanswered due to a lack of statistical of Auckland; Auckland University power, limited observation time, of Technology; University of Otago heterogeneous populations or other Young Women’s Health Study Medical School constraints. (YWHS) II: Culture and HIV Funding: Tripartite Cooperation InC3 was established to create a merged Agreement between Canadian international multi-cohort project of prevention in Cambodia Institutes of Health Research (CIHR); pooled data from well characterised The YWHS is a prospective study of National Health and Medical Research cohorts of injecting drug users in order young (15 to 29 years) women engaged Council of Australia (NHMRC); Health to conduct studies of risk, incidence in sex work in Phnom Penh. Women Research Council of New Zealand and the natural history of acute HIV are followed up at quarterly intervals (HRC) and HCV infection. Specific aims are and asked to complete a structured Co-location: Viral Hepatitis to: 1) Examine temporal trends in HIV questionnaire in Khmer and to provide Epidemiology and Prevention Program and HCV incidence, and determine blood for HIV testing, self-collected and Public Health Interventions the behavioural, social, and biological urine for chlamydia, gonorrhoea and Research Group factors that explain trends over time; ATS testing, and cervical swabs for 2) Estimate HCV incidence rates by human papilloma virus (HPV) testing. HIV status and sexual behaviour; 3) HPV vaccination is offered to eligible Liver Spots: A study of hepatitis B Estimate the rate and determinants of participants. Aims are to: 1) Estimate knowledge, treatment and health spontaneous viral clearance of acute prevalence and incidence of HIV and HCV infection in IDU; 4) Estimate the STIs including HPV; 2) Examine the care among Indigenous Australians rates, outcomes and key predictors of socio-cultural factors and risks associated This project aims to engage HCV re-infection and re-clearance among with ATS use and; 3) Assess rates of Indigenous individuals, families and HCV resolvers; 5) Examine whether completion and adherence to a multi- communities affected by hepatitis HCV infection disclosure is associated dose vaccine regimen for the prevention B, as well as health care providers with changes in risk exposures in IDU of HPV. As part of the YWHS, trained and policy makers, in addressing and; 6) Assess factors associated with interviewers also conducted qualitative the social and treatment needs of initiation, adherence and effectiveness in-depth interviews to explore social and Aboriginal and Torres Strait Islander of clinical treatment of acute HCV. cultural influences on HIV/STI risk and people living with chronic hepatitis B. This collaboration has been successful protective behaviours and ATS use. Working with both urban and rural/ in pooling behavioural, clinical and Status: Data are being analysed and remote communities, the study will virological data on 522 participants with results prepared for publication investigate facilitators and barriers well-defined HCV seroconversion events Personnel: John Kaldor, Lisa Maher, to biomedical knowledge, cultural from nine cohorts in Australia, Canada, Kimberly Page, Saphonn Vonthanak, healthcare needs, traditional health Europe and the United States. This is Serey Phal, Joel Palefsky, Tooru Nemoto beliefs and facilitators and barriers the largest consortium of investigators Collaborating centres: University of of treatment uptake. Information assembled to investigate acute HCV California, San Francisco (lead); National generated from in-depth interviews infection. The behavioural, clinical and Center for HIV/AIDS, Dermatology and and survey data will contribute virological data already collected and STDs (NCHADS); Cambodian Women’s to meeting the chronic health the access to stored specimens from this Development Association management and treatment needs merged study has the potential to provide Funding: National Institutes of Health of participating individuals and invaluable insight into the control of HCV communities as well as providing infection, including the development data to inform the development of of novel HCV therapeutics and vaccine New hazards for young women sex culturally appropriate resources and strategies. workers: Effects and crises arising services for Indigenous Australians. Pilot Status: ongoing work on the project began in late 2010. Personnel: Gregory Dore, Jason Grebely, from recent anti-trafficking laws in Status: Ongoing Lisa Maher, Tanya Applegate, Gail Cambodia Personnel: Anna Olsen, Lisa Maher Matthews, Maryam Alavi, Kimberly Page, This qualitative study aims to assess the Funding: NHMRC Training Fellowship Julie Bruneau, Andrea Cox, Judith Hahn, impact and effects of the implementation

ANNUAL REPORT 2012 43 of recent anti-trafficking and anti- prostitution laws on female sex workers (FSW) in Phnom Penh, Cambodia. Specifically, the study aims to 1) Assess the impact of these laws on individual risk and protective behaviours and risk environments (sex work settings) and; 2) Document how women have adapted to the reputed harsh and severe implementation of these laws. Status: Data collection for this study has been completed and analysis is currently underway. Personnel: Lisa Maher Collaborators: University of California, San Francisco (lead); Cambodian Women’s Development Association. Funding: University of California Pacific Rim Research Program

Staying safe: A sociology of how injecting drug users avoid viral infection in the long-term This study aims to reconstruct the life trajectories of injecting drug users to identify social practices and conditions linked to long term avoidance of hepatitis C virus infection. Using qualitative life history studies from long-term PWID who have not been exposed to hepatitis C alongside those who have been exposed; this is the first research in the UK on long-term avoidance of viral infections associated with injecting drug use. To date a total of 38 in-depth qualitative interviews have been conducted. Status: Ongoing Personnel: Lisa Maher, Tim Rhodes, Chris Bonell, Vivian Hope, Carla Treloar, Samuel Friedman Collaborators: London School Hygiene Tropical Medicine, University of London (lead); National Development and Research Institutes, New York; National Centre for HIV Social Research. Funding: Economic and Social Research Council

44 ANNUAL REPORT 2012 n SURVEILLANCE COMMITTEES 2012

ANNUAL SURVEILLANCE Jo Watson Associate Professor and Director, WHO Executive Director, National Association Collaborating Centre for STD (WPR and REPORT ADVISORY COMMITTEE of People with HIV Australia, Sydney SEAR). Staff Specialist Microbiology David Wilson BSc, BInfTech, Melanie Middleton BMedSc, MPH Department – SEALS. School of Medical BAppSc(Hons), GradCert(Biostats), (Secretary) Sciences UNSW PhD (Chair) The Kirby Institute Meeyin Lam BAppSc, MIPH The Kirby Institute Epidemiologist (BBVs and STIs), Benjamin C Cowie MBBS PhD FRACP Communicable Diseases Branch, NSW Epidemiologist & Physician, WHO Ministry of Health Regional Reference Laboratory for NATIONAL BLOODBORNE Ann McDonald BSc, MPH Hepatitis B, Victorian Infectious Diseases The Kirby Institute Reference Laboratory, Melbourne VIRUS AND SEXUALLY Kate Pennington (to September) Simon Donohoe TRANSMISSIBLE Epidemiologist, Health Protection & Manager, AFAO-NAPWHA Education INFECTIONS SURVEILLANCE Surveillance Branch, Office of Health Team, Australian Federation of AIDS Protection, Department of Health and Organisations, Sydney SUBCOMMITTEE* Ageing, Canberra Basil Donovan MB BS, MD, Dip Ven Footnote *Subcommittee of the April R Roberts-Witteveen, MAE (London), FAChSHM, FAFPHM, FRCPI Communicable Diseases Network Australia Epidemiologist, Health Protection The Kirby Institute Service, ACT Health Liza Doyle Christine E Selvey MBBS, MSc (Chair) Jiunn-Yih Su MB, MPH Division Manager, National Policy and Executive Director, Communicable Surveillance Project Officer, Sexual Education, Australasian Society for HIV Diseases Unit, Queensland Department Health and Blood Borne Viruses Unit, Medicine, Sydney of Health, Brisbane Centre for Disease Control, Northern Andrew Grulich MB BS, MSc, PhD, Benjamin C Cowie MBBS PhD FRACP Territory Department of Health FAFPHM Epidemiologist & Physician, WHO Mark Veitch MBBS, MAppEpi, FAFPHM The Kirby Institute Regional Reference Laboratory for Senior Medical Advisor, Public and Lisa Maher PhD Hepatitis B, Victorian Infectious Diseases Environmental Health Services, The Kirby Institute Reference Laboratory, Melbourne Department of Health and Human Limin Mao PhD John de Wit MSc, PhD Services, Tasmania Senior Research Fellow, National Centre Professor and Director, National Centre Russell Waddell MB BS, BSc, FAChSHM in HIV Social Research, UNSW, Sydney in HIV Social Research, UNSW, Sydney Director, STD Services, Royal Adelaide Ann McDonald BSc, MPH Carolien Giele RN, RM, BSc(Hons), Hospital The Kirby Institute Grad Dip Clin Epi, MPH James Ward Tadgh McMahon DrPH Epidemiologist, Communicable Disease Baker IDI Central Australia Manager, Multicultural HIV and Hepatitis Control Directorate, Department of Jo Watson Service, Sydney Health, Perth Executive Director, National Association Andrew Nakhla BComm, LLB Margaret Hellard MB BS, FRACP, PhD, of People with HIV Australia, Sydney The Kirby Institute FAFPHM David Wilson BSc, BInfTech, Kate Pennington Head, Centre for Population Health, BAppSc(Hons), GradCert(Biostats), Epidemiologist, Health Protection & Burnet Institute, Melbourne; Professor, PhD Surveillance Branch, Office of Health Infectious Diseases and Epidemiology; The Kirby Institute Protection, Department of Health and NHMRC Senior Research Fellow Melanie Middleton BMedSc, MPH Ageing, Canberra Nasra Higgins BHlthSc(EnvHlth), Grad (Secretary) Helen Tyrrell RN, BA(Hons), MBA, Dip Epid & Biostat, MEpid The Kirby Institute FACHSE, CHE Epidemiologist, Communicable Disease Chief Executive Officer, Hepatitis Epidemiology and Surveillance, Health Australia, Canberra Protection Branch, Department of Health Russell Waddell MB BS, BSc, FAChSHM John Kaldor PhD Director, STD Services, Royal Adelaide The Kirby Institute Hospital Monica M Lahra FRCPA PhD

ANNUAL REPORT 2012 45 AUSTRALIAN NEEDLE AND Needle and Syringe Program SYRINGE PROGRAM SURVEY Coordinator, Directions ACT, Canberra Jenny Iversen BAppSc (Secretary) ADVISORY GROUP 2012 Kirby Institute Jude Bevan BAppSc, Grad Dip HSc Senior Policy and Planning Officer (Hepatitis C), Sexual Health and Blood Borne Virus Program, Department of Health, Perth Jenny Grant (from August) A/Manager, Clean Needle Program, Drug and Alcohol Services South Australia, Adelaide Roland Jauernig BA(Psych), MAppSc Manager, Health Protection Services, Department of Human Services, Melbourne John Kaldor PhD Kirby Institute Robert Kemp (Chair) Principal Policy Advisor Hepatitis C and Manager, Needle and Syringe Program, Queensland Health Shayne Kilford (to Oct) Needle and Syringe Program Coordinator, Northern Territory AIDS and Hepatitis Council, Darwin Stephen Lymb BA, Grad Dip Soc Sc Manager, Population Programs, Drug and Alcohol Services South Australia, Adelaide Lisa Maher PhD Kirby Institute Sharyn Marshall (from October) Program Manager, Northern Territory AIDS and Hepatitis Council, Darwin Rose Mason, Grad Dip Mental Health Nurs. Senior Policy Analyst, Harm Minimisation Unit, AIDS/Infectious Diseases Branch, NSW Department of Health, Sydney Michael Oster RN, RPN, Grad Cert PHC (to August) Manager, Clean Needle Program, Drug and Alcohol Services South Australia, Adelaide Greg Perry RN, RPN, Grad Dip Soc Sc Nurse Unit Manager, Biala Alcohol and Drug Service, Metro North Health Service District, Queensland Health Fiona Poeder Hepatitis C Education Program Manager, Australian Injecting and Illicit Drug Users League (AIVL), Canberra John Ryan BA, LLB Chief Executive Officer, Association for Prevention and Harm Reduction Programs Australia (Anex), Melbourne Francine Smith State Coordinator, Population Health, Department of Health and Human Services, Hobart Libby Topp PhD (to March) Kirby Institute Tammy Waters Dip AOD

46 ANNUAL REPORT 2012 n EXTERNAL BOARDS, COMMITTEES AND ADVISORY GROUPS 2012

1st Canadian Symposium on Hepatitis C Virus, Montreal, ANEX Australian Drugs Conference Reference Group (Lisa Maher) Canada, Organising Committee (Jason Grebely) Anex Research Advisory Committee (John Kaldor) 8th Australasian Viral Hepatitis Conference Organising Annecy HIV group for international HIV surveillance (David Committee (Greg Dore Co-chair, Tanya Applegate) Wilson, Australian representative) 8th Australasian Viral Hepatitis Conference Organising Asian Network of People who Use Drugs, Hepatitis C Technical Committee, Epidemiology and Public Health Stream (Lisa Maher) Advisory Group (Lisa Maher) 8th Australasian Viral Hepatitis Conference Organising Committee, Asian Pacific Journal of Tropical BiomedicineEditorial Board Community and Social Research Stream (Peter Higgs) (David Wilson) 9th International Congress on Drug Therapy in HIV Infection ATAHC II Protocol Steering Committee (Greg Dore, Gail Scientific Committee (HIV9) (David Cooper) Matthews, Jason Grebely, Kathy Petoumenos) 12th IUSTI World Congress, Melbourne, 2012, Organising Australasian Health and Research Data Managers Association Committee (Basil Donovan) Executive Committee (Pip Marks) 13th International Workshop on Adverse Drug Reactions and Australasian Professional Society on Alcohol & other Drugs, Lipodystrophy in HIV Organising Committee (David Cooper) 2012 Conference, Scientific Program Committee (Peter Higgs) 14th Bangkok Symposium on HIV Medicine Organising Australasian Society for HIV Medicine, Board members (Mark Committee (David Cooper) Boyd, Greg Dore) 16th Bangkok Symposium on HIV Medicine Organising Australasian Society for HIV Medicine, NSW HIV Shared Care Committee (David Cooper, Stephen Kerr) Workshop Committee (Mark Boyd) 2012 International Microbicides Conference M2012 Australasian Society for HIV Medicine, Risk Management and Organising Committee (John Kaldor [Chair], Andrew Vallely, Audit Sub-Committee (Mark Boyd) Lisa Maher) Australasian Society for HIV Medicine, Education and Training 2012 Microbicides Conference Organising Committee (Mary Committee (Sarah Pett) Poynten) Australasian Society for HIV Medicine, Hepatitis B for Primary ACCESS Aboriginal Community Controlled Health Service Care Providers Monograph Editorial Committee (Gail Matthews) steering committee (John Kaldor) Australasian Society for HIV Medicine, HIV and the Body ACCESS family planning network steering committee (Basil Steering Committee (Sarah Pett) Donovan, Rebecca Guy) Australasian Society for HIV Medicine, NSW Hepatitis B ACCESS general practice network steering committee (Basil Reference Committee (Gail Matthews) Donovan, Rebecca Guy) Australasian Society for HIV Medicine, NSW Hepatitis C ACCESS sexual health service network steering committee Reference Committee (Gail Matthews) (Hammad Ali, Basil Donovan, Rebecca Guy, John Kaldor) Australasian Society for HIV Medicine, NSW Hepatitis Addiction and Moral Agency ARC Discovery Project Advisory Reference Committee (Greg Dore) Committee (Lisa Maher) Australasian Society for HIV Medicine, reviewer of abstracts AIDS and Behaviour Editorial Board (Garrett Prestage) (Anthony Kelleher) AIDS Council of New South Wales Board (Garrett Prestage, Ben Australian Antiretroviral Guidelines Panel (David Templeton, Bavinton) member) AIDS Council of New South Wales Ethics Review Committee Australian Chlamydia Control Effectiveness Pilot (ACCEPt) (Garrett Prestage chair) Project Executive Committee (Basil Donovan, Rebecca Guy, AIDS Council of New South Wales HIV and Sexually John Kaldor) Transmissible Infections Working Group (Garrett Prestage) Australian Collaboration for Chlamydia Enhanced Sentinel AIDS Council of New South Wales Lesbian Health Board Surveillance (ACCESS) Coordinating Committee (Basil Advisory Committee (Julie Mooney-Somers) Donovan, Rebecca Guy, John Kaldor) AIDS Council of New South Wales Research and Policy Advisory Australian Government Department of Health and Ageing Committee (Garrett Prestage) Ministerial Advisory Committee on Blood Borne Viruses and Alcohol and Drug Foundation NSW, Kathleen York House Sexually Transmissible Infections (Andrew Grulich member) (Libby Topp, Director) Australian Government Department of Health and Ageing- Altair Trial MRS Substudy Protocol Steering Committee (David funded HIV/AIDS, hepatitis C and sexually transmissible Cooper, Sean Emery, Steve Kerr, Rebekah Puls) infections, education and health promotion materials, expert Altair Trial Protocol Steering Committee (David Cooper, Sean working group (John Kaldor) Emery, Kathy Petoumenos, Rebekah Puls) Australian HIV Observational Database Steering Committee

ANNUAL REPORT 2012 47 (Mark Boyd, Matthew Law, Hamish McManus, Kathy Encore1 Protocol Steering Committee (Janaki Amin, David Petoumenos, Stephen Wright) Cooper, Sean Emery, Rebekah Puls) Australian Institute of Policy and Science (David Wilson, Enhancing Hepatitis C Treatment Uptake and Outcomes associate member) in Opiate Dependency Pharmacotherapy Settings Steering Australian Liver Association Clinical Trial Network Executive Committee (ex officio) (John Kaldor) Committee (Greg Dore) Estimation of HIV Prevalence for European Countries Working Australian and New Zealand Industrial and Applied Group (David Wilson) Mathematics (ANZIAM) (John Murray, President) European Developing Country Clinical Trials Partnership Australian New Zealand Breast Cancer Trials Group (EDCTP) microbicide trial feasibility study, East Africa Steering Independent Data Safety and Monitoring Committee (Matthew Committee (Andrew Vallely) Law) Faculty of Medicine, Expert Review Panel (Sean Emery) Australian NSP Survey National Advisory Group (Jenny Iversen, Faculty of Medicine, Research Management Committee Lisa Maher, Libby Topp) (Anthony Kelleher) Australian Radiation Protection and Nuclear Safety Agency Faculty of Medicine, Women’s Employment Committee Radiation Health and Safety Advisory Council (John Kaldor) (Rebekah Puls) Australian Red Cross Blood Service (David Wilson, monitoring Family Planning NSW Scientific Advisory Group (Basil advisor) Donovan, John Kaldor) Australian Society for Infectious Disease, Prosthetic Joint FOXFIRE Data Safety and Monitoring Committee (Matthew Law) Infection Trial Steering Committee (Mark Boyd) Gastroenterology Metropolitan Committee on Hepatitis C (Greg Cancer Working Group, international epidemiologic databases Dore co-chair) to evaluate AIDS (Andrew Grulich) Genital Warts Surveillance Network (Hammad Ali, Basil CAS HIV/STI Health Promotion Subcommittee chlamydia Donovan, Rebecca Guy, David Regan) working group (Hammad Ali, Rebecca Guy) Harm Reduction Journal Editorial Board (Lisa Maher) Centre for Research Excellence in Injecting Drug Use, Education Heart Foundation HIV & CVD Consumer Resource Working Subcommittee (Jason Grebely) Group (Kathy Petoumenos) CHEST Management Committee (Bette Liu) Hepatitis Victoria, Board of Directors (Peter Higgs, president) Cochrane Collaborative Review Group on HIV infection and Hepatitis NSW Medical Research Advisory Panel (Greg Dore) AIDS, Biomedical Interventions Reviews Editor (John Kaldor) HIV Consortium for Partnership in Asia and the Pacific Communicable Disease Network of Australia Committee, Management Committee (John Kaldor, Louise Causer) Surveillance and Monitoring Plan for national strategies HIV HIV DART 2008 Conference Organising Committee (David STI BBV Sub-Committee (David Wilson) Cooper co-chair) Communicable Diseases Intelligence Editorial Board (John Kaldor) HIV Netherlands, Australia, Thailand Research Collaboration Communicable Diseases Network Australia (John Kaldor) (HIV-NAT) International Advisory Board (David Cooper, Co- Communicable Diseases Network Australia, Human Director, Chris Duncombe) Papillomavirus (HPV) Surveillance Working Party (John Kaldor) HIV Therapy Editorial Board (David Cooper, John Kaldor) Communicable Diseases Network Australia, New Developments HIV+ Health Promotion Interagency (Garrett Prestage, Jack in HIV Surveillance Committee (John Kaldor, Chair) Bradley) Communicable Diseases Network Australia, Subcommittee on HIVNAT International Advisory Board (Sean Emery) Surveillance of Bloodborne Viral and Sexually Transmitted HPV Evaluation Linkage Partnership Australia (HELPA) Infections (Basil Donovan, Rebecca Guy, John Kaldor, Tarana Management Committee (Matthew Law, David Regan) Lucky, Keira Robinson, Ann McDonald, Melanie Middleton, IeDEA Adherence sub-Working Group (Stephen Kerr) David Wilson) IeDEA Cancer Working Group (Matthew Law, Stephen Kerr) Communicable Diseases Network of Australia (CDNA), National IeDEA Data Harmonization Working Group (Azar Kariminia) Strategies HIV STI BBV Sub-Committee, Surveillance and IeDEA Executive Committee (David Cooper, Matthew Law) Monitoring Plan (David Wilson) Immunovirology Research Network Steering Committee Comprehensive International Program for Research on AIDS (Anthony Kelleher) (CIPRA) HIV Research Program in Thailand and Cambodia Implementing Expanded Naloxone Availability in the ACT International Steering Committee (David Cooper) (IENAACT) Committee (Anna Olsen) Council of the PNG Institute of Medical Research (Andrew Infectious Disease Reports Editorial Board (David Wilson) Vallely, Member) INSIGHT network, Executive Committee (David Cooper, Sean Current HIV/AIDS Reports Editorial Board (David Cooper, Emery) Honorary Member) INSIGHT network, Infrastructure Committee (Sarah Pett, Cate Current Opinion in HIV and AIDS (David Cooper, co-editor) Carey) Current Opinion in HIV and AIDS Editorial Board (John Kaldor) INSIGHT network, Monitoring Group Committee (David Developing Papua New Guinea’s National HIV Strategy 2011- Courtney-Rodgers, Nisha Seneviratne) 2015 (David Wilson, expert reviewer) INSIGHT network, Quality Oversight and Performance Drug and Alcohol Review Editorial Board (Peter Higgs, Lisa Maher) Evaluation Committee (David Courtney-Rodgers) eJournal of the International AIDS Society Editorial Board (John INSIGHT network, Training Committee (Cate Carey) Kaldor) Intensive Insulin Therapy Trialists’ Collaboration Steering Encore Program Committee (Sean Emery, Rebekah Puls) Committee (Bette Liu) Encore1 Central Nervous System Exposure Protocol Steering International AIDS Society Meeting, Epidemiology and Committee (Janaki Amin, Carlo Dazo, Rebekah Puls) Prevention Stream, Vienna, Austria, Rapporteur (David Wilson) Encore1 Neurocognitive Substudy Protocol Steering Committee International Centre for Science in Drug Policy, Technical (Rebekah Puls, Anna Donaldson, Steve Kerr, Amanda Clarke) Advisor (Lisa Maher) Encore1 Pharmacokinetic Protocol Steering Committee (Dianne International Conference on the Reduction of Drug-related Carey, Rebekah Puls) Harm Scientific- Program Committee (Lisa Maher)

48 ANNUAL REPORT 2012 International HIV/AIDS Alliance Ukraine, Scientific Advisory Review Panel Virology and Microbiology (Stuart Turville) Board (Lisa Maher) National Health and Medical Research Council, Project Grant International Journal of Drug Policy Editorial Board (Jo Kimber, Review Panel, Clinical Trials (Greg Dore) Lisa Maher) National Health and Medical Research Council Project Grant International Journal of STD & AIDS Editorial Board (Basil Review Panel, Indigenous Health (John Kaldor) Donovan) National Health and Medical Research Council Public Health International Society for STD Research (Basil Donovan, Discipline panel (Andrew Grulich) president elect) National Health and Medical Research Council Centres of International Society for STD Research organising committee Research Excellence (Immunisation in Under Studied and Special (Basil Donovan, David Cooper, Andrew Grulich, Rebecca Guy, Risk Populations), Scientific Advisory Board (Lisa Maher) John Kaldor) National Health and Medical Research Council Research International Symposium on Hepatitis Care in Substance Users, Translation Faculty (Lisa Maher) Brussels, Belgium, Organising committee (Jason Grebely) National HIV Post Exposure Prophylaxis Guidelines Reference International Union against Sexually Transmitted Infections, Group (Andrew Grulich) Executive Committee (Basil Donovan, Senior Counsellor) National Prison Entrants Bloodborne Virus Survey Steering Journal of Acquired Immune Deficiency Syndromes Editorial committee (Tony Butler, chair) Board (David Cooper) National Prisoner Health Indictor Project, Technical Expert Journal of AIDS and Clinical Research Editorial Board (David Group (Tony Butler, chair) Wilson) National Prisoner Health Indictor Group (Tony Butler) Journal of Hepatology Editorial Board (Greg Dore) National Strategies STI HIV BBV project working groups Journal of HIV Therapy Current Trends Advisory Board (David (Rebecca Guy, John Kaldor, Garret Prestage) Cooper) National Surveillance Committee (Ann McDonald) Lao People’s Democratic Republic National Strategy and Netherlands AIDS Foundation Grant Scheme (David Wilson, Action Plan on HIV/AIDS/STI 2011-2015 (David Wilson expert reviewer) reviewer) Northern Territory Sexual Health Advisory Group (John Kaldor) Lionel Murphy Foundation (Board of Trustees) (Lisa Maher) NPA-IH Aboriginal Hepatitis C Advisory Committee (Brigitte Lotus House Refuge Management Committee (Lisa Maher) Gerstl) Medicine Today Board of Editorial Consultants (Basil Donovan) NSW Chief Health Officer Report Special Topic: STI (Basil MGM Interagency (Iryna Zablotska) Donovan, David Wilson, advisory group members) MIMS Annual Honorary Editorial Board (Basil Donovan) NSW Department of Corrective Services Ethics Committee Multicultural HIV and Hepatitis Service Advisory Group (Lisa (John Kaldor) Maher, Chair) NSW Greater Metropolitan Clinical Taskforce Hepatitis C Sub- NAPWA Treatments Policy Advisory Group (Fraser Drummond, committee (Greg Dore, co-chair) Sarah Pett) NSW Health CAS Health Promotion Sub-Committee Chlamydia National Association of People Living with HIV/AIDS, HIV Working Group (Rebecca Guy) Medication Working Group (Dianne Carey) NSW Health Expert Advisory Panel - Wide bore syringes (Lisa National Breast Cancer Foundation Register4 Epidemiological Maher) Questionnaire Design Advisory Group (Bette Liu) NSW HIV Point of Care Testing Working Group (Andrew National Centre for HIV/AIDS, Dermatology and STD Grulich, Damian Conway, Rebecca Guy, Garret Prestage) (NCHADS) Steering Committee for Cambodian Treatment NSW Ministerial Advisory Committee on Hepatitis (MACH) Access Program (CTAP) and AusAID funded HIV projects (John (Greg Dore, Lisa Maher) Kaldor) NSW Ministerial Advisory Committee on HIV/AIDS and National Centre for Immunisation Research and Surveillance Sexually Transmissible Infections, Health Promotion of Vaccine Preventable Disease Scientific Advisory Committee Subcommittee (Andrew Grulich chair, Garrett Prestage (John Kaldor) member) National Centre in HIV Social Research (NCHSR) Scientific NSW Ministerial Advisory Committee on HIV/AIDS and Advisory Committee (Lisa Maher) Sexually Transmissible Infections Health Promotion Sub- National Gay Men’s Syphilis Action Plan NSW Implementation Committee - Chlamydia Working Group (Hammad Ali, Rebecca Committee (Rebecca Guy) Guy) National Gay Men’s Syphilis Action Plan Steering Committee NSW Users and AIDS Association Expert Advisory Committee and Monitoring and Evaluation Subcommittee (David Wilson, (Lisa Maher) Rebecca Guy) NSW Users and AIDS Association Peer Distribution Advisory National Gay Men’s Syphilis Action Plan Technical Working Committee (Lisa Maher) Group (Basil Donovan, Andrew Grulich, Rebecca Guy, Garrett NSW Users and AIDS Association Research Ethics Advisory Prestage, David Wilson) Committee (Lisa Maher) National Health and Medical Research Council, Council (Greg Office of Management and Budget (OMB) Peer Reviewer, Public Dore) Health Services (PHS) Guidelines for Pre-Exposure Prophylaxis National Health and Medical Research Council Grant Review (PrEP) for HIV Prevention with Men Who Have Sex with Men, Panel (Panel 5E) (Sean Emery) Centres for Disease Control (John Kaldor) National Health and Medical Research Council Partnership OpiCare Leadership Team (Greg Dore, Jason Grebely) Projects Grant Review Panel (Basil Donovan) Papua New Guinea Annual Medical Symposium 2011 National Health and Medical Research Council Centres of Organising Committee (Andrew Vallely) Research Excellence Grant Review Panel (John Kaldor) Papua New Guinea HIV Modelling Reference Group (John Murray) National Health and Medical Research Council Project Grant Papua New Guinea Policy Forum on Male Circumcision for External Reviewer (Anthony Kelleher, Kersten Koelsch) HIV Prevention Organising Committee (Andrew Vallely, John National Health and Medical Research Council Project Grant Kaldor)

ANNUAL REPORT 2012 49 PEARL study (HN152) Data and Safety Monitoring Board UNSW Academic Board Committee Member (John Kaldor) Committee (Matthew Law) UNSW Academic Board Higher Degree Research Committee Practical Advances in Treating HIV (PATH II) Steering (John Kaldor) Committee (Sean Emery, Chair) UNSW Faculty of Medicine Higher Degree Research Committee Project Coordinating Committee for the NSW Aboriginal Sexual (Libby Topp) and Reproductive Health Evaluation Program (Brigitte Gerstl) UNSW Faculty of Medicine Postdoctoral Advisory Committee ProPrems Trial Data Safety Monitoring Committee (John Kaldor) (Jason Grebely, Mary Poynten) Public Health Association of Australia (Tony Butler) UNSW Faculty of Medicine Research Grant/Early Career Grant Queensland Ministerial Advisory Committee on HIV/AIDS, Review (Anthony Kelleher) Hepatitis C and Sexual Health Member (Andrew Vallely) UNSW Hepatitis C Vaccine Initiative Steering Committee (John Repatriation Medical Authority (John Kaldor) Kaldor) Review of the Australian National HIV Testing Policy, Member UNSW Human Research Ethics Advisory Panel: Medical/ Expert Reference Committee, (Andrew Grulich) Community (Greg Dore, Mark Boyd) Sax Institute (David Wilson) UNSW Institutional Biosafety Committee (Stuart Turville) Sexual Health (David Cooper, Editor) UNSW School of Public Health and Community Medicine Sexual Health Editorial Board (Basil Donovan, Andrew Grulich, Research Committee (Tony Butler) John Kaldor, Garrett Prestage) User’s News and New South Wales Users and AIDS Association Sexual Health of Adolescents Living with HIV (Unicef Thailand Advisory Group (Jason Grebely) and the We Understand Group) (Stephen Kerr, Advisory Board VAC/GMHC Sexually Adventurous Men’s Project Committee member) (Garrett Prestage) Sexual Reproductive Health Program Resource Advisory group World Health Organisation Guidelines Development Working (Brigitte Gerstl) Group: Guidance for Viral Hepatitis B and C Prevention in People Sexually Transmitted Infections Programs Unit (STIPU) Advisor Who Inject Drugs; Surveillance, Screening and Antiretroviral Group, NSW (Rebecca Guy) Management in People with HIV and Viral Hepatitis B and C Co- Sexually Transmitted Infections, Editorial Board (David Cooper) infections (Lisa Maher) Sexually Transmitted Infections, Elsevier, New Delhi (Basil World Health Organisation Strategic and Technical Advisory Donovan, Section Editor) Committee for HIV/AIDS (David Cooper) Sidney Myer Health PhD Scholarship Selection Committee World Health Organisation Working Group on Incidence Assays (Peter Higgs) for HIV Infection (John Kaldor co-Chair) SIRFLOX Independent Data and Safety Monitoring Board World Health Organisation/UNAIDS HIV Vaccine Advisory Committee (Matthew Law) Committee (David Cooper, Chair) SPARTAC Trial Steering Committee (David Cooper, Anthony World Hepatitis Day Clinical and Public Health Advisory Panel Kelleher) (Greg Dore) St Vincent’s Centre for Applied Medical Research/UNSW Research degree review committee (Anthony Kelleher) St Vincent’s Hospital Campus Institutional Biosafety Committee (Anthony Kelleher) St Vincent’s Hospital Human Research Ethics Committee (Kathy Petoumenos, Handan Wand, Dianne Carey) St Vincent’s Research & Biotechnology Precinct Hub Governance Council (David Cooper) Steering Committee for NHMRC grant under the International Collaborative Indigenous Health Research Partnership (John Kaldor) STIGMA - NSW Implementation committee for the National Syphilis Action Plan (Rebecca Guy) STIGMA (Iryna Zablotska) SydPath Research Committee (Anthony Kelleher) The Cancer Council NSW Cancer Research Committee (Andrew Grulich) The Data Collection on Adverse Events of Anti-HIV Drug Study International Steering Committee (Matthew Law) The HIV/AIDS Legal Centre (HALC) Management Board (Iryna Zablotska) Overdose Awareness Day Committee (Peter Higgs) Therapeutic Goods Administration (TGA) expert advisory panel for influenza vaccine testing (Anthony Kelleher) TREAT Asia HIV Observational Database Steering Committee (Matthew Law) TREAT Asia Paediatric HIV Observational Database Steering Committee (Matthew Law, Azar Kariminia) TREAT Asia Steering Committee (David Cooper) UNAIDS Estimation of Australia’s HIV/AIDS indicators (David Wilson) United Kingdom Medical Research Council/National Health Service Clinical Research Panel (Sean Emery)

50 ANNUAL REPORT 2012 n STAFF 2012

DIRECTOR’S OFFICE Senior Lecturer Jeanne Ellard BA (Hons), MPhil, PhD Janaki Amin BSc(Hons), MPH(Hons), PhD Associate Lecturers Director and Scientia Professor of Stephen Kerr BPharm(Hons), MIPH, PhD Ben Bavinton BA (Hon), MPH Medicine (based at HIV-NAT, Thailand) Ian Down MPH David Cooper AO FAA, BSc(Med), MB Kathy Petoumenos BSc, MA, Michelle McKechnie BMedSci (Hon), PhD BS, MD, DSc, FAA, FRACP, FRCPA, FRCP MPH(Hons), PhD Research Assistants Executive Assistant David Regan BA, BSc(Hons), PhD Brian Acraman Janette Button Handan Wand MA, MSc, PhD Lara Cassar CertIVBusAdmin Research Assistant Lecturer Patrick McGrath BA, Dip Ed, Grad Dip Damien Cordery BSc(Hons), MPH, PhD Azar Kariminia BSc, MSc, PhD Matthew O’Dwyer BLibStud, MPH (Hons) Vaccines program grant co-ordinator Associate Lecturer Project Officer John Wilkinson BSc(Hons), PhD Ben Hui BE(computer engineering), Jack Bradley Manager, Research Communication MBiomedE Program Coordinator Louisa Wright M Journalism, MPH Research Associates Anna Checkley BA (Hons) Igor Korostil MSc Conjoint Associate Professor Statisticians Richard Hillman MD FRCP FAChSHM ABORIGINAL AND TORRES Amit Achhra MBBS MPH University of Sydney David Boettiger MPharm MSC Epi Adjunct Lecturer STRAIT ISLANDER PROGRAM Awachana Jiamsakul BSc, MS Kathy Triffitt BA, Grad Dip, Ph D Positive Program Heads (acting) Hamish McManus BEcon, BActS, MBIOS Life NSW John Kaldor PhD Cecilia Moore MSc MPH Rebecca Guy BAppSc, MAppEpid, PhD Stephen Wright BMath, MAppStat Research Manager Computer Systems Officers IMMUNOVIROLOGY AND Simon Graham BIS, MApplEpid Noorul Absar BTech, Grad Dip(Inf Sc), Clinical Project Leader MComp(SW Eng) PATHOGENESIS PROGRAM Mary Ellen Harrod BA, Dip Arts, M Rossitza Chevkenova BSc Professor and Head Prelim, PhD Program co-ordinator Anthony Kelleher BSc(Hons), MB Project Coordinator Courtney Bendall DipBus BS(Hons), PhD, FRACP, FRCPA Linda Garton RN, Grad Cert Adv Prac, Administrative assistant Senior Lecturer and NHMRC CDA Sex Hlth Supreet Mehik B Homoeop Med Surg Fellow Senior Research Officers Stuart Turville BSc (Hons) PhD Amalie Dyda BHSc, MAppEpid Lecturer Brigitte Gerstl BSoc, MPH HIV EPIDEMIOLOGY AND Kersten Koelsch MBBS, MD Project Officers Clinical Project Co-ordinator Belinda Ford BSc, MPH PREVENTION PROGRAM Patricia Grey BA, Post Grad Dip App Sci, Rebecca Lorch DipNurs BSc(Hons) Head, Professor and NHMRC Principal CNS, Dip (Counselling) Research Officer Research Fellow Research Fellows Imogen Green BSc MSc Andrew Grulich MBBS, MSc, PhD, Anupriya Aggarwal PhD Administrative assistant FAFPHM Chantelle Hood PhD Andrew Nakhla BComm, LLB Associate Professor Mee Ling Munier PhD Garrett Prestage BA, PhD, JP David van Bockel PhD Senior Lecturers Research Assistants BIOSTATISTICS AND (Fengyi) Jeff Jin MB, MPH, PhD Mehreen Arshi BSc MPhil (Isobel) Mary Poynten MBBS, DCH, MPH Michelle Bailey BSc(Hons) DATABASES PROGRAM (Hon), PhD Susanna Ip BSc Head and Professor David J Templeton MBChB, DipVen, Glen Lockwood BSc Matthew Law MA, MSc, PhD MForensMed, PhD, MACLM, MFFLM, Data Administrator Associate Professor FAChSHM Ansari Shaik BA, MBA John Murray BSc(Hons), MSc, PhD (part Iryna Zablotska-Manos PhD, MD, MPH Administrative assistant time) Lecturer Tracey Barrett

ANNUAL REPORT 2012 51 JUSTICE HEALTH PROGRAM Melanie Middleton BMedSci, MPH Hila Haskelberg BSc Head and Professor Tarana Lucky MBBS, MPH Sally Hough BAppSci, Postgrad Cert PM Tony Butler MSc (Quant methods) MSc Research Assistants Simone Jacoby BSc, Dip Nutrition, Adv (IT) PhD DipAppEpi Andrew Craig BSc Dip Bot Med Research assistant Corrine Iu BScEd, MPH Joe Levitt AAS Michael Doyle Grad Dip (Indig H Shamin Kinathil BE(Hons), BSc Nisha Berthon-Jones BMedSc, BBus Promotion) Elizabeth Mlambo BSc, MPH Megan Evans BappSc HIM Research Fellows Gordana Popovic BEd, BSc(Hons) Natalie Espinosa BS (Biomed), Claudette Satchell BSc (Hons) PhD Andrew Shattock BSc, MSc MA.AppSc (Ex&Sc) Lorraine Yap PhD Program Coordinator Jessica Taylor (BNurs) Senior Research Officer Megan Tapia David Silk BSc (Hons) Joanne Reekie BSc (Hons), MPhil, PhD Elise Tu BSc (Hons), PhD Research Officers Program Managers Shamin Kinathil MSc, BE (Hons), BSc SEXUAL HEALTH PROGRAM Helen Kriketos BA Paul Simpson BSc (Psych) Cathy O’Connell Head and Professor of Sexual Health Data Managers Basil Donovan MB BS, DipVen (Lond), Kymme Courtney-Vega Dip Sp Th PUBLIC HEALTH MD, FAFPHM, FRCPI, FAChSHM Andrea Redgrave BEng, MSEc Senior Lecturer and NHMRC Post- Jose Aurelio Vieira Vulcao BA INTERVENTIONS RESEARCH doctoral Fellow Administrative Assistants GROUP Rebecca Guy BAppSc, MAppEpid, PhD Pamela Findlay Head and Professor of Epidemiology Lecturers Tanya Johannesen BDes John Kaldor PhD Hammad Ali BSc, MBBS, MPH Rosemary Robson Associate Professor Damian Conway, MB BCh MMed(STD/ Andrew Vallely MBBS, MRCP, MSC, HIV) FAChSHM MRCGP DRCOG DFF DTMH, PhD Fraser Drummond MB ChB, MRCA, DA VIRAL HEPATITIS Senior Lecturer (UK) (to June) Bette Liu MBBS(Hons) MPH(Hons) DPhil Senior Research Officer EPIDEMIOLOGY AND Lecturers Kirsty Smith RN, Grad Dip Education, MPH PREVENTION PROGRAM Louise Causer MB BS, MSc, DTM&H Project Co-ordinators Professor and Head Joanne Jackson (Micallef) BMedSc Lisa Edwards BNurs MPH Lisa Maher PhD (Hons), PhD Rebecca Lorch DipAdultNurs BSc(Hons) Senior Lecturer Bradley Mathers MSD, MBChB, BHB Research Assistants Libby Topp BSc(Psychol)(Hons), PhD Clinical Trials Co-ordinator Larissa Lewis BA Associate Lecturer Lucia Romani BSocSci MA Muhammad Shahid Jamil MBBS MPH Sarah Wright BSc, PGDip Sci, PhD Senior Research Officer MHM (Physiology) Joanne Reekie BSc (Hons), MPhil, PhD Denton Challander BA, BMT Lecturer Program Manager Visiting research fellow Mihaela Ivan MD MSc FAFPHM Skye McGregor BA, BSc, MA Hsin-Chun (Grace) Lee MD Post Doctoral Research Fellows Program Coordinator Peter Higgs PhD, MA, BSW Lucy Watchirs Smith BA, MPH Anna Olsen PhD SURVEILLANCE AND Study Co-ordinators Jenny Iversen BAppSc EVALUATION PROGRAM FOR THERAPEUTIC AND VACCINE Bethany White BA (Psych), MPH PUBLIC HEALTH Research Assistants Head and Associate Professor RESEARCH PROGRAM Anna Bates BA, MPH David Wilson BSc, BInfTech, Head and Professor Sammy Chow BSc (Hons) BAppSc(Hons), GradCert(Biostats), PhD Sean Emery BSc(Hons), PhD Jarliene Enriquez Senior Health Economist Senior Lecturer Program Coordinator Klara Henderson BA, MCOM, PhD Mark Boyd BA, BM, BS, DCTM&H, Rachel McCleave BA(Hons), BEd(Prim) Senior lecturer MHID, MD, FRACP Lei Zhang BSc(Adv Hons), MSc, PhD, MPH Sarah Pett BSc(Hons), MB BS(Hons), Lecturer DTM&H, MRCP (UK), FRACP,PHD VIRAL HEPATITIS CLINICAL Richard Gray BSc(Hons), PhD Rebekah Puls BSc(Hons), PhD Post Doctoral Research Fellows/ Lecturer RESEARCH PROGRAM Associate Lecturers Dianne Carey BPharm, MPH, PHD Head and Associate Professor Mehala Balamurali BSc(Hons), PhD Senior Clinical Project Co-ordinators Greg Dore MB BS, BSc, PhD, FRACP, MPH Alexander Hoare BSc(Hons), PhD Cate Carey RN, BA, MAppSc(Research) Senior Lecturers Josephine Reyes BS, MS, PhD Allison Humphries BSc, MSc (Med), Grad Gail Matthews MBChB, MRCP(UK), Research Associate Dip PH FRACP PhD Cliff Kerr BSc(Hons), LMusA, DipArts, PhD David Courtney-Rodgers Tanya Applegate BSc (Hons), PhD HIV Surveillance Coordinator Clinical Project Co-ordinators Jason Grebely BSc, PhD Ann McDonald BSc, MPH Maria Arriaga BSc, MScMed (STD/HIV) Associate lecturer Senior Surveillance Officer Megan Clewett BappSc HIM Daniel Bradshaw BMBCh MA MRCP (UK) Carleigh Cowling BNurs, PGDipMid Carlo Dazo BMedSc (Hons) Clinical Trials Manager Surveillance Officers Anna Donaldson MSC Pip Marks BSc, MPH (Hons)

52 ANNUAL REPORT 2012 Clinical Project Co-ordinators Robert Myers Marianne Byrne B.Sci (Hons); Grad Cert Visiting Fellows ClinTrialsMan Bruce Brew MB BS(Hons), MD, FRACP Amanda Erratt ADip (Med Record Professor of Medicine Admin) St Vincent’s Hospital, Sydney Michelle Micallef Phd, BBMedSci (Hons) Nick Crofts MB BS, MPH, FAFPHM John J Morrison, BSc (Hons), PhD Professor and Director Sophie Quiene MSc Turning Point Alcohol and Drug Centre, Barbara Yeung RN, BHSc (Nursing), MPH Melbourne Systems manager Hsin-Chun Lee MD Ineke Shaw BSc, Grad Cert BioStats Assistant Professor and Infectious Senior Research Officer Disease Physician, Francois Lamoury EICnam (Biology) College of Medicine, National Cheng Research Assistants Kung University, Taiwan Sofia Bartlett BSc (Hons) Cathy Pell MB BS, MM FAChSM Data Managers Sexual Health Physician Sharmila Siriragavan BMedSci Taylor Square Private Clinic, Sydney Mahshid Tammadoni BE, MAppSc Don Smith MB ChB, MD Labkey Database Developer Associate Professor and Head of Research Trent Schafer BA IT Development Laboratory Coordinator Albion Street Centre, Sydney Austin Butcher Mark Sullivan BSc Program Coordinator Chief Operating Officer Dee Bryant VivaGelTM Microbicide Development Conjoint senior lecturer Consortium Dr Alex Thompson MBBS, PhD, FRACP, Medicines Development Limited, St Vincent’s Hospital Melbourne Melbourne Alex Wodak MB BS, MRACP, FRACP, OPERATIONS AND MRCP, FAFPHM, FAChAM Director, Alcohol and Drug Service ADMINISTRATION St Vincent’s Hospital, Sydney Operations Manager Conjoint Associate Professors Daren Draganic BSc(Hons) Jintanat Ananworanich MD PhD Finance Manager Deputy Director, HIV Netherlands Eilis Duggan BBS(Hons), ACA Australia Thailand Research Accountants Collaboration (HIV-NAT) Gina Lam BA(Hons), EMBA Richard Hillman MD FRCP FAChSHM Selina Cheng BA, MComm, CPA Associate Professor and Director Teresa Wong BAcc, CPA HIV & STI Postgraduate Program, Finance officer University of Sydney Daisy Kibir Catherine O’Connor MB.BS(Hons), Librarian DrPH, MM, FAChSHM, FRACGP, Coralie Kronenberg BA, Dip IM Lib, AALIA DRACOG IT Specialist Director, Sexual & Womens Health, Sergio Sandler MSc, EE, Dip Ed Sydney Local Health District Computer Systems Officers Honorary Senior Lecturer Lisa Howard Dip IT Dr. Alex Thompson, MBBS, PhD, FRACP Charles Tran BCompSc Head of Hepatology Research Manager, Human Relations St. Vincent’s Hospital, Melbourne Brigette Sharp BA(Hons), MAppSc Adjunct Lecturers Manager, Administration Phillip Read BSc, MBBS, MRCP, DipGUM, Yvette Toole DFFP, DipHIV, MPH, FAChSHM Receptionist Post-graduate Fellow, Sydney Sexual Rata Joseph Health Centre, Sydney Hospital Kathy Triffitt BA, Grad Dip, Ph D Manager, Health Promotion RESEARCHERS AFFILIATED TO Positive Life NSW NCHECR Visiting Professor Jennifer Hoy MB BS, Grad Dip Epi Bio, FRACP Senior Visiting Fellow Philip Cunningham BAppSc(Med) Chief of Operations, St Vincent’s Centre for Applied Medical Research

ANNUAL REPORT 2012 53 n POSTGRADUATE STUDENTS AND STUDENT SUPERVISION

PHD CANDIDATES AT THE (St Vincent’s Hospital, Melbourne); Gail Supervisors: Tony Kelleher, Kersten Matthews Koelsch, John Zaunders (SVH) KIRBY INSTITUTE Damian Conway Denise Chee Hsu Amit C Achhra Novel approaches to HIV testing for men Using novel biomarkers to define the Bio-markers and other predictors of who have sex with men. role of TB specific effector T cell and TB AIDS and non-AIDS diseases in HIV Supervisors: Rebecca Guy, Martin Holt specific regulatory T cell in patients with observational (cohort) studies (NCHSR), Andrew Grulich Mycobacterium tuberculosis (TB) and Supervisors David Cooper; Janaki Amin; Laura Cook HIV co- infection Matthew Law Characterisation of T regulatory cells Supervisors: David Cooper; Jintanat Maryam Alavi Supervisors: Tony Kelleher, Nabila Seddiki Ananworanich (HIVNAT); Tony Kelleher Barriers to the assessment and treatment Andrew Peter Craig Tina Iemma of hepatitis C virus infection in injecting Biomathematical and biostatistical The Role of Dynamin-II in HIV drug users modelling of Chlamydia infection, Pathogenesis Supervisors: Greg Dore, Jason Grebely immunity, pathology and vaccine Supervisors: Stuart Turville; Phillip Hammad Ali strategies Robinson (University of Sydney) Epidemiology of Chlamydia and Supervisor: David Wilson Mofizul Islam development of national systems to Ian Down The impact of targeted primary health measure incidence in Australia. Meanings of HIV and ‘safe-sex’ among a care on injecting drug users’ health Supervisors: Rebecca Guy, Basil Donovan, sample of recently diagnosed gay men in Co-supervisor: Libby Topp David Wilson Australia Jennifer Iversen Jonathan Anderson Supervisors: Garrett Prestage, Jeanne Enhanced sentinel sero-surveillance The role of economic evaluation in Ellard among people who inject drugs in decision-making about HIV Fraser Drummond Australia Supervisors: David Cooper; Sean Emery; Chemoprophylaxis for syphilis in MSM - Supervisors: Lisa Maher; Libby Topp; Kathy Petoumenos a trial of systemic chemoprophylaxis for Handan Wand Maria Arriaga syphilis in HIV positive men who have Brendan Jacka Aspects of Human Immunodeficiency sex with men Viral epidemiology of multiple Hep C Virus (HIV) management Supervisors: Basil Donovan; John infections in international high risk Supervisors: Sarah Pett, Mark Boyd Kaldor; Rebecca Guy; Jeff Klausner populations Ben Bavinton Brigitte Gerstl Supervisors: Tanya Applegate; Jason HIV viral load and transmission in Biostatistics, epidemiology, public health Grebely; Greg Dore serodiscordant male homosexual couples. Supervisor: Handan Wand James Jansson Supervisors: Andrew Grulich, Garrett Simon Graham Mapping HIV outcomes: geographical Prestage Quality improvement in Aboriginal and clinical forecasts of people living Louise Causer Community Controlled Health Services with HIV in Australia Rapid points of care (RPOC) tests in New South Wales Supervisors: David Wilson, Richard Gray for diagnosis of sexually transmitted Supervisors: Rebecca Guy; Handan Wand Amy Kwon infections (STIs): evaluation of accuracy, Behzad Hajarizadeh Using mathematical modelling to acceptability and impact in Australia and Diagnosis and natural history of acute evaluate public health interventions for Papua New Guinea (PNG). hepatitis C virus infection viral epidemics Supervisors: John Kaldor, Rebecca Guy Supervisors: Greg Dore; Jason Grebely; Supervisors: David Wilson; Rosie Thein; Eric Pui Fung Chow Tanya Applegate Cliff Kerr Understanding the past, forecasting the Hila Haskelberg Linh-Ve Le future – investigating the epidemiology Antiretroviral toxicity in HIV-infected HIV incidence and predictors of sexual of HIV/AIDS in China patients and drug injecting behavioural risk Supervisors: Lei Zhang, David Wilson Supervisors: Sean Emery; Andrew Carr among female sex workers/men who Paul Clark (St Vincent’s Hospital); Janaki Amin have sex with men in Vietnam Barriers to Hepatitis C treatment and William Hey-Cunningham Supervisors: John Kaldor; Lisa Maher; cure. Delineation of the latent HIV reservoir with Keith Sabin (WHO, Hanoi) Supervisors: Greg Dore; Alex Thompson subpopulations of Memory CD4 T cells Frederick Ji-Yoon Lee

54 ANNUAL REPORT 2012 Chronic non-AIDS effects of HIV (St. Vincent’s Hospital) Supervisors: Kathy Petoumenos, infection and anti-retroviral therapies. Lisa Natoli Matthew Law Andrew Carr Supervisor: Rebecca Guy Yin Xu Scott Ledger Chansavath Phetsouphanh Mechanisms for SIV entry into T The effects of anti-attachment and fusion Characterisation of CD4+ Antigen follicular helper cells inhibitor gene-therapies in the protection specific T cells to HIV Supervisors: Tony Kelleher, John of HIV susceptible cells Supervisors: Tony Kelleher, Nabila Zaunders Supervisors: Geoff Symonds, John Murray Seddiki Dorothy Machalek Suzanne Polis The natural history of anal human Adherence to hepatitis B antiviral MASTERS STUDENTS AT THE papillomavirus infection and anal therapies cellular abnormalities in mature aged Supervisors: Lisa Maher, Armany Zekry KIRBY INSTITUTE homosexual men (St George Hospital) Anna Charisse Farr Supervisors: Andrew Grulich, Jeff Jin, Phillip Read Evaluation of HIV in the Philippines Mary Poynten Clinical and epidemiological aspects of (Masters by Research) Kylie-Ann Mallitt syphilis Supervisor: David Wilson Geospatial Models of HIV Transmission Rebecca Guy, Basil Donovan, Belinda Hengel Supervisors: Handan Wand, David Wilson Lucia Romani What works? Improving Primary Health Allison Martin (Humphries) Factors associated with scabies in a Care Centre access and STI amongst Toxicities associated with antiretroviral highly endemic population young people in remote Aboriginal and treatment of HIV-1 antiretroviral Supervisors: John Kaldor, Andrew Steer Torres Strait Islander communities in treatment effects on HIV Infection (Murdoch Childrens Research Institute) Australia Supervisors: Sean Emery, Janaki Amin, Karen Schneider Supervisors: John Kaldor; Rebecca Guy; Andrew Carr (St Vincent’s Hospital) Economic evaluation of HIV monitoring Lisa Maher Elizabeth Mlambo Supervisors: David Wilson; Matthew Phillip Keen Developing enhanced surveillance and Law; Basil Donovan Late HIV diagnoses among gay and other evaluating available data for monitoring Kirstine Sutherland Smith men who have sex with men in Australia HIV among culturally and linguistically Home-based sample collection to between 2003–2012 diverse (CALD) populations living in increase chlamydia retesting and detect Supervisor: Garrett Prestage Australia. reinfections following treatment. Rebecca Lorch Supervisors: David Wilson, Rebecca Guy Supervisor : Rebecca Guy Role of the Practice Nurse in chlamydia Kristin McBride Sowbhagya Somanadhan testing in general practice Studies of the latent reservoirs of HIV-1 Influence of civil society on HIV Supervisors: Rebecca Guy, Jane Hocking Supervisors: David Cooper; Tony policies and services in India and the and Meredith Temple-Smith (both Kelleher; Kersten Koelsch participation of people living with HIV/ University of Melbourne) Skye McGregor AIDS Tarana Lucky Masters by Research Capacity building for health research in Supervisor: Lisa Maher Using quantitative techniques to improve developing countries Dam Anh Tran monitoring and evaluation of HIV Supervisors: John Kaldor, Klara Accessibility to anti retroviral (ARV) epidemics in Australia Henderson treatment in Vietnam. Supervisors: David Wilson, Handan Wand Hamish McManus Supervisors: Lei Zhang, Anthony Quang Duy Pham Evaluation of survival in HIV-positive Shakeshaft (NDARC), David Wilson, Modelling HIV drug resistance in patients Chris Doran (University of Newcastle) Vietnam Supervisors: Kathy Petoumenos, Winnie Wing Yin Tong Supervisors: Lei Zhang, David Wilson Matthew Law Measurement of immune responses to Bronwyn Silver Catalina Mendez clinically significant viral pathogens in Sexual and reproductive health of Understanding siRNA induced immunocompromised adults Aboriginal women in remote communities transcriptional silencing of HIV-1. Supervisors: Andrew Carr (St Vincent’s Supervisors: John Kaldor; Rebecca Supervisors: Tony Kelleher, Kazuo Suzuki Hospital), Tony Kelleher Guy; Alice Rumbold (Menzies School of (St. Vincent’s Hospital) Lucy Alexandra Watchirs Smith Health Research) Brian Mulhall Supervisor: Bette Liu James Ward Sexually transmitted infections (STI) Edward (Ned) Waters Sexual health and risk factors among in patients in the Australian HIV The analysis, ecology and implications of young Aboriginal people Observational Database HPV variants in HPV related cancers. Supervisors: John Kaldor, Basil Donovan Supervisors: Matthew Law, Christopher Supervisors: David Regan; David Philp Fairley (University of Melbourne). (SPHCM); Andrew Grulich; Anthony Smith Mee Ling Munier Chris Weatherall SUPERVISION OF NON-KIRBY The role of HIV-specific CD4+ T-cells at Immunology of HIV infection primary infection Supervisors: Tony Kelleher, David Cooper INSTITUTE STUDENTS Supervisors: Tony Kelleher; Bill Sewell Bethany White Leon Pierre Botes (The University of (Garvan Institute); John Zaunders (St Hepatitis C vaccine preparedness Sydney) PhD Candidate Vincent’s Hospital) Supervisors: Lisa Maher, Greg Dore Validation of the acceptability and Daniel Murray Stephen Wright reliability of self collected anal swabs The role of microRNAs in HIV-1 infection Antiretroviral therapies and used for cytological screening, to detect and pathogenesis immunological outcomes in HIV-positive anal squamous intra-epithelial lesions in Supervisors: Tony Kelleher, Kazuo Suzuki patients HIV-positive men who have sex with men

ANNUAL REPORT 2012 55 Supervisor: Richard Hillman, Jeff Jin Danielle Horyniak (Monash University) Improving health and reducing harm among young people who inject drugs Co-supervisor: Peter Higgs Robert Kemp (University of Queensland) Development of the Needle and Syringe Program in Queensland Co-supervisor: Lisa Maher Stephen Lambert (University of Queensland) Chlamydia in the Australian Defence Forces Supervisors: Scott Kitchener (University of Queensland), Basil Donovan Samantha McAllery (University of Sydney) Proteomics of True de novo HIV in the Context of Productive Infection Supervisor: Stuart Turville Loay Othman (La Trobe University), PhD Candidate HIV and stigma in the United Arab Emirates Supervisor: Garrett Prestage Tim Read (Melbourne University), PhD Candidate Sexually transmitted viruses in men having sex with men Supervisors: Christopher Fairley, Andrew Grulich Rachel Sacks-Davis (Monash University) Hepatitis C virus transmission and progression in cohorts of people who inject drugs Supervisors: Margaret Hellard and Campbell Aitken (Burnet Institute); Jason Grebely Ivy Shih (University of Sydney) Characterization of Human Immunodeficiency Virus (HIV) spread between physiologically relevant cell targets of the immune system Supervisor: Stuart Turville, N Nasr (University of Sydney) Huachun Zou (University of Melbourne), PhD Candidate HPV infection in young men who have sex with men Supervisors: Marcus Chen (Melbourne), Andrew Grulich Karen Hawke (University of South Australia) Epidemiology of HIV resistance and subtypes in South Australia Co-supervisor: John Kaldor

56 ANNUAL REPORT 2012 n COLLABORATING ORGANISATIONS 2012

NATIONAL and Advocacy (CAHMA) Interchange General Practice, Canberra Communicable Diseases Network John Curtin School of Medical Research, Association for Prevention and Harm Australia, Canberra Australian National University, Canberra Reduction Programs (ANEX), Melbourne Hepatitis Australia, Canberra Microbiology Department Canberra Australasian Chapter of Sexual Health Immunovirology Research Network Hospital, Woden Medicine, Sydney (IVRN), UNSW, Sydney National Centre in Epidemiology and Australasian Faculty of Public Health Inflammation and Infection Research Population Health, Australian National Medicine, Sydney Centre UNSW University, Canberra Australasian Professional Society on National Aboriginal Community Sexual Health and Family Planning ACT Alcohol and other drugs (APSAD) Controlled Health Organisation, Canberra The Canberra Hospital, Canberra Australasian Society for HIV Medicine, National Association of People with HIV Winnunga Nimmityjah Aboriginal Health Sydney Australia, Sydney Services, Canberra Australasian Society of Clinical National Centre for Epidemiology and Immunology and Allergy (ASCIA) Population Health, Australian National Primary Immunodeficiency Register, University, Canberra NEW SOUTH WALES Sydney National Centre for Immunisation Australia and New Zealand Research and Surveillance of Vaccine Aboriginal Health and Medical Research Cardiothoracic Transplant Registry, Preventable Diseases, Sydney Council of NSW Sydney National Centre in HIV Social Research, Aboriginal Medical Service Western Australia and New Zealand Dialysis UNSW, Sydney Sydney, Mount Druitt Village and Transplant Registry (ANZDATA), National Drug and Alcohol Research AIDS Council of NSW (ACON), Sydney, Adelaide Centre, UNSW, Sydney Lismore, Newcastle, Penrith, Port Australia and New Zealand Liver National Serology Reference Laboratory, Macquarie and Wollongong Transplant Registry, Brisbane Australia, Melbourne AIDS Project Management Group Australian Agency for International National Trachoma Surveillance Albion Street Centre, Sydney Development (AusAID), Canberra Reference Group Albury Community Health Centre, Albury Australian Centre for Hepatitis and Office of Aboriginal and Torres Strait Armajun Aboriginal Health Service HIV Virology Research (ACH2), UNSW, Islander Health (OATSIH), Canberra Incorporated, Inverell Sydney Phase Forward Pty Ltd, Sydney Bigge Park Medical Centre, Sydney Australian Centre for Perinatal Science Public Health Laboratory Network Blacktown Needle and Syringe Program (ACPS), Sydney Royal Australasian College of Physicians, Services, Sydney Australian Federation of AIDS Sydney Blue Mountains Sexual Health Clinic, Organisations, Sydney Royal Australian and New Zealand Katoomba Australian Gonococcal Surveillance College of Psychiatrists Burwood Road General Practice, Sydney Program, Sydney Therapeutic Goods Administration, Central Access Service, Sydney Australian Government Department of Canberra Central Coast Harm Reduction Service, Health and Ageing, Canberra Gosford, Long Jetty and Woy Woy Australian Injecting and Illicit Drug Users Central Coast NSP Services, Gosford and League (AIVL), Canberra Long Jetty Australian Institute of Health and AUSTRALIAN CAPITAL Centre for Addiction Medicine, Welfare, Canberra TERRITORY Westmead Hospital Australian Liver Association, Sydney Centre for Health Informatics, UNSW Australian Paediatric Surveillance Unit, ACT Health Centre for Health Initiatives, University Sydney AIDS Action Council of the ACT of Wollongong Australian Red Cross Blood Service, Canberra Sexual Health Centre, Centre for Health Protection, NSW Sydney Canberra Hospital Ministry of Health, Sydney Australian Research Centre in Sex, Canberra University Centre for Health Research in Criminal Health and Society, La Trobe University, Communicable Disease Control Program, Justice, Justice Health, NSW Health Melbourne ACT Health, Canberra Department, Sydney Canberra Alliance for Harm Minimisation Directions ACT, Canberra Centre for Infection and Inflammation

ANNUAL REPORT 2012 57 Research, School of Medical Sciences, (SHAIDS), Lismore) Syringe Program, Sydney UNSW Liverpool Hospital, Sydney Southern NSW Local Health District Centre for Immunology, St Vincent’s Liverpool Sexual Health Clinic, Sydney South Eastern Area Laboratory Services Hospital, Sydney Macquarie Sexual Health Centre, Dubbo (SEALS), Prince of Wales Hospital Centre for Learning and Change, Mid North Coast Local Health District South Eastern Sydney Local Health University of Technology, Sydney Harm Reduction Services District Centre for Values, Ethics and the Law in Multicultural HIV/AIDS and Hepatitis C South Western Sydney Local Health Medicine, University of Sydney Service, Sydney District Centre for Vascular Research, UNSW Murrumbidgee Local Health District SpeeDx Pty Ltd, Sydney Clinic 16, Royal North Shore Hospital, Nepean Blue Mountains Local Health St George Hospital, Sydney Sydney District St George Hospital Short Street Sexual Clinic 180, Sydney Nepean Hospital, Sydney Health Clinic Communicable Diseases Branch, NSW Nepean Sexual Health Clinic St Leonards Medical Centre Health Department, Sydney North Coast Area Health Service, Harm St Vincent’s Hospital, Sydney Coffs Harbour Sexual Health Clinic Reduction Services St Vincent’s Centre for Applied Medical Concord Hospital, Sydney Northern Sydney Central Coast Area Research Department of Microbiology, South Health Service, NSW Health, Sydney St Vincent’s Clinic Bone Densitometry Eastern Area Laboratory Services, Prince Northern Sydney Sexual Health Service St Vincent’s Medical Imaging, Sydney of Wales Hospital, Sydney Northern NSW Local Health District Sydney Children’s Hospital, Randwick Douglass Hanly Moir Pathology Harm Reduction Services Sydney Local Health District Dubbo Sexual Health Centre, Dubbo NSW Centre for Health Record Linkage, Sydney Medical School, University of Durri Aboriginal Corporation Medical Sydney Sydney Service, Kempsey NSW Health, Sydney Sydney Medically Supervised Injecting East Sydney Doctors, Sydney NSW Health, Mental health and Drug Centre Family Planning NSW and Alcohol Office, Sydney Sydney Sexual Health Centre Far West Local Health District NSW State Reference Laboratory for SydPath, Sydney First Step Program, Port Kembla and Nowra HIV/AIDS, St Vincent’s Hospital, Sydney Tamworth Sexual Health Service, Garvan Institute of Medical Research, NSW Users and AIDS Association Tamworth Sydney (NUAA), Sydney Taree Manning Clinic Gateway Opioid Treatment Service Orange Sexual Health Clinic Taylor Square Private Clinic, Sydney Clinic, Nepean Hospital Parramatta Needle and Syringe Program The Byrne Surgery, Sydney General Medical Practice, Coffs Harbour Services, Sydney The Cancer Council NSW, Sydney Grafton Sexual Health Clinic, Grafton Parramatta Sexual Health Clinic, Sydney The Children’s Hospital, Westmead Greater Western Area Health Service Perinatal and Reproductive University of Sydney – Discipline of Harm Reduction and Viral Hepatitis Epidemiology Research Unit, Addiction Medicine, Sydney Branch, Centre for Population Health, incorporating the National Perinatal University of Technology – Faculty of NSW Ministry of Health Statistics Unit, UNSW Nursing, Midwifery and Health Health ConneXions Harm Reduction Port Kembla Sexual Health Clinic, UNSW Cancer Research Centre, Program, Liverpool Warrawong integrated cancer research group Hepatitis NSW (formerly Hepatitis C Positive Life NSW Wagga Wagga Community Health Centre Council of NSW), Sydney Prince of Wales Hospital, Sydney Wellington Aboriginal Corp Health Holden Street Clinic, Gosford Rankin Court Treatment Centre, Sydney Service, Wellington Holdsworth House Medical Practice, Resource and Education Program for Western NSW Local Health District Sydney and Byron Bay Injecting Drug Users (REPIDU), Sydney Western Sydney Aboriginal Medical Hunter Harm Reduction Services, Royal North Shore Hospital, Sydney Service Mt Druitt Newcastle Royal Prince Alfred Hospital, Sydney Western Sydney Local Health District Hunter New England Local Health Royal Prince Alfred Hospital Clinic 36 Westmead Hospital, Sydney District Outreach Clinic, Sydney Westmead Millennium Institute for Hunter New England Sexual Health Royal Prince Alfred Hospital (RPA) Drug Medical Research, Sydney Service Health Services, Sydney Woodlands Clinic, Blue Mountains Anzac Hunter Pharmacotherapy Services Royal Prince Alfred Hospital Regent Memorial Hospital, Katoomba Illawarra Aboriginal Medical Service House Outreach Clinic, Sydney Aboriginal Corporation, Wollongong Royal Prince Alfred Hospital (RPA) Illawarra Sexual Health, Woollongong Sexual Health Clinic, Sydney NORTHERN TERRITORY and Port Kembla Sax Institute, Sydney Illawarra Shoalhaven Local Health School of Biotechnology and Aboriginal Community Controlled Health District Biomolecular Sciences, UNSW Services, Northern Territory John Hunter Hospital, Newcastle School of Mathematics, UNSW Aboriginal Medical Services Alliance Justice Health, NSW Health, Sydney School of Medical Sciences, UNSW Northern Territory, Darwin Kelly Close NSP Service, Mt Druitt School of Public Health, University of AIDS/STI Program, Disease Control, Kirketon Road Centre, Sydney Sydney Department of Health and Community Kite Street Community Health Centre, School of Public Health and Community Services, Darwin Orange Medicine, UNSW Alice Springs Sexual Health Service Lismore/ Tweed Heads Sexual Health Sex Workers Outreach Project (SWOP), Clinic 34 & AIDS Services (also known as Sexual Sydney Baker IDI Heart and Diabetes Institute, Health and Infectious Diseases Service South Court Primary Care Needle and Alice Springs

58 ANNUAL REPORT 2012 Communicable Disease Centre, Royal Royal Brisbane and Women’s Hospital, TASMANIA Darwin Hospital, Darwin Brisbane Anglicare NSP Services, Glenorchy and Darwin Sexual Health Service School of Population Health, The Hobart Family Planning Northern Territory, University of Queensland, Brisbane Clarence Community Health Service, Coconut Grove Sexual Health & HIV Service, Brisbane Hobart Menzies School of Health Research, Spiritus Positive Directions Department of Health and Human Casuarina Townsville Aboriginal and Islanders Services Tasmania Microbiology Laboratory, Royal Darwin Health Services Ltd, Townsville Hobart, Devonport and Launceston Hospital Townsville ATODS NSP Service Sexual Health Service Northern Territory Sexual Health and Townsville Sexual Health Services Salvation Army Launceston BBV Unit West Moreton Sexual Health Service, Tasmanian Council on AIDS, Hepatitis Northern Territory AIDS and Hepatitis QLD and Related Diseases (TasCAHRD), C Council, Alice Springs, Darwin and Hobart Palmerston Tasmanian Aboriginal Centre, Hobart Northern Territory Department of Health and Families SOUTH AUSTRALIA Western Diagnostic Pathology Aboriginal Community Controlled Health Services, South Australia VICTORIA Adelaide Sexual Health Clinic 275 Alfred Radiology, Melbourne QUEENSLAND AIDS Council of South Australia (ACSA), Barwon Drug and Alcohol Services, Adelaide Geelong AIDS Medical Unit, North Quay Drug and Alcohol Services South Burnet Institute, Melbourne Apunipima Cape York Health Council, Australia (DASSA), Adelaide Centre for Population Health, Burnet BungalowBiala Alcohol and Drug Communicable Disease Control Branch, Institute, Melbourne Services, Brisbane SA Health Centre for Women’s Health, Gender and Australasian Leukaemia and Lymphoma Country Health, Adelaide Society, Melbourne School of Population Group (AALG) Tissue Bank Department of Health Health, University of Melbourne Biala Alcohol and Drug Treatment Flinders Clinical Trials Pharmacy, Darebin Community Health Centre, Services, Brisbane Adelaide Northcote Brisbane Sexual Health & HIV Harm Minimisation Program, Deakin Health Economics Unit, Deakin Service (formerly AIDS Medical Unit, Hindmarsh Centre, Adelaide University, Melbourne Queensland Health) Infectious Diseases Laboratories, Deakin University,Melbourne Cairns Base Hospital Institute of Medical and Veterinary Department of Health, Victoria Cairns Base Hospital NSP Services Science, Adelaide Department of Microbiology and Cairns ATODS NSP Service Institute of Medical and Veterinary Immunology, The University of Cairns Sexual Health Service (also Science (IMVS) Melbourne, Melbourne known as the Dolls House Sexual Health Microbiology and Infectious Diseases Harm Reduction Victoria Clinic) Department, SA Pathology at Women’s Health Informatics Unit, Rural Health Clinic 87, Sunshine Coast-Wide Bay and Children’s Hospital, North Academic Centre, University of Health Service District, Nambour Adelaide Melbourne Clinical Medical Virology Centre, Noarlunga Community Health Health Information Exchange, Salvation University of Queensland Services, Adelaide Army, Melbourne Communicable Disease Unit, Queensland Nunkuwarrin Yunti of South Australia Health Works, Footscray Health, Brisbane Inc, Adelaide Indigenous Eye Health Unit, School of Gladstone Road Medical Centre, Brisbane O’Brien Street Practice, Adelaide Population Health, The University of Gold Coast Sexual Health Clinic, Miami Parks Community Health Services, Melbourne Goondir Health Service, Dalby Adelaide Inner Space, Melbourne Kobi House, Toowoomba Positive Life SA La Trobe University, Melbourne James Cook University, Cairns Port Adelaide Community Health Living Positive Victoria Princess Alexandra Hospital, Brisbane Service, Port Adelaide Melbourne Sexual Health Centre Princess Alexandra Sexual Health, South Radiology SA, Adelaide The Microbiological Diagnostic Unit, Brisbane Royal Adelaide Hospital, Adelaide University of Melbourne Queensland Aboriginal and Islander Royal Adelaide Hospital Clinic 275 Middle Park Clinic, Melbourne Health Council, Brisbane Sexually Transmitted Diseases (STD) Monash Medical Centre, Melbourne Queensland Health, Brisbane Services, Internal Medicine Service, Murdoch Childrens Research Institute, Queensland Health Scientific Services, Royal Adelaide Hospital Melbourne Coopers Plains South Australian Health Department National Reference Laboratory Queensland Injectors Health Network South Australian Voice for Intravenous Nexpep, Victoria (QuIHN), Brisbane, Gold Coast and Education (SAVIVE) Noarlunga, North Richmond Drug Safety Program, Sunshine Coast Norwood, Parks, Port Adelaide Melbourne Queensland Paediatric Infectious STI and BBV Section, Communicable Northside Clinic, Fitzroy North Diseases Laboratory, Queensland Disease Control Branch, SA Health, Nossal Institute Children’s Medical Research Institute Adelaide Prahran Market Clinic, Melbourne Queensland Positive People The Care and Prevention Program, Royal Melbourne Hospital, Melbourne Queensland University of Technology, Adelaide University, Adelaide Royal Women’s Hospital, Melbourne Brisbane University of Adelaide School of Population Health, The

ANNUAL REPORT 2012 59 University of Melbourne, Melbourne Studies, University of Kwzulu-Natal, Chulalongkorn Hospital, Bangkok Southern Hepatitis/HIV/AIDS Referral & South Africa Cipto Mangunkusumo General Hospital, Prevention Service (SHARPS), Frankston Agence Nationale de Sécurité du Jakarta St Vincent’s Hospital, Melbourne Médicament et des Produits de Santé, Clinica Alemana, Argentina The Alfred Hospital, Melbourne France Clinique OPUS/LORI, Montreal, Canada The Centre Clinic, Melbourne ANMAT, Argentina Clinton HIV/AIDS Initiative The University of Melbourne Arkansas Children’s Hospital Research Columbia University, New York, USA Victorian Aboriginal Community Institute Concept Center for Addiction Treatment, Controlled Health Organisation, ARUD (Arbeitsgemeinschaft für Munich, Germany Melbourne risikoarmen Umgang mit Drogen), Concerted Action on Seroconversion to Victorian Aboriginal Health Service, Fitzroy Zurich, Switzerland AIDS and Death in Europe (CASCADE) Victorian AIDS Council/Gay Men’s Asian Network of People Who Use Drugs and its contributors, Coordinating Unit, Health Centre (GMHC), Melbourne (ANPUD) London Victorian Cervical Cytology Registry Auckland University of Technology Copenhagen HIV Programme, Hvidovre Victorian Cytology Service Inc, Melbourne Avdeling Spesialiserte Ruspoliklinikker, University Hospital, Copenhagen Victorian Infectious Diseases Reference Norway Department of Epidemiology, Johns Laboratory, Melbourne Bach Mai Hospital, Hanoi, Vietnam Hopkins Bloomberg School of Public Bamrasnaradura Hospital, Bangkok Health, Johns Hopkins University, Barts and the London NHS Trust, Baltimore USA London, UK Department of Statistical Science, WESTERN AUSTRALIA Beijing Ditan Hospital, Beijing University College, London, UK Aboriginal Community Controlled Health BFARM, Germany Desmond Tutu HIV Foundation, Cape Services, Western Australia Bill and Melinda Gates Foundation Town, South Africa Aboriginal Health Council of Western Bingham University Teaching Hospital, Division of Infectious Diseases, Australia, Perth Jos, Nigeria Department of Internal Medicine, Yonsei Centre for Clinical Immunology and Brighton & Sussex University NHS Trust, University College of Medicine, Seoul Biomedical Statistics, Perth Argentina Duke Clinical Research Institute, Duke Communicable Disease Control Branch, British Columbia Centre for Disease University, Durham, North Carolina, USA Department of Health, Perth Control, Vancouver, Canada East Toronto Hepatitis C Program, Curtin University of Technology British Columbia Centre for Excellence in Toronto, Canada Data Linkage Western Australia, Perth HIV/AIDS, Vancouver, Canada ESPOO Treatment and Rehabilitation Department of Health, Western Australia Brown University, Providence, USA A-Clinic, Finland Department of Microbiology and CAICI, Rosario, Argentina Faculté Créteil Henri Mondor, Créteil, Infectious Diseases, PathWest Laboratory CAICI, Rosario,Argentina France Medicine, Royal Perth Hospital Calgary Regional Health Authority, Canada Faculty of Medicine, Udayana University Derbarl Yerrigan Health Service, Perth Cambodian Women’s Development and Sanglah Hospital, Denpasar, Bali, Fremantle Hospital Association (CWDA) Indonesia Fremantle Hospital Sexual Health Service Canadian Aboriginal AIDS Network Family Health International (FH), Kimberley Aboriginal Medical Services CEADI, Buenos Aires, Argentina Cambodia Council, Broome CEIN – Unidad Infectológica de FHI 360 Cambodia M Clinic Prevención, Diagnóstico y Tratamiento. Foundation for AIDS Research (amfAR), Murdoch University, Perth Neuquén, Argentina New York National Drug Research Institute, Curtin Centers for Disease Control and Fundacion Arriaran, Santiago, Chile University of Technology Prevention, USA Fundacion Centro de Estudios Royal Perth Hospital, Perth Centre for Infectious Disease Prevention Infectologicos (FUNCEI), Clinica La Royal Perth Hospital Sexual Health Clinic and Control, Health Canada Sagrada Familia, Buenos Aires Royal Perth Hospital, Department of Centre for Excellence in HIV/AIDS, Fundacion IDEAA, Argentina Clinical Immunology Vancouver, British Columbia, Canada; Fundación IDEAA, Buenos Aires, Sexual Health and Blood Borne Virus Centre for Research on Drugs and Health Argentina Program, Department of Health, Perth Behaviour, London School of Hygiene & Gemeinschaftspraxis Jessen, Berlin, University of Western Australia, Perth Tropical Medicine, UK Germany 3 WA AIDS Council Mobile Exchange, Perth CETI, La Plata, Buenos Aires, Argentina German Cancer Research Center, Western Australian AIDS Council Chaing Mai University, Chaing Mai, Heidelberg (WAAC), Perth Thailand Goroka General Hospital, Goroka, Papua Western Australia Country Health Chelsea and Westminster Hospital, New Guinea Service (WACHS), Perth London Hanoi School of Public Health, Vietnam Western Australian Substance Users Chiang Rai Regional Hospital, Chiang HART Consulting, Malaysia Association (WASUA), Perth Rai, Thailand Harvard University, Boston Children Hospital No. 1, Ho Chi Min City, Health Canada Vietnam Health Research Council of New Zealand INTERNATIONAL Children Hospital No. 2, Ho Chi Min City, HIV Netherlands, Australia, Thailand Vietnam Research Collaboration (HIV-NAT), 1 Military Hospital, Pretoria, South Africa Chonburi Regional Hospital, Chonburi, Thailand Academic Medical Centre, University of Thailand Hôpital Pitié-Salpêtrière, Paris Amsterdam, Amsterdam Chris Hani Baragwanath Hospital, Hôpital Saint-Louis, Paris Africa Centre for Health and Population Soweto, South Africa Hospital Almenara, Lima, Peru

60 ANNUAL REPORT 2012 Hospital Central, Mendoza, Argentina Medicine, University of Bern, Switzerland Institutes, New York Hospital Clínic de Barcelona, Spain Instituto de Enfermedades Tropicales National Epidemiology Center, Hospital CLínico Universitario de Alexander von Humboldt Baumgarten, Department of Health, Philippines Valencia, Spain MIB medical center for infectious diseases National Harm Reduction Association, Hospital de la Santa Creu i Sant Pau, Instituto de Medicina Tropical Alexander Nepal Barcelona, Spain von Humboldt, Lima, Peru National Hospital for Tropical Diseases, Hospital de la Universidad Catolica Instituto Nacional de Ciencias Médicas y Hanoi, Vietnam Pontifica, Santiago, Chile Nutricion Salvador Zubrián, Mexico City National Institute of Allergy and Hospital Dos de Mayo, Lima, Peru Integrated Treatment Centre, Hong Kong Infectious Diseases, National Institutes of Hospital Dr Diego Paroissien, Argentina International AIDS Society, Geneva Health, Bethesda, USA Hospital General de Agudos JM Ramos International Consortium of Investigators National Institute of Hygiene and Mejia, Buenos Aires Working on Non-Hodgkin’s Lymphoma Epidemiology (NIHE), Vietnam Hospital General de Agudos Teodoro Epidemiologic Studies (InterLymph) National Institute on Drug Abuse, Álvarez, Buenos Aires Irish Medicines Board National Institutes of Health, Bethesda, Hospital General de Guadelajara, Mexico Johann Wolfgang Goethe-University USA Hospital General de Leon, Mexico Hospital, Medical HIVCENTER National Institute of Public Health, Hospital General Universitario Gregorio Johns Hopkins University, Baltimore Cambodia Marañón (HGUGM), Spain Jos University Teaching Hospital, Jos, National Taiwan University Hospital, Hospital Germans Trias i Pujol, Nigeria Taipei Badalona, Spain JOSHA Research, Bloemfontein, South Ngã Pae o te Mãramatanga, University of Hospital Interzonal General de Agudos Africa Auckland Dr. Diego Paroissien, Buenos Aires, JW Goethe Universität, Frankfurt Nottingham University Hospitals NHS Argentina Khon Kaen Hospital, Khon Kaen, Trust, Nottingham, UK Hospital Italiano de Buenos Aires, Thailand NRL, Fitzroy, Victoria, Australia; Buenos Aires, Argentina Khon Kaen University, Khon Kaen, Orleans hospital (CHR Orleans La Hospital Kuala Lumpur, Malaysia Thailand Source), Orleans, France Hospital La Paz, Madrid, Spain Klinikum der Universitat Zu Koln Oslo University Hospital, Oslo, Norway Hospital Likas, Kota Kinabalu, Malaysia Koda Bern/Poliklinik Fur Infektiologe, P.H. Diagnostic Centre, Pune, India Hospital Nacional Prof Dr Alejandro Bern Switzerland Papua New Guinea Institute for Medical Posadas, Buenos Aires Kumamoto University, Japan Research (PNGIMR), Goroka, Papua New Hospital Paroissien, Buenos Aires, La Agencia Española de Medicamentos y Guinea Argentina Productos Sanitarios, Spain Papua New Guinea National AIDS Hospital Principe de Asturias, Madrid, Mai Hoa Do Consulting, Vietnam Council (NAC), Port Moresby, Papua New Spain Malaysian AIDS Council, Malaysia Guinea Hospital Privado - Centro Médico de Malaysian Ministry of Health, Malaysia Papua New Guinea National Department Córdoba, Argentina Malaysia National Anti-Drug Agency, of Health (NDoH), Port Moresby, Papua Hospital Pulau Pinang, Malaysia Malaysia New Guinea Hospital Raja Perempuan Zainab II, Malaysian Prison Department, Malaysia Pacific Adventist University (PAU), Port Kelantan, Malaysia Massachusetts General Hospital, Boston Moresby, Papua New Guinea Hospital Rawson, Bajada Pucara, Mater Misericordiae University Hospital, Port Moresby General Hospital, Port Argentina Dublin Moresby, Papua New Guinea HOSPITAL REGIONAL CARLOS HAYA Medical Group Practice, Berlin 3 Papua New Guinea Institute for Medical DE MÁLAGA, Spain Medical Research Council, Durban, Research, Goroka, Papua New Guinea Hospital San Borja-Arriaran, Santiago, South Africa Partners AIDS Research Center, Boston Chile Medical Research Council Clinical Trials Pasteur Institute, France Hospital Sungai Buloh, Kuala Lumpur Unit, London Philippines National AIDS Council Hospital Universitari i Politecnic La Fe, MHRA, UK Plateau State Specialist Hospital, Jos, Spain Ministry of Health and Population, Nepal Nigeria ICH Study Center Hamburg Klinik für Ministry of Health Japan Praxiszentrum Im Tal (PIT), Ludwig- Immunologie und Rheumatologie, Ministry of Health, Chile Maximilians-Univesitat, Munich, Germany Medzinische Hochschule Hannover Ministry of Health, Mexico Providence Health Care, Vancouver IMPACTA, Lima, Peru Ministry of Public Health, Bangkok Public Health Service (GGD), Imperial College, St Mary’s Hospital, Mt Hagen General Hospital, Mt Hagen, Amsterdam, the Netherlands London Papua New Guinea Queen Elizabeth Hospital, Hong Kong Indonesia National AIDS Commission, Nagoya Medical Centre, Nagoya, Japan Ragon Institute of MGH, MIT and Indonesia Nantong University, China Harvard, Boston, USA Indonesian Ministry of Health, Indonesia National Cancer Institute, National Ramathibodi Hospital, Mahidol Infections and Immunity, Avenir Group, Institutes of Health, Bethesda, USA University, Bangkok Hôpital Pitié Salpêtrière, Université National Center for Global Health and Rambam Medical Centre, Haifa, Israel Pierre et Marie Curie-Paris, France Medicine, Tokyo, Japan Research Institute for Health Science, Institut für Virologie, der Universität zu National Center for HIV/AIDS, Chiang Mai, Thailand Köln, Cologne, Germany Dermatology and STDs (NCHADS), Royal Malaysian Police, Malaysia Institute of Human Virology Nigeria Phnom Penh Sanglah Hospital, Bali, Indonesia (IHVN), Abuja, Nigeria National Center for AIDS/STD Control Sanpatong Hospital, Chiang Mai, Thailand Institute of Infectious Disease, Pune, India and Prevention, China School of Public Health, University of Institute of Social and Preventative National Development and Research Minnesota, USA

ANNUAL REPORT 2012 61 Siriraj Hospital, Bangkok Waikato Hospital, Hamilton NZ South Riverdale Community Health Wellington Hospital, Wellington NZ Centre, Toronto, Canada Western General Hospital, Edinburgh Srinagarind Hospital, Khon Kaen, Thailand Wojewodzki Szpital Zakazny, Warsaw, St Luc Hospital, Centre Hospitalier Poland de l’Universite de Montreal (CHUM), The World Bank Canada The World Health Organisation, Geneva St. Thomas’s Hospital, London, UK The World Health Organization, Manila, Tan Tock Seng Hospital, Singapore Philippines Tel Aviv Sourasky Medical Centre, Israel Viet Nam Administration of HIV/AIDS Thai Ministry of Health, Thailand Control, Vietnam Thai Ministry of Public Health/US Yale University, USA Centre for Disease Control & Prevention Yonsei University, Seoul, Korea Collaboration (TUC) Bangkok YRG Centre for AIDS Research and Thai Red Cross Society, Thailand Education, Chennai, India The United Nations Children’s Fund Zentrum für Suchtmedizin ZfS, Basel, (UNICEF), New York, USA Switzerland Toronto General Research Institute, Ziekenhuis Oost Limburg, Genk, Belgium Toronto, Canada ZNA Stuivenberg, Antwerp, Belguim TREAT Asia, American Foundation for AIDS Research (amFAR), Bangkok, Thailand PHARMACEUTICAL AND Tsinghua University Uduyana University, Sanglah Hospital, Bali BIOMEDICAL INDUSTRY UNAIDS, Geneva Abbott Australasia Pty Ltd, Sydney UNAIDS, Vietnam Boehringer Ingelheim Pty Ltd, Sydney Universitas Gadjah Mada, Yogyakarta, Bristol-Myers Squibb Pharmaceuticals, Indonesia Melbourne Universitätsklinikum Düsseldorf, Klinik Calimmune, USA für Gastroenterologie, Hepatologie und CSL Limited, Melbourne Infektiologie-MX- Amb Gilead Sciences, Foster City, California Université Laval, Quebec, Canada GlaxoSmithKline Australia, Melbourne University of Amsterdam and Infectious Janssen-Cilag Pty Ltd, Sydney Disease Cluster, Amsterdam Public Matrix Laboratories, Hyderabad, India Health Service Merck Sharp and Dohme, Sydney University of Bonn, Bonn, Germany Roche Pharmaceuticals University of Bristol, UK Roche Products Pty Ltd, Sydney University of British Columbia SpeeDX Pty Ltd, Sydney University of California, San Diego ViiV Healthcare, Sydney University of California, San Francisco University of Health Sciences, Phnom Penh, Cambodia University of Indonesia, Indonesia University of Malaya, Malaysia University of Malaya Medical Centre, Kuala Lumpur University of Maryland, Baltimore, USA University of Minnesota, Minneapolis, USA University of Missouri, St Louis, USA University of Montreal, Canada University of Otago Medical School, Canada University of Ottawa, Canada University of Oxford, UK University of Papua New Guinea (UPNG), Port Moresby, Papua New Guinea University of Toronto, Canada Urban Health Research Initiative, Vancouver, British Columbia, Canada USAID, USA US Centres for Disease Control (CDC), Vietnam Vaccine and Gene Therapy Institute (VGTI) Port St. Lucie, Florida, USA VIA LIBRE, Lima, Peru Virgen del Rocio University Hospital, Spain

62 ANNUAL REPORT 2012 n FUNDING 2012

AUD$ NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL (NHMRC) PROGRAM GRANTS HIV & HCV vaccines and immunopathogenesis 1,979,206 Sexually transmitted infections - causes, consequences and interventions 1,177,856 Building research capacity for health interventions to improve Aboriginal health (subcontract from University of Sydney) 14,188

PROJECT GRANTS A population-based record linkage study of the impact of chlamydia infection on reproductive health in women 165,181 A randomised controlled trial to evaluate the effectiveness and cost-effectiveness of chlamydia testing in general practice 20,252 A randomised trial of rapid point-of-care tests for chlamydia and gonorrhoea infections in remote aboriginal communities 465,913 A randomised trial to control sexually transmitted infections in remote Aboriginal communities 237,994 A randomised trial to determine the safety and efficacy of early vs deferred treatment of HIV 206,790 Evaluation of naturally occurring resistance to Direct Acting Antiviral Drugs (DAAs) in individuals with acute hepatitis C infection 13,518 HCV incidence cohort: 10 year mortality study 27,500 Hepatitis C, prisons and treatment opportunities 209,599 Hepatitis C vaccine preparedness study 233,354 HIV assembly, transport, egress and transfer from infected dendritic cells 86,759 Modelling and economic evaluation of hepatitis C epidemic mitigation strategies in Australia 157,714 Modelling the interaction between sexually transmitted infections and HIV transmission to inform public health policy 194,766 Neisseria gonorrhoeae antimicrobial resistance, detection and propagation 34,363 Social norms regarding HIV/STI risk and risk reduction behaviours among men who have sex with men in Australia 182,660 Viral load, HIV treatment and HIV transmission in serodiscordant male homosexual couples 395,740

PARTNERSHIP GRANTS Evaluation of a model for assessment and treatment of hepatitis C virus among injecting drug users in the opiate pharmacotherapy setting (ETHOS) 253,941

CAPACITY BUILDING GRANTS From Broome to Berrima: Building Australia-wide research capacity in Indigenous offender health and health care delivery 442,798

CENTRES OF CLINICAL RESEARCH EXCELLENCE Aboriginal Health: Blood borne viral and sexually transmitted infections 142,653

EQUIPMENT GRANTS Upgrade from BDFACSAria 1 to BDFACSAria II 80,000

FELLOWSHIPS Prof. Basil Donovan (Practitioner Fellowship) 106,526 Prof. Greg Dore (Practitioner Fellowship) 106,526 Dr Jason Grebely (Career Development Fellowship) 99,431 Prof. Andrew Grulich (Principal Research Fellowship) 142,949 A/Prof. Rebecca Guy (Postdoctoral Training Fellowship) 36,240 Dr Peter Higgs (Postdoctoral Training Fellowship) 93,834 Dr Fengyi Jin (Postdoctoral Training Fellowship) 93,521 Prof. John Kaldor (Senior Principal Research Fellowship) 161,674 Prof. Anthony Kelleher (Practitioner Fellowship) 106,526 Dr Bette Liu (Postdoctoral Training Fellowship) 82,833 Prof. Lisa Maher (Senior Research Fellowship) 118,157 Dr Anna Olsen (Postdoctoral Training Fellowship) 75,068 Dr Mary Poynten (Postdoctoral Training Fellowship) 71,654 Dr David Templeton (Postdoctoral Training Fellowship) 36,457 Dr Andrew Vallely (Postdoctoral Training Fellowship) 82,391

ANNUAL REPORT 2012 63 POSTGRADUATE SCHOLARSHIPS Maryam Salehi Alavi 58,928 Paul Clark 55,576 Damian Conway 12,750 Denise Hsu 73,865 Tina Iemma 25,979 Bethany White 13,525

AUSTRALIAN RESEARCH COUNCIL (ARC) DISCOVERY PROJECTS Understanding spatial trends in HIV/AIDS infections in South Africa and Australia 75,370

LINKAGE PROJECTS In vivo molecular imaging using engineered affinity reagents and fluorescent laser scanning confocal endomicroscopy 95,634 Sexual health and relationships in young Indigenous people 194,988

FUTURE FELLOWSHIPS Prof. Tony Butler 216,630 A/Prof. David Wilson 188,508

AUSTRALIAN GOVERNMENT FEDERAL DEPARTMENT OF HEALTH AND AGEING Research activities for blood borne virus and sexually transmissible infections 7,002,861 Establishment and maintenance of a trachoma surveillance and reporting unit 214,224 Evaluation of chlamydia pilot in general practice (subcontract with University of Melbourne) 104,065

NSW OFFICE OF MEDICAL RESEARCH Institute of Virology infrastructure funding 2,843,194

NSW MINISTRY OF HEALTH The eTEST project: An initiative to enhance STI testing in gay men 56,339 Evaluation of a model for assessment and treatment of hepatitis C virus amonginjecting drug users in the opiate pharmacotherapy setting (ETHOS) 200,000 Mapping of the community networks and groups among men who has sex with men in NSW (The Mapping Study) 10,000 NCHECR HIV surveillance and epidemiology support 125,000 NPA-IECD Aboriginal sexual/reproductive health project 187,846 NPA-IH Aboriginal hepatitis C project 41,238 NSW Aboriginal sexual health and BBV research study (SHIMMER) 112,550 NSW needle and syringe program enhanced data collection 121,000 Reducing impulsive behaviour in repeat violent offenders using a selective serotonin reuptake inhibitor 297,637 Sexual health and relationships in young Indigenous People 20,500

OTHER STATE DEPARTMENTS Australia-Canada-India Chlamydia Research Alliance (Queensland Department of Employment, Economic Development and Innovation) 35,000 HIV seroconversion and PASH studies (Victoria Health) 150,000 Sexual health and relationships in young Indigenous people (ACT Health) 2,000 Sexual health and relationships in young Indigenous people (Queensland Health) 50,000 Sexual health and relationships in young Indigenous people (Tasmania Health & Human Services) 3,000 Sexual health and relationships in young Indigenous people (Victoria Health) 31,000 Sexual health and relationships in young Indigenous people (Western Australia Health) 3,000 Study of risk and HIV among men who have sex with men in Western Australia (Western Australia Health) 15,390

64 ANNUAL REPORT 2012 NATIONAL INSTITUTES OF HEALTH, USA Asia Pacific HIV research collaboration: cancer studies (subcontract with American Foundation for AIDS Research) 20,725 Asia Pacific HIV research collaboration: tuberculosis studies (subcontract with American Foundation for AIDS Research) 38,538 Eco-pathogenomics of chlamydial reproductive tract infection (subcontract with University of Maryland) 29,534 International collaborative of prospective studies of HIV and Hepatitis in IDU (subcontract with University of California) 29,036 INSIGHT - Leadership (subcontract with University of Minnesota) 308,190 INSIGHT - FLU 002 & FLU 003 (subcontract with University of Minnesota) 299,805 STALWART study (subcontract with University of Minnesota) 8,843 START study (subcontract with University of Minnesota) 854,821 TREAT Asia HIV Observational Database (subcontract with American Foundation for AIDS Research) 248,251 TREAT Asia pediatric HIV observational database (TApHOD) (subcontract with American Foundation for AIDS Research) 185,500 TREAT Asia studies to evaluate resistance (TASER) (subcontract with American Foundation for AIDS Research) 54,715 Treatment of recently acquired hepatitis C virus infection (ATAHC 2) 350,252

OTHER GRANTS AND CONTRACTS AUSTRALIAN A prospective cohort study of hepatitis C treatment delivery in primary care settings (Australian Society for HIV Medicine) 34,235 Epidemiology, prevention and management of liver cancer in NSW: towards a strategic partnership (Cancer Council NSW/University of Sydney) 50,000 Evaluation of improving sexual health in Aboriginal and Torres Strait Islander youth demonstration projects (Australian Institute of Health and Welfare) 13,018 Identifying predisposing factors for, and the consequences of, common and emerging infectious diseases in a large prospective cohort study of adults (Ramaciotti Foundation) 74,688 In vivo molecular imaging using engineered affinity reagents and fluorescent laser scanning confocal endomicroscopy (Medlmmune Limited) 94,268 Inhibition of Dynamin ii (dynii) as a HIV therapeutic and microbicide strategy (Australian Centre for HIV and Hepatitis Virology Research) 122,733 Monitoring transfusion transmissible infections among blood donors (Australian Red Cross Society) 23,376 Papua New Guinea-Australia HIV & AIDS program (AusAID/JTA International Pty Ltd) 9,750 Qualitative longitudinal study to investigate masculinity sexuality and agency among male youth in PNG (AusAID/JTA International Pty Ltd) 127,050 Support for clinical and epidemiological HIV research capacity in Indonesia (AusAID/Australian Society for HIV Medicine) 484,032

INTERNATIONAL A randomised open-label study of second-line combination ART (American Foundation for AIDS Research, USA) 100,939 ENCORE: Evaluation of novel concepts in optimization of antiretroviral efficacy (Bill and Melinda Gates Foundation, USA) 3,106,310 Evaluation of HIV epidemics and programs in Asia (World Bank, USA) 286,651

PHARMACEUTICAL INDUSTRY Abbott Australasia Pty Ltd 140,000 CSL Limited 47,415 Gilead Science Pty Ltd 6,690 Janssen-Cilag Pty Ltd 18,255 Merck Sharp & Dohme 573,786 Tibotec Pharmaceuticals Ltd via Quintiles Pty Ltd 10,420

28,525,952

ANNUAL REPORT 2012 65 n PUBLICATIONS 2012

PEER-REVIEWED T, Kelleher AD, Suzuki K. Direct evidence SR, Marks P, Sasadeusz J, Cooper of nuclear Argonaute distribution during DA, Bowden S, Locarnini S, Dore GJ, transcriptional silencing links the actin Ruxrungtham K. Assessment of HBV flare A cytoskeleton to nuclear RNAi machinery in a randomized clinical trial in HIV/HBV Aandahl RZ, Reyes JF, Sisson SA, Tanaka in human cells. Nucleic Acids Research coinfected subjects initiating HBV-active MM. A model-based Bayesian estimation 2012;40:1579-1595. antiretroviral therapy in Thailand. AIDS of the rate of evolution of VNTR Res Ther 2012;9:6. loci in Mycobacterium tuberculosis. Aitken CK, Kerr T, Hickman M, Stoové PLoS Computational Biology M, Higgs P, Dietze PM. A cross sectional Avihingsanon A, van der Lugt J, 2012;8(6):e1002573 study of emergency department visits Singphore U, Gorowara M, Boyd M, by people who inject drugs. Emerg Med Ananworanich J, Phanuphak P, Burger Achhra AC, Amin J, Hoy J, Tanuma J, 2012;201170. D, Ruxrungtham K. Pharmacokinetics Sirisanthana T, Nolan D, Merati T, Giles and 48 Week Efficacy of Adjusted Dose M on behalf of TAHOD and AHOD. Alavi M, Grebely J, Matthews GV, Indinavir/Ritonavir in Rifampicin- Differences in lipid measurements by Petoumenos K, Yeung B, Day C, , Lloyd Treated HIV/Tuberculosis-Coinfected antiretroviral regimen exposure in AR, Van Beek I, Kaldor JM, Hellard Patients: A Pilot Study. AIDS Res Hum cohorts from Asia and australia. AIDS M, Dore GJ, Haber PS on behalf of the Retrovir 2012;28(10):1170-6. Res Treat 2012;2012:246280. ATAHC Study Group. Effect of pegylated interferon-alpha-2a treatment on mental B Achhra AC, Amin J, Law MG, Grulich AE, health during recent hepatitis C virus Yeung J, Kelleher AD, Cooper DA, the infection. J Gastroenterol Hepatol Babiker A, Emery S, Fatkenhauer G, Health in Men study group. Changes in 2012;27(5):957-65. Gordin FM, Grund B, Lundgren JD. metabolic, inflammatory and coagulation Neaton JD, Pett SL, Phillips A, Touloumi biomarkers after HIV seroconversion – Ali H, Donovan B, Liu B, Hocking J, Agius G, Vjecha MJ for the INSIGHT START the Health in Men (HIM) Biomarker sub- P, Ward J, Bourne C, Kaldor JM, Guy Study Group. Considerations in the study. Antiviral Therapy 2012;10.3851/ RJ. Chlamydia prevention indicators for rationale, design and methods of the IMP2434. Australia: review of the evidence for New Strategic Timing of Antiretroviral South Wales. Sex Health 2012;9:399-406 Treatment (START) Study. Clin Trials Achhra AC, Amin J, Sabin C, Chu H, 2012; April [Epub]. Dunn D, Kuller LH, Kovacs JA, Cooper Ali H, Guy RJ, Fairley CK, Wand H, Chen DA, Emery S, Law MG for the INSIGHT MY, Dickson B, O’Connor CC, Marshall Baleriola C, Johal H, Robertson P, Jacka ESPRIT and SMART study groups. L, Grulich AE, Kaldor JM, Hellard ME, B, Whybin R, Taylor P, Rawlinson WD. Reclassification of risk of death with Donovan B. Understanding trends in Infectious disease screening of blood the knowledge of D-dimer in a cohort of genital Chlamydia trachomatis can specimens collected post-mortem treated HIV-infected individuals. AIDS benefit from enhanced surveillance: provides comparable results to pre- 2012;26:1707-1717. findings from Australia. Sex Transm mortem specimens. Cell Tissue Bank Infect 2012;88(7):552-7. 2012; 13(2):251-258. Achhra AC, Amin J. Race and CD4+ T-cell count in HIV prognosis Ananworanich J, Gorowara M, Baleriola C, Tu E, Johal H, Gillis J, Ison and treatment. Future Virology Avihingsanon A, Kerr SJ, van Heesch MG, Law M, Coghlan P, Rawlinson WD. 2012;7(2):193-203. N, Khongpetch C, Uanithirat A, Hill Organ donor screening using parallel A, Ruxrungtham K, Burger DM on nucleic acid testing allows assessment of Aggarwal A, Iemma TL, Shih I, Newsome behalf of the HIV-NAT 127 Study transmission risk and assay results in real TP, McAllery S, Cunningham AL, Turville Team. Pharmacokinetics of and short- time. Transpl Infec Dis 2012;14(3):278-87. SG. Mobilization of HIV spread by term virologic response to low-dose diaphanous 2 dependent filopodia in 400-milligram once-daily raltegravir Becker N, Falster MO, Vajdic CM, de infected dendritic cells. PLoS Pathog maintenance therapy. Antimicrob Agents Sanjose S, Martínez-Maza O, Bracci 2012;8(6):e1002762. Chemother 2012;56:1892-1898. PM, Melbye M, Smedby KE, Engels EA, Turner J, Vineis P, Costantini AS, Ahlenstiel CL, Lim HG, Cooper DA, Ishida Avihingsanon A, Matthews GV, Lewin Holly EA, Spinelli JJ, La Vecchia C,

66 ANNUAL REPORT 2012 Zheng T, Chiu BC, Montella M, Cocco D, Brander C, Walker BD, Brumme Z. strategies in ART-treated adults. J Acquir P, Maynadié M, Foretova L, Staines Uncommon pathways of immune escape Immune Defic Syndr 2012;60:143-149. A, Brennan P, Davis S, Severson R, attenuate HIV-1 integrase replication Cerhan JR, Breen EC, Birmann B, capacity. J Virol 2012;86(12):6913-23. Chakrabarty S, Murray JM. Modelling Cozen W, Grulich AE, Newton R. Self- hepatitis C virus infection and the reported history of infections and the Brotherton J, Garland S, Donovan B. development of hepatocellular risk of non-Hodgkin lymphoma: an Genital HPV types in Australia. Lancet carcinoma. J Theoretical Biol InterLymph pooled analysis. Int J Cancer Infect Dis 2012;12(2):102-3. 2012;305:24-29. 2012;131(10):2342-8. Brotherton JML, Stein AN, Conway EL, Chih S, MacDonald PS, McCrohon JA, Boesecke C, Pett SL. Clinical studies with Regan DG, Grulich A, Law M, Hocking Ma D, Moore J, Fenelev MP, Law M, chemokine receptor-5 (CCR5)-inhibitors. JS. Human papillomavirus and head Kovacic JC, Graham RM. Granulocyte Curr Opin HIV AIDS 2012;7(5):456-62. and neck cancers: emerging trends and colony stimulating factor in chronic improving survival. Aust N Z J Public angina to stimulate neovascularisation: A Bond CE, Umapathy A, Ramesnes Health 2012;36(2):195-196. placebo controlled crossover trial. Heart I, Greco SA, Zhao ZZ, Mallitt KA, 2012;98(4):282-290. Buttenshaw RL, Montgomery GW, Brown DA, Hance KW, Rogers CJ, Leggett BA, Whitehall VLJ. P53 mutation Sansbury LB, Albert PS, Murphy Chow EPF, Iu KI, Fu X, Wilson DP, is common in microsatellite stable, BRAF G, Laiyemo AO, Wang Z, Cross AJ, Zhang L. HIV and sexually transmissible mutant colorectal cancers. Int J Cancer Schatzkin A, Danta M, Srasuebkul P, infections among money boys in China: 2012;130:1567-1576. Amin J, Law M, Breit SN, Lanza E. 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Ge D, Tillmann HL, Urban TJ, Shianna CP, Macla L, Lin S, Sainsbury A, Herzog Correlation of selenium and zinc levels K, Fellay J, Goodman Z, Noviello S, H, Law M, Stenvinkel P, Brown DA. to antiretroviral treatment outcomes Pedicone LD, Afdhal N, Sulkowski M, Macrophage inhibitory cytokine-1 in Thai HIV-infected children without Albrecht JK, Goldstein DB, McHutchison (MIC-1/GDF15) and mortality in end- severe HIV symptoms. Eur J Clin Nutr JG, Muir AJ. The association of genetic stage renal disease. Nephrology Dialysis 2012;66(8):900-5. variants with hepatic steatosis in patients Transplantation 2012;27(1):70-75. with genotype 1 chronic hepatitis C C infection. Dig Dis Sci 2012;57(8):2213-21. 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ANNUAL REPORT 2012 67 infection receiving antiretroviral therapy D (Cooper DA – member). Extended in Bangkok. Open Virol J 2012;6:23-28. follow-up confirms early vaccine- DeJesus E, Rockstroh JK, Henry K, Molina enhanced risk of HIV acquisition and Conway DP, Healey LM, Rauwendaal JM, Gathe J, Ramanathan S, Wei X, Yale demonstrates waning effect over time E, Templeton DJ, Davies SC. Providing K, Szwarcberg J, White K, Cheng AK, among participants in a randomized trial HIV-negative results to low-risk clients by Kearney BP, GS-236-0103 Study Team of recombinant adenovirus HIV vaccine telephone. Sex Health 2012;9(2):160-5. (Cooper DA – member). Co-formulated (Step Study) (Cooper DA – member, elvitegravir, cobicistat, emtricitabine Step Study Protocol Team). J Infect Dis Copeland L, Robertson JR, McKenzie and tenofovir disoproxil fumarate versus 2012;206:258-266. J, Kimber J, Macleod J, Hickman M, ritonavir-boosted atazanavir plus co- De Angelis D. Premature mortality formulated emtricitabine and tenofovir Dung TC, Hien NT, Nga PT, Dinh PN, Seale in Scottish drug users: A life history disoproxil fumarate for initial treatment H, MacIntyre R, Maher L, McLaws ML, approach. Scott Med J 2012;57(1):38-42. of HIV-1 infection: a randomised, double- Phuong NTL, Dwyer D. Use of cloth masks blind, phase 3, non-inferiority trial. Lancet among healthcare workers in hospitals in Cordery DV, Martin A, Amin J, Kelleher 2012;379:2429-2438. Hanoi. Vietnam J Prevent Med 2012;22(2) AD, Emery S, Cooper DA on behalf of (129):104-110. the STEAL study group. The influence of DeJesus E, Rockstroh JK, Lennox JL, Saag HLA supertype on thymidine analogue MS, Lazzarin A, Zhao J, Wan H, Rodgers E associated with low peripheral fat in HIV. AJ, Walker ML, Miller M, DiNubile MJ, AIDS 2012;26:2337-2344. Nguyen B-Y, Teppler H, Leavitt R, Sklar P Else L, Jackson A, Puls RL, Hill A, Fahey for the STARTMRK Investigators (Cooper P, Lin E, Amara A, Siccardi M, Watson V, Couture MC, Evans JL, San Sothy N, DA – member). Efficacy of raltegravir Tija V, Emery S, Khoo S, Back D, Boffito Stein ES, , Sichan K, Maher L, Page K versus efavirenz when combined with M. Pharmacokinteics of lamivudine on behalf of the Young Women’s Health tenofovir/emtricitabine in treatment- and lamivudine triphosphate after Study. Correlates of amphetamine- naïve HIV-1-infected patients: Week-192 administration of 300mg and 150mg type stimulant use and associations overall and subgroup analyses from once-daily to healthy volunteers; with HIV-related risks among young STARTMRK. HIV Clin Trials 2012;13:228- the ENCORE2 study. J Antimicrob women engaged in sex work in Phnom 232. Chemother 2012;56:1427-33. Penh, Cambodia. Drug Alcohol Depend 2012;120:119-126. Delva W, Wilson DP, Abu-Raddad F L, Gorgens M, Wilson D, Hallett Couture MC, Page K, Stein E, Sansothy TB, Welte A. Principles of good HIV Feigin A, Higgs P, Hellard M, Dietze N, Sichan K, Kaldor J, Evans J, Maher epidemiology modelling for public P. The impact of khat use on East L, Palefsky J, on behalf of the Young health decision-making in all modes of African communities in Melbourne: A Women’s Health Study Collaborative. prevention and evaluation. PLoS Med preliminary investigation. Drug Alcohol Cervical human papillomavirus infection 2012;9(7):e1001239. Rev 2012;31(3):288-93. among young women engaged in sex work in Phnom Penh, Cambodia: Donovan B, Guy R. Developments in Finfer S, Liu B, Chittock DR, Norton R, prevalence, genotypes and risk factors. research for STI prevention in Peru. Myburgh JA, McArthur C, Mitchell I, BMC Infec Dis 2012;12:166. Lancet 2012;379(9821):1081-2. Foster D, Dhingra V, Henderson WR, Ronco JJ, Bellomo R, Cook D, McDonald Cowie BC, Dore GJ. 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Sex PA, Kaldor JM, Lloyd AR, Ffrench, R.; METAVIR score: improved prediction Health 2012;9(5):472-480. on behalf of the ATAHC Study Group. of sustained virological response in Impaired Hepatitis C Virus (HCV)-Specific HCV genotype 1 patients. Antivir Ther Dray A, Perez P, Moore D, Dietze P, Interferon-γ Responses in Individuals 2012;17(5):849-54. Bammer G, Jenkinson R, Siokou C, With HIV Who Acquire HCV Infection: Green R, Hudson SL, Maher L. Are Correlation With CD4+ T-Cell Counts. J Crawford KW, Ripin DH, Levin AD, drug detection dogs and mass-media Infect Dis 2012;206(10):1568-1576. Campbell JR, Flexner C for the campaigns likely to be effective policy participants of The Conference on responses to psychostimulant use and G Antiretroviral Drug Optimization related harm? Results from an agent- (Cooper DA collaborator; Emery S based simulation model. Int J Drug Garland SM, Pirotta M, Donovan member). optimising the manufacture, Policy 2012;23:148-153. B. 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68 ANNUAL REPORT 2012 C Treatment Outcomes in Australian and preventing death from compensated Guy RJ, Patton GC, Kaldor JM. Internet Clinics. Med J Aust 2012;196:633-637. cirrhosis in the community. Liver Int pornography and adolescent health. 2012;32:2-4 (invited editorial). Med J Aust. 2012;196(9):546-7 Goller JL, Ward J, Saunders M, Couzos (editorial) S, Kaldor JM, Hellard MA, on behalf of Group THMCTaPEW, Barnighausen the ACCESS Collaboration (Donovan T, Becker S, Bendavid E, Bershteyn A, H B Principal Investigator). Chlamydia Blandford J, Boily M-C, Burns D, Cambiano sentinel surveillance in Aboriginal V, Cohen MS, Cremin I, Delva W, Dye C, Haire B, Kaldor J, Jordens CF. How good Community Controlled Health Services: Eaton JW, Egger M, Fraser C, Galai N, is “Good Enough”? The case for varying higher testing and positivity rates among Garnett G, Ghys PD, Hallett TB, Heaton L, standards of evidence according to need younger people. Aust N Z J Public Health Holmes CB, Hontelez J, Jewell B, Keiser O, for new interventions in HIV prevention. 2012;36(6):577-81 Klein D, Lima V, Long E, Lyerla R, Marais Am J Bioeth 2012;12(6):21-30 C, Meng F, Meyer-Rath G, Miller WC, Gotuzzo E, Markowitz M, Ratanasuwan Muraguri N, Nichols BE, Nigmatulina KR, Hajarizadeh B, Grebely J, Dore GJ. Case W, Smith G, Prada G, Morales-Ramirez Over M, Padian N, Phillips A, Pretorius definitions for acute hepatitis C virus JO, Strohmaier KM, Lu C, Bhanja S, C, Rousseau C, Salomon J, Sangrujee infection: A systematic review. J Hepatol Nguyen BY, Teppler H; Protocol 004 N, Serwadda D, Tanser F, Vesga JF, 2012;57(6):1349-60. Study Team. Sustained efficacy and Vickerman P, Walker D, Wang R, Welte A, safety of raltegravir after 5 years of White RG, Williams B, Wilson DP, Wilson Hamers RL, Oyomopito R, Kityo C, combination antiretroviral therapy as D, Zaba B. 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Cohort Profile: the Indigenous and non-Indigenous PharmAccess African (PASER-M) and Australians. Med J Aust 2012;197:642-6. Guy R, Hocking J, Low N, Ali H, the TREAT Asia (TASER-M) monitoring Bauer HM, Walker J, Klausner JD, studies to evaluate resistance – HIV Grebely J, Dore GJ. What is killing people Donovan B, Kaldor JM. Interventions drug resistance in sub-Saharan Africa with HCV infection? Sem Liver Dis to increase rescreening for repeat and the Asia-Pacific. Int J Epidemiol 2011:31:331-9. chlamydial infection. Sex Transm Dis 2012;41(1):43-54. 2012;39(2):136-46. Grebely J, Hellard M, Appelgate T, Hamlyn E, Ewings FM, Porter K, Petoumenos K, Yeung B, Feld JJ, Guy R, Hocking JS, Wand HC, Stott S, Cooper DA, Tambussi G, Schechter M, Rawlinson W, Lloyd AR, George J, Kaldor Ali H, Kaldor JM. How effective are short Pedersen C, Okulicz JF, McClure M, JM, Dore GJ, Matthews GV; on behalf message service reminders at increasing Babiker A, Weber J, Fidler S on behalf of the ATAHC Study Group. Virological clinic attendance? A meta-analysis and of the INSIGHT SMART and SPARTAC responses during treatment for recent systematic review. Health Serv Res Investigators. Plasma HIV viral rebound hepatitis C virus: Potential benefit for 2012;47(2):614-632. following protocol-indicated cessation ribavirin use in HCV/HIV co-infection. of ART commenced in primary and AIDS 2012;26(13):1653-61. Guy R, Wand H, Holt M, Mao L, Wilson chronic HIV infection. PLoS One DP, Bourne C, Drummond F, Honnor 2012;7:e43754 Grebely J, Pham ST, Matthews GV, G, Keen P, Donovan B, Prestage G. Petoumenos K, Bull RA, Yeung B, High annual syphilis testing rates Hamlyn E, Hickling S, Porter K, Frater J, Rawlinson W, Kaldor JM, Lloyd AR, among gay men in Australia, but Phillips R, Robinson M, Nicola ME, Kaye Hellard M, Dore GJ, White PA on behalf insufficient retesting. Sex Transm Dis S, McClure M, Fidler S on behalf of the of the ATAHC Study Group. Hepatitis 2012;39(4):268-75. SPARTAC Investigators (Cooper DA – C virus reinfection and superinfection member). Increased levels of CD4 T-cell among treated and untreated Guy R, Wand H, Knight V, Read PJ. activation in individuals with CXCR4 participants with recent infection. SMS reminders improve re-screening using viruses in primary HIV-1 infection. Hepatol 2012;55(4):1058-1069. in women and heterosexual men with AIDS 2012;26:887-890 chlamydia infection at Sydney Sexual Grebely J, Prins M, Hellard M, Cox AL, Health Centre: a before-and-after study. Harris M, Treloar C, Maher L. Staying Osburn WO, Lauer G, Page K, Lloyd AR, Sex Transm Infect 2012;39(4):260-267. safe from hepatitis C: Engaging with Dore GJ; International Collaboration of multiple priorities. Qual Health Res Incident HIV and Hepatitis C in Injecting Guy R, Ward JS, Smith KS, Su JY, Huang 2012;22:31-42. Cohorts (InC3). Hepatitis C virus RL, Tangey A, Skov S, Rumbold A, Silver clearance, reinfection, and persistence, B, Donovan B, Kaldor JM. The impact of Haskelberg H, Hoy JF, Amin J, Ebeling with insights from studies of injecting sexually transmissible infection programs PR, Emery S, Carr A, STEAL Study drug users: towards a vaccine. Lancet in remote Aboriginal communities in Group. Changes in bone turnover and Infect Dis 2012;12(5):408-14. Australia: a systematic review. Sex bone loss in HIV-infected patients Grebely J, Talwalkar JA. Recognizing Health 2012;9(3):205-12. changing treatment to tenofovir-

ANNUAL REPORT 2012 69 emtricitabine or abacavir-lamivudine. drug use and related health behaviours J PLoS One 2012;7(6):e38377. in a small case series of East African migrants in Melbourne: Letter. Aust N Z J Jansson J, Wilson DP. Projected Hellard M, Jenkinson R, Higgs P, Stoove Pub Health 2012;36(6):586-7. demographic profile of people living M, Sacks-Davis R, Gold J, Hickman with HIV in Australia: planning M, Vickerman P, Martin N. Modeling Hsu DC, Zaunders JJ, Plit M, Leeman for an older generation. PLoS One the utility of antiviral treatment for C, Ip S, Iampornsin T, Pett SL, Bailey 2012;7(8):e38334. primary prevention of hepatitis C M, Amin J, Ubolyam S, Avihingsanon infection among people who inject A, Ananworanich J, Ruxrungtham Jarrin I, Pantazis N, Gill MJ, Geskus drugs in Victoria, Australia. Med J Aust K, Cooper DA, Kelleher AD. A novel R, Perez-Hoyos S, Meyer L, Prins M, 2012;196(10):638–641. assay detecting recall response Touloumi G, Johnson A, Hamouda O, to Mycobacterium tuberculosis: de Olalla PG, Porter K, del Amo J and Heymer KJ, Wentzlaff-Eggebert M, Comparison with existing assays. CASCADE Collaboration in EuroCoord Mortimer E, Wilson DP. An economic Tuberculosis 2012;92:321-327. (Cooper DA – member). Uptake of case for providing free access to combination antiretroviral therapy and antiretroviral therapy for HIV-positive I HIV disease progression according to people in South Australia. Sex Health geographical origin in seroconverters 2012;9(3):220-6. Islam FM, Wu J, Jansson J, Wilson D. in Europe, Canada and Australia. Clin Relative risk of cardiovascular disease Infect Dis 2012;54:111-118 Hill PS, Tynan A, Law G, Millan J, among people living with HIV: a Browne K, Sauk J, Kupul M, Kelly A, systematic review and meta-analysis. HIV Jiamsakul A, Kantor R, Li PC, Siba P, Kaldor J, Vallely A on behalf of Med 2012;13(8):453-68. Sirivichayakul S, Sirisanthana T, the Male Circumcision Acceptability Kantipong P, Lee CK, Kamarulzaman A, and Impact Study. A typology of penile Islam FM, Wu J, Jansson J, Wilson DP. Ratanasuwan W, Ditangco R, Singtoroj cutting in Papua New Guinea: results of Relative risk of renal disease among T, Sungkanuparph S on behalf of the a modified Delphi study among sexual people living with HIV: a systematic TREAT Asia Studies to Evaluate Resistence health specialists. AIDS Care 2012;24:77- review and meta-analysis. BMC Public – Monitoring Study (TASER-M). 86. Health 2012;12:234. Comparison of predicted susceptibility between genotype and virtual phenotype Hillman RJ, van Leeuwen MT, Vajdic Islam M, Topp L, Conigrave KM, van Beek HIV drug resistance interpretation systems CM, McHugh L, Prestage GP, Botes I, Maher L, White A, Rodgers C, Day C. among treatment-naive HIV-infected LP, Zablotska I, Medley G, Tabrizi The reliability of sensitive information patients in Asia: TASER-M cohort analysis. SN, Grulich AE, Jin FY. Prevalence provided by IDU in a clinical setting: BMC Res Notes 2012;5(1):582. and predictors of high-grade anal Clinician administered versus audio intraepithelial neoplasia in a community- computer assisted self interviewing Jin F, Grulich AE, Mao L, Zablotska I, based sample of homosexual men. Sex (ACASI). AIDS Care 2012;24(12):1496- O’Dwyer M, Poynten M, Prestage GP. Health 2012;9(6) 574-579. 503. Sexual Partner’s Age as a Risk Factor for HIV Seroconversion in a Cohort of HIV- Hoare A, Gray RT, Wilson DP. Could Islam MM, Topp L, Conigrave KM, White Negative Homosexual Men in Sydney. implementation of Australia’s National A, Reid SE, Grummett S, Haber PS, Day AIDS Behav 2012; December [Epub] Gay Men’s Syphilis Action Plan have an CA. Linkage into specialist hepatitis C indirect effect on the HIV epidemic? Sex treatment services of injecting drug users Jin F, Prestage GP, Templeton DJ, Health 2012;9(2):144-151. attending a needle syringe program- Poynten IM, Donovan B, Zablotska I, based primary healthcare centre. J Subst Kippax SC, Mindel A, Grulich AE. The Holt M, Murphy D, Callander D, Ellard Abuse Treat 2012;43(4):440-5. impact of HIV seroadaptive behaviors J, Rosengarten M, Kippax S, de Wit JBF. on sexually transmissible infections HIV-negative and HIV-positive gay men’s Islam MM, Topp L, Day CA, Dawson in HIV-negative homosexual men in attitudes towards antiretroviral-based A, Conigrave KM. Primary healthcare Sydney, Australia. Sex Transm Dis preventionsimilar attitudes to pre- outlets that target injecting drug users: 2012;39(3):191-4. exposure prophylaxis (PrEP) but greater Opportunity to make services accessible scepticism among HIV-negative men and acceptable to the target group. Int K about ‘treatment as prevention’. J Int J Drug Policy 2012;23:103-104 (letter; Aids Soc 2012;15:146-7. author’s reply). Kab V, Evans J, Sansothy N, Stein E, Couture MC, Maher L, Page K, on Holt M, Murphy DA, Callander D, Islam MM, Topp L, Day CA, Dawson behalf of the Young Women’s Study Ellard J, Rosengarten M, Kippax SC, A, Conigrave KM. The accessibility, Collaborative. Testing for amphetamine- de Wit JBF. Willingness to use HIV acceptability, health impact and cost type stimulant (ATS) use to ascertain pre-exposure prophylaxis and the implications of primary healthcare validity of self-reported ATS use among likelihood of decreased condom use are outlets that target injecting drug users: young female sex workers in Cambodia. both associated with unprotected anal A narrative synthesis of literature. Int J Addict Sci Clin Prac 2012;7(1):11. intercourse and the perceived likelihood Drug Policy 2012;23:94-102. of becoming HIV positive among Iversen J, Topp L, Wand H, Maher L. Kariminia A, Butler T, Jones J, Law M. Australian gay and bisexual men. Sex Individual-level syringe coverage among Increased mortality among Indigenous Transm Infec 2012;88(4):258-63. Needle and Syringe Program attendees persons during and after release from Horyniak D, Higgs P, Degenhardt L, in Australia. Drug Alcohol Depend. prison in New South Wales. Aust N Z J Cogger S, Power R, Dietze P. 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70 ANNUAL REPORT 2012 Kelly A, Kupul M, Aeno H, Neo J, therapy: a randomised trial. HIV Med are strong predictors of death in a South Naketrumb R, Fitzgerald L, Hill PS, 2012;11(8):493-501. African cohort with advanced HIV Kaldor JM, Siba P, Vallely A. More than disease. PLoSONE 2012;7:e24243. just a cut: A qualitative study of penile Kosalaraksa P, Bunupuradah practices and their relationship to T, Vonthanak S, Wiangnon S, Lewis D, Newton DC, Guy RJ, Ali H, masculinity, sexuality and contagion and Hansudewechakul R, Vibol U, Chen MY, Fairley CK, Hocking JS. The their implications for HIV prevention in Kanchanawanit S, Ngampiyaskul prevalence of Chlamydia trachomatis Papua New Guinea. BMC Int Health Hum C, Wongsawat J, Luesomboon W, infection in Australia: a systematic Rights 2012;12(1):10. Lumbiganon P, Sopa B, Apornpong T, review and meta-analysis. BMC Infect Dis Chuenyam T, Cooper DA, Ruxrungtham 2012;12(1):113. Kelly A, Kupul M, Aeno H, Neo J, K, Ananworanich J, Puthanakit T. Naketrumb R, Fitzgerald L, Kaldor JM, Prevalence of anemia and underlying Lim MS, Goller JL, Guy R, Gold J, Stoove Siba P, Vallely A. Why women object to iron status in naïve antiretroviral therapy M, Hocking JS, Fairley CK, Henning male circumcision to prevent HIV in a HIV-infected children with moderate D, McNamee K, Owen L, Sheehan P, middle prevalence country. Qual Health immune suppression. AIDS Res Hum Hellard ME. Correlates of Chlamydia Res 2012;S1:23(2):180-193. Retroviruses 2012;(12):1679-86. trachomatis infection in a primary care sentinel surveillance network. Sex Health Kelly A, Kupul M, Fitzgeral L, Aeno H, Kramski M, Schorcht A, Johnston AP, 2012;9(3):247-53. Neo J, Naketrumb R, Siba P, Kaldor JM, Lichtfuss GF, Jegaskanda S, De Rose Vallely A. ‘Now we are in a different R, Stratov I, Kelleher AD, French MA, Lim PL, Zhou J, Ditangco RA, Law MG, time; various bad diseases have come’. Center RJ, Jaworowski A, Kent SJ. Role Sirisanthana T, Kumarasamy N, Chen Understanding men’s acceptability of of monocytes in mediating HIV-specific YMA, Phanuphak P, Lee CKC, Saphonn male circumcision for HIV prevention in antibody-dependent cellular cytotoxicity. J V, Oka S, Zhang F, Choi JY, Pujari a moderate prevalence setting. BMC Pub Immunol Methods 2012;384(1-2):51-61. S, Kamarulzaman A, Li PCK, Merati Health 2012;12(1):67 T, Yunihastuti E, Messerschmidt L, Kwan B, Ryder N, Knight V, Kenigsberg A, Sungkanuparph S and the TREAT Asia Kelly GC, Tanner M, Vallely A, Clements McNulty A, Read P, Bourne C. Sensitivity HIV Observational Database. Failure to A. Malaria elimination: Moving forward of 20-minute voiding intervals in men prescribe pneumocystis prophylaxis is with spatial decision support systems. testing for Chlamydia trachomatis. Sex associated with increased mortality, even Trends Parasitol 2012;28(7):297-304. Transm Dis 2012;39(5):405-406. in the cART era: results from the TREAT Asia HIV Observational Database. J Int Keoshkerian E, Helbig K, Beard M, Kwon JA, Anderson J, Kerr CC, Thein AIDS Soc 2012;15:1. Zaunders J, Seddiki N, Kelleher A, H-H, Zhang L, Iversen J, Dore GJ, Hampartzoumian T, Zekry A, Lloyd AR. Kaldor JM, Law MG, Maher L, Wilson Liu B, Donovan B, Hocking JS, Knox J, A novel assay for detection of hepatitis DP. Estimating the cost-effectiveness of Silver B, Guy R. Improving adherence C virus-specific effector CD4 + T cells needle-syringe programs in Australia. to guidelines for the diagnosis and via co-expression of CD25 and CD134. J AIDS 2012;26(17):2201-2210. management of pelvic inflammatory Immunol Methods 2012;375(1-2): 148- disease: a systematic review. Infec Dis 158. L Obst Gyn 2012;2012:325108. Kerr SJ, Avihingsanon A, Putcharoen O, Lam YMP, McBride KL, Amin J, Cordery Liu B, Donovan B, Parker J, Guy R, Chetchotisakd P, Layton M, Ubolyam S, DV, Kelleher AD, Cooper DA, Koelsch K. Hocking J, Kaldor JM, Wand H, Jorm L. Ruxrungtham K, Cooper DA, Phanuphak Switching virally suppressed, treatment- Increasing chlamydia diagnoses but little P, Duncombe C. Assessing adherence experienced patients to a raltegravir- change in hospitalisations for ectopic in Thai patients taking combination containing regimen does not alter levels pregnancy and infertility among women antiretroviral therapy. Int J STD AIDS of HIV-1 DNA. PLoS one 2012;7:3 e31990 in New South Wales from 2001 to 2008. 2012;23:160-165 Sexual Health 2012;9(4):355-9. Kinner SA, Streitberg L, Butler T, Levy Larney S, Topp L, Indig D, O’Driscoll C, M. Prisoner and ex-prisoner health - Greenberg D. A cross-sectional survey Liu BC, Guthridge S, Li SQ, Markey P, improving access to primary care. Aust of prevalence and correlates of suicidal Krause V, McIntyre P, Sullivan E, Ward Fam Physician 2012;41(7):535-7. ideation and suicide attempts among J, Wood N, Kaldor J. The end of the prisoners in New South Wales, Australia. Australia antigen? An ecological study Klinklom A, Puthanakit T, Gorowara BMC Pub Health 2012;12:14. of the impact of universal newborn M, Phasomsap C, Kerr S, Sriheara C, hepatitis B vaccination two decades on. Ananworanich J, Burger D, Ruxrungtham Lea T, Prestage G, Mao LM, Zablotska Vaccine 2012;30(50):7309-14. K, Pancharoen C. Low dose of I, De Wit J, Holt M. Trends in Drug Use lopinavir/ritonavir achieves adequate among Gay and Bisexual Men in Sydney, Liu B, Guy R, Donovan, Kaldor JM. pharmacokinetic parameters in HIV- Melbourne and Queensland, Australia. Chlamydia trachomatis re-infections in a Infected Thai Children. Antivir Ther Drug Alc Rev 2012;31:47. population-based cohort of women. Sex 2012;17:283-289. Transm Infect 2012;89(1):45-50. Ledwaba L, Tavel JA, Khabo P, Maja Koelsch KK. No significant effect of P, Qin J, Sangweni P, Liu X, Follmann Liu BC, McIntyre P, Kaldor JM, Quinn uridine or pravastatin treatment for D, Metcalf JA, Orsega S, Baseler B, H, Ridda I, Banks E. Pertussis in HIV lip atrophy in men who have Neaton JD, Lane HC for Project Phidisa older adults: prospective study of risk ceased thymidine analogue nucleoside (S Emery member). Pre-ART levels of factors and morbidity. Clin Infect Dis reverse transcriptase inhibitor inflammation and coagulation markers 2012;55(11):1450-6.

ANNUAL REPORT 2012 71 Lodi S, Meyer L, Kelleher AD, Rosinska men: An integrated approach. Lancet Rajbhandari D, Taylor CB, Webb SA; M, Ghosn J, Sannes M, Porter K. 2012;380(9839):378-87. CHEST Investigators; Australian and New Immunovirologic Control 24 Months Zealand Intensive Care Society Clinical After Interruption of Antiretroviral McManus H, O’Connor CC, Boyd M, Trials Group. Hydroxyethyl Starch or Therapy Initiated Close to HIV Broom J, Russell D, Watson K, Roth N, Saline for Fluid Resuscitation in Intensive Seroconversion. Arch Intern Med Read PJ, Petoumenos K, Law M on Behalf Care. N Engl J Med 2012;367(20):1901-11. 2012;172(16):1252-5. of the Australian HIV Observational Database (AHOD). Long-Term survival N M in HIV positive patients with up to 15 years antiretroviral therapy. PLoS One Nair-Shalliker V, Smith DP, Egger S, Machalek DA, Grulich AE, Jin FY, 2012;7(11):e48839. Hughes AM, Kaldor JM, Clements M, Templeton DJ, Poynten IM. The Kricker A, Armstrong BK. Sun exposure epidemiology and natural history of Morris BJ, Wodak AD, Mindel A, may increase risk of prostate cancer in anal human papillomavirus infection in Schrieber L, Duggan KA, Dilley A, the high UV environment of New South men who have sex with men. Sex Health Willcourt RJ, Lowy M, Cooper DA, Wales, Australia: A case-control study. Int 2012;9(6):527-37. Lumbers ER, Russell CT, Leeder SR. J Cancer 2012; 131(5):E726-32 Infant male circumcision: An evidence- Machalek DA, Poynten M, Jin F, Fairley based policy statement. Open J Prev Med Nasr N, Maddocks S, Turville SG, CK, Farnsworth A, Garland SM, Hillman 2012;2:79-92 Harman AN, Woolger N, Helbig KJ, RJ, Petoumenos K, Roberts J, Tabrizi SN, Wilkinson J, Bye CR, Wright TK, Templeton DJ, Grulich AE. Anal human Morris BJ, Wodak AD, Mindel A, Schrieber Rambukwelle D, Donaghy H, Beard papillomavirus infection and associated L, Duggan KA, Dilley A, Willcourt RJ, MR, Cunningham AL. HIV-1 infection neoplastic lesions in men who have sex Lowy M, Cooper DA. The 2010 Royal of human macrophages directly induces with men: a systematic review and meta- Australasian College of Physicians’ policy viperin which inhibits viral production. analysis. Lancet Oncol 2012;13(5):487- statement ‘Circumcision of infant males’ Blood 2012;120(4):778-88. 500. is not evidence based. Intern Med J 2012;42:822-828 Nieters A, Conde L, Slager SL, Brooks- Maher L. Tackling hepatitis C in Wilson A, Morton L, Skibola DR, Australia: the third national strategy. Morris BJ, Wodak AD, Mindel A, Novak AJ, Riby J, Ansell SM, Halperin Lancet Infect Dis 2012;12(3):172-3. Schrieber L, Duggan KA, Dilley A, E, Shanafelt TD, Agana L, Wang AH, Willcourt RJ, Lowy M, Cooper DA. Intern De Roos AJ, Severson RK, Cozen W, Maher L, Walsh N. Injecting drug use and Med J 2012 (Reply);42:1279-1280 Spinelli J, Butterbach K, Becker N, de HIV. Curr Opin HIV AIDS 2012;7(4):317-9. Sanjose S, Benavente Y, Cocco P, Staines Mossenson A, Algie K, Olding M, Garton A, Maynadié M, Foretova L, Boffetta P, Maher L, Wand H. Hepatitis C virus L, Reeve C. ‘Yes wee can’ - a nurse-driven Brennan P, Lan Q, Zhang Y, Zheng T, transmission in people who inject drugs: asymptomatic screening program for Purdue M, Armstrong B, Kricker A, Vajdic Swabs may not be the main culprit. J chlamydia and gonorrhoea in a remote CM, Grulich A, Smith MT, Bracci PM, Infect Dis 2012;205(12):1892. emergency department. Sex Health Chanock SJ, Hartge P, Cerhan JR, Wang 2012;9(2):194-5. SS, Rothman N, Skibola CF. PRRC2A Maher L, Waring E. Beyond simple and BCL2L11 gene variants influence differences: White collar crime, gender Mota T, Murray JM, Center R, Purcell D, risk of non-Hodgkin lymphoma: results and workforce position. PHOEBE McCaw J. Application of a case-control from the InterLymph consortium. Blood 2012;2(1):44-54. study design to investigate genotypic 2012;120(23):4645-8. signatures of HIV-1 transmission. Malacova E, Butler T, Yap L, Grant L, Retrovirol 2012;9:54. O Richards A, Smith AMA, Donovan B. Sexual coercion prior to imprisonment: Muessig KE, Smith MK, Powers KA, Oliver BG, Elliott JH, Price P, Phillips M, prevalence, demographic and Lo YR, Burns DN, Grulich AE, Phillips Cooper DA, French MA. Tuberculosis behavioural correlates. Int J STD AIDS AN, Cohen MS. Does ART prevent after commencing antiretroviral 2012;23(8):533-539. HIV transmission among MSM? AIDS therapy for HIV infection is associated 2012;26(18):2267-73. with elevated CXCL9 and CXCL10 Mallitt KA, Wand H, McDonald A, Wilson responses to Mycobacterium tuberculosis DP. Is back-projection methodology still Murray JM, McBride K, Gelgor L, antigens. J Aquir Immune Defic Syndr relevant for estimating HIV incidence Boesecke C, Bailey M, Mische C, Amin J, 2012;61(3):287-292. from National Surveillance Data? Open Baker D, Finlayson RJ, Bloch MT, Suzuki Oliver BG, Price P, Wand H, French AIDS 2012;6:108-111. K, Zaunders JJ, Emery S, Cooper DA, MA. Increased plasma CXCL10 may Mallitt KA, Wilson DP, McDonald A, Koelsch KK, Kelleher AD on behalf of be a marker of increased risk of Wand H. HIV incidence trends vary the PINT Study Team. Integrated HIV immune restoration disease associated between jurisdictions in Australia: an DNA accumulates prior to treatment with non-viral pathogens. JAIDS extended back-projection analysis of while episomal HIV DNA records 2012;59(3):e47-e49. men who have sex with men. Sex Health ongoing transmission afterwards. AIDS 2012;9(2):138-143. 2012;26(5):543-50. Olsen A, Banwell C, Dance P, Maher L. Positive health beliefs and behaviours Mayer KH, Bekker LG, Stall R, Grulich Myburgh JA, Finfer S, Bellomo R, Billot in the midst of difficult lives: Women AE, Colfax G, Lama JR. Comprehensive L, Cass A, Gattas D, Glass P, Lipman who inject drugs. 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72 ANNUAL REPORT 2012 P Observational Database (AHOD). HIV Sex Health 2012;9(5):453-458. Med 2012;14:77-84. Pantazis N, Morrison C, Amornkul PN, Prestage G, Down IA, Bradley J, Lewden C, Salata RA, Minga A, Chipato Petoumenos K, Worm SW, Fontas E, McCann PD, Brown G, Jin F, Hurley T, Jaffe H, Lakhi S, Karita E, Porter K, Weber R, De Wit S, Bruyand M, Reiss M. Is optimism enough? Gay men’s Meyer L, Touloumi G for the CASCADE P, El-Sadr W, D’Arminio Monforte A, beliefs about HIV and their perspectives Collaboration in EuroCoord and ANRS Friis-Moller N, Lundgren JD, Law M and on risk and pleasure. Sex Transm Dis 1220 Primo-CI Study Group (Cooper on behalf of the D:A:D Study Group. 2012;39(3):167-72. DA – member). Differences in HIV Predicting the short-term risk of diabetes natural history among African and non- in HIV-positive patients: the Data Prestage G, Jin F, Grulich A, de Wit J, African seroconverters in Europe and Collection on Adverse Events of Anti- Zablotska I. Gay men are less likely to use seroconverters in sub-Saharan Africa. HIV Drug (D:A:D) Study. J Int AIDS Soc condoms with casual sex partners they PLoS One 2012;7:e32369 2012;15:17426. know ‘well’. AIDS Behav 2012;16(3):664-8.

Park JN, White B, Bates A, Enriquez J, Petoumenos K, Worm SW. HIV Purcell D, Cunningham A, Turville S, Liao L, Maher L. Motivators and barriers infection, ageing and cardiovascular Tachedjian G, Landay A. Biology of influencing willingness to participate in disease: Epidemiology and Prevention. Mucosally Transmitted Sexual Infection- candidate HCV vaccine trials: perspectives Invited review paper. Sex Health Translating the Basic Science into of people who inject drugs. Drug Alcohol 2012;S1:8(4):465-473. Novel HIV Intervention: A Workshop Depend 2012;123(1-3):35-40. Summary. AIDS Res Hum Retrovir Pham QD, Nguyen TV, Hoang CQ, Cao 2012;28(11):1389-96. Pattullo V, Thein HH, Heathcote EJ, V, Khuu NV, Huong TTP, Mai AH, Tran Guindi M. Combining semiquantitative HN, Wilson DP, Zhang L. Prevalence Puthanakit T, Saphonn V, Ananworanich measures of fibrosis and qualitative of HIV/STIs and associated factors J, Kosalaraksa P, Hansuedewechakul features of parenchymal remodelling to among men who have sex with men R, Vibol U, Kerr SJ, Kanjanavanit identify fibrosis regression in hepatitis in An Giang, Vietnam. Sex Transm Dis S, Ngampiyaskul C, Wongsawat J, C: A multiple biopsy study. Histopathol 2012;39(10):799-806. Luesomboon W, Ngo-Giang-Huong N, 2012;61(3):473-87. Chettra K, Cheunyam T, Suwarnlerk Phanuphak N, Ananworanich J, T, Ubolyam S, Shearer WT, Paul R, Pedrana A, Hellard M, Guy R, El-Hayek Teeratakulpisarn N, Jadwattanakul T, Mofenson LM, Fox L, Law MG, Cooper C, Gouillou M, Asselin J, Batrouney C, Kerr SJ, Chomchey N, Hongchookiat DA, Phanuphak P, Vun MC, Ruxrungtham Nguyen P, Stoovè M. Stop the Drama P, Mathajittiphun P, Pinyakorn S, K on behalf of the PREDICT Study Group. Downunder: A Social Marketing Rungrojrat P, Praihirunyakit P, Early versus deferred antiretroviral Campaign Increases HIV/Sexually Gerschenson M, Phanuphak P, Valcour therapy for children older than 1 Transmitted Infection Knowledge and V, Kim JH, Shikuma C on behalf of the year infected with HIV (PREDICT): a Testing in Australian Gay Men. Sex SEARCH 003 Study Group. A 72-week multicentre, randomised, open-label trial. Transm Dis 2012;39(8):651-8. randomized study of three first-line Lancet Infec Dis 2012;12(12):933-941. antiretroviral regimens: d4T switched Pedrana AE, Hellard ME, Guy R, to AZT vs. AZT vs. TDF in combination R Wilson K, Stoové M. The Difference with 3TC and NVP. Antivir Ther 2012; in Self-Reported and Biological 17(8):1521-31. Ramjee G, Wand H. Population-level Measured HIV Prevalence: Implications impact of hormonal contraception on for HIV Prevention. AIDS Behav Poynton IM, Jin F, Templeton DJ, incidence of HIV infection and pregnancy 2012;16(6):1454-63. Prestage GP, Donovan B, Pawlita M, in women in Durban, South Africa. Bull Fairley CK, Garland S, Grulich AE, World Health Organ 2012;90:748-755. Pedrana AE, Hellard ME, Wilson K, Guy Waterboer T. Prevalence, incidence and Read PJ, Donovan B. Clinical aspects R, Stoové M. High rates of undiagnosed risk factors for HPV16 seropositivity of adult syphilis. Intern Med J HIV infections in a community sample in homosexual men. Sex Transm Dis 2012;42(6):614-20. of gay men in Melbourne, Australia. J 2012;39(9):726-32. Acquir Immune Defic Syndr 2012;59:94-99. Poynten IM, Stein AN, Conway EL, Read P, Guy R, Wand H, Donovan B, Perez P, Dray A, Moore D, Dietze P, Prestage G, Regan DG, Jin FY, Hocking McNulty AM. Unprotected fellatio Bammer G, Jenkinson R, Siokou C, Green J, Grulich AE. Geographical clustering of between female sex workers and their R, Hudson SL, Maher L. SimAmph: anal cancer incidence in Australia. Sex clients in Sydney, Australia. Sex Transm An agent-based simulation model for Health 2012;9:509-12. Infect 2012;88(8):581-584. exploring the use of psychostimulants and related harm among young Poynten IM, Zablotska I, Grulich AE. Read PJ, Martin L, McNulty A. Would Australians. Int J Drug Policy Considerations regarding antiretroviral you self-collect swabs in a unisex toilet? 2012;23:62-71. chemoprophylaxis in MSM. Curr Opin Sexual Health 2012;9(4):395-6. HIV AIDS 2012;7(6):549-56. Petoumenos K, van Leuwen MT, Vajdic Read PJ, Mandalia S, Khan P, Harrisson CM, Woolley I, Chuah J, Templeton DJ, Prestage G. The spectre of promiscuity: U, Naftalin C, Gilleece Y, Anderson J, Grulich AE, Law MG on behalf of the gay male and bisexual non-monogamies Hawkins DA, Taylor GP, de Ruiter A. Australian HIV Observational Database and polyamories. Cult Health Sex When should HAART be initiated in (Cooper DA – contributor). Cancer, 2012;14(6):719-21. pregnancy to achieve an undetectable immunodeficiency and antiretroviral Prestage G, Brown G, Keen P. Barriers to HIV viral load by delivery? AIDS treatment: results from the Australian HIV testing among Australian gay men. 2012;26(9):1095-103.

ANNUAL REPORT 2012 73 Regan DG. Population benefits of HPV Savkovic B, Symonds G, Murray JM. T vaccination for boys: a complex equation. Stochastic model of in-vivo X4 emergence Evid Based Med 2012;17(4):118-9. during HIV infection: implications for Tabrizi SN, Brotherton JM, Kaldor JM, the CCR5 inhibitor Maraviroc. PLoS one Skinner SR, Cummins E, Liu B, Bateson Regan DG. HPV vaccination for boys: 2012;7(7):e38755. D, McNamee K, Garefalakis M, Garland a complex equation. Evid Based Med SM. Fall in human papillomavirus 2012;17(4):118-119. Seddiki N, Swaminathan S, Phetsouphanh prevalence following a national C, Kelleher AD. miR-155 is differentially vaccination program. J Infect Dis Reyes JF, Chan CS, Tanaka MM. Impact expressed in Treg subsets, which may 2012;206(11):1645-51 of homoplasy on variable numbers of explain expression level differences of tandem repeats and spoligotypes in miR-155 in HIV-1 infected patients. Blood Templeton DJ, Manokaran N, O’Connor Mycobacterium tuberculosis. Infect 2012;119(26):6396-7 [Letter]. CC. Prevalence and predictors of Genet Evol 2012;S1:12(4):811-818. chlamydia co-infection among patients Shields M, Guy RJ, Jeoffreys NJ, infected with gonorrhoea at a sexual Richmond RL, Butler TG, Indig D, Finlayson RJ, Donovan B. A longitudinal health clinic in Sydney. Sex Health Wilhelm KA, Archer VA, Wodak AD. evaluation of Treponema pallidum PCR 2012;9(4):392-4. The challenges of reducing tobacco use testing in early syphilis. BMC Infect Dis among prisoners. Drug Alcohol Rev 2012;12:353. Thein HH, Walter SR, Gidding HF, 2012; 31(5):625-30. Amin J, Law MG, George J, Dore GJ. Silver BJ, Knox J, Smith KS, Ward JS, Survival after diagnosis of hepatocellular Richters J, Butler T, Schneider K, Yap Boyle J, Guy R, Kaldor J, Rumbold AR. carcinoma and potential impact of L, Kirkwood K, Grant L, Richards A, Frequent occurrence of undiagnosed treatment in a hepatitis B or C infected Smith AMA, Donovan B. Consensual pelvic inflammatory disease in remote cohort. Hepatol Res 2012;42(12):1175-86. sex between men and sexual violence communities of central Australia. Med J in Australian prisons. Arch Sex Behav Aust 2012;197(11):647-51 Thein HH, Zhang L, Wand H, Wilson DP. 2012;41(2):517-524. Application of Estimation and Projection Small W, Krusi A, Wood E, Montaner Package and Spectrum to the context Rouwenhorst E, Mallitt KA, Prestage J, Kerr T. Street-level policing in the of Australia’s HIV epidemic. Epidemiol G. Gay Men’s Use of Condoms With Downtown Eastside of Vancouver, Canada, 2012;2:111. Casual Partners Depends on the Extent during the 2010 Winter Olympics. Int J of Their Prior Acquaintance. AIDS Behav Drug Policy 2012;23:128-133. Tilley DM, Hristov S, Templeton DJ, 2012;16(6):1589-96. Sharp NC, O’Connor CC. Cervical Small W, Moore D, Shoveller J, Wood E, cancer screening and abnormalities S Kerr T. Risk and safety within injection among women in a residential drug- settings: Injection drug users’ reasons for rehabilitation program. Aust J Prim Sacks-Davis R, Horyniak D, Grebely J, attending a supervised injection facility. Health 2012;18:266-267. Hellard M. Behavioural interventions for Health Risk Soc 2012;14(4):307-324. preventing hepatitis C infection in people Tran AD, Shakeshaft AP, Ngo AD, Mallitt who inject drugs: A global systematic Small W, Wood E, Tobin D, Rikley J, KA, Wilson DP, Doran CM, Zhang L. review. Int J Drug Policy 2012;23:176-184 Lapushinsky D, Kerr T. The Injection Determinants of antiretroviral therapy Support Team: A peer-driven program to initiation and treatment outcomes for Sacks-Davis R, Daraganova G, Aitken C, address unsafe injecting in a Canadian people living with HIV in Vietnam. HIV Higgs P, Tracy L, Bowden S, Jenkinson setting. Substance Use & Misuse Clinical Trials. 2012;14(1):21-33. R, Rolls D, Pattison P, Robins G, Grebely 2012;47:491-501. J, Barry A, Hellard M. Hepatitis C Virus Tran AD, Shakeshaft AP, Ngo AD, Phylogenetic Clustering Is Associated Swaminathan S, Murray DD, Kelleher Zhang L, Doran CM, Wilson DP. with the Social-Injecting Network in a AD. The role of microRNAs in HIV- Structural barriers to timely initiation Cohort of People Who Inject Drugs. PLoS 1 pathogenesis and therapy. AIDS of antiretroviral treatment in Vietnam: one. 2012;7(10):e47335. 2012;26(11):1325-34. findings from six outpatient clinics. PLoS one. 2012;7(12):e51289. Sasson SC, Zaunders JJ, Seddiki N, Swaminathan S, Suzuki K, Seddiki N, Bailey M, McBride K, Koelsch KK, Merlin Kaplan W, Cowley MJ, Hood CL, Clancy Tynan A, Vallely A, Kelly A, Law G, Milan KM, Smith DE, Cooper DA, Kelleher AD. JL, Murray DD, Mendez C, Glegor L, J, Siba P, Kaldor J, Hills PS; on behalf of Progressive activation of CD127+132- Anderson B, Roth N, Cooper DA, Kelleher the Male Circumcision Acceptability and recent thymic emigrants into terminally AD. Differential regulation of the Let-7 Impact Study, PNG (MCAIS). Vasectomy differentiated CD127-132+ T-Cells in family of microRNAs in CD4+ TCells as a proxy: extrapolating health system HIV-1 infection. PLoS one 2012;7:2 e31148 alters IL-10 expression. J Immunol lessons to male circumcision as an 2012;188:6238-6246 HIV prevention strategy in Papua Savkovic B, Macpherson JL, Zaunders New Guinea. BMC Health Serv Res. J, Kelleher AD, Knop AE, Pond S, Swart A, Burns L, Mao L, Grulich AE, 2012;4(1):299 Evans L, Symonds G, Murray JM. Amin J, O’Connell DL, Meagher NS, T-lymphocyte perturbation following Randall DA, Degenhardt L, Vajdic CM. V large-scale apheresis and hematopoietic The importance of blood-borne viruses stem cell transplantation in HIV- in elevated cancer risk among opioid- Vajdic CM, Mccaughan GW, Grulich AE. infected individuals. Clin Immunol dependent people: a population-based Cancer risk after organ transplantation. 2012;144(2):159-71 cohort study. BMJ Open 2012;2(5). JAMA 2012;307(7):663-663.

74 ANNUAL REPORT 2012 Vallely A, Fitzgerald L, Fiya V, Aeno H, who inject drugs at increased risk of Strait Islanders’ health. Sex Health Kelly A, Sauk J, Kupul M, Neo J, Millan J, hepatitis C virus infection. BMJ Open 2012;9(2):109-12. Siba P, Kaldor JM. Intravaginal practices 2012;2(1):e000387. and microbicide acceptability in Papua Waters EK, Hamilton AJ, Smith AMA, New Guinea: implications for HIV Wand H, Lote N, Semos I, Siba P. Philp DJ, Donovan B, Regan DG. prevention in a moderate-prevalence Investigating the spatial variations of Fixed sized samples for type-specific setting. BMC Res Notes 2012;5(1):613. high prevalences of severe malnutrition surveillance of human papillomavirus among children in Papua New Guinea: (HPV) in genital warts. Sex Health Vally H, Hall G, Dyda A, Raupach J, results from geoadditive models. BMC 2012;10(1):95-96. Knope K, Combs B, Desmarchelier P. Res Notes 2012;5:228. Epidemiology of Shiga toxin producing Waters EK, Kaldor JM, Hamilton AJ, Escherichia coli in Australia, 2000-2010. Wand H, Namarola N, Siba P. Smith AMA, Philp DJ, Donovan B, Regan BMC Pub Health 2012;12:63. Investigating the spatial variations of DG. Tracking type specific prevalence of high prevalence’s of severe malnutrition human papillomavirus in cervical pre- Vickerman P, Grebely J, Dore GJ, Sacks- among children in Papua New Guinea. cancer: a novel sampling strategy. BMC Davis R, Page K, Thomas DL, Osburn WO, BMC Res Notes 2012;5:288. Med Res Methodol 2012;14(1):77. Cox AL, Aitken CK, Hickman M, Hellard M on behalf of the InC3 Collaborative Wand H, Ramjee G. Analyzing Whiley DM, Goire N, Lahra MM, Group. The more you look the more you continuous measures in HIV prevention Donovan B, Limnios AE, Nissen MD, find: Effects of hepatitis C virus testing research using semiparametric regression Sloots TP. The ticking time bomb: interval on reinfection incidence and and parametric regression models: How escalating antibiotic resistance in clearance and implications for future to use data to get the (right) answer? Neisseria gonorrhoeae is a public vaccine study design. J Infect Dis 2012; AIDS Behav 2012;16(6):1448-1453. health disaster in waiting. J Antimicrob 205:1342-1350. Chemother 2012;67(9):2059-61. Wand H, Ramjee G. Assessing and W evaluating the combined impact of White B, Dore GJ, Lloyd A, Rawlinson behavioural and biological risk factors W, Maher L. Ongoing susceptibility to Walker J, Tabrizi SN, Fairley CK, Chen MY, for HIV seroconversion. AIDS Care hepatitis B virus infection among people Bradshaw CS, Twin J, Taylor N, Donovan 2012;24(9):1155-1162. who inject drugs in Sydney. Aust N Z J B, Kaldor JM, McNamee K, Urban E, Pub Health 2012;36(4):351-357. Walker S, Currie M, Birden H, Bowden Wand H, Ramjee G. The effects of F, Gunn J, Pirotta M, Gurrin L, Harindra injectable hormonal contraceptives Wilson DP. HIV Treatment as V, Garland SM, Hocking JS. Chlamydia on HIV seroconversion and on Prevention: Natural Experiments trachomatis Incidence and Re-Infection sexually transmitted infections. AIDS Highlight Limits of Antiretroviral among Young Women - Behavioural and 2012;26(3):375-80. Treatment as HIV Prevention. PLoS Med Microbiological Characteristics. PLoS one Wand H, Ramjee G. Population level 2012;9(7):e1001231. 2012;7(5):e37778. impact of hormonal contraceptives on incidence of HIV and pregnancy among Wilson DP, Islam FM, Wu J, Jansson Wallace J, Hajarizadeh B, Richmond J, cohort of women, Durban, South Africa. J. A critical epidemiologic review of McNally S, Pitts M. Managing chronic Bull World Health Organ 2012;90:748-755. cardiovascular disease risk in HIV- hepatitis B - The role of the GP. Aust Fam infected adults: The importance of the Phys 2012;41(11):893-8. Wand H, Ramjee G. Assessing and HIV uninfected comparison group, evaluating the combined impact of confounding, and competing risks: reply. Walsh N, Maher L. HIV and viral hepatitis behavioural and biological risk factors HIV Med 2012;14(3):193-4. C coinfection in people who inject for HIV seroconversion in a cohort drugs: implications of new direct acting of South African women. AIDS Care Winston A, Duncombe C, Li PCK, Gill antivirals for hepatitis C virus treatment. 2012;24(9):1155-62. JM, Kerr SJ, Puls RL, Taylor-Robinson Curr Opin HIV AIDS 2012;7(4):339-44. SD, Emery S, Cooper DA for the Altair Wand H, Whittaker C, Ramjee G. HIV Study Group. Two patterns of cerebral Wand H, Falster K, Wilson D, Law M, incidence among non-pregnant women metabolite abnormalities are detected on Maher L. Disproportionate impact of living in selected rural, semi-rural and proton magnetic resonance spectroscopy combination antiretroviral therapy on urban areas in Kwazulu-Natal South in HIV-infected subjects commencing AIDS incidence in Australia: results from Africa. AIDS Behav 2012;16(7):2062-71. antiretroviral therapy. Neuroradiol a modified back-projection model. AIDS 2012;54:1331-1339 Behav 2012;16(2):360-7. Wand HC, Ramjee GA. The relationship between age of coital debut and HIV Winston A, Puls R, Kerr S, Duncombe Wand H, Guy R, Wilson D, Law M, Maher seroprevalence among women in C, Li PCK, Gill JM, Taylor-Robinson SD, L. High rates of late HIV diagnosis among Durban, South Africa: A cohort study. Emery S, Cooper DA for the Altair Study people who inject drugs compared BMJ Open 2012;2(1):000285. Group. Dynamics of cognitive change in to men who have sex with men and Ward J, Guy R, Huang RL, Knox J, HIV-infected individuals commencing heterosexual men and women in Couzos S, Scrimgeour D, Moore L, three different initial antiretroviral Australia. AIDS Behav 2012;17(1):235-41. Leahy T, Jenny H, Donovan BD, Kaldor regimens: a randomized, controlled JM. Rapid point-of-care tests for HIV study. HIV Med 2012;13:245-251 Wand H, Iversen J, Wilson D, Topp L, and sexually transmissible infection Maher L. Developing and validating control in remote Australia: can they Worm SW, Kamara DA, Reiss P, Fontas E, a scoring tool for identifying people improve Aboriginal people’s and Torres De Wit S, El-Sadr W, Monforte AD, Law

ANNUAL REPORT 2012 75 M, Phillips A, Ryom L, Dabis F, Weber R, Zhang L, Chow EP, Zhang J, Jing J, aimed at increasing screening for Sabin C, Lundgren JD on behalf of the Wilson DP. Describing the Chinese HIV bacterial sexually transmitted infections D:A:D Study Group. Evaluation of HIV surveillance system and the influences among men who have sex with men: protease inhibitor usage and the risk of political structures and social stigma. a systematic review. Sex Transm Dis of sudden death or non-haemorrhagic Open AIDS 2012;6:163-8. 2012;39(5):382-7. stroke. J Infect Dis 2012;205(4):535-539. Zhang L, Gray RT, Wilson DP. Modelling Zou H, Fairley CK, Hocking JS, Wren L, Parsons MS, Isitman G, Center the epidemiological impact of scaling up Garland SM, Grulich AE, Chen MY. The RJ, Kelleher AD, Stratov I, Bernard NF, HIV testing and antiretroviral treatment prevalence of anal human papillomavirus Kent SJ.Influence of Cytokines on HIV- in China. Sex Health 2012;9(3):261-71. among young HIV negative men who Specific Antibody-Dependent Cellular have sex with men. BMC Infec Dis Cytotoxicity Activation Profile of Natural Zhang L, Wilson DP. Trends in notifiable 2012;12:341. Killer Cells. PLoS One 2012;7(6):e38580. infectious diseases in China: implications for surveillance and population health Wren LH, Chung AW, Isitman G, Kelleher policy. PLoS One 2012;7(2):e31076. AD, Parsons MS, Amin J, Cooper DA, Stratov I, Navis M, Kent SJ. Specific Zhang XH, Chow EPF, Wilson DP, Sun E-PUBLICATIONS antibody-dependent cellular cytotoxicity XS, Zhao R, Zhang J, Jing J, Zhang L. These publications have appeared responses associated with slow Prevalence of HIV and syphilis infections electronically in 2012 in advance of their progression of HIV infection. Immunol among long-distance truck drivers appearance in print. Publications which 2012;138(2):116-123. in China: a data synthesis and meta- have appeared in online-only journals are analysis. Int J Infec Dis 2012;17(1):e2-7. listed above. Y Zhou J, Jaquet A, Bissagnene E, Musick B Yap L, Butler T, Richters J, Malacova E, B, Wools-Kaloustian K, Maxwell N, Boulle Wand H, Smith AMA, Grant L, Richards A, Wehbe F, Masays D, Iriondo-Perez Babiker A, Emery S, Fatkenhauer G, A, Donovan B. Penile implants among J, Hemingway-Foday J, Law M and the Gordin FM, Grund B, Lundgren JD. prisoners - a cause for concern? PLoS Western Africa, Eastern Africa, Southern Neaton JD, Pett SL, Phillips A, Touloumi One 2012;8(1):e53065. Africa, Caribbean and Central and South G, Vjecha MJ for the INSIGHT START America, and Asia Pacific regions of the Study Group. Considerations in the Yiannoutsos CT, Johnson LF, Boulle International Epidemiologic Databases rationale, design and methods of the A, Musick BS, Gsponer T, Balestre to Evaluate AIDS (IeDEA). Short-term Strategic Timing of Antiretroviral E, Law M, Shepherd BE, Egger M risk of anaemia following initiation of Treatment (START) Study. Clin Trials for the International Epidemiologic combination antiretroviral treatment 2012; April [Epub]. Databases to Evaluate AIDS (IeDEA) in HIV-infected patients in countries in Collaboration. Estimated mortality sub-Saharan Africa, Asia-Pacific and Botes LP, Pett S, Carr A, Marriott D, of adult HIV-infected patients central and South America. J Int AIDS Soc Cooper DA, Matthews G, Carbone S, starting treatment with combination 2012;15:5. Kumaradevan N, McHugh L, Hillman RJ. antiretroviral therapy. Sex Transm Anal cytological abnormalities are poor Infec 2012;88:i33-i43. Zhou J, Tanuma J, Chaiwarith R, Lee CKC, predictors of high-grade intraepithelial Law MG, Kumarasamy N, Phanuphak P, neoplasia amongst HIV-positive men who Z Chen YMA, Kiertiburanakul S, Zhang F, have sex with men. Sex Health 2012; Vonthanak S, Ditangco R, Pujari S, Choi December [Epub] Zablotska I, Holt M, de Wit J, McKechnie JY, Merati TP, Yunihastuti E, Li PCK, M, Mao L, Prestage G. Gay Men Who Are Kamarulzama A, Nguyen VK, Pham TTT, Bowring AL, Goller JL, Gouillou M, Not Getting Tested for HIV. AIDS Behav Lim PL. Loss to follow-up in HIV-infected Harvey C, Bateson D, McNamee K, 2012;16(7):1887-94. patients from Asia-Pacific Region: Results Stephens A, Wardle R, Read C, Boyle from TAHOD. AIDS Res Treatment D, Donovan B, Guy R, Hellard MA. Zablotska IB, Holt M, Prestage G. 2012;2012:375217. Chlamydia testing and retesting patterns Changes in gay men’s participation in at Family Planning Clinics in Australia. gay community life: implications for HIV Zhuang X, Liang Y, Chow EPF, Wang Sex Health 2012; December [Epub] surveillance and research. AIDS Behav Y, Wilson DP, Zhang L. HIV and HCV 2012;16(3):669-75. prevalence among entrants to methadone Bunupuradah T, Chetchotisakd maintenance treatment clinics in China: a P, Ananworanich J, Munsakul W, Zhang L, Chow EPF, Jahn HJ, Kraemer systematic review and meta-analysis. BMC Jirajariyavej S, Kantipong P, Prasithsirikul A, Wilson DP. High HIV Prevalence Infec Dis 2012;12(130). W, Sungkanuparph S, Bowonwatanuwong and Risk of Infection among Rural-to- Zhuang X, Wang Y, Chow EP, Liang Y, C, Klinbuayaem V, Kerr SJ, Jiratchaya urban Migrants in Various Migration Wilson DP, Zhang L. Risk factors associated Sophonphan J, Mootsikapun P, Auchieng Stages in China: a Systematic Review with HIV/HCV infection among entrants C, Kaew-on P, Chautrakarn S, Ubolyam S, and Meta-Analysis. Sex Transm Dis in methadone maintenance treatment Cooper DA, Phanuphak P, Bhakeecheep 2012;40(2):136-47. clinics in China: A systematic review and S, Hirschel B, Ruxrungtham K on behalf Zhang L, Chow EPF, Wilson DP. meta-analysis. Drug Alcohol Depend of the HIV STAR Study Group. Second- Distributions and trends in sexual 2012;126(3):286-295. line lopinavir/ritonavir monotherapy in behaviors and HIV incidence among men patients failing NNRTI-based regimen who have sex with men in China. BMC Zou H, Fairley CK, Guy R, Chen MY. The was associated with frequent low-level Pub Health 2012;12:546. efficacy of clinic-based interventions viremia: The HIV STAR randomized

76 ANNUAL REPORT 2012 controlled study. Antivir Ther 2012; July I 20. [Epub ahead of print] [Epub] Islam MM, Shanahan M, Topp L, Conigrave KM, White A, Day CA. The cost Olsen A, Temple-Smith M, Banwell C. Butler T, Malacova E, Richters J, Yap of providing primary health-care services Consideration of gender in diagnosis and L, Grant L, Richards A, Smith AMA, from a needle and syringe program: A management of blood-borne viruses: the Donovan B. Sexual behaviour and sexual case study. Drug Alcohol Rev 2012; Nov case of hepatitis C. Australian Journal of health of Australian prisoners. Sex 29 [Epub] Primary Health 2012; May 31 [Epub] Health 2012; December [Epub] Islam MM, Topp L, Conigrave KM, White P D A, Haber PS, Day CA. Are primary health care centres that target injecting drug Pham QD, Wilson DP, Zhang L. A Review Deacon RM, Topp L, Wand H, Day CA, users attracting and serving the clients of the Extent of HIV Drug Resistance in Rodgers C, Haber PS, van Beek I, Maher they are designed for? A case study from Vietnam. J AIDS Clin Res 2012; S5 [Epub]. L. Correlates of Susceptibility to Hepatitis Sydney, Australia. Int J Drug Policy 2012; B among People Who Inject Drugs in Jul 18 [Epub] Prestage G, Brown G, Down IA, Jin F, Sydney, Australia. J Urban Health 2012 Hurley M. “It’s Hard to Know What is a Jun 9 [Epub] Iversen J, Topp L, Wand H, Maher L. Risky or not a Risky Decision”: Gay Men’s Are people who inject performance and Beliefs About Risk During Sex. AIDS G image-enhancing drugs an increasing Behav 2012 Mar 20 [Epub] population of Needle and Syringe Grebely J, Morris MD, Rice TM, Bruneau Program attendees? Drug Alc Rev 2012; R J, Cox AL, Kim AY, McGovern BH, August 29 [Epub] Shoukry NH, Lauer G, Maher L, Lloyd Ramjee G, Wand H. Impact of hormonal AR, Hellard M, Prins M, Dore GJ, Page J contraceptives on the incidence of HIV K on behalf of the InC3 Study Group. infection and pregnancy rates in a cohort Cohort Profile: The International Jin F, Grulich AE, Mao L, Zablotska I, of women in Durban, South Africa. Bull Collaboration of Incident HIV and O’Dwyer M, Poynten M, Prestage GP. World Health Organ 2012; July [Epub] Hepatitis C in Injecting Cohorts (InC3) Sexual Partner’s Age as a Risk Factor for Study. Int J Epidemiol 2012 Nov 30. HIV Seroconversion in a Cohort of HIV- Richmond R, Indig D, Butler T, Wilhelm [Epub] Negative Homosexual Men in Sydney. K, Archer V, Wodak A. A Randomised AIDS Behav 2012; December [Epub] Controlled Trial of a Smoking Cessation H Intervention Conducted among Prisoners. K Addiction 2012; December [Epub] Hawke KG, Waddell RG, Gordon DL, Ratcliff RM, Ward PR, Kaldor JM. Korostil I, Peters G, Cornebise J, Regan S HIV Non-B Subtype Distribution: D. Adaptive Markov chain Monte Emerging Trends and Risk Factors for Carlo forward simulation for statistical Seddiki N, Phetsouphanh C, Swaminathan Imported and Local Infections Newly analysis in epidemic modelling of human S, Xu Y, Rao S, Li J, Sutcliffe EL, Denyer Diagnosed in South Australia. AIDS papillomavirus. Statistics Med 2012; Sep G, Finlayson R, Gelgor L, Cooper DA, Res Hum Retroviruses 2012 Oct 25. 7 [Epub] Zaunders J, Kelleher AD; The miR-9/ [Epub] Blimp-1/IL-2 axis is differentially regulated L in progressive HIV infection. Eur J Hu H, Harmer C, Anuj S, Wainwright Immunol 2012 Nov 7 [Epub] CE, Manos J, Cheney J, Harbour C, Lee FJ, Amin J, Bloch M, Pett SL, Zablotska I, Turnbull L, Whitchurch Marriott D, Carr A. Skeletal muscle T CB, Grimwood K, Rose B; the ACFBAL toxicity associated with raltegravir-based study investigators. Type 3 secretion combination anti-retroviral therapy in Topp L, Iversen J, Baldry E, Maher L. system effector genotype and HIV-infected adult. J Acquir Immune Housing Instability among People Who secretion phenotype of longitudinally Defic Syndr 2012 Dec 28 [Epub] Inject Drugs: Results from the Australian collected Pseudomonas aeruginosa Needle and Syringe Program Survey. J isolates from young children M Urban Health 2012 Jun 26 [Epub] diagnosed with cystic fibrosis following newborn screening. Clin Mooney-Somers J, Olsen A, Erick Treloar C, Hull P, Dore GJ, Grebely J. Microbiol Infect 2012; Jan 13 [Epub] W, Scott R, Akee A, Maher L. Young Knowledge and barriers associated with Indigenous Australians’ sexually assessment and treatment for hepatitis C Huang X, Lodi S, Fox Z, Li W, Phillips transmitted infection prevention virus infection among people who inject A, Porter K, Lutsar I, Kelleher A, Li N, practices: A community-based drugs. Drug Alcohol Rev 2012 May 21 Xu X, Wu H, Johnson AM; (On behalf of participatory research project. J [Epub] the Beijing PRIMO cohort study and the Community Appl Soc Psychol 2012; Jan CASCADE Collaboration in EuroCoord [Epub] W 1999). Rate of CD4 decline and HIV-RNA change following HIV Seroconversion O Walker J, Walker S, Fairley CK, Bilardi in men who have sex with men: a J, Chen MY, Bradshaw CS, Urban E, comparison between the Beijing PRIMO Olsen A, Banwell C, Dance P. Reinforced Pirotta M, Birden H, Donovan B, Kaldor and CASCADE cohorts. J Acq Immun Biographies Among Women Living With JM, Gunn J, Hocking JS. What do young Defic Syndr. 2012; Dec 6 [Epub] Hepatitis C. Qual Health Res 2012 Dec women think about having a chlamydia

ANNUAL REPORT 2012 77 test? Views of women who tested planning. Bulletin of the World Health K positive compared with women who tested Organization. 2012 90:831-8. Kelleher AD, Cooper DA. Acute HIV negative. Sex Health 2012 Nov 19 [Epub] Infection. In: Volberding P, Greene W, Wang Y, Naumann U, Wright ST, Warton Cowling CS, Povovic G, Liu BC, Ward Lange JMA,. Gallant JE, Sewankambo N, DI. mvabund - an R package for model- JS, Snelling TL, Kaldor JM, Wilson editors. SANDE’S HIV/AIDS MEDICINE: based analysis of multivariate abundance DP. Australian trachoma surveillance Medical Management of AIDS 2013 data. Methods Ecol Evol 2012; 21 Feb [Epub]. annual report, 2010. Commun Dis Intell. Elsevier Ltd. Publishers; 2012. pp.77-88 2012;36(3):E242-50 Warton DI, Wright ST, Wang Y. Distance- L based multivariate analyses confound Currie B, Iversen J, Maher L. Drug location and dispersion effects. 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78 ANNUAL REPORT 2012 ABOUT THE KIRBY INSTITUTE The Kirby Institute was launched on 4 April 2011. It was formerly known as the National Centre in HIV Epidemiology and Clinical Research (NCHECR), which was established in 1986 by the Australian Government to fulfil a number of key roles in Australia’s fight against HIV/AIDS. The Kirby Institute is affiliated with the Faculty of Medicine, University of New South Wales.

The Kirby Institute’s primary functions relate to the co-ordination of national surveillance programs, clinical research and clinical trials. While its original focus was exclusively on HIV/AIDS, the Kirby Institute’s work has expanded to encompass hepatitis B and C, and sexually transmissible infections. The Kirby Institute also conducts research into the transmission, prevention and natural history of these infections.

The Kirby Institute’s research program has increasingly taken on a regional focus, with major collaborative programs in Thailand and Cambodia. The Kirby Institute conducts research through eleven programs. Dissemination of the Kirby Institute’s research output is undertaken through publication in scientific journals and a range of surveillance reports.

This publication was funded by the Australian Government Department of Health and Ageing. The views expressed in this publication do not necessarily represent the position of the Australian Government.

ISSN No. 1441-2640

The Kirby Institute has three locations: Director’s Unit and the Immunovirology and Pathogenesis Program: 405 Liverpool Street, Darlinghurst NSW 2010 Australia

The Therapeutic Vaccine Research Program; Biostatistics and Databases Program; Sexual Health Program; Aboriginal and Torres Strait Islander Health Program, Justice Health Research Program and the Public Health Interventions Research Group: UNSW Cliffbrook Campus, 45 Beach Street, Coogee NSW 2034

The HIV Epidemiology and Prevention Program; Viral Hepatitis Epidemiology and Prevention Program; Viral Hepatitis Clinical Research Program; Surveillance and Evaluation Program for Public Health; Administration and Finance: The CFI Building, Corner Boundary and West Streets, Darlinghurst NSW 2010

Postal address: The CFI Building, Corner Boundary and West Streets, Darlinghurst NSW 2010 Telephone +61 (2) 9385 0900 Web: www.kirby.unsw.edu.au/ Fax +61 (2) 9385 0920 Email: [email protected]

The Kirby Institute Annual Report 2012 Editor: Louisa Wright