Author: Ashleigh Brissett

Don’t forget we supply our member services with FREE condoms and lube! 

Check out our new packaging! (see pic above) 

Each packet comes with 2x latex condoms and 2x lube sachets in a handy packet with instructions on how to use on the back. 

Each box comes with 250 packets, so reach out to our Sexual Health Nurse at AH&MRC (kalderton@ahmrc.org.au) to order yours now! 

For additional clinical resources, head to the AH&MRC Shop. All members receive these items for free. Log in here. 

If you’re a member and need a login, please contact comms@ahmrc.org.au 

NSW Health had a recent notification of a locally acquired, extensively drug resistant (XDR) gonorrhoea. The XDR showed high level resistance and decreased susceptibility to first line drugs, azithromycin and ceftriaxone, used in the treatment of gonorrhoea. 

This comes as a timely reminder to ALWAYS collect a gonococcal culture to determine antimicrobial sensitivity PRIOR to administering treatment for gonorrhoea – but don’t delay treatment. 

An endocervical swab collected by a clinician is the ideal investigation.  However a self-collected high vaginal swab is often more acceptable for patients. 

Refer to the Australian STI Management Guidelines for further information and management of gonorrhoea. 

*Hot Tip* – Place your swabs next to your ceftriaxone stock as a reminder to collect a culture before treating your patients.  

UPDATE: On 28th March 2025, NSW Health released a new gonorrhoea alert.

An additional case of overseas-acquired XDR gonorrhoea was reported to NSW Health this month.

The health alert emphasises the importance of obtaining a travel history from patients (including partners’ travel) during STI screenings. Of particular concern is any potential exposure to gonorrhoea in South-East Asia, where there is an increase in drug-resistant gonorrhoea.

Please find the NSW Health Alert here and share amongst your colleagues.

If you have any questions, please contact publichealth@ahmrc.org.au 

Breast screening (i.e. with mammograms) every 2 years is recommended for Aboriginal and Torres Strait Islander women in NSW aged 40-74 years. In addition to the routine mammogram result that is sent to the GP it is expected that, later this year, BreastScreen NSW will include a Breast Density report.  

Breast density refers to the proportion of fibroglandular tissue (i.e. milk ducts, milk glands, supportive tissue) to fatty tissue. Breast density can only be seen on a mammogram; it cannot be assessed/felt during a breast examination.  

Although it is common and normal to have dense breasts, reporting on breast density as part of breast screening is important for 2 main reasons:  

1. Breast density has an impact on how effective screening is as increased density can mask or hide cancers, potentially making cancer detection less accurate. This is because dense tissue and breast cancers both appear white on a mammogram. 
2. Higher breast density is one factor associated with an increased risk of breast cancer. 

Please see Dense breast tissue and screening mammograms (BreastScreen NSW) for more details. 

The findings of one study, which investigated breast density of women in Western Australia, demonstrated that:   

1. Aboriginal women, on average, had lower breast tissue density compared to non-Aboriginal women; 
2. However, the association between dense breast tissue and increased risk of breast cancer is stronger in Aboriginal women than in their non-Aboriginal peers. 

These findings suggest that mammograms are a “particularly good screening tool for Aboriginal women“. They also demonstrate that Indigenous status should be taken into account when using breast cancer prediction tools. 

Clinicians discussing breast screening results with their patients will also need to be able to explain the breast density report.  

It is important that women understand that although some risk factors such as Breast Density cannot be changed, it is possible to reduce the risk of breast cancer by improving diet, reducing alcohol intake, maintaining a good weight and getting some exercise.  More information about breast cancer risk is available on the Cancer Australia website.

Breast screening with mammograms is essential to detect breast cancer as early as possible.  

NSW Health has developed a video to help primary health care teams recognise and manage acute rheumatic fever (ARF) and rheumatic heart disease (RHD). ARF/RHD predominantly affect Aboriginal and Torres Strait Islander peoples. At-risk individuals can develop ARF/RHD following Group A Streptococcus (GAS) infection e.g. tonsillitis or impetigo.  

ARF and invasive GAS notifications have increased in NSW, particularly among children. Consider ARF as a possible diagnosis when young people present with suggestive signs and symptoms, such as: fever, joint pain, chest discomfort or chorea (rapid, jerky involuntary body movements). Further investigations, including inflammatory markers are recommended to establish a diagnosis.

In addition, both ARF and RHD are notifiable in NSW (with RHD notifiable only if the person is aged less than 35 years).

ARF and RHD can be prevented. For at-risk patients, treat tonsillitis and impetigo with antibiotics for GAS. Let’s work together to prevent ARF and RHD in NSW.

Resources for health professionals.