World STI & HIV Congress day 2

A summary of the second day of the World STI and HIV congress in Brisbane, Australia. Read on…

Morning Session on Publishing and Grant Writing for early career researchers (14 Sep)

William Miller encouraged young scientists to submit research articles to the journal Sexually Transmitted Diseases. He gave the audience a healthy message about being polite in research writing but also not to be afraid about being provocative.

Drawing upon her experience from inside the world of journal publishing, Virginia Barbour gave three basic but valuable key points on publishing:

1. Know Your Research: Good Publishing starts with good research
2. Know Your audience: Think about what you want to say to them
3. Know what funder/employer/institution expects: talk with colleagues and then talk again

Barbour encouraged authors to use a checklist, read the author instructions diligently, work closely with coauthors (so that there are no surprises down), and don’t surprise your editor with things like an additional section in the article post-review. Her final message was to get an ORCiD number and to use social media to maximise your work’s impact!

Carolyn Deal gave a talk about understanding institutional structures and funding mechanisms when applying for a research grant. She reminded young researchers to tell a succinct and coherent story in grant writing. The aims, she stated, should inform the reviewers about everything they need to know about the research objectives, central hypothesis, and significance of the proposed studies. A central message was to find that balance between trying to do too much and being so focussed that your study is boring to reviewers.

Attendees were given a chance to ask questions to journal editors including Jackie Cassell of Sexually Transmitted Infections; Kit Fairley of Sexual Health; Peter Aggleton of Culture, Health and Sexuality; Cochrane STI Group (Cindy Farquhar), Nicola Low of PLoS Medicine, and Sexually Transmitted Diseases (Williams Miller). Kees Rietmeijer from the ASTDA & Hammad Ali from the @KirbyInstitute chaired the discussion. The question of “What is the difference between STI and STD?” came up, but a more vibrant discussion began when discussing Cover Letters. Some editors loved good cover letters even going so far as to suggest using one of the most telling images from your article in the letter. Other editors despised cover letters, especially long cover letters. I think the audience was left to make up their own mind.

Plenary Talks Monday, 14 September 2015

Gollow Lecture: “STI and sustainable development in 2015 and beyond” presented by Dr Helen Rees (Executive Director, Wits Reproductive Health & HIV Institute and Professor of Obstetrics and Gynaecology, University of Witwatersrand, Johannesburg, South Africa, and Honorary Professor, London School of Hygiene and Tropical Medicine, London, United Kingdom). Unpacking the UN Sustainable Development Goals, she explained to audience members how STI research is integral to the future of global health (in particular SDG Goals 3, 5, 10 and 17). She drew upon data to demonstrate that rates of HIV decline faster in countries that also have effective healthcare service delivery for treating STIs. Helen Rees highlighted that STIs remain an important priority in HICs and LMICs. She also argued that the success of the HPV vaccine should encourage researchers to pay attention to the development of other STI vaccines. Beyond the UN Sustainable Development Goals, she also suggested that researchers integrate STI research with work in the non-health sector (e.g. human rights) as well as Global Health Initiatives.

Following the rousing plenary by Helen Rees, Virginia Barbour delivered an equally upbeat plenary talk on STIs and the open access revolution in publishing. Virginia Barbour has experience at the Lancet and was a Founding co–editor of PLOS Medicine. She is the Executive Officer, Australian Open Access Support Group, Brisbane, Australia, and Chair of the Committee on Publication Ethics. She strongly encouraged researchers to engage and publish in open access research journals. Open access was an essential innovation, she argued, in the future of academic and scientific research.

The third plenary talk was by Dr Nick Thomson (Faculty and group head, Pathogen Genetics, Wellcome Trust Sanger Institute, Cambridge and Professor of Bacterial Genomics and Evolution, Department of Pathogen Molecular Biology, London School of Hygiene & Tropical Medicine, London, United Kingdom). He spoke about the constant surprises in studying the genomics of Chlamydia trachomatis. This organism is an obligate intracellular bacterium with a complex developmental cycle. In the laboratory, it is difficult and expensive to grow. In the clinic, Chlamydia trachomatis is the number one bacterial STI; typing is based on the Momp gene (aka OmpA); and there is a strong association between serotype and infection site (e.g. some strains are related to infectious blindness and other strains are related to Sexually transmitted infection). However, Chlamydia trachomatis is polyphyletic as evidenced by cases in Northern Territory that were caused by urogenital strains. Thomson spoke about using single nucleotide polymorphisms to detail the evolutionary history of the organism. Interestingly, the organism has entered human population more than once. Data indicates that the true diversity of circulating chlamydia isolates is much higher than thought.

Plenary talks continued in the afternoon with Dr Kerry Arabena talking passionately about the vulnerability of women, particularly Aboriginal and Torres Strait Islander women, in modern Australian society. She called strongly for reform in Australian politics in society arguing that a neoliberalist discourse leaves women sexualised and racialised as ‘the Other’, and leaves them to be viewed as ‘vectors of disease’ or ‘vehicles for health gain’ particularly through pregnancy. Addressing family violence was a key issue in Arabena’s eyes. Dr Kerry Arabena is the Professor of Indigenous Health and Director at the Indigenous Health Equity Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.

The complex puzzle of Bacterial vaginosis and STI interactions was an information rich plenary talk by Dr Scott McClelland, Professor of Allergy and Infectious Diseases, School of Medicine, University of Washington, Seattle, USA. Bacterial vaginosis can be symptomatic or asymptomatic and interacts with other STIs, which left me asking the question if singular explanations of disease aetiology are outdated and if we need to move towards more multifactorial models of disease causation.

Dr Yang Bin discussed syphilis elimination in China where funding for HIV and STI control has been split with most funding directed towards HIV. This split has not been helpful to current attempts to stop the spread of Syphilis. Syphilis was apparently eliminated from China (and Chinese medical textbooks) by 1964 through widespread screening and treatment, but was re-introduced into the country in 1979. Dr Yang Bin is Dean of Guangdong Provincial Dermatology Hospital / Director of Guangdong Provincial Centers for Skin Diseases and STI Control, and Professor, Jinan University, Guangdong Medical College, and Anhui Medical University, China.

Panel Sessions

With six parallel sessions on topics, it was hard to decide which panel to attend. Themes included the spread of antimicrobial resistant gonorrhoea, point-of-care STI diagnosis, extragenital STIs, adolescent sexual health, neglected/emerging STIs, and STIs in vulnerable and high risk populations in the USA. The discussion of neglected and emerging infectious diseases chaired by David Lewis and Sally Roberts piqued my interest. Oriol Mitjà and Allan Pillay delivered fascinating research about Treponema pallidum subspecies pertenue (Yaws) and how Haemophilus ducreyi has been flying below the diagnostic radar. Yaws is passed by direct contact between children. The bacterium creates big round ulcers with granulating tissue. Special culture media to grow H.ducreyi is not widely available, which makes the microbe expensive to grow in the lab. The availability of specific diagnostic tests for H.ducreyi  are also lacking. Mitjà and Pillay have been conducting really important research on the diagnosis and treatment of these microbes in tropical countries such as Ghana, Solomon Islands, Vanuatu, and PNG. Professor Nicola Low then showed research demonstrating that the demonstrating that ebola virus could be detected in the semen of ebola survivors for up to six months. Can ebola be sexually transmitted? Professor Low advocated for a sensitive and ethical programme of research to investigate further. The final presentation was by Philip Giffard who spoke about Chlamydia trachomatis strains in Indigenous Australian populations, which added to Dr Nick Thomson’s earlier plenary by explaining more about the variants of urogenital Chlamydia trachomatis. With the evolution of these organisms, and with a consideration of disease transmission in resource-poor settings, perhaps we should strongly consider the importance of developing affordable genomic tools for the diagnosis of infectious diseases such as Chlamydia trachomatis, Treponema pallidum subspecies pertenue (Yaws) and Haemophilus ducreyi.

Drug resistance was a hot topic in several panels. Drug resistance has been detected in a number of STIs including Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Mycoplasma genitalium, among others. Researchers speaking on this topic included Peera Hemarajata, Marcus Pond, Valentina Dona, Sepehr Tabrizi, Philip Read, Wilheimina Huston (@willaonthego), Stephanie Fingerhuth, Matthew Golden, Xiaohong Su, Alje Van Dam, Ella Trembizki, Ben Hui, David Whiley, William Shafer, David Trees, Magnus Unemo, and Angie Pinto and Michael Roche talking about HIV-1 drug resistance. Perspectives from the humanities and social sciences would complement efforts to try and understand the development of drug resistance by providing conceptual tools to pay attention to complexity, question the familiar, reconfigure boundaries to create novel frameworks, and to critically examine assumptions, arguments and false reasoning.

Poster sessions

The exhibition hall was filled to the brim with posters. Anthropologists would be interested in the posters on Social Sciences, Policy and Programmes, particularly the posters on HIV-Related stigmas and intersecting stigmas. Researchers working on Tuberculosis and HIV co-infection would be interested in the posters by Elucir Gir, Carolina de Castro Castrighini, and Lis Aparecida de Souza Neves, Thiago Nascimento do Prado et al., D P C K A Lal. There was also an intriguing paper on mental health and HIV, which will be an area of particular interest to cross-cultural psychologists and neuroanthropologists.