28 March 2018
Recent reports indicate alarming rates of sexually transmitted infections (STIs) in adolescents and young adults in remote communities in northern and central Australia. These reports should prompt urgent action to improve sexual health services in these communities.
Chlamydia is the most commonly reported STI among young Australians with over 85,000 cases each year and many more undiagnosed and untreated. Other STIs such as syphilis, gonorrhoea and trichomonas are also commonly diagnosed in Aboriginal and Torres Strait Islander young people. These infections have significant social and health consequences like stigma, shame, poor pregnancy outcomes, pelvic inflammatory disease (PID), infertility and increased likelihood of HIV transmission. Social determinants of health such as access to quality clinical care, demographic and social factors such as age, mobility and sexual networks are likely to be sustaining the high rates of these STIs. However, sexual behaviour does not appear to be a significant factor as surveys show very little difference between the behaviour of Indigenous and non-Indigenous young people.
The incorrect attribution of these STIs to child sexual abuse is misleading. Only a small proportion of all reported STIs are among those aged less than 14 which is an issue of child safety, early sexual debut and child sexual assault. However, most STIs in remote communities are reported among people aged 16 and above.
While the Australasian Sexual Health Alliance (ASHA) supports a child safety first approach, urgent efforts are required to establish healthy relationships and sexual health education programs in these communities and support existing health care staff and services to address the high burden of disease. ASHA believes the data on high rates of sexually transmitted infections among Indigenous adolescents and young adults should prompt urgent public health action to strengthen and improve sexual health services in their communities.
We acknowledge the contribution of Professor James Ward and Dr Nick Medland in the preparation of this statement.
- Kirby Institute. Bloodborne viral and sexually transmissible infections in Aboriginal and Torres Strait Islander people: annual surveillance report 2017. Sydney: Kirby Institute, UNSW Sydney; 2017.
- James Ward, Joanne Bryant, Handan Wand, Marian Pitts, Anthony Smith, Dea Delaney-Thiele, Heather Worth, John Kaldor. Sexual Health and relationships in young Aboriginal and Torres Strait Islander people: Results from the first national study assessing knowledge, risk practices and health service use in relation to sexually transmitted infections and blood borne viruses. Baker IDI Heart and Diabetes Institute, 2014.
- Multi-jurisdictional Syphilis Outbreak Working Group. 20th Communique
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The Australasian Sexual Health Alliance (ASHA) is a group of partner organisations established to improve national and local responses to sexual health issues, via a multidisciplinary support network for the sexual health workforce. It aims to strengthen bonds between specialists, GPs, nurses, researchers and other key contributors to the sexual health sector, through collaboration in sexual health education, training, policy-making and research.
For any general queries, contact:
Sarah Maunsell, ASHA Secretariat
T: +61 2 8204 0700 (Reception)