New STI report paints mixed picture of Australia’s sexual health
CHLAMYDIA is the now most commonly reported sexually transmitted infection in Australia and new HIV cases in the general population have plateaued, according to the latest annual sexual health report.
The 2016 Australian Annual Surveillance Report, released today ahead of the Australasian Sexual Health Conference in Adelaide, paints a mixed picture of the nation’s sexual health.
The report shows around one in 20 Australians between 15 and 29 years of age had chlamydia in 2015 and that almost three quarters (72 per cent) of these new infections remained undiagnosed and untreated.
Associate Professor Rebecca Guy, co-author of the report from the UNSW’s Kirby Institute, says this steady increase in chlamydia notifications in the past 10 years is largely due to increased rates of testing.
“These positive changes in testing are encouraging, but more is needed to increase testing, particular among young men,” she said.
Prof Guy also explains that rates of new cases of HIV in Australia had stabilised over the past four years, with just over 1000 cases being reported each year between 2012 and 2015.
“In this time period when notifications have stabilised, there’s been an expansion in Australia in the delivery of key HIV services, including initiatives to make testing more accessible and easy,” she said.
STI rates much higher among indigenous Australians
However, the researchers also found that HIV rates among Aboriginal and Torres Strait Islander men had doubled in the past five years and are now two times higher than non-indigenous men.
Associate Professor James Ward from the South Australian Health and Medical Research Institute who also worked on the report says there has been “a clear divergence” in diagnosis rates between the indigenous and non-indigenous populations.
“There’s been a doubling of diagnoses in people aged over 35 years in the Aboriginal and Torres Strait Islander population and very stable rates in people under the age of 35 and in the non-indigenous population over 35 years over the last 10 years,” he said.
This gap was even more pronounced in remote and very remote areas where access to HIV prevention and treatment services were limited and there are higher rates of other STIs and injecting drug users.
“There is some underlying risk factors for the Aboriginal and Torres Strait Islander population that make it really susceptible to a rapidly increasing HIV epidemic if it was to take hold,” Ward said.
Dr Bridget Haire, president of the Australian Federations of AIDS Organisations, says the problem is further exacerbated thanks to a decline in funding for Aboriginal and Torres Strait Island health programs.
“This is not helpful at time when infections are rising because one of the things that groups such as the Anwernekenhe National Alliance would do would be speaking to people about their experience of living with HIV, which can be very galvanising in terms of health promotion,” she said.
In terms of other STIs, rates of genital warts had plummeted by 91 per cent in Indigenous women below 21 years of age, largely thanks to the national human papillomavirus (HPV) vaccination programs in schools.
However, rates of chlamydia, gonorrhea and syphilis were three times, 10 times and six times higher, respectively, in the Indigenous population compared to non-Indigenous, with even larger differences recorded in remote and very remote areas.
“This disparity highlights the importance really of a strengthened focus on prevention, including clinical service delivery, health promotion and treatment outcomes for this population,” Ward said.
Gay and bisexual men leading charge in fight against HIV
In some good news to come out of the report, Australia had met two out of three targets in the international 90-90-90 strategy to tackle HIV, which states that by 2020, 90 per cent of all people living with HIV will know their status, 90 per cent of people diagnosed with HIV will be on antiretroviral therapy (ART), and 90 per cent of HIV- positive people on ART will have a suppressed viral load.
Guy explains that Australia had met the first and third targets, with rates of 90 per cent and 92 per cent respectively, and that we were not too far off from reaching the second target, with a still impressive 84 per cent of Australians living with HIV receiving ART.
Dr Limin Mao, co-author and senior researcher from the Centre for Social Research in Health at UNSW, says gay and bisexual men are “leading the way in eradicating HIV transmission in Australia”.
“We have record proportion of HIV-positive gay men on antiretroviral treatment, with the majority successfully managing viral suppression,” she said.
Mao explains that the proportion of HIV-positive gay and bisexual men on ART had surged from 60 per cent in 2006 to a record-high of 87 per cent in 2015, and that proportion of those who had achieved viral suppression had jumped from 55 per cent to 88 per cent in the same time frame.
However, she has called for further resources and support to help remove barriers to access to HIV prevention, such as making pre-exposure prophylaxis (PrEP), a HIV medicine taken daily to prevent people from acquiring HIV, more readily accessible for at-risk groups and younger gay men in particular.
Another finding that the proportion of gay men engaging in condomless sex with casual partners had increased to 41 per cent in 2015, but Haire explains that this should not be a cause for concern.
“We need to recognise that for gay men everywhere, we now have evidence-based risk reduction for HIV that doesn’t depend on condoms, and so it’s not necessarily about an increase in unsafe sex, it’s about people using different strategies to reduce their risk,” she said.
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Condoms can protect against sexually transmitted infections but not shark attack, talent show judges or Miley Cyrus. Courtesy: TenWaysUK
Originally published as Our sexual health report card released