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REVIEW

Chlamydia prevention indicators for Australia: review of the evidence from New South Wales

Hammad Ali A E , Basil Donovan A B , Bette Liu A , Jane S. Hocking C , Paul Agius D , James Ward A , Christopher Bourne B , John M. Kaldor A and Rebecca J Guy A
+ Author Affiliations
- Author Affiliations

A The Kirby Institute, The University of New South Wales, Sydney, NSW 2052, Australia.

B Sydney Sexual Health Centre, Sydney Hospital, Sydney, NSW 2000, Australia.

C Centre for Women’s Health, Gender and Society, Melbourne School of Population Health, University of Melbourne, Melbourne, Vic. 2004, Australia.

D Mother and Child Health Research, La Trobe University, Melbourne, Vic., 3000, Australia.

E Corresponding author. Email: hali@kirby.unsw.edu.au

Sexual Health 9(5) 399-406 https://doi.org/10.1071/SH11183
Submitted: 19 December 2011  Accepted: 19 March 2012   Published: 20 August 2012

Abstract

Background: Annual notifications of chlamydia (Chlamydia trachomatis) diagnoses have increased steadily in Australia in the last decade. To guide public health programs, we developed 10 national chlamydia prevention indicators and report on each indicator for New South Wales (NSW). Methods: Using systematic methods, we reviewed the literature to report on the 10 health and behaviour indicators for 15- to 29–year-old heterosexuals in NSW from 2000. We included data with two or more time points. Results: Chlamydia notification rates (Indicator 1) in 15- to 29–year-olds have increased by 299%, from 237 per 100 000 population in 2001 to 946 per 100 000 population in 2010; and the percent of 15- to 34-year-olds with an annual Medicare-rebated chlamydia test (Indicator 2) increased by 326%, from 1.9% in 2001 to 8.1% in 2010. Since 2004, sentinel surveillance showed a 28% increase in chlamydia prevalence (Indicator 3) in 15- to 29-year-old females tested at their first sexual health service visit (from 8.5% in 2004 to 10.9% in 2010) but no significant increase in males. No NSW-specific chlamydia incidence (Indicator 4) was available. Pelvic inflammatory disease hospitalisation separations rate decreased from 0.58 per 1000 in 2001 to 0.44 per 1000 in 2010 in 15- to 29-year-old females (Indicator 5).Secondary school surveys in 2002 and 2008 showed chlamydia knowledge increased in males. The sexual risk-taking behaviour of young people remained unchanged (Indicators 6–10). Conclusions: Although notifications have risen steeply, the modest increase in chlamydia prevalence maybe a more realistic reflection of transmission rates. Strategies are needed to increase testing and to modify sexual risk behaviour. Crucial gaps in epidemiological data were identified.

Additional keywords: epidemiology, heterosexuals, surveillance, young people.


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