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Aboriginal health worker screening for sexually transmissible infections and blood-borne viruses in a rural Australian juvenile correctional facility

David J. Templeton A B C D , Beverley A. Tyson A , Joel P. Meharg A , Katalin E. Habgood A , Patricia M. Bullen A , Sharafat Malek B and Rick McLean B

A Dubbo Sexual Health Clinic, Greater Western Area Health Service, 194 Brisbane Street, Dubbo, NSW 2830, Australia.

B School of Rural Health, Dubbo Campus, University of Sydney, 11 Moran Drive, Dubbo, NSW 2830, Australia.

C Present address: National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Level 2, 376 Victoria Street, Darlinghurst, NSW 2010, Australia and RPA Sexual Health, Sydney South West Area Health Service Community Health, Ground Floor, Page Building, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia.

D Corresponding author. Email:

Sexual Health 7(1) 44-48
Submitted: 30 March 2009  Accepted: 19 October 2009   Published: 15 February 2010


Introduction: In Australia, Aboriginal youth are disproportionately represented in juvenile detention centres. We assessed the prevalence of sexually transmissible infections (STIs) and blood-borne viruses (BBVs) identified by an Aboriginal Health Worker (AHW)-led screening program delivered to male detainees of a rural juvenile detention centre. Methods: A retrospective review of first screening visit data was performed. Demographic and behavioural data were collected and the prevalence of STI/BBV was assessed. Results: Over a 4-year period to November 2004, 101 screens on new medium-to-long-term detainees were performed. The median age of participants was 17 years (range 14–20) and 87% were Aboriginal. Most reported multiple lifetime sexual partners (mean 14, range 0–60) and a minority had used a condom for the last episode of vaginal intercourse. Injecting drug use and non-professional tattoos or piercings were both reported by over one-third of participants, with over 80% reporting previous incarceration. One-quarter of those screened were newly diagnosed with one or more STI/BBV. The most common infection identified was urethral chlamydia (prevalence 16.3%, 95% confidence interval 10.0–25.5%), although the prevalence of newly diagnosed syphilis, hepatitis B and hepatitis C were each over 5%. Many participants remained susceptible to hepatitis B. Conclusion: An AHW-led STI/BBV screening program identified a large number of asymptomatic and previously undiagnosed infections in this group of young male detainees. Such an education and screening program using skilled Aboriginal staff not affiliated with the correctional system could have a substantial impact on the prevalence of STI/BBV among juvenile detainees.

Additional keywords: adolescent, health services, indigenous, prisoners.


[1]  Forrest CB Tambor E Riley AW Ensminger ME Starfield B 2000 The health profile of incarcerated male youths. Pediatrics 105 286 91

[2]  From the Centers for Disease Control and Prevention 1996 HIV/AIDS education and prevention programs for adults in prisons and jails and juveniles in confinement facilities – United States, 1994. JAMA 275 1306 8

[3]  Thompson SC Ogilvie EL Veit FC Crofts N 1998 Juvenile offenders and hepatitis B: risk, vaccine uptake and vaccination status. Med J Aust 169 306 9

[4]  2003 NSW Young People in Custody Health Survey. Key Findings Report. Sydney: NSW Department of Juvenile Justice; 2003.

[5]  Luke G , Cunneen C . Aboriginal over-representation and discretionary decisions in the NSW juvenile justice system. Sydney: Juvenile Justice Advisory Council of NSW; 1995.

[6]  Wright MR Giele CM Dance PR Thompson SC 2005 Fulfilling prophecy? Sexually transmitted infections and HIV in Indigenous people in Western Australia. Med J Aust 183 124 8

[7]  Klausner JD Kent CK 2004 HIV and sexually transmitted diseases. Latest views on synergy, treatment, and screening. Postgrad Med 115 79 84

[8]  Cohen DA Kanouse DE Iguchi MY Bluthenthal RN Galvan FH Bing EG 2005 Screening for sexually transmitted diseases in non-traditional settings: a personal view. Int J STD AIDS 16 521 7 doi:10.1258/0956462054679115

[9]  The National Indigenous Australians’ Sexual Health Strategy. Implementation plan for 2001/02 to 2003/04. Canberra: Commonwealth Department of Health and Ageing; 2002.

[10]  Kenny DT , Nelson P , Butler T , Lennings C , Allerton M , Champion U . NSW Young People on Community Orders Health Survey 2003–2006: Key Findings Report. Sydney: The University of Sydney, 2006.

[11]  Cohen MS 1998 Sexually transmitted diseases enhance HIV transmission: no longer a hypothesis. Lancet 351 Suppl. 3 5 7 doi:10.1016/S0140-6736(98)90002-2

[12]  Fisher DA Huffam SE 2003 Management of chronic hepatitis B virus infection in remote-dwelling Aboriginals and Torres Strait Islanders: an update for primary healthcare providers. Med J Aust 178 82 5

[13]  Smith JA Linder CW Jay MS DuRant RH 1986 Isolation of Neisseria gonorrhea from the urethra of asymptomatic adolescent males. Clin Pediatr 25 566 8

[14]  Chen MY Donovan B 2003 Screening for genital Chlamydia trachomatis infection: are men the forgotten reservoir? Med J Aust 179 124 5

[15]  Barry PM Kent CK Scott KC Goldenson J Klausner JD 2009 Is jail screening associated with a decrease in Chlamydia positivity among females seeking health services at community clinics? – San Francisco, 1997–2004. Sex Transm Dis 36 Suppl. 2 S22 8

[16]  Skolnick AA 1998 Look behind bars for key to control of STDs. JAMA 279 97 8 doi:10.1001/jama.279.2.97

[17]  Butler TG Dolan KA Ferson MJ McGuiness LM Brown PR Robertson PW 1997 Hepatitis B and C in New South Wales prisons: prevalence and risk factors. Med J Aust 166 127 30

[18]  van der Poorten D Kenny DT George J 2008 Prevalence of and risk factors for hepatitis C in Aboriginal and non-Aboriginal adolescent offenders. Med J Aust 188 610 4

[19]  Magura S Kang SY Shapiro JL 1994 Outcomes of intensive AIDS education for male adolescent drug users in jail. J Adolesc Health 15 457 63

[20]  Pack RP Diclemente RJ Hook EW 3rd Oh MK 2000 High prevalence of asymptomatic STDs in incarcerated minority male youth: a case for screening. Sex Transm Dis 27 175 7 doi:10.1097/00007435-200003000-00011

[21]  Shafer MA 1994 Sexual behavior and sexually transmitted diseases among male adolescents in detention. Sex Transm Dis 21 181 2 doi:10.1097/00007435-199405000-00009

[22]  Oh MK Cloud GA Wallace LS Reynolds J Sturdevant M Feinstein RA 1994 Sexual behavior and sexually transmitted diseases among male adolescents in detention. Sex Transm Dis 21 127 32 doi:10.1097/00007435-199405000-00001

[23]  Levy M . Custodial Medicine Module of Monash University Postgraduate Program in Forensic Medicine. Melbourne; Churchill; 2004.

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