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REVIEW

Prevalence of chlamydia, gonorrhoea, syphilis and trichomonas in Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis

Simon Graham A D , Lucy Watchirs Smith B , Christopher K. Fairley C and Jane Hocking A

A Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Vic. 3052, Australia.

B Kirby Institute, UNSW Australia, Sydney, NSW 2052, Australia.

C Melbourne Sexual Health Centre and Central Clinical School, Monash University, 580 Swanston Street, Carlton, Vic. 3053, Australia.

D Corresponding author. Email: simon.graham@unimelb.edu.au

Sexual Health 13(2) 99-113 http://dx.doi.org/10.1071/SH15171
Submitted: 25 August 2015  Accepted: 5 November 2015   Published: 18 January 2016

Abstract

Higher notification rates of sexually transmissible infections (STIs) are reported among Aboriginal and Torres Strait Islander (Aboriginal) compared with non-Aboriginal people in Australia. The aim of this study is to estimate the pooled prevalence of chlamydia, gonorrhoea, syphilis and trichomonas among Aboriginal people in Australia by sex, age-group, setting (clinic vs population/community-based) and population group [adults, pregnant females, young people (12–29 years) and prisoners]. The databases Medline, PubMed and Web of Science were searched in May 2015. A meta-analysis was conducted to estimate the pooled prevalence of the four STIs in Aboriginal people and if possible, by gender, age-group, setting and population group. A total of 46 studies were included. The pooled prevalence was 11.2% (95%CI: 9.4–13.0%) for chlamydia (36 studies), 12.5% (95%CI: 10.5–14.6%) for gonorrhoea (28 studies), 16.8% (95%CI: 11.0–22.6%) for syphilis (13 studies) and 22.6% (95%CI: 18.5–26.7%) for trichomonas (11 studies); however, there was significant heterogeneity between studies (I2 <97.5%, P < 0.01). In the subgroup analysis, a higher pooled prevalence occurred in females than males for chlamydia (12.7% vs 7.7%) and gonorrhoea (10.7% vs 8.1%). The prevalence of chlamydia was 12.4% in clinic-based compared with 4.3% in population-based studies. The highest pooled prevalence by population group was among pregnant females (16.8%) and young people (16.2%) for chlamydia, pregnant females (25.2%) for trichomonas; and young people for gonorrhoea (11.9%). This review highlights the need to decrease the prevalence of STIs among Aboriginal people through community-based programs that target asymptomatic young people.

Additional keywords: Indigenous, sexual health, STI, sexually transmissible infection.


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