Integrating testing for sexually transmissible infections into annual health assessments for Aboriginal and Torres Strait Islander young people: a cross-sectional analysis

Heather McCormack; Handan Wand; Christopher Bourne; James Ward; Clare Bradley; Donna Mak; Rebecca Guy

doi:10.1071/SH23107

RESEARCH ARTICLE (Open Access)

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Integrating testing for sexually transmissible infections into annual health assessments for Aboriginal and Torres Strait Islander young people: a cross-sectional analysis

Heather McCormack

^A ^B ^* , Handan Wand ^A , Christopher Bourne ^A ^B ^C , James Ward ^D , Clare Bradley ^D , Donna Mak ^E ^F and Rebecca Guy ^A

+ Author Affiliations

- Author Affiliations

^A Kirby Institute, UNSW, Sydney, NSW, Australia.

^B NSW STI Programs Unit, Centre for Population Health, NSW Ministry of Health, Sydney, NSW, Australia.

^C Sydney Sexual Health Centre, Sydney, NSW, Australia.

^D UQ Poche Centre for Indigenous Health, University of Queensland, Brisbane, Qld, Australia.

^E Department of Health, East Perth, WA, Australia.

^F School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia.

^* Correspondence to: hmccormack@kirby.unsw.edu.au

Handling Editor: Darren Russell

Sexual Health https://doi.org/10.1071/SH23107

Submitted: 7 June 2023 Accepted: 23 August 2023 Published: 11 September 2023

© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

In the context of an expanding syphilis epidemic, we assessed the integration of sexually transmissible infection (STI) testing within annual health assessments for Aboriginal and Torres Strait Islander young people aged 16–29 years in Aboriginal Community Controlled Health Services between 2018 and 2020.

Methods

Using routinely collected electronic medical record data from a national sentinel surveillance system (ATLAS), we performed a cross-sectional analysis to calculate the proportion of assessments that integrated any or all of the tests for chlamydia, gonorrhoea, syphilis, and HIV. We used logistic regression to identify correlates of integration of any STI test.

Results

Of the13 892 assessments, 23.8% (95% CI 23.1, 24.6) integrated a test for any STI and 11.5% (95% CI 10.9, 12.0) included all four STIs. Of assessments that included a chlamydia/gonorrhoea test, 66.9% concurrently included a syphilis test. Integration of any STI test was associated with patients aged 20–24 years (OR 1.2, 95% CI 1.1–1.4) and 25–29 years (OR 1.1, 95% CI 1.0–1.2) compared to 16–19 years and patients residing in very remote (OR 4.2, 95% CI 3.7–4.8), remote (OR 2.4, 95% CI 2.1–2.8), and regional areas (OR 2.5, 95% CI 2.2–2.8) compared to metropolitan areas. There was no association with patient sex.

Conclusions

Integration of STI testing into annual health assessments for Aboriginal and Torres Strait Islander young people was higher in remote areas where disease burden is greatest. Integration is similar in men and women, which contrasts with most studies that have found higher testing in women.

Keywords: epidemiology, health promotion, health services, HIV prevention, interventions, Medicare Benefits Schedule Item 715, prevention, sexually transmissible infections, social determinants, statistics.

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