Sexual risk and healthcare seeking behaviour in young Aboriginal and Torres Strait Islander people in North Queensland
Robert Scott A , Regina Foster A , Lisa N. Oliver A , Anna Olsen B , Julie Mooney-Somers C , Bradley Mathers B , Joanne M. Micallef B , John Kaldor B and Lisa Maher B D
+ Author Affiliations
- Author Affiliations
A Townsville Aboriginal and Islander Health Service, 57–59 Gorden Street, Garbutt, Qld 4814, Australia.
B The Kirby Institute, UNSW Australia, Sydney, NSW 2052, Australia.
C Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW 2006, Australia.
D Corresponding author. Email: Lmaher@kirby.unsw.edu.au
Sexual Health 12(3) 194-199 https://doi.org/10.1071/SH14092
Submitted: 24 May 2014 Accepted: 22 October 2014 Published: 15 December 2014
Abstract
Background: Compared with non-Indigenous Australians, Aboriginal and Torres Strait Islander people have higher rates of sexually transmissible infections (STI). The identification of the sexual risk and healthcare seeking behaviours of young Aboriginal and Torres Strait Islander people in a regional Australian setting was sought. Methods: A cross-sectional survey of 155 young Aboriginal and Torres Strait Islander people (16–24 years) in Townsville was conducted. Results: Most participants (83%) reported ever having had sex, with a median age of 15 years at first sex and a range from 9 to 22 years. While young men reported more sexual partners in the last 12 months than young women, they were also more likely to report condom use at the last casual sex encounter (92% vs 68%, P = 0.006). Young women were significantly more likely than young men to report never carrying condoms (35% vs 16%); however, they were more likely to have had STI testing (53% vs 28%, P = 0.004). Of those reporting previous STI testing, 29% reported ever being diagnosed with an STI. Conclusions: The sample of young Aboriginal and Torres Strait Islander people reported an early age at first sex, variable condom use and low uptake of STI testing. The high prevalence of self-reported STI diagnoses indicate a need for opportunistic sexual health education and efforts designed to promote the uptake of STI screening in this group.
Additional keywords: Aboriginal and Torres Strait Islander, condoms, regional, sexually transmitted infections, testing, youth.
References
[1] Australian Health Ministers’ Advisory Council. Aboriginal and Torres Strait Islander health performance framework 2012 report. Canberra: Australian Government Department of Health and Ageing; 2012.[2] Australian Institute of Health and Welfare (AIHW). The health and welfare of Australia’s Aboriginal and Torres Strait Islander people: An Overview 2011. Canberra: AIHW; 2011.
[3] The Kirby Institute. Blood borne viral and sexually transmitted infections in Aboriginal and Torres Strait Islander People: surveillance and evaluation report 2011. Sydney: The Kirby Institute, the University of New South Wales; 2011.
[4] Stewart J, Walsh A. Collaborating to make Aboriginal and Torres Strait Islander young people’s sexual and reproductive health ‘everybody’s business’. Aborig Isl Health Work J 2011; 35 6–7.
[5] Larkins S, Page RP, Panaretto KS, Scott R, Mitchell MR, Alberts V, Veitch PC, McGinty S. Attitudes and behaviours of young Indigenous people in Townsville concerning relationships, sex and contraception: the “U Mob Yarn Up” project. Med J Aust 2007; 186 513–8.
| 17516898PubMed |
[6] Mooney-Somers J, Olsen A, Erick W, Scott R, Akee A, Maher L. Young indigenous Australians’ sexually transmitted infection prevention practices: a community-based participatory research project. J Community Appl Soc Psychol 2012; 22 519–32.
| Young indigenous Australians’ sexually transmitted infection prevention practices: a community-based participatory research project.Crossref | GoogleScholarGoogle Scholar |
[7] Miller GC, McDermott R, McCulloch B, Fairley CK, Muller R. Predictors of the prevalence of bacterial STI among young disadvantaged Indigenous people in north Queensland, Australia. Sex Transm Infect 2003; 79 332–5.
| Predictors of the prevalence of bacterial STI among young disadvantaged Indigenous people in north Queensland, Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3szpvFKisg%3D%3D&md5=fe2ee18310502528e0d6104334f789c6CAS | 12902589PubMed |
[8] Department of Health and Ageing (DOHA). Third National Aboriginal and Torres Strait Islander blood borne viruses and sexually transmissible infections strategy 2010–2013. Canberra: Australian Government; 2010.
[9] Australian Bureau of Statistics (ABS). Townsville (C) (Local Government Area), 2011 Census Quickstats. Canberra: ABS; 2011. Available at: http://www.censusdata.abs.gov.au/census_services/getproduct/census/2011/quickstat/LGA37010 [verified 24 February 2013].
[10] Australian Bureau of Statistics (ABS). 2011 Census Quickstats. Canberra: ABS; 2011. Available at: http://www.censusdata.abs.gov.au/census_services/getproduct/census/2011/quickstat/0?opendocument &navpos=220 [verified 24 February 2013].
[11] Buhrer-Skinner M, Muller R, Menon A, Gordon R. Novel approach to an effective community-based chlamydia screening program within the routine operation of a primary healthcare service. Sex Health 2009; 6 51–6.
| Novel approach to an effective community-based chlamydia screening program within the routine operation of a primary healthcare service.Crossref | GoogleScholarGoogle Scholar | 19254492PubMed |
[12] Mooney-Somers J, Erick W, Scott R, Akee A, Kaldor J, Maher L. Enhancing Aboriginal and Torres Strait Islander young people’s resilience to blood-borne and sexually transmitted infections: findings from a community-based participatory research project. Health Promot J Austr 2009; 20 195–201.
| 19951239PubMed |
[13] Mooney-Somers J, Olsen A, Erick W, Scott R, Akee A, Kaldor J, Maher L. Learning from the past: young Indigenous people’s accounts of blood-borne viral and sexually transmitted infections as resilience narratives. Cult Health Sex 2011; 13 173–86.
| Learning from the past: young Indigenous people’s accounts of blood-borne viral and sexually transmitted infections as resilience narratives.Crossref | GoogleScholarGoogle Scholar | 20972915PubMed |
[14] Flicker S, Guta A, Larkin J, Flynn S, Fridkin A, Traver R, Pole JD, Layne C. Survey design from the ground up: collaboratively creating the Toronto teen survey. Health Promot Pract 2010; 11 112–22.
| Survey design from the ground up: collaboratively creating the Toronto teen survey.Crossref | GoogleScholarGoogle Scholar | 18367639PubMed |
[15] Smith A, Rissel CE, Richters J, Grulich AE, de Visser RO. The rationale and methods of the Australian Study of Health and Relationships. Aust N Z J Public Health 2003; 27 106–17.
| The rationale and methods of the Australian Study of Health and Relationships.Crossref | GoogleScholarGoogle Scholar | 14696700PubMed |
[16] Smith A, Agius P, Mitchell A, Barrett C, Pitts M. Secondary students and sexual health 2008, monograph Series No. 70. Melbourne: Australian Research Centre in Sex, Health & Society, La Trobe University; 2009.
[17] Ungar M, Liebenberg L, Boothroyd R, Kwong WM, Lee TY, Leblanc J, Duque L, Makhnach A. The study of youth resilience across cultures: lessons from a pilot study of measurement development. Res Hum Dev 2008; 5 166–80.
| The study of youth resilience across cultures: lessons from a pilot study of measurement development.Crossref | GoogleScholarGoogle Scholar |
[18] Mooney-Somers J, Maher L. The Indigenous Resiliency Project: a worked example of community-based participatory research. NSW Public Health Bull 2009; 20 112–8.
| The Indigenous Resiliency Project: a worked example of community-based participatory research.Crossref | GoogleScholarGoogle Scholar |
[19] Brydon-Miller M. Using participatory action research to address community health issues. In: Murray M, editor. Critical health psychology. London: Palgrave MacMillan; 2003. pp. 187–202.
[20] Burns S, Schubotz D. Demonstrating the merits of the peer research process: a Northern Ireland case study. Field Methods 2009; 21 309–26.
| Demonstrating the merits of the peer research process: a Northern Ireland case study.Crossref | GoogleScholarGoogle Scholar |
[21] Coughlin S. Recall bias in epidemiologic studies. J Clin Epidemiol 1990; 43 87–91.
| Recall bias in epidemiologic studies.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3c3gtl2mug%3D%3D&md5=8013ef5dbc97f6b418cbec7133ff2ea8CAS | 2319285PubMed |
[22] Grunseit A, Richters J. Age at first intercourse in an Australian national sample of technical college students. Aust N Z J Public Health 2000; 24 11–6.
| Age at first intercourse in an Australian national sample of technical college students.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c3ktVCnsg%3D%3D&md5=e6bbccb6e817fdc455c4e2a35709c844CAS | 10777972PubMed |
[23] Lindsay J, Smith A, Rosenthal D. Secondary students: HIV/AIDS and sexual health. Melbourne: Centre for the Study of Sexually Transmissible Diseases, La Trobe University; 1997.
[24] Rissel C, Richters J, Grulich A, De Visser R, Smith A. Sex in Australia: first experiences of vaginal intercourse and oral sex among a representative sample of adults. Aust N Z J Public Health 2003; 27 131–7.
| Sex in Australia: first experiences of vaginal intercourse and oral sex among a representative sample of adults.Crossref | GoogleScholarGoogle Scholar | 14696703PubMed |
[25] Zubrick SR, Silburn SR, Lawrence DM, Mitrou FG, Dalby RB, Blair EM, Griffin J, Milroy H, De Maio JA, Cox A, Li J. The Western Australian Aboriginal Child Health Survey: the social and emotional wellbeing of Aboriginal children and young people [electronic version]. Perth: Curtin University of Technology and Telethon Institute for Child Health Research; 2005. Available at: http://aboriginal.childhealthresearch.org.au/media/394828/western_australian_aboriginal_child_health_survey_citations.pdf [verified 18 September 2013].
[26] Vella A, Agius P, Bowring A, Hellard M, Lim M. Early age at first sex: associations with sexual health and socioeconomic factors among a sample of young music festival attendees in Melbourne. Sex Health 2014; 11 359–65.
| Early age at first sex: associations with sexual health and socioeconomic factors among a sample of young music festival attendees in Melbourne.Crossref | GoogleScholarGoogle Scholar | 25167937PubMed |
[27] Ward J, Bryant J, Wand H, Pitts M, Smith A, Delaney-Thiele D, Worth H, Kaldor J. Sexual health and relationships in young Aboriginal and Torres Strait Islander people: results from the first national study assessing knowledge, risk practices and health service use in relation to sexually transmitted infections and blood borne viruses: The Goanna Survey. Baker IDI Heart and Diabetes Institute Alice Springs. July 2014. Available at: http://www.bakeridi.edu.au/Assets/Files/Final%20Goanna%20Report%20July%202014.pdf [verified 19 October 2014].
[28] Smith J, Fenwick J, Skinner R, Hallet J, Merriman G, Marshall L. Sex, condoms and sexually transmissible infections: a qualitative study of sexual health in young Australian men. Arch Sex Behav 2012; 41 487–95.
| Sex, condoms and sexually transmissible infections: a qualitative study of sexual health in young Australian men.Crossref | GoogleScholarGoogle Scholar | 20830513PubMed |
[29] Edwards G, Barber B. Women may underestimate their partners’ desires to use condoms: possible implications for behaviour. J Sex Res 2010; 47 59–65.
| Women may underestimate their partners’ desires to use condoms: possible implications for behaviour.Crossref | GoogleScholarGoogle Scholar | 19343571PubMed |
[30] Willis J, Anderson I, Morris K. Sexual health promotion for Aboriginal and Torres Strait Islander people: a community guide to evidence-based practice in social and behavioural interventions. Melbourne: The Australian Research Centre for Sex, Health and Society. La Trobe University; 2005.
[31] Pavlin N, Parker R, Fairley C, Gunn J, Hocking J. Take the sex out of STI screening! Views of young women on implemented chlamydia screening in general practice. BMC Infect Dis 2008; 8 62
| Take the sex out of STI screening! Views of young women on implemented chlamydia screening in general practice.Crossref | GoogleScholarGoogle Scholar | 18471280PubMed |
[32] Newton D, Keogh L, Temple-Smith M, Fairley C, Chen M, Bayly C, Williams H, McNamee K, Henning D, Hsueh A, Fisher J, Hocking J. Key informant perceptions of youth-focussed sexual health promotion programs in Australia. Sex Health 2013; 10 47–56.
| 23158432PubMed |
[33] Australian Institute of Health and Welfare (AIHW). National Drugs Strategy Household Surveys (NDSHS) 2013 data and references. Available from: http://www.aihw.gov.au/alcohol-and-other-drugs/ndshs/2013/data-and- references/ [verified 17 September 2014].
[34] de Visser R, Rissel C, Smith A, Richters J. Socioedemographic correlates of selected health risk behaviours in a representative sample of Australian young people. Int J Behav Med 2006; 13 153–62.
| Socioedemographic correlates of selected health risk behaviours in a representative sample of Australian young people.Crossref | GoogleScholarGoogle Scholar | 16712433PubMed |
[35] Kong F, Guy R, Hocking J, Merritt T, Pirotta M, Heal C, Bergeri I, Donovan B, Hellard M. Australian general practitioner chlamydia testing rates among young people. Med J Aust 2011; 194 249–52.
| 21381999PubMed |
[36] Goller J, Ward J, Saunders M, Couzos S, Kaldor J, Hellard M. Chlamydia sentinel surveillance in Aboriginal Community Controlled Health Services finds higher testing and positivity rates among younger people. Aust N Z J Public Health 2012; 36 577–81.
| Chlamydia sentinel surveillance in Aboriginal Community Controlled Health Services finds higher testing and positivity rates among younger people.Crossref | GoogleScholarGoogle Scholar | 23216501PubMed |
[37] Australian Bureau of Statistics (ABS). Health services: patient experiences in Australia. Cat no. 4839.0.55.001. Canberra: ABS; 2009 Available at: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4CD5ABB5FABC202FCA25792E000D5A7E?opendocument [verified 24 February 2013].
[38] Scrimgeour M, Scrimgeour D. Health care access for Aboriginal and Torres Strait Islander people living in urban areas, and related research issues: a review of literature. Darwin: Cooperative Research Centre for Aboriginal Health; 2007.
[39] Fagan P, Cannon F, Crouch A. The young person check: screening for sexually transmitted infections and chronic disease risk in remote Aboriginal and Torres Strait Islander youth. Aust N Z J Public Health 2013; 37 316–21.
| The young person check: screening for sexually transmitted infections and chronic disease risk in remote Aboriginal and Torres Strait Islander youth.Crossref | GoogleScholarGoogle Scholar | 23895473PubMed |
[40] Hengel B, Jamil M, Mein J, Maher L, Kaldor J, Guy R. Outreach for chlamydia and gonorrhoea screening: a systematic review of strategies and outcomes. BMC Public Health 2013; 13 1040
| Outreach for chlamydia and gonorrhoea screening: a systematic review of strategies and outcomes.Crossref | GoogleScholarGoogle Scholar | 24188541PubMed |
[41] Ward J, Bryant J, Worth H, Hull P, Solar S, Bailey S. Use of health services for sexually transmitted and blood-borne viral infections by young Aboriginal people in New South Wales. Aust J Primary Health 2013; 19 81–6.
| Use of health services for sexually transmitted and blood-borne viral infections by young Aboriginal people in New South Wales.Crossref | GoogleScholarGoogle Scholar |
[42] Morgan D, Slade M, Morgan C. Aboriginal philosophy and its impact on health care outcomes. Aust N Z J Public Health 1997; 21 597–601.
| Aboriginal philosophy and its impact on health care outcomes.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c7jtFSnsw%3D%3D&md5=300f4a6200a44ead4cb1082443f205e7CAS | 9470265PubMed |
[43] Junga-Williams R. For all Australians? Natl AIDS Bull 1998; 12 10–3.
[44] Larson A, Shannon C, Eldridge C. Indigenous Australians who inject drugs: results from a Brisbane study. Drug Alcohol Rev 1999; 18 53–62.
| Indigenous Australians who inject drugs: results from a Brisbane study.Crossref | GoogleScholarGoogle Scholar |
[45] Jones R, Biddlecom A. Is the Internet filling the sexual health information gap for teens? An exploratory study. J Health Commun 2011; 16 112–23.
| Is the Internet filling the sexual health information gap for teens? An exploratory study.Crossref | GoogleScholarGoogle Scholar | 21207311PubMed |
[46] Australian Institute of Health and Welfare (AIHW). Demonstration projects for improving sexual health in Aboriginal and Torres Strait Islander youth: evaluation report. Cat. No. IHW 81. Canberra: AIHW; 2013.
