Changing pattern of sexually transmissible infections and HIV diagnosed in public sexual health services compared with other locations in New South Wales, 2010–14
Christopher Bourne A B C E , Meeyin Lam D , Christine Selvey D , Rebecca Guy C and Denton Callander CA NSW STI Programs Unit, Centre for Population Health, NSW Health, Level 2, 349 Crown Street, Surry Hills NSW 2010.
B Sydney Sexual Health Centre, South East Sydney Local Health District.
C Kirby Institute, UNSW Australia, Wallace Wurth Building, High St, Kensington NSW 2052, Australia.
D Health Protection, NSW Health, 73 Miller Street, North Sydney NSW 2060, Australia.
E Corresponding author. Email: Christopher.Bourne@health.nsw.gov.au
Sexual Health 15(4) 366-369 https://doi.org/10.1071/SH17183
Submitted: 25 September 2017 Accepted: 09 03 2018 Published: 16 July 2018
Abstract
Background: In Australia, testing and treatment for HIV and other sexually transmissible infections (STIs) is usually managed in general practice, while publicly funded sexual health clinics (PFSHC) attract people at higher risk for infection. The proportion of HIV and STI diagnoses in New South Wales (NSW) occurring in PFSHC stratified by priority population was investigated. Methods: From 2010 to 2014, NSW notification frequencies for chlamydia, gonorrhoea, infectious syphilis, and HIV were compared with the number of diagnoses in PFSHC. The annual proportion of diagnoses at PFSHC was calculated and Wilcoxon rank-sum tests assessed trends. Diagnoses from PFSHC were also organised by priority population, including gay and bisexual men (GBM), people living with HIV, Aboriginal and Torres Strait Islander people, people who use injecting drugs, sex workers and young people. Results: The annual proportion of HIV and STIs diagnosed at PFSHC increased (all P < 0.001): chlamydia from 12% to 15%, gonorrhoea 23% to 38%, infectious syphilis 21% to 40% and HIV 22% to 30%. Overall, the majority of all infections diagnosed at PFSHC were among GBM, with the proportional distribution of chlamydia increasing from 32% to 46% among GBM (P < 0.001) and decreasing among young people (50% to 40%; P < 0.001). There were no other significant changes by population or infection at PFSHC. Conclusions: Increasing proportions of STI and HIV are being diagnosed at NSW PFSHC, mostly among GBM. PFSHC reorientation to priority populations continues to make a large and increasing contribution to STI and HIV control efforts in NSW.
References
[1] Grulich AE, de Visser RO, Badcock PB, Smith AMA, Richters J, Rissel C, Simpson JM. Knowledge about and experience of sexually transmissible infections in a representative sample of adults: the Second Australian Study of Health and Relationships. Sex Health 2014; 11 481–94.| Knowledge about and experience of sexually transmissible infections in a representative sample of adults: the Second Australian Study of Health and Relationships.Crossref | GoogleScholarGoogle Scholar |
[2] Santella AJ, Pollack A, Harrison C, Sawleshwarkar SN, Britt HC, Hillman RJ. Management rates of sexually transmissible infections by Australian general practitioners, 2000–2012. Sex Health 2014; 11 52–7.
| Management rates of sexually transmissible infections by Australian general practitioners, 2000–2012.Crossref | GoogleScholarGoogle Scholar |
[3] Ali H, Donovan B, Fairley CK, Ryder N, McNulty A, Chen MY, Marshall L, O’Connor CC, Dickson B, Grulich AE, Hellard ME, Kaldor JM, Guy RJ. Are Australian sexual health clinics attracting priority populations? Sex Health 2013; 10 456–9.
| Are Australian sexual health clinics attracting priority populations?Crossref | GoogleScholarGoogle Scholar |
[4] Knight V, Ryder N, Guy R, Lu H, Wand H, McNulty A. New Xpress sexually transmissible infection screening clinic improves patient journey and clinic capacity at a large sexual health clinic. Sex Transm Dis 2013; 40 75–80.
| New Xpress sexually transmissible infection screening clinic improves patient journey and clinic capacity at a large sexual health clinic.Crossref | GoogleScholarGoogle Scholar |
[5] Ali H, Donovan B, Fairley CK, Chen MY, O’Connor CC, Grulich AE, McNulty , Ryder N, Hellard ME, Guy RJ. Increasing access by priority populations to Australian sexual health clinics. Sex Transm Dis 2013; 40 819–21.
| Increasing access by priority populations to Australian sexual health clinics.Crossref | GoogleScholarGoogle Scholar |
[6] Centre for Population Health. NSW Sexually Transmissible Infections Strategy 2006–2009. Sydney: NSW Ministry of Health; 2006.
[7] Centre for Population Health. NSW HIV strategy 2012–2015. Sydney: NSW Ministry of Health; 2012.
[8] Bourne C, Allen D, Brown K, Davies SC, McNulty A, Smith DE, O’Connor CC, Couldwell D, Jackson E, Bolton M, Rodgers C, Konecny P, Smith DJ, Parker A. What proportion of sexually transmissible infections and HIV are diagnosed in New South Wales’ public sexual health services compared with other services? Sex Health 2013; 10 119–23.
| What proportion of sexually transmissible infections and HIV are diagnosed in New South Wales’ public sexual health services compared with other services?Crossref | GoogleScholarGoogle Scholar |
[9] The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia. Annual Surveillance Report. Sydney: The Kirby Institute, UNSW; 2016.
[10] NSW Government. Public Health Act 2010 No 127. Sydney: NSW Government; 2012. Available online at: https://www.legislation.nsw.gov.au/#/view/act/2010/127/full [verified 4 June 2018].
[11] Guy RJ, Kong F, Goller J, Franklin N, Bergeri I, Dimech W, Reilly N, Sullivan E, Ward J, Kaldor JM, Hellard M, Donovan B. A new national Chlamydia Sentinel Surveillance System in Australia: evaluation of the first stage of implementation. Commun Dis Intell Q Rep 2010; 34 319–28.
[12] Australian Government Department of Health. Australian National Notifiable Diseases and Case definitions. Canberra: Australian Government Department of Health; 2017. Available online at: http://www.health.gov.au/internet/main/publishing.nsf/Content/cdna-casedefinitions.htm [verified 04/06/2018]
[13] Communicable Diseases Control Branch. Surveillance of sexually transmitted infections and blood-borne viruses in South Australia, 2014. Adelaide: Government of South Australian; 2015.
[14] Communicable Disease Control Directorate. The epidemiology of notifiable sexually transmitted infections and blood-borne viruses in Western Australia 2014. Perth: Department of Health, Western Australia; 2015.
[15] Australian Bureau of Statistics, 2012. ‘Same-sex couple families’ in Reflecting a Nation: Stories from the 2011 Census, 2012–2013, cat. No. 2071.0, Canberra: ABS; 2014 Available online at: http://www.abs.gov.au/socialtrends [verified 4 June 2018].
[16] McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, Gilson R, Sullivan AK, Clarke A, Reeves I, Schembri G, Mackie N, Bowman C, Lacey CJ, Apea V, Brady M, Fox J, Taylor S, Antonucci S, Khoo SH, Rooney J, Nardone A, Fisher M, McOwan A, Phillips AN, Johnson AM, Gazzard B, Gill ON. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet 2016; 387 53–60.
| Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial.Crossref | GoogleScholarGoogle Scholar |
[17] Kojima N, Davey DJ, Klausner JD. Pre-exposure prophylaxis for HIV infection and new sexually transmitted infections among men who have sex with men. AIDS 2016; 30 2251–2.
| Pre-exposure prophylaxis for HIV infection and new sexually transmitted infections among men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
