Do we need to worry about sexually transmissible infections (STIs) in older women in Australia? An investigation of STI trends between 2000 and 2018
Louise Bourchier
A D , Sue Malta A B , Meredith Temple-Smith C and Jane Hocking A
+ Author Affiliations
- Author Affiliations
A Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3053, Australia.
B National Ageing Research Institute, Poplar Road, Parkville, Vic. 3052, Australia.
C Department of General Practice, The University of Melbourne, 780 Elizabeth Street, Melbourne, Vic. 3004, Australia.
D Corresponding author. Email: louise.bourchier@unimelb.edu.au
Sexual Health 17(6) 517-524 https://doi.org/10.1071/SH20130
Submitted: 23 July 2020 Accepted: 5 November 2020 Published: 18 December 2020
Journal Compilation © CSIRO 2020 Open Access CC BY-NC-ND
Abstract
Background: This study examined trends in chlamydia, gonorrhoea and syphilis diagnosis, and chlamydia testing and positivity, among older women in Australia between 2000 and 2018. Methods: Using national notifiable disease data and Medicare data, diagnosis rates were calculated for each sexually transmissible infection (STI), as well as testing and positivity rates for chlamydia. Data were compared between two older groups (55–64 and 65–74 years) and two younger groups (15–24 and 25–34 years). Poisson regression examined trends for 2000–18 and 2014–18 separately. Results: Rates for all STIs increased across all age groups and were highest in the two youngest age groups. From 2014 to 2018, chlamydia rates increased the most among those aged 55–64 years [incidence rate ratio (IRR) = 1.06; 95%CI: 1.02–1.10] and declined in those aged 15–24 years (IRR = 0.99; 95%CI: 0.99–0.99). Gonorrhoea rates increased the most among those aged 65–74 years (IRR = 1.47; 95%CI: 1.23–1.77) and least in those aged 15–24 years (IRR = 1.12; 95%CI: 1.10–1.13). Syphilis rates increased the most among those aged 55–64 years (IRR = 1.58; 95%CI: 1.25–1.99) and least in those aged 15–24 years (IRR = 1.29; 95%CI: 1.23–1.35). Chlamydia test positivity declined among younger women but remained stable in older women. Conclusions: In general, STIs are increasing among older women in Australia at a faster rate than among younger women. Although the greatest burden is among younger women, STIs need to be considered and monitored among older women.
Keywords: chlamydia, gonorrhoea, sexually transmissible infections (STIs), syphilis, women.
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