Sexual risk and testing for sexually transmissible infections in Aboriginal and Torres Strait Islander peoples and non-Indigenous young South Australians: results of an online survey

Stephen Harfield; Salenna Elliott; Federica Barzi; Kiara Minto; Judith A. Dean; James Ward

doi:10.1071/SH24041

RESEARCH ARTICLE (Open Access)

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Sexual risk and testing for sexually transmissible infections in Aboriginal and Torres Strait Islander peoples and non-Indigenous young South Australians: results of an online survey

Stephen Harfield

^A ^B ^C ^* , Salenna Elliott ^A , Federica Barzi ^A , Kiara Minto

^A , Judith A. Dean

^A ^B and James Ward ^A

+ Author Affiliations

- Author Affiliations

^A Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia.

^B School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia.

^C Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.

^* Correspondence to: s.harfield@uq.edu.au

Handling Editor: Darren Russell

Sexual Health 21, SH24041 https://doi.org/10.1071/SH24041

Submitted: 23 February 2024 Accepted: 13 June 2024 Published: 1 July 2024

© 2024 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

Disproportionate rates of sexually transmissible infections (STIs) among Aboriginal and Torres Strait Islander young people are often attributed to risk-taking behaviours, but research rarely conducts direct comparison with their non-Indigenous peers to address this negative discourse.

Methods

‘Let’s Talk About It 2019’ was a cross-sectional online survey of South Australians (16–29 years). It prioritised recruitment of Aboriginal and Torres Strait Islander respondents to compare behaviours with non-Indigenous peers using multivariable Poisson regression models.

Results

Aboriginal and Torres Strait Islander (n = 231) and non-Indigenous (n = 2062) respondents reported similar condom use (40% vs 43%, P = 0.477) and sexual debut median ages (16 years vs 17 years). Higher proportions of Aboriginal and/or Torres Strait Islander respondents reported a recent health check (48% vs 38%, P = 0.002), STIs (60% vs 49%, P < 0.001) and HIV (37% vs 28%, P = 0.006) testing, STI diagnosis (29% vs 21%, P = 0.042), and intoxication during last sex (30% vs 18%, P < 0.001).

Conclusions

Behaviours associated with STI transmission were mostly similar among Aboriginal and Torres Strait Islander and non-Indigenous respondents. Higher STI/HIV testing among Aboriginal and Torres Strait Islander respondents suggests effectiveness of targeted programs. Interventions targeting substance use and condom use among all young people are needed. Future interventions need to focus beyond behaviours and explore social determinants of health and sexual networks as contributors to disproportionate STI rates.

Keywords: Aboriginal and Torres Strait Islander, Australasia, Indigenous, public health, sexual behaviours, STIs, young people, youth.

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