Australian Burden of Disease Study: Illicit Drug Use, Intimate Partner Violence, Unsafe Sex

 Australian Institute of Health and Welfare, Last updated: 

Burden of disease is a measure of the years of healthy life lost from living with, or dying from disease and injury. A portion of this burden is preventable, being due to modifiable risk factors. This report provides information on the deaths and burden of disease due to risk factors included in the Australian Burden of Disease Study 2015. 

New analyses of the key drivers of change over time in the burden of disease due to selected risk factors have recently been added to these data visualisations (August 2020).

The following excerpts may be of interest:

Or you can see all the data here

 

 

Internet-based self-sampling for Chlamydia trachomatis testing

Söderqvist JGullsby KStark L, et al
Internet-based self-sampling for Chlamydia trachomatis testing: a national evaluation in Sweden

Abstract:

Objective Internet-based testing for Chlamydia trachomatis (CT) with self-sampling at home has gradually been implemented in Sweden since 2006 as a free-of-charge service within the public healthcare system. This study evaluated the national diagnostic outcome of this service.

Methods Requests for data on both self-sampling at home and clinic-based sampling for CT testing were sent to the laboratories in 18 of 21 counties. Four laboratories were also asked to provide data on testing patterns at the individual level for the years 2013–2017.

Results The proportion of self-sampling increased gradually from 2013, comprising 22.0% of all CT tests in Sweden in 2017. In an analysis of 14 counties (representing 83% of the population), self-sampling increased by 115% between 2013 and 2017 for women, compared with 71% for men, while test volumes for clinic-based sampling were fairly constant for both sexes (1.8% increase for women, 15% increase for men). In 2017 self-sampling accounted for 20.3% of all detected CT cases, and the detection rate was higher than, but similar to, clinic-based testing (5.5% vs 5.1%). The proportion of self-sampling men was also higher, but similar (33.7% vs 30.8%). Analysis of individual testing patterns in four counties over 5 years showed a higher proportion of men using self-sampling only (67%, n=10 533) compared with women (40%, n=8885).

Conclusions Self-sampling has increased substantially in recent years, especially among women. This service is at least as beneficial as clinic-based screening for detection of CT, and self-sampling reaches men more than clinic-based testing.

Let’s Celebrate Safer Sex this National Condom Day (SHINE SA Media Release)

SHINE SA, 11 February 2020

Forget Valentine’s Day, there’s a new romantic day occupying February 14: National Condom Day! With only 36% of young South Australians always using a condom during casual sex, it’s no surprise that STI rates are on the rise. Like an elusive Valentine’s partner, many STIs are hidden. Around 70% of people with chlamydia have no symptoms, going unnoticed while being transmitted to others.

So what could be more romantic than preventing the unintended consequences of unprotected sex? Show some romance by taking advantage of how easy it is to get your hands on a condom. Condoms are widely available, don’t require a prescription and can even be found for free at SHINE SA clinics. SHINE SA encourages all young people to take steps to engage in safer sex. This means always having a condom handy, making time for that discussion with your partner/s, ensuring you have informed and enthusiastic consent and getting regular sexual health checks either through a GP or at a SHINE SA clinic.

Natasha Miliotis SHINE SA’s Chief Executive said:

“National Condom Day is a great reminder to take control of our own sexual health. Through the use of condoms and regular testing, STIs are preventable.”

For more information on the sexual health of young people in South Australia see: www.sahmri.org/aboriginal-health-equity-theme/news-270/

Want to learn more about safer sex? To mark National Condom Day SHINE SA have released the Safer Sex – Use a Condom campaign. The campaign highlights the importance of condoms and the concepts of safety, pleasure and respect for a safer sex life. View the campaign here: www.shinesa.org.au/safersex

For further information and media enquiries see media release for contacts:

 

Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility

Clinical Infectious Diseases, ciz429, https://doi.org/10.1093/cid/ciz429
Published: 24 August 2019

Abstract

Background

We evaluated the risk of pelvic inflammatory disease (PID), ectopic pregnancy, and infertility in women with a previous Chlamydia trachomatis (CT) diagnosis compared with women who tested negative for CT and CT untested women, considering both targeted and incidental (ie, prescribed for another indication) use of CT-effective antibiotics.

Methods

This was a retrospective study of women aged 12–25 years at start of follow-up within the Clinical Practice Research Datalink GOLD database linked to index of multiple deprivation quintiles, 2000–2013. CT test status and antibiotic use were determined in a time-dependent manner. Risk of PID, ectopic pregnancy, or female infertility were evaluated using of Cox proportional hazard models.

Results

We studied 857 324 women, contributing 6 457 060 person-years. Compared with women who tested CT-negative, women who tested CT-positive had an increased risk of PID (adjusted hazard ratio [aHR], 2.36; 95% confidence interval [CI], 2.01–2.79), ectopic pregnancy (aHR, 1.87; 95% CI, 1.38–2.54), and infertility (aHR, 1.85; 95% CI, 1.27–2.68). The PID risk was higher for women with 2 or more positive CT tests than those with 1 positive test. PID risk increased with the number of previous antibiotic prescriptions, regardless of CT test status.

Conclusions

We showed an association between CT-positive tests and 3 adverse reproductive health outcomes. Moreover, this risk increased with repeat CT infections. CT-effective antibiotic use showed no decreased risks of subsequent PID regardless of CT history. Our results confirm the reproductive health burden of CT, which requires adequate public health interventions.

STI/BBV testing tool for asymptomatic people

NSW STI Programs Unit, ASHM & Qld. Govt.,  2019

This resource has charts and information about how routine STI/BBV testing can be offered, who to, and how to follow up.

Developed by NSW STI Programs Unit, NSW Australia, and reproduced with permission by the Sunshine Coast Hospital and Health Service, ASHM and Communicable Diseases Branch.

 

 

STIs among transgender men and women attending Australian sexual health clinics

Med J Aust. 2019 Aug 29. doi: 10.5694/mja2.50322. [Epub ahead of print]

Abstract

Objectives

To estimate rates of HIV infection, chlamydia, gonorrhoea, and infectious syphilis in transgender men and women in Australia; to compare these rates with those for cisgender people.

Design

Cross‐sectional, comparative analysis of de‐identified health data.

Setting, participants

We analysed data for 1260 transgender people (404 men, 492 women, 364 unrecorded gender), 78 108 cisgender gay and bisexual men, and 309 740 cisgender heterosexual people who attended 46 sexual health clinics across Australia during 2010–2017.

Main outcome measures

First‐visit test positivity for sexually transmitted infections (STIs), stratified by patient group and year; demographic and behavioural factors associated with having STIs.

Results

14 of 233 transgender men (6.0%) and 34 of 326 transgender women (10%) tested during first clinic visits were chlamydia‐positive; nine transgender men (4%) and 28 transgender women (8.6%) were gonorrhoea‐positive. One of 210 tested transgender men (0.5%) and ten of 324 tested transgender women (3.1%) were diagnosed with infectious syphilis; 14 transgender men (3.5%) and 28 transgender women (5.7%) were HIV‐positive at their first visit. The only significant change in prevalence of an STI among transgender patients during the study period was the increased rate of gonorrhoea among transgender women (from 3.1% to 9.8%). Compared with cisgender gay and bisexual men, transgender men were less likely (adjusted odds ratio [aOR], 0.46; 95% CI, 0.29–0.71; P = 0.001) and transgender women as likely (aOR, 0.98; 95% CI, 0.73–1.32; P = 0.92) to be diagnosed with a bacterial STI; compared with heterosexual patients, transgender men were as likely (aOR, 0.72; 95% CI, 0.46–1.13; P = 0.16) and transgender women more likely (aOR, 1.56; 95% CI, 1.16–2.10; P = 0.003) to receive a first‐visit bacterial STI diagnosis.

Conclusions

The epidemiology of STIs in transgender people attending Australian sexual health clinics differs from that of cisgender patients. Gender details must be captured by health data systems to facilitate appropriate delivery of sexual health care.