Changing Epidemiology of Gonorrhea in Adelaide, South Australia

Ellis SL, Tsourtos G, Waddell R, Woodman R, Miller ER.

Changing Epidemiology of Gonorrhea in Adelaide, South Australia.

Sex Transm Dis. 2020 Jun;47(6):402-408. doi: 10.1097/OLQ.0000000000001162.

Abstract

Background: Gonorrhea is a significant public health concern. The changing epidemiology of gonorrhea in Australia has highlighted the need for detailed examination of surveillance data to determine population groups at greatest risk for infection.

Methods: We analyzed deidentified gonorrhea notification data for the years 2012 to 2017, in Adelaide (N = 3680), calculating age-adjusted notification and antibiotic resistance rates. Age, gender, year, sexual orientation, and socioeconomic status were assessed for associations with gonorrhea notifications using negative binomial, log binomial and spatial autoregressive models. Maps were generated to examine spatial localization of gonorrhea rates in Adelaide.

Results: Gonorrhea notification rates in Adelaide increased annually, with a 153% adjusted increase in rates from 2012 to 2017, localized to specific areas and inversely associated with income levels. The increase in rates in 2016 and 2017 was associated with young heterosexuals from low income areas. Azithromycin-resistant notifications increased significantly in 2016 in young heterosexuals. Reinfections were significantly more likely in men who have sex with men than other population groups.

Conclusions: This study demonstrates the changing epidemiology of gonorrhea in Adelaide from a largely men who have sex with men profile toward an increase in young heterosexual gonorrhea. This could be seen as a harbinger for future increases in heterosexually transmitted HIV and other sexually transmitted infections in Australia.

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Intersex people and COVID-19

Intersex Human Rights Australia, 12 April 2020

COVID-19 can infect any individual, irrespective of age or health but its impact exacerbates existing inequalities. All populations that suffer health inequalities are disproportionately affected, and people with intersex variations are no exception.

Current health is determined to some extent by biological factors.

Sexual health and its linkages to reproductive health: an operational approach

 World Health Organization, 2017

Sexual health and reproductive health are closely linked, but crucial aspects of sexual health can be overlooked when grouped under or together with the domain of reproductive health.

In order to create broader awareness of comprehensive sexual health interventions and to ensure that sexual health and reproductive health both receive full attention in programming (including provision of health services) and research, the World Health Organization (WHO) has reviewed its working definition of sexual health to create a framework for an operational approach to sexual health.

The framework, which is intended to support policy-makers and programme implementers and to provide a stronger foundation for further research and learning in sexual health, is presented and described in full in this brief.

Australia’s health 2018 (Report)

Australian Institute of Health and Welfare,  Release Date: 

 

Australia’s Health 2018 is the AIHW’s 16th biennial report on the health of Australians. It examines a wide range of contemporary topics in a series of analytical feature articles and short statistical snapshots.

The report also summarises the performance of the health system against an agreed set of indicators.

Australia’s health 2018: in brief is a companion report to Australia’s health 2018.

Table of contents:

Whole report:

PDF Report (17.3Mb)

Australia’s health 2018 in brief:

Companion ‘in brief’ booklet presents highlights in a compact easy-to-use format.

 

Sexual activity and sexual health among young adults with/without intellectual disability

BMC Public Health 201818:667

https://doi.org/10.1186/s12889-018-5572-9

Abstract

Background

There is widespread concern about the sexual ‘vulnerability’ of young people with intellectual disabilities, but little evidence relating to sexual activity and sexual health.

Method

This paper describes a secondary analysis of the nationally representative longitudinal Next Steps study (formerly the Longitudinal Survey of Young People in England), investigating sexual activity and sexual health amongst young people with mild/moderate intellectual disabilities. This analysis investigated family socio-economic position, young person socio-economic position, household composition, area deprivation, peer victimisation, friendships, sexual activity, unsafe sex, STIs, pregnancy outcomes and parenting.

Results

Most young people with mild/moderate intellectual disabilities have had sexual intercourse by age 19/20, although young women were less likely to have sex prior to 16 than their peers and both men and women with intellectual disabilities were more likely to have unsafe sex 50% or more of the time than their peers. Women with intellectual disabilities were likely to have been pregnant and more likely to be a mother.

Conclusion

Most young people with mild/moderate intellectual disabilities have sex and are more likely to have unsafe sex than their peers. Education and health services need to operate on the assumption that most young people with mild/moderate intellectual disabilities will have sex.

Media release from SHINE SA: Teen Pregnancy

SHINE SA, Issued: 25 May 2018

Following the release of the Australian Institute of Health and Wellbeing’s Report, that includes the latest figures on teen birth-rates, SHINE SA believes that a decrease in the teen birth-rate as indicated in the report, is a positive outcome from the study.

“A decrease may reflect better sexual health information for young people including education in schools, and better access to sexual health services”, said Dr Amy Moten, Coordinator, Medical Education at SHINE SA.

“Increased access to Long Acting reversible Contraception for young people, as promoted by Family Planning Alliance Australia, is also a significant factor in reducing teen pregnancy rates”, Dr Moten said.

Low socio-economic status can be a marker of poor health outcomes overall. This increases with remoteness from metropolitan areas and Indigenous status. This has been shown in previous studies and also is supported by national data regarding cervical screening that shows that low socio-economic and Indigenous status reduces the rate of screening compared to people from a higher socioeconomic areas.

Social determinants of health are linked to social and economic factors that influence health. Young people from a lower socioeconomic area are likely to have poorer health literacy, lower levels of education and poorer access to health services including contraception. These have all been shown to be linked to an increased birth rate over all ages. Barriers to access health and contraceptive services such as cost and availability of these services increase with distance from metropolitan areas.

“Generally, teen mums often face increased stigma about being a parent and should be supported in their decision to continue parenting”, Dr Moten said.

“At SHINE SA, we provide pregnancy testing, counselling and advice. When a young person is pregnant they can discuss their options and be referred to appropriate services. For a young person continuing to parent we would refer them to the Metropolitan Youth Health Service for example, which has a Young Parenting program”, Dr Moten said.

SHINE SA believes that young mums should be supported to continue their education as completing secondary school after pregnancy has been shown to improve long term outcomes in both mother and child.

Dr Amy Moten, Coordinator Medical Education, SHINE SA
Issued: 25 May 2018