Surge In STIs Across Australia Sparks Concerns Over Testing Decline
A new report from the Kirby Institute at UNSW Sydney reveals a concerning surge in sexually transmitted infections (STIs) across Australia, with diagnoses of gonorrhoea doubling and syphilis tripling over the past decade.
Chlamydia, too, has seen a 12% increase since 2013, and researchers are worried that the decline in testing, exacerbated by the COVID-19 pandemic, may contribute to a continuation of these upward trends.
Epidemiologist Dr. Skye McGregor, who led the report, expressed concern about the simultaneous rise in STIs and reduced testing. “Any rise in STIs is bad news, but rising STIs against a backdrop of decreased testing, and the persistent upward trend over the past decade, is particularly concerning,” said Dr. McGregor.
Gonorrhoea And Syphilis Among Gay Men
Gonorrhoea (71 per cent) and syphilis (82 per cent) were most common in men, particularly among gay, bisexual and men who have sex with other men.
鈥淲hen we look closely at the data, most gonorrhoea diagnoses are among gay and bisexual men. Alongside encouraging regular testing, this prompts us to investigate emerging prevention approaches, such as vaccination,鈥� Dr McGregor said.
鈥淲e infer an increase in STIs among gay and bisexual men by analysing the diagnoses by sex and seeing disproportionate numbers among men compared to women,鈥� said Professor Andrew Grulich, head of the HIV Epidemiology and Prevention program at the Kirby Institute.
鈥淚t is likely that these increases can be explained by more comprehensive screening and greater availability and awareness of highly effective HIV prevention strategies and in turn a decrease in the use of condoms and greater sexual mixing.鈥�
鈥淏ut we know how effective health promotion can be in this community, as we have seen with the huge reductions in HIV. We need to carry over these learnings to STIs, to drive down infections in this group,鈥� said Grulich.聽
Syphilis Among Women
The decline in Medicare-rebated tests for chlamydia and gonorrhoea from 2019 to 2022 is attributed to the ongoing impacts of the COVID-19 pandemic. Dr. McGregor emphasised the need for increased awareness, stating, “Chlamydia, gonorrhoea, and syphilis are all easily treatable with antibiotics. The key message we want Australians to take away from these data is that for any sexually active person, condoms remain highly effective at preventing STIs, and regular STI testing is crucial.”
In 2022 alone, there were 93,777 diagnoses of chlamydia, 32,877 diagnoses of gonorrhoea, and 6,036 diagnoses of infectious syphilis.聽
Of particular concern was the tripling of syphilis cases over the past decade, with a six-fold increase in female diagnoses. Dr. McGregor highlighted the risks associated with syphilis in pregnancy, including miscarriage, stillbirth, and congenital syphilis, which can have severe and even fatal consequences for infants.
Aboriginal and Torres Strait Islander Communities
The report detailed 15 cases of congenital syphilis in 2022, with eight occurring among Aboriginal and Torres Strait Islander peoples.聽
The report also highlighted the prevalence of undiagnosed and untreated chlamydia cases, reinforcing the need for increased testing. Dr. McGregor urged sexually active individuals to consult healthcare professionals regularly, emphasizing the simplicity of testing procedures for chlamydia and gonorrhoea.
Aboriginal and Torres Strait Islander peoples continued to experience significantly higher rates of STIs in 2022, with disparities more pronounced in regional and remote communities. 鈥淎boriginal and Torres Strait Islander peoples are diagnosed with chlamydia two times more frequently than non-Indigenous people. For gonorrhoea and syphilis, the rate is more than five times as high. These disparities are even more significant in regional and remote communities,” said Robert Monaghan, Manager of Aboriginal and Torres Strait Islander Health Research at the Kirby Institute.聽
鈥淭his highlights an urgent need for culturally appropriate health promotion, testing, and treatment strategies. It is crucial that these are co-designed with Aboriginal and Torres Strait Islander peoples,” said 惭辞苍补驳丑补苍.听
Dr. McGregor acknowledged the importance of exploring emerging prevention approaches, such as vaccination, to curb the rising trends.
Australia has seen success in eliminating genital warts through the HPV vaccination program, with negligible diagnoses among the target population. Additionally, donovanosis, once prevalent in remote Aboriginal communities, appears to have been eliminated.
