Community and clinic-based screening for curable sexually transmissible infections in a high prevalence setting in Australia

a retrospective longitudinal analysis of clinical service data from 2006 to 2009

Bronwyn Silver*, John M. Kaldor, Alice Rumbold, James Ward, Kirsty Smith, Amalie Dyda, Nathan Ryder, Teem-Wing Yip, Jiunn-Yih Su, Rebecca J. Guy

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: In response to the high prevalence of sexually transmissible infections (STIs) in many central Australian Aboriginal communities, a community-wide screening program was implemented to supplement routine primary health care (PHC) clinic testing. The uptake and outcomes of these two approaches were compared. Methods: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) community and clinic screening data for Aboriginal people aged 15-34 years, 2006-2009, were used. Regression analyses assessed predictors of the first test occurring in the community screen, positivity and repeat testing. Results: A total of 2792 individuals had 9402 tests (median: four per person) over 4 years. Approximately half of the individuals (54%) were tested in the community and clinic approaches combined, 29% (n≤806) in the community screen only and 18% (n≤490) in the clinic only. Having the first test in a community screen was associated with being male and being aged 15-19 years. There was no difference between community and clinic approaches in CT or NG positivity at first test. More than half (55%) of individuals had a repeat test within 2-15 months and of these, 52% accessed different approaches at each test. The only independent predictor of repeat testing was being 15-19 years. Conclusions: STI screening is an important PHC activity and the findings highlight the need for further support for clinics to reach young people. The community screen approach was shown to be a useful complementary approach; however, cost and sustainability need to be considered.

Original languageEnglish
Pages (from-to)140-147
Number of pages8
JournalSexual Health
Volume13
Issue number2
DOIs
Publication statusPublished - 2016
Externally publishedYes

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Keywords

  • Aboriginal Australians
  • chlamydia trachomatis
  • neisseria gonorrhoeae
  • screening
  • STI

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