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‘Get asymptomatic testing’: STI test push amid rising cases
Testing rates continue to stagnate despite the spike, leaving some to question whether GPs are comfortable discussing the topic.
Gonorrhoea rates from the past three months are 33% higher than the historical five-year mean.
Data and research across the board has shown rising rates of sexually transmitted infections (STIs) in Australia over the past decade, but there are new concerns that testing is not keeping up with cases.
The latest available reporting from the University of New South Wales’ Kirby Institute shows there has been a decrease in testing compared to pre-pandemic levels, despite increases in new chlamydia, gonorrhoea, and infectious syphilis diagnoses.
‘This highlights a need for greater testing coverage and for testing to be routinely offered,’ its report reads.
The rate of infectious syphilis notifications has more than tripled since 2013, from 7.6 to 24.3 per 100,000 as of 2022.
Between 2013 and 2022 the infectious syphilis notification rate among females increased almost six‑fold from 1.3 to 8.8 per 100,000.
The cases reported are rising even amongst the decrease in testing, the Kirby Institute says.
Behavioural researcher Dr Margaret Heffernan said people are not getting tested as Australians are ‘a society of prudes in our attitudes towards sexual activity’.
‘Whilst perceiving ourselves to be sexually liberated, individuals are compromised and stigmatised by sexually transmitted infections,’ she said.
‘Despite calls for sexual education programs, the sporadic implementation of education and the trivialisation of sexual values through the media indicate the topic is taboo, resulting in embarrassment, shame and judgment for individuals who acquire an STI.
‘Not all GPs, parents and teachers are adequately trained or feel comfortable in discussing sexual health.’
Chair of RACGP Specific Interests – Sexual Health Medicine Dr Sara Whitburn told newsGP she does not believe this is because GPs are not doing enough.
‘But it is about encouraging more people in the community to get asymptomatic testing for their own sexual health,’ she said.
‘It is important that we encourage people to consider their sexual health risk and access testing even when they don’t have symptoms if they are at increased risk for STIs.’
The latest fortnightly report from the National Notifiable Diseases Surveillance System (NNDSS) leads with the current syphilis response, in which ‘priority public health actions’ are being taken.
‘Including those related to workforce and community engagement, to ensure progress is made towards reducing the incidence of syphilis and elimination of congenital syphilis in Australia,’ it reads.
It also states that in the past year, there have been 44,215 reported cases of gonorrhoea, which is higher than the historical five-year mean.
Additionally, in the past three months, there have been 10,918 cases reported, which is 33% higher than the historical five-year mean.
Increases in antimicrobial resistance in gonococcal isolates have also been reported.
Dr Whitburn said the rise in STIs could be attributed to several causes:
- social distancing decreasing and more people are being sexually active with more contact
- condom use has decreased, likely impacted by lack of sexual education during the pandemic
- people not practicing safer sex after being in a past, long-term relationships
- using contraception that does not protect against STIs
Dr Heffernan said the decreasing rates in testing levels can be partially explained by system and socio-cultural factors.
‘Many STIs are asymptomatic, leading to lack of early diagnosis and treatment,’ she said.
‘Accessibility to and affordability of healthcare clinics has seen many clinics move from bulk-billing to fee-for-service, despite the STI test being either free or low-cost.
‘With cost-of-living demands on discretionary income expenditure, increasingly, daily living expenses are prioritised at the expense of health care expenditure.’
Dr Whitburn said GPs should test patients whenever asked, and routinely, even when patients are asymptomatic.
‘STI screening can also be offered at contraceptive consults when offering cervical screening tests and when people are presenting for general health checks,’ she said.
‘The RACGP Red Book and
the Australian STI guidelines are great resources in advising who needs STI screening routinely and how to provide STI screening and treatment.’
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chlamydia sexual health sexually transmissible infections STIs syphilis testing
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