Less knowledge, more testing at core of STI increase

Less condom use, less sex education during the COVID years and increased testing have all combined to create a surge in the number of sexually transmissible infections (STIs) being reported in Australia, says an RACGP sexual health expert.
 
An ABC report on the increase, using data from the Department of Health and Aged Care, showed significant increases in the number of STI notifications received over the past two decades.
 
Chlamydia remains the most prevalent STI. In the 20 years from 2004–24, cases of chlamydia more than tripled, from almost 36,000 cases to more than 102,000.
 
The comparative rises in gonorrhoea and syphilis cases were even greater across the same period. Gonorrhoea cases increased more than six-fold, from just over 7000 to more than 44,000, while syphilis numbers grew almost ten-fold, from just over 600 to almost 6000.
 
Chair of RACGP Specific Interests Sexual Health Medicine, Dr Sara Whitburn, said while chlamydia was ‘very common’, innovations in testing, such as self-tests, had supported the increase in positive results.
 
‘I think it’s a combination of testing, but also maybe people are using condoms less, both through perhaps having had their sexual education interrupted during the COVID years, and also not understanding that information about blood-borne viruses is also good information for sexually transmitted infections,’ Dr Whitburn told newsGP.
 
She suggests condom use may be changing because of the availability of other STI prevention methods, including pre-exposure medications such as chemoprophylaxis, proprophylaxis (PrEP), and post-sex antibiotics such as doxy-PEP.
 
However, she said the message that PrEP – used to help prevent HIV transmission – did not offer protection from other STIs was often ‘missing in sexual health education for young people’ due to COVID.
 
Dr Whitburn said the increased media attention around sexual health, such as the ABC report and the Federal Government’s response earlier this year to the 2023 Senate inquiry into sexual, maternity and reproductive healthcare, were all important in ‘pushing more discussion’ around the topic.
 
‘And GPs can certainly part of that,’ she said.
 
‘I do think sexual health is part of good health, and I do think it’s a core part of general practice.
 
‘GPs have good communication skills. We often have to ask about sensitive information for other types of health histories, so we’ve got the skills to ask these kinds of questions.’
 
Dr Whitburn said GPs were well placed to offer ‘opportunistic’ sexual health testing, but that they needed more time to take a patient’s sexual health history.
 
‘It does take time to do a full sexual health history,’ she said. ‘I do support opportunistic testing –that short discussion of asymptomatic testing, “while you’re here, it’s as easy as doing a wee or a self-taken swab”.
 
‘But it’s about supporting GPs to be able to have the time to have the conversations around sexual health and talk about testing and the impact of STIs.
 
‘We know access and cost are barriers to people coming and seeing their GP. However, GPs are a really important part of sexual healthcare.
 
‘The more support we can have to improve access and decrease costs, the better for people to come and talk to us.’
 
Log in below to join the conversation.
 
 

chlamydia general practice gonorrhoea sexual health STI STIs syphilis