Feature
Sexual health education for Aboriginal and Torres Strait Islander peoples
In the fifth part of a series focusing on the coming third edition of the ‘National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people’, newsGP looks at Aboriginal and Torres Strait Islander peoples’ sexual health and prevention from blood-borne viruses.
Sexually transmitted infection (STI) and blood-borne virus (BBV) rates within Aboriginal and Torres Strait Islander populations can often be difficult to identify and diagnose, due to certain cultural beliefs and a potential lack of access to appropriate healthcare in remote areas. But education and culturally appropriate primary healthcare play an essential role in helping to increase diagnosis these communities
The National Aboriginal Community Controlled Health Organisation’s (NACCHO) and the RACGP’s National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (National Guide) states that the prevalence and incidence of some STIs can also be challenging to estimate accurately due to under-identification of Aboriginal and/or Torres Strait Islander status, but that rates are increasing.
The National Guide advocates for interventions by healthcare professionals to help decrease rates of STIs and BBVs in Aboriginal and Torres Strait Islander communities. Routine screening, education on and accessibility of condoms, hepatitis B and human papillomavirus (HPV) immunisation programs, and needle and syringe exchange programs, can all contribute to early diagnoses and prevention of STIs and BBVs, as well as appropriate management for those diagnosed with infection.
Aboriginal and Torres Strait Islander people are over-represented in prison populations and have high rates of receptive sharing of syringes, both risk factors for acquiring hepatitis C. As a consequence, the hepatitis C notification rate among Aboriginal and Torres Strait Islander people has increased by more than 20% between 2012–16, while remaining stable in non-Indigenous Australians. With new, effective treatments now available for hepatitis C, eliminating the stigma associated with the infection is a crucial strategy.
Recent research reveals that gonorrhoea notifications are seven times more common among Aboriginal and Torres Strait Islander people than for non-Indigenous Australians. The chlamydia notification rate in major cities was found to be nearly three times as high among Aboriginal and Torres Strait Islander people than non-Indigenous Australians, increasing to five times higher in remote areas. In addition, rates of syphilis are again increasing in Aboriginal and Torres Strait Islander communities, after declining up to 2010.
The National Guide reports that rates of HIV were more than two times higher for Aboriginal and Torres Strait Islander peoples than for non-Indigenous Australians in 2015, and that infectious syphilis notifications have increased significantly due to a 2015 outbreak in Far North Queensland. Current syphilis infection in northern Australia is considered ‘out of control’ in Aboriginal and Torres Strait Islander healthcare organisations.
One example of safe-sex education is the Condom tree program in Western Australia, which aims to reduce cost barriers and feelings of shame and embarrassment by providing free condoms in local communities.
The Department of Health recently released a series of videos voiced by Aboriginal and Torres Strait Islander people to help promote STI prevention in their communities. Initiatives such as these videos are designed to help reduce feelings of shame or stigma Aboriginal and Torres Strait Islander people may have attached to STIs and/or BBVs.
A diverse range of support for Aboriginal and Torres Strait Islander peoples and healthcare workers, including a comprehensive HIV resource, is available for communities throughout Australia.
The National Guide details more resources, with the aim of empowering Aboriginal and Torres Strait Islander communities through greater levels of sexual health education and the provision of high-quality culturally appropriate primary care.
The National Guide covers further information on sexual health in the following chapters:
- Sexual health and blood-borne viruses
- Antenatal care
- The health of young people
- Alcohol
- Family abuse and violence
Aboriginal-and-Torres-Strait-Islander-health national-guide sexual-health
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