Gonorrhoea is on the Rise, but No-One Really Knows Why
Health authorities are urging people to have regular tests for sexually transmitted infections (STIs) as new data shows gonorrhoea and syphilis on the rise in Australia, and a gap opening between Indigenous and non-Indigenous Australians when it comes to HIV.
The Kirby Institute at the University of New South Wales has released its annual surveillance report on STIs.
It shows that in the past five years, cases of gonorrhoea have increased by 63 per cent, and especially in urban areas.
“Up until recently, gonorrhoea had been uncommon for young heterosexual people living in the major cities,” the institute’s Rebecca Guy said.
The highest rates are in people aged 15-24, but the greatest increase has been in the 25–40 age bracket.
Dr Guy said it was not known why the rise has occurred but it was not due to more testing.
She said there was no data to suggest that fewer people were using condoms or more people were having casual sex due to dating apps.
The ABC also approached Family Planning New South Wales and the youth sexual health service Yeah but they also said they didn’t know why gonorrhoea was on the rise.
“The data which is available from sexual behaviour surveys were conducted a number of years ago so they haven’t been collected in the last few years when that change has occurred,” Dr Guy said.
“There’s some surveys planned next year so they I think will be telling.”
Health authorities recently reported an increase in treatment-resistant gonorrhoea but Dr Guy said that had not contributed to the rise.
She said gonorrhoea was easily cured by antibiotics but if left untreated it could lead to pelvic inflammatory disease or infertility.
Dr Guy said the problem was most people wouldn’t have any symptoms, so may never know they have the infection.
“Therefore raising awareness is important about going to have a test, getting partners to have a test and treatment, and also using condoms,” she said.
Gap Widening When it Comes to HIV
The report shows that HIV diagnoses increased by 33 per cent among Aboriginal and Torres Strait Islander communities, while falling 22 per cent for the non-Indigenous population.
“Over the last 30 years or so, rates of diagnoses of HIV have been very similar to non-Aboriginal populations. Right now, and over the last five years, the rate has doubled,” said James Ward, an associate professor from the South Australian Health and Medical Research Institute.
“We’re actually calling for greater political action around HIV in Aboriginal and Torres Strait Islander communities because we’re really at a point when it could tip into an endemic state.
“That would be a real shame in Australia in 2017 because we have all the tools necessary to stop it. We’re creating a gap that should not be necessary.”
He said that was because over the past five years gay Australian men have been getting treatment for HIV or using PrEP — a drug taken daily to prevent HIV.
Dr Ward said these interventions had not been well adopted by Indigenous communities, which also had greater proportions of diagnoses due to injecting drug use and heterosexual sex.
“We have two very different populations affected in the Aboriginal and Torres Strait Islander communities — pretty much half and half heterosexual and gay men,” he said.
“And within the heterosexual population we’ve got people who inject drugs at a higher proportion than non-Aboriginal people.
“So there are very few strategies for women and we haven’t got the strategies right for people who inject drugs.”
Syphilis ‘Should Never Happen in a Developed Nation’
Dr Ward said cases of syphilis increased by about 200 per cent among young heterosexual Indigenous people living in remote areas of Queensland, the NT, the north-west of WA and SA over the past five years.
He said that all started from one outbreak in 2011.
“There was a lack of a rapid response to that outbreak,” he said.
“The response was delayed even further because at the time public health services in remote and regional Queensland were being dismantled by the government in Queensland at the time, the Campbell Newman government.”
He said health departments were trying to keep track of the disease, that a major awareness campaign was underway, and clinicians were being urged to test people — but there was a long way to go.
“The really big problem with infectious syphilis is that since this outbreak began in 2011 there’ve been five babies lost to congenital syphilis and that should never happen in a developed nation like Australia,” Dr Ward said.
But Here’s Some Good News
While chlamydia is still the most common STI in Australia, Dr Guy said the rate of that infection had remained stable over the past five years.
Between March and December 2016 an estimated 30,343 people were cured of hepatitis C due to a new direct-acting antiviral therapy, which became universally available in Australia last year.
“So, really encouragingly in this first sort of period where we’ve seen greater uptake of treatment, there’s also been for the first time reductions in some of those poor health outcomes such as liver disease,” Dr Guy said.