Dr Skye McGregor, Epidemiologist, and Robert Monaghan, Epidemiologist, The Kirby Institute.

There has been considerable success in the prevention and control of certain blood borne viruses (BBV) and sexually transmissible infections (STI) among Aboriginal and Torres Strait Islander peoples in Australia in recent years. Genital warts diagnoses have declined substantially among Aboriginal and Torres Strait Islander peoples, since introduction of the HPV vaccination program in 2007. New diagnoses of genital warts in young Aboriginal and Torres Strait Islander women aged <21 years, declined from 5.0% in 2006 to 0.0% in 2021. In young men, new diagnoses declined from 3.7% in 2006 to 0.7% in 2021. Ongoing high vaccine coverage is crucial to ensure cervical cancer diagnoses also decline. Low numbers of hepatitis B notifications among Aboriginal and Torres Strait Islander peoples also indicates the success of Australian vaccination programs. After a peak of 47 new HIV notifications in 2016, there were 17 new cases reported in both 2021, and 2022. However, these numbers need to be considered in the context of interruptions to health care due to COVID-19. Enhanced public health efforts need to be continued to ensure low rates of HIV can be sustained and national goals of elimination of HIV transmission achieved.

In contrast, rates of chlamydia, gonorrhoea, and syphilis remain high or continue to increase among Aboriginal and Torres Strait Islander peoples. In 2021, rates of these infections were 3, 5, and 6 times higher than the non-Indigenous population, with substantial increases in rates in regional and remote settings. The data on the number of gonorrhoea and infectious syphilis notifications in males compared to females, suggest that new cases of these infections among Aboriginal and/or Torres Strait Islander communities are more commonly due to heterosexual contact, compared to the non-Indigenous population, where transmission through male-to-male sexual contact is likely more common. Infectious syphilis among Aboriginal and Torres Strait Islander communities is particularly concerning, with rates almost tripling between 2012 and 2021. The increase in infectious syphilis has also seen an associated rise in congenital syphilis cases. In 2021, there were 9 congenital syphilis cases reported as Aboriginal and/or Torres Strait Islander, 60% of all cases. Congenital syphilis has potential life-long implications for individuals and communities, and public health responses need to consider the complex set of factors that contribute to cases. Regular and comprehensive STI testing is crucial to address all of these infections.

The Blood borne viral (BBV) and sexually transmissible infections (STI) in Aboriginal and Torres Strait Islander peoples: Annual surveillance report is published annually by the Kirby Institute, UNSW Sydney and aims to stimulate and support discussions on ways to minimise the risk of transmission of these infections as well as the personal and social impacts within Aboriginal and Torres Strait Islander communities. The full report and accompanying data can be found at https://kirby.unsw.edu.au/sites/default/files/kirby/report/KI_Aboriginal-and-Torres-Strait-Islander-ASR-2022.pdf.

Published: May 2023