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Low HIV testing rates among people with a sexually transmissible infection diagnosis in remote Aboriginal communities

James S Ward, Amalie Dyda, Skye McGregor, Alice Rumbold, Linda Garton, Basil Donovan, John M Kaldor and Rebecca J Guy
Med J Aust 2016; 205 (4): 168-171. || doi: 10.5694/mja15.01392

Summary

Objective: To determine the rates of HIV testing among people who had received positive test results for chlamydia, gonorrhoea and trichomoniasis, or who had been tested for syphilis.

Design, setting and participants: Pathology data for the period January 2010 – December 2014 from 65 remote Aboriginal communities participating in the STRIVE trial of sexually transmissible infection (STI) control were analysed.

Main outcome measures: Rates of HIV testing within 30 and 90 days of an STI test (for chlamydia, gonorrhoea or trichomoniasis), the result of which was positive, and within 30 days of a test for syphilis; factors independently associated with concurrent HIV testing.

Results: 31.8% of 15 260 positive STI test results were linked with an HIV test within 30 days of the test (including 5.6% not on the same day), and 34.8% within 90 days; 44.1% were linked with syphilis testing within 30 days. 53.4% of all those tested for syphilis were also tested for HIV within 30 days. Multivariate analysis found that HIV testing was more likely for men, in geographical regions 3 and 4, in association with positive STI test results during 2012, 2013 or 2014 (v 2010), and in association with positive test results for gonorrhoea or chlamydia. Similar associations with these factors were found for syphilis testing.

Conclusions: A significant challenge in Aboriginal health is avoiding an increase in the number of HIV infections. One critical intervention in this regard is timely and appropriate testing. Adhering to screening recommendations is clearly an aspect of the delivery of sexual health services to remote communities that can be improved in striving to achieve this aim.

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  • James S Ward1
  • Amalie Dyda2
  • Skye McGregor2
  • Alice Rumbold3,4
  • Linda Garton5
  • Basil Donovan2
  • John M Kaldor2
  • Rebecca J Guy2

  • 1 South Australian Health and Medical Research Institute, Adelaide, SA
  • 2 Kirby Institute, University of New South Wales, Sydney, NSW
  • 3 Robinson Research Institute, The University of Adelaide, Adelaide, SA
  • 4 Menzies School of Health Research, Charles Darwin University, Brisbane, QLD
  • 5 Northern Territory Department of Health, Darwin, NT

Correspondence: james.ward@sahmri.com

Acknowledgements: 

STRIVE is a collaboration between the researchers named in the authorship list, conducted in partnership with the Northern Territory Department of Health, the Aboriginal Medical Services Alliance of the Northern Territory, Apunipima Cape York Health Council, Kimberley Aboriginal Medical Services Council, and the WA Country Health Service. Our collaborators include the STRIVE investigators Handan Wand, Janet Knox, Christopher K Fairley, Debbie Taylor-Thompson, Belinda Hengel, Lisa Maher, Bronwyn Silver, Donna Ah Chee, John Boffa, David Glance, Mathew Law, Robyn McDermott and Steven Skov. The study would not have been possible without the commitment of all participating health services and their staff and the ongoing support and advice from our partners. We acknowledge the important contributions of the STRIVE Executive Committee. The authors are grateful to Western Diagnostic Pathology, Pathwest Laboratory Medicine WA, SA Pathology, and Queensland Health Pathology and Scientific Services, and their staff, who undertook testing for sexually transmitted infections on behalf of the participating health services and provided the anonymous line record data that formed the basis for our analyses. STRIVE was funded by an NHMRC Project Grant (566806).

Competing interests:

No relevant disclosures.

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