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This article features in Episode 5 of the Australian Social Trends Podcast series. Listen to the episode, or subscribe to the series, here CONTENTS Article - Introduction - Bacterial STIs - Viral STIs - States and territories - Aboriginal and Torres Strait Islander people - Looking ahead Additional Topics - Prevention - Causes of death - STIs and travelling abroad - Sexually transmissible infections; a brief history Explanatory Information - Data sources and definitions - Endnotes CHLAMYDIA NOTIFICATIONS, AUSTRALIA - 2001 - 2011(a) ![]() Footnote(s): (a) Per 100,000 population aged 15 years and over. Source(s): National Notifiable Diseases Surveillance System ; ABS Australian Demographic Statistics, September 2011 (cat. no. 3101.0) Related terms sexually transmitted disease, std infection rate, sti infection rate, chlamydia australia, chlamydia in men, chlamydia in women, std symptoms, sti symptoms, std syphilis, std herpes, hiv in australia, hiv infection rate, hiv aids, bacterial, infection, viral, std in women, sti in women, std in men, sti in men, what is chlamydia, what is gonorrhoea, what is syphilis, what is hiv, what is genital herpes, unprotected sex, safe sex INTRODUCTION ![]() Footnote(s): (a) Per 100,000 population aged 15 years and over. Source(s): National Notifiable Diseases Surveillance System ; ABS Australian Demographic Statistics, September 2011 (cat. no. 3101.0) In 2011, more women than men were diagnosed with chlamydia, with 46,636 women aged 15 years and over diagnosed with the infection, compared with 33,197 men aged 15 years and over. Women aged between 15 and 19 years had the highest rates of diagnosis in 2011, with 2,228 per 100,000 receiving a positive diagnosis, while men aged between 20 and 24 years had the highest rate, with 1,423 per 100,000. Overall, chlamydia diagnosis for men and women aged between 15 and 29 years accounted for 82% of diagnoses for the whole population. While chlamydia notifications were more common in women than men in the younger age ranges, from the age of 30, the reverse was true. For both women and men, the rates of diagnosis for chlamydia have increased considerably over the past 10 years. Overall, the rate for women aged 15 years and over has more than tripled, from 152 per 100,000 in 2001, to 502 per 100,000 in 2011. The rate for men aged 15 years and over has also more than tripled, from 106 per 100,000 in 2001, to 366 per 100,000 in 2011. The largest increases were for women and men aged 15-19 years. For women aged 15-19 years, the notification rate increased from 569 per 100,000 in 2001, to 2,228 per 100,000 in 2011. For men, the rate increased nearly five times, from 150 per 100,000 in 2001, to 714 per 100,000 in 2011. GONORRHOEA NOTIFICATIONS, AUSTRALIA - 2011-2011 ![]() Footnote(s): (a) Per 100,000 population aged 15 years and over. Source(s): National Notifiable Diseases Surveillance System; ABS Australian Demographic Statistics, September 2011 (cat. no. 3101.0) Gonorrhoea Gonorrhoea is a bacterial infection with similar characteristics to chlamydia. Like chlamydia, gonorrhoea infects reproductive organs, can be asymptomatic and increases the chances of contracting other infections. If left untreated, gonorrhoea can also cause infertility in men and women. While antibiotics can cure gonorrhoea, drug-resistant strains are increasing in many parts of the world and successful treatment is becoming more difficult. (Endnote 2) Notification rates of gonorrhoea have generally increased over the past 10 years. In 2011, the national notification rate for people aged 15 years and over was 65 per 100,000 population, up from 40 per 100,000 in 2001. GONORRHOEA NOTIFICATIONS BY AGE - 2011(a) ![]() Footnote(s): Per 100,000 population aged 15 years and over. Source(s): National Notifiable Diseases Surveillance System; ABS Australian Demographic Statistics, September 2011 (cat. no. 3101.0) In contrast with chlamydia, more men than women were diagnosed with gonorrhoea in 2011: 8,056 men, compared with 3,789 women. Men aged 20-24 years had the highest diagnosis rate, with 213 diagnoses per 100,000, followed by 185 per 100,000 for those aged 25-29 years. For women, the highest rates of diagnosis were in the youngest age groups, with 178 and 128 diagnosed per 100,000 for those aged 15-19 years and 20-24 years respectively. Men and women aged between 15 and 34 years accounted for nearly three quarters (74%) of total gonorrhoea diagnosis. For both men and women, the rate of diagnosis has increased over the past 10 years, particularly amongst people aged 45 years and over. For men aged 45-49 years, the rate more than doubled between 2001 and 2011, from 25 per 100,000 to 66 per 100,000. Women of the same age range experienced a similar increase, from 3.4 per 100,000 to 8.6 per 100,000. SYPHILIS NOTIFICATIONS, AUSTRALIA - 2004-2011(a) ![]() Footnote(s): (a) Per 100,000 population aged 15 years and over. Source(s): National Notifiable Diseases Surveillance System; ABS Australian Demographic Statistics, September 2011 (cat. no. 3101.0) Syphilis Syphilis is a highly infectious bacterial disease, which can cause sores on the infected persons genitals, cervix and mouth. It can arise up to 10 years after the original infection, and if left untreated, can cause serious, irreversible damage to the brain, spinal cord and other organs. (Endnote 3) Syphilis typically consists of three stages: primary, secondary and the late/latent stage. In the primary and secondary stages, syphilis is highly contagious and can be asymptomatic, allowing the spread of the disease as well as its undetected progression to the latent stage. It is in the latent stage that serious complications can arise. Syphilis is rare in Australia. However, rates are increasing in some communities, including men who have sex with men and people with HIV/AIDS. (Endnote 3), (Endnote 4) While syphilis responds to penicillin, if not treated it becomes a chronic disease with a variable course and long periods of latency. In 2011, there were 1,233 new cases of syphilis which had been diagnosed within two years of contracting the infection. After peaking at 8.3 diagnoses per 100,000 population in 2007, the number of diagnoses declined to 6.2 per 100,000 in 2010. SYPHILIS NOTIFICATIONS BY AGE - 2011(a) ![]() Footnote(s): (a) Per 100,000 population aged 15 years and over. Source(s): National Notifiable Diseases Surveillance System; ABS Australian Demographic Statistics, September 2011 (cat. no. 3101.0) In 2011, men aged 15 years and over had a rate of diagnosis seven times as high as women aged 15 years and over, with 12 per 100,000 men diagnosed, compared with 1.7 per 100,000 women. For men, the age group most affected was the 40-44 year age group, with 23 per 100,000 diagnosed. The pattern of diagnosis for men with syphilis was different from other bacterial STIs, as middle aged men were the most likely to be diagnosed with syphilis. Women aged 15-19 years had a rate of diagnosis of 5.7 per 100,000, followed by 20-24 years, with 4.6 per 100,000. The notification rate for women aged 15-19 years exceeded that of men (5.7 women per 100,000, compared with 5.0 men per 100,000) and was the only age group to do so. Between 2004 and 2011, the rate of syphilis diagnosis increased for men in every age group. The most dramatic increases were for those aged 45-49 years (200%) and 55-59 years (206%). For women, the rate of diagnosis for each age group either declined or remained steady, with only three age groups showing increases: the 15-19 years age group increased by 60%, 35-39 years increased by 84% and 45-49 years increased by 129%. HIV NOTIFICATIONS, AUSTRALIA - 2002-2010(a) ![]() Footnote(s): (a) Per 100,000 population aged 13 years and over. Source(s): The Kirby Institute, HIV, viral hepatitis and sexually transmissible infections in Australia, Annual Surveillance Report 2011; ABS Australian Demographic Statistics, September 2011 (cat. no. 3101.0) VIRAL STIs HIV Human immunodeficiency virus (HIV) is a chronic retrovirus that affects the immune system. The virus suppresses the immune system and enables the onset of life-threatening infections. If left untreated, infection with HIV leads to the development of acquired immunodeficiency syndrome (AIDS), a syndrome of opportunistic infections and diseases that develops as immunosuppression deepens. (Endnote 5) HIV is spread through unprotected sex, from mother to baby during pregnancy, childbirth and breastfeeding, and sharing needles. (Endnote 5) Some people with HIV have no symptoms until the disease progresses to AIDS. (Endnote 6) Anti-retroviral drug treatment is the main type of treatment. It is not a cure, but can slow the progression of HIV to AIDS by keeping the level of HIV virus low and stopping any weakening of the immune system. (Endnote 5) In 2010, there were 1,031 new cases of HIV among men and women aged 13 years and over, or 5.5 notifications per 100,000 population. HIV NOTIFICATIONS BY AGE - 2010(a) ![]() Footnote(s): (a) Per 100,000 population aged 13 years and over. Source(s): The Kirby Institute, HIV, viral hepatitis and sexually transmissible infections in Australia, Annual Surveillance Report 2011; ABS Australian Demographic Statistics, September 2011 (cat. no. 3101.0) In 2010, men in the 30-39 year age group had the highest rate of new HIV diagnosis (18 per 100,000). While this age group has historically had the highest rate of HIV diagnosis, the rate of diagnosis has started to fall, from 22 per 100,000 in 2002 to 18 per 100,000 in 2010. Women of the same age group also had the highest rate of diagnosis, but this rate was nearly one fifth the rate for men, 3.7 per 100,000 compared with 18 per 100,000. However, the rate of diagnosis has actually increased for women aged 30-39 years, from 2.7 per 100,000 in 2002 to 3.7 per 100,000 in 2010. GENITAL HERPES, ESTIMATED PREVALENCE(a) BY AGE, AUSTRALIA - 1999-2000 ![]() Footnote(s): (a) Genital herpes is not a notificable infection. As such, the prevalence presented above is an estimation of the prevalence in Australia. Source(s): Cunningham, A. L. et al. (2006) Genital herpes Herpes simplex virus (HSV) is the virus responsible for genital herpes and cold sores. There are two types, HSV-1 and HSV-2. While both HSV-1 and HSV-2 can cause genital herpes, HSV-2 is the primary cause. Infection with HSV-2 is common; approximately 1 in 8 Australians aged 25 years and over have the virus (1 in 6 women and 1 in 12 men) (Endnote 7) and it is considered one of the most common STIs. (Endnote 8) Genital herpes is spread through skin to skin contact with an infected person and can be asymptomatic. (Endnote 9) Once infected, the virus remains in the body for life and recurrent infections or outbreaks may occur from time to time. This period of outbreak is viral shedding, when the virus is active and people are considered contagious.(Endnote 9) There is no treatment that can cure genital herpes, but antiviral medication can shorten and even suppress outbreaks. The number of notifications per annum of genital herpes is not known because it is not a notifiable infection. However, to estimate prevalence, an Australia-wide population based study was conducted using data collected between 1999 and 2000. (Endnote 7) The study found that prevalence was highest in the 35-44 year age range and women had a significantly higher prevalence than men (16% compared with 8% respectively). (Endnote 7) It has been suggested that the prevalence of HSV-2 has been associated with increasing duration of sexual activity, increasing number of lifetime sexual partners and increasing number of past infections with other STIs. (Endnote 10) It is also thought that transmission of HSV-2 occurs more readily from male to female than female to male, hence the greater prevalence of HSV-2 among women. (Endnote 10) STI NOTIFICATION RATE BY STATE AND TERRITORY - 2011(a)(b)
(b) Includes notification rates for all ages and ‘unknown’. (c) Data are for 2010. Source: National Notifiable Diseases Surveillance System; the Kirby Institute, HIV, viral hepatitis and sexually transmissible infections in Australia, Annual Surveillance Report 2011; ABS Australian Demographic Statistics, September 2011 (cat. no. 3101.0) STATES AND TERRITORIES In 2011, the Northern Territory, Queensland, Western Australia and Victoria had the highest notification rates for several STIs. For most states and territories, the notification rates for chlamydia, gonorrhoea and syphilis have increased over the past decade. Moreover, the notification rates for the Northern Territory have been much higher than the rates for Australia. In 2011, the rate for chlamydia was three times as high as the Australian rate, while the rate for gonorrhoea was 16 times as high as the Australian rate. Since collecting notifications for syphilis in 2004, the rates for the Northern Territory have been much higher than all other states and territories, reaching a peak of 71 per 100,000 in 2006, compared with 4.3 per 100,000 for Australia. Although the notification rates for syphilis are highest in the Northern Territory, the rates have been declining since 2006, falling by 80% to 13.9 per 100,000 in 2011. In 2010, rates for newly diagnosed HIV were highest in Queensland, followed by Victoria and New South Wales (5.4, 5.1 and 4.9 per 100,000 population respectively). Until 2008, New South Wales had the highest rate of newly diagnosed HIV. However, with the exception of a few years, New South Wales and the Northern Territory are the only locations where a long term decline in HIV diagnosis is evident, from 6.2 and 4.0 per 100,000 in 2002, to 4.9 and 2.6 per 100,000 in 2010 respectively. ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE In 2010, 9% of chlamydia notifications were among Aboriginal and Torres Strait Islander people, (Endnote 11) despite this population representing just 2.5% of the total population (as of 2006). The notification rate for the Aboriginal and Torres Strait Islander population was nearly four times that of the non-Indigenous notification rate: 1,257 per 100,000, compared with 340 per 100,000 respectively. (Endnote 11) Similar to the non-Indigenous population, around 80% of chlamydia diagnoses were among those aged 15 to 29 years. (Endnote 11) In 2010, more than a third (36%, or 3,604) of all gonorrhoea diagnoses were among Aboriginal and Torres Strait Islander people. (Endnote 11) The rate of diagnosis was more than 26 times that for the non-Indigenous population: 804 per 100,000, compared with 30 per 100,000 respectively. (Endnote 11) In the same year, 12% of syphilis notifications were among Aboriginal and Torres Strait Islander people, affecting more men than women (79 and 51 respectively). (Endnote 11) Between 2006 and 2010, the rate of diagnosis decreased from 40 to 25 per 100,000 Aboriginal and Torres Strait Islander people, while the rate of diagnosis in the non-Indigenous population increased from 3 to 5 per 100,000. (Endnote 11) The rates of HIV diagnosis were similar for the Aboriginal and Torres Strait Islander population and the non-Indigenous populations. In 2010, 22 Aboriginal and Torres Strait Islander people were diagnosed with HIV at a rate of 4.6 per 100,000, compared with 1,021 diagnoses in the non-Indigenous population, or 4.0 per 100,000 population. (Endnote 11) It is estimated that the prevalence of genital herpes in the Aboriginal and Torres Strait Islander population is 18%, considerably higher than the 12% estimated for the non-Indigenous population. (Endnote 7) LOOKING AHEAD The notification rates for many STIs are increasing. However, it is not clear whether this is the result of a rise in infection rates, more people being tested for STIs resulting from increased awareness, or a combination of both. (Endnote 12) In the nine years between 1998-99 and 2007-08, there was a reported six-fold increase in tests for STIs, from 32 per 100,000 to 205 per 100,000. (Endnote 8) It has been suggested that this may be due to the success of public health campaigns promoting STI screening as standard practice for safe sex. (Endnote 8) However, gaps in data make it difficult to present a comprehensive picture of STIs in Australia. Without knowing the reasons behind the recent increases in STIs, it is difficult to determine the success of public health campaigns or whether such campaigns have been targeted effectively. ADDITIONAL TOPICS
EXPLANATORY INFORMATION
ENDNOTES 1 Centres for Disease Control and Prevention, 2012, Is there a connection between HIV and other sexually transmitted diseases?, viewed 9 May 2012, <www.cdc.gov>. 2 Ward, B.J. and Plourde, P., 2006, Travel and Sexually Transmitted Infections, Journal of Travel Medicine, Vol 13, Issue 5, pp. 300-317. 3 NSW Health, 2012, Syphilis Factsheet, viewed 9 May 2012, <www.health.nsw.gov.au> 4 The Kirby Institute, 2011, HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2011, viewed 9 May 2012, <http://hiv.cms.med.unsw.edu.au> 5 Australian Federation of AIDS Organisations, 2012, Reporting HIV in Australia: Information for Journalists, September 2011, viewed 10 May 2012, <www.afao.org.au> 6 Australian Government, 2012, HIV/AIDS, viewed 10 May 2012, <www.sti.health.gov.au> 7 Cunningham, A.L. et al., 2006, Prevalence of infection with herpes simplex virus types 1 and 2 in Australia: a nationwide population based survey, Sexually Transmitted Infections, Vol 82, pp. 164-168. 8 Australian Institute of Health and Welfare, 2009, ‘Sexual health’ in General practice in Australia, health priorities and policies 1998 to 2008, General Practice series no. 24, cat. no GEP 24 <www.aihw.gov.au> 9 Science Daily, 2011, Persons with herpes simplex 2, but without symptoms, still shed virus, viewed 12 May 2012, <www.sciencedaily.com> 10 Ashley, R. et al., 1994, Antibody to herpes simplex virus type 2 as serological marker of sexual lifestyle in populations, British Medical Journal, Vol 309, Issue 6965, pp. 1325-1335. 11 The Kirby Institute 2011 Bloodborne viral and sexually transmitted infections in Aboriginal and Torres Strait Islander People: Surveillance and Evaluation Report 2011, viewed 9 May 2012, <http://hiv.cms.med.unsw.edu.au> 12 Department of Health and Ageing, 2011, National Women’s Health Policy: Sexually transmitted infections, viewed 23 May 2012, <www.health.gov.au> 13 AIDS Action Council, 2012, ‘there isn’t room for ambiguity’, viewed 9 May 2012, <http://aidsaction.org.au> 14 The Australian, 2007, Grim Reaper stemmed AIDS tide, viewed 9 May 2012, <www.theaustralian.com.au> 15 Department of Health and Ageing, 2010, Second National Sexually Transmissible Infections Strategy 2010-2013, viewed 23 May 2012, <www.health.gov.au> 16 Vivancos, R. et al., 2010, Foreign travel, casual sex, and sexually transmitted infections: systematic review and meta-analysis, International Journal of Infectious Disease, Vol 14, Issue 10, pp. 842-851. 17 News-Medical Net, 2012, Syphilis History, viewed 10 May 2012, <www.news-medical.net> 18 What is Gonorrhea?, 2012, History of Gonorrhea, viewed 10 May 2012, <www.whatisgonorrhea.com> 19 Miller, S., 2007, What is the history of herpes and how is it spread?, viewed 10 May 2012, <www.ezinearticles.com> Document Selection These documents will be presented in a new window.
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