Australia’s STI epidemic

AUSTRALIANS are losing condoms and gaining infections: An epidemic of sexually transmitted infections is sweeping the nation, MELANIE LEACH reports.

Is there really a problem?

Sexually Transmitted Infections (STIs) rates have been steadily increasing over the past ten years, but in the past year there has been a dramatic surge. According to figures issued at the Australasian HIV/AIDS Conference in Canberra on 27 September, new gonorrhoea diagnoses jumped by 25 per cent over 2009 levels to 10,000 last year, and there were more than 74,000 new chlamydia cases. In the ACT 102 gonorrhoea cases have been reported, up from 56 cases for the whole of last year. Since January 927 chlamydia diagnoses were made in Canberra, compared to 1157 in 2010. The increase has been described by many health experts as an epidemic.

Some claim that the increase in STI diagnosis is due to increased testing. However, while this may be a slight contributor Professor Basil Donovan, head of the Sexual Health Program at The Kirby Institute, University of NSW, said that Australia has a very low testing rate by international standards and that the increase is real.

Who is at risk?

Government campaigns against STIs state, “Every sexually active person is a target.” However, people are most at risk if they engage in sexual activity without the use of a condom. In Australia three quarters of known cases occur among people aged between 15 and 29. Therefore, young sexually active people are at the greatest risk.

Why has the rate of STIs grown?

Public health experts at the conference said that many sexually active young people born after the AIDS education campaigns of the 1980s were failing to use condoms. Juliet Langridge, a nurse at the Canberra Sexual Health Clinic, said that the reason behind the rise is simple: the current generation of teenagers and young adults tend to change sexual partners more frequently than previous generations.

“Young people are having sex with more people,” she said. “They are uniformed about sexual health and they don’t use condoms.”

In the most recent national study of condom use, conducted by Roy Morgan in 2008, only one in five sexually-active Australians between the ages of 16 and 49 reported having worn a condom in the previous six months. And of that condom-wearing minority, only 40% wrapped up every time they had sex.

Professor Donovan, says that complacency about condoms affects all age groups.

“Part of the problem is that people have compartmentalised their fear of AIDS,” she said. “They see it as someone else’s problem,” he said.

“The other STIs just don’t generate the same level of concern or incentive to use condoms.”

What is the government doing to combat this?

The increase in STIs in young people led to the announcement by the Australian Government in the 2007-08 Federal Budget of a national prevention program to raise awareness of STIs and encourage behavioural changes that will help reduce the prevalence and spread of STIs.

The campaign launched in May 2009 with advertising in magazines, on the radio, online and outdoors to reach young people aged 15 to 29 years. The advertising provides young people with important information about the transmission, symptoms, treatment and, most importantly, the prevention of STIs.

However, it has been two years since the campaign was launched and there has been a huge increase in STIs young people, therefore the campaign is not working.

What else can be done?

Education and then more education. Polling results show that too many young people either lack good knowledge about sexual health, do not feel empowered enough to ask for contraception or have not learned the skills to negotiate contraceptive use with their partners to protect themselves from STIs. The Clueless or Clued Up: Your Right to be informed about contraception study in 2010 showed that 24 per cent of Australian students reported not using contraceptives because they didn’t know which method to use or did know where to get it from.

The average age of first intercourse in Australia has dropped to 16 and because of this many experts at the conference said that schools needed to take on a greater role in educating students about STI prevention.

“The fact that STIs have increased so drastically in teenagers means that there just isn’t enough education,” Mrs Langridge said. “Kids are going to have sex, as a society we need to accept this and teach them the safest way to do so. Schools need to put more emphasis into ensuring students are properly informed about sex.”

Is school-based sexual education enough?

Most sexual health experts agree that the best way to stop the rise in STIs is to educate adolescents and it is generally accepted that this education needs to start in schools. However, sexual education is not a part of the national curriculum, which it is not compulsory and can be taught however a school chooses.

I went to St Clares College in Canberra and I remember being given booklets about sex with the pages on contraception having been ripped out, because the Catholic Church didn’t believe in contraception. Some schools offer very comprehensive education regarding STIs, however, some offer none at all. Therefore, either sexual education needs to be a part of the national curriculum or there needs to be another way to educate teenagers.