Aboriginal & Torres Strait Islander Report

Dot art

Introduction

Aboriginal and Torres Strait Islander peoples make up 3% of the total Australian population, with the greatest proportion living in New South Wales (31%) and Queensland (29%). The Bloodborne viral and sexually transmissible infections in Aboriginal and Torres Strait Islander people: Annual Surveillance Report 2016 provides information on the occurrence of blood borne viruses and sexually transmitted infections among Aboriginal and Torres Strait Islander people in Australia for the purposes of stimulating and supporting discussion on ways forward in minimising the transmission risks, as well as the personal and social consequences of these infections within Aboriginal and Torres Strait Islander communities. 

Aboriginal and Torres Strait Islander peoples continue to experience a disproportionate burden of disease. HIV notification rates among Aboriginal and Torres Strait Islander men have doubled over the past five years and rates of chlamydia, gonorrhoea and infectious syphilis are 3, 10 and 6 times greater than the non–Indigenous population in 2015, with even more substantial differences in remote and very remote areas.

 

You can explore the Aboriginal and Torres Strait Islander data in the interactive graphs below. Click on the tabs above the graph to view different data.

Scroll down to read the key findings and to download the full version of the report.

 

Note: Time trends in diagnoses of specific infections by jurisdiction were included in this report if information on Aboriginal and Torres Strait Islander status was available for at least 50% of diagnoses of the infection in every one of the past five years of the reporting period. Further details on the specific jurisdictions included for each infection can be found in the report.

Key Findings

HIV

HIV

 

In 2015, there were 38 new HIV diagnoses among people identified as Aboriginal and Torres Strait Islander.

HIV_2

 

The rate of newly diagnosed HIV infection in the Aboriginal and Torres Strait Islander population in 2015 was more than two times higher than the Australian–born non–Indigenous population.

 

 

 

HIV notifications rates were highest in Aboriginal and Torres Strait Islander peoples aged older than 35 years.

HIV_4

 

Between 2011 and 2015, there was a 2–fold increase in HIV notifications rates in Aboriginal and Torres Strait Islander males. Over the same period, the rate in the Australian–born non–Indigenous male population decreased by 13%.

 ​​​

In the last five years, a higher proportion of newly diagnosed HIV infections among the Aboriginal and Torres Strait Islander population were attributed to injecting drug use (16% vs. 3%) and heterosexual contact (21% vs. 14%), as compared with the non–Indigenous Australian–born population.

HIV_6

 

Just under a third (30%) of the new HIV diagnoses among the Aboriginal and Torres Strait Islander population in 2015 were determined to be late (they were in people who were likely to have had their infection for at least four years without being tested).

Hepatitis B and C

HEP_1

 

A total of 10,790 cases of newly diagnosed hepatitis C infection were reported in Australia in 2015; 9% were among the Aboriginal and Torres Strait Islander population, 32% were among the non–Indigenous population and a further 59% where Aboriginal and Torres Strait Islander status was not reported.

HEP_2

 

The rate of newly diagnosed hepatitis C infection in the Aboriginal and Torres Strait Islander population in 2015 was 167 per 100,000 people, nearly five times higher than in the non–Indigenous population (36 per 100,000 people).

 

 

In 2015, receptive syringe sharing, a key risk factor for hepatitis C transmission was higher among Aboriginal and Torres Strait Islander respondents (24%) than among non–Indigenous respondents (14%), according to data from the Australian Needle and Syringe Program Survey.

HEP_4

 

 

There were a total of 6,502 notifications of newly diagnosed hepatitis B infections in Australia in 2015. Of these, 3% were among the Aboriginal and Torres Strait Islander population, 34% were among the non–Indigenous population, and there were a further 63% for which Indigenous status was not reported.

HEP_5

 

In 2015, the notification rate of newly diagnosed hepatitis B infection for the Aboriginal and Torres Strait Islander population was 3 times higher than the non–Indigenous population. 

HEP_6

 

In the five–year period 2011–2015, there was a 22% decline in the notification rate of newly diagnosed hepatitis B infection in the Aboriginal and Torres Strait Islander population.

Sexually Transmissible Infections

STI_1

 

There were a total of 66,033 chlamydia notifications in 2015. Of these, 9% were among the Aboriginal and Torres Strait Islander population, 39% were among the non–Indigenous population, and Indigenous status was not reported for 51% of notifications.

STI_2

 

The chlamydia notification rate for the Aboriginal and Torres Strait Islander population of 1,325 per 100,000 people in 2015 was more than three times than that of the non–Indigenous notification rate of 391 per 100,000 people.

STI_3

 

In 2015, the chlamydia notification rate in major cities in the Aboriginal and Torres Strait Islander population was two times higher than that among the non–Indigenous population, increasing to eight times higher in remote areas.

STI_4

 

There were a total of 18,588 gonorrhoea notifications in Australia in 2015. 19% were among the Aboriginal and Torres Strait Islander population, 45% were in the non–Indigenous population, and there were a further 36% for which Aboriginal and Torres Strait Islander status was not reported.

STI_5

 

In 2015, the gonorrhoea notification rate in the Aboriginal and Torres Strait Islander population was 10 times that of the non–Indigenous population, increasing to 72 times higher in remote areas. 

In Aboriginal and Torres Strait Islander people, there were nearly an equal number of gonorrhoea notifications among males and females in 2015, indicating predominantly heterosexual transmission, and most resided in remote areas. In contrast, gonorrhoea notifications in non–Indigenous people in 2015 were predominantly in men, in urban settings, suggesting that transmission is primarily related to sex between men.

STI_7

 

There were a total of 2,736 infectious syphilis notifications nationally in 2015, with 16% among the Aboriginal and Torres Strait Islander population, 75% among the non–Indigenous population, and a further 8% notifications for which Aboriginal and Torres Strait Islander status was not reported.

STI_8

 

In 2015, the infectious syphilis notification rate in the Aboriginal and Torres Strait Islander population was six times higher than the non–Indigenous population, increasing to 132 times higher in remote areas.

STI_9

 

The notification rate of infectious syphilis among the Aboriginal and Torres Strait Islander population declined by 47% between 2006 and 2009, and then increased by 180% between 2010 and 2015, largely driven by an outbreak in Northern Australia (including regions of Queensland, the Northern Territory and Western Australia). 

In Aboriginal and Torres Strait Islander peoples, the number of infectious syphilis notifications among males and females was nearly equal in 2015, indicating predominantly heterosexual transmission. In contrast, diagnoses in non–Indigenous peoples are predominantly in men, in urban settings, suggesting that transmission is primarily related to sex between men.

STI_11

 

There were 22 congenital syphilis cases over the period 2011–2015, 64% (14) of which were in the Aboriginal and Torres Strait Islander population.

STI_12

 

Over the past nine years, there has been a 91% reduction in genital warts in Aboriginal and Torres Strait Islander females younger than 21 attending sexual health clinics, following introduction of the adolescent national HPV vaccine program in schools.

Interpretation

The higher and increasing rate of both HIV and hepatitis C notifications in Aboriginal and Torres Strait Islander peoples in the past five years is in contrast to stable rates in the non–Indigenous population. The divergence in HIV rates possibly relates to higher levels of condomless anal sex among Aboriginal and Torres Strait Islander gay men. The higher rates of hepatitis C diagnosis may reflect differences in injecting practices and could also be accounted for by very high rates of incarceration and hepatitis C diagnosis in this setting, and higher case detection among Aboriginal and Torres Strait Islander peoples. These increases require a strengthened focus on prevention in this vulnerable population as outlined in the National Strategies.

The decline in hepatitis B diagnoses in young Aboriginal and Torres Strait Islander peoples suggest the immunisation programs for hepatitis B are starting to have a benefit. However there remain higher rates of hepatitis B notifications in Aboriginal and Torres Strait Islander peoples in all age groups compared to the non–Indigenous population highlighting the need for a continued focus on hepatitis B testing and vaccination among Aboriginal and Torres Strait Islander peoples.

There has been a decline in rates of gonorrhoea among the Aboriginal and Torres Strait Islander population in the past five years, but rates remain 72 fold higher in remote areas compared with the non-Indigenous population. There has also been a resurgence of infectious syphilis in remote communities after years of declining rates, which brings with it cases of congenital syphilis, emphasising the need for health promotion and strategies to detect infections early as outlined in the National Strategies.