Aboriginal & Torres Strait Islander Report

Aboriginal dot painting

Introduction

Aboriginal and Torres Strait Islander peoples make up 3% of the total Australian population, with the greatest proportion living in New South Wales (33%) and Queensland (28%). The Blood-borne viral and sexually transmissible infections in Aboriginal and Torres Strait Islander people: Annual Surveillance Report 2018 provides information on the occurrence of blood-borne viruses and sexually transmitted infections among Aboriginal and Torres Strait Islander people in Australia. This report has the ability to both stimulate and support discussion around the ways in which transmission risks, as well as the personal and social consequences of these infections, can be minimised for Aboriginal and Torres Strait Islander communities in the future.

Aboriginal and Torres Strait Islander peoples continue to experience a disproportionate burden of disease. The age-standardised rate of HIV diagnoses increased by 41% in the Aboriginal and Torres Strait Islander population between 2013 and 2016, compared with a 12% decline in non-Indigenous people, and in 2017 the rates were 1.6 times that of the non-Indigenous population. In the same period, the rate of hepatitis C diagnoses increased by 15%, while diagnoses in the non-Indigenous population decreased by 12%. In 2017, rates of chlamydia, gonorrhoea and infectious syphilis were 3, 7 and 7 times greater than the non–Indigenous population, with even more substantial differences in remote and very remote areas. Since 2011, there has also been a resurgence of infectious syphilis in regional and remote communities in central and Northern Australia, including cases of congenital syphilis, rates of which are dramatically higher in Aboriginal and Torres Strait Islander populations. 

There is some good news. Rates of diagnosis of hepatitis B in Aboriginal and Torres Strait Islander people decreased by 37%, reducing the gap of infection rates between Aboriginal and Torres Strait Islander people and the non-Indigenous population.  Genital warts, once the most common STI managed at sexual health clinics, have decreased significantly, following the introduction of the national vaccination program for human papillomavirus (HPV) in 2007. Since then, Aboriginal and Torres Strait Islander people aged 21 years or younger being diagnosed with genital warts at their first sexual health clinic has reduced by 82% in men and 100% in women.

 

You can explore the Aboriginal and Torres Strait Islander data in the interactive graphs below.

Scroll down to read the interpretation of the data 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.

HIV
Viral hepatitis
Sexually transmissible infections

What does this mean?

The higher and increasing rate of both HIV and hepatitis C diagnoses in Aboriginal and Torres Strait Islander people in the past five years is in contrast to declining rates in the non-Indigenous population. This divergence in HIV rates could relate to a number of factors including lack of equitable access to biomedical prevention strategies, and differences in risk factors. Increases in HIV and hepatitis C diagnoses demonstrate the need for additional culturally appropriate prevention measures in this priority population.

The decline in hepatitis B diagnoses in younger Aboriginal and Torres Strait Islander people suggests that immunisation programs for hepatitis B have reduced the gap in hepatitis B diagnosis rates between Aboriginal and Torres Strait Islander people and the non-Indigenous population. However, newly diagnosed cases of hepatitis B in Aboriginal and Torres Strait Islander people in older age groups remain high 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 people.

There has been some success in controlling genital warts in Aboriginal and Torres Strait Islander people. However, rates of chlamydia, gonorrhoea and infectious syphilis remain very high in remote areas. Considerable efforts are under way to control syphilis in the affected jurisdictions. There is an ongoing need for health promotion and strategies to detect and treat STIs early.

Social determinants of health, such as poverty and discrimination, can also influence risk factors for blood-borne viruses and STIs, as well as health service utilisation among Aboriginal and Torres Strait Islander people, and must be addressed in the development of culturally appropriate and relevant prevention, testing and treatment strategies

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