Condy Canuto

Background: This study describes chlamydia and gonorrhoea testing, positivity, treatment, and retesting among individuals aged ≥15 years attending an urban Aboriginal Community Controlled Health Service during the period 2016–2021. Method: Utilising routinely collected clinical data from the ATLAS program (a national sentinel surveillance network), a retrospective time series analysis was performed. The study assessed testing rates, positivity, treatment efficacy, retesting and trends over time within an urban Aboriginal Community Controlled Health Service. Results: Testing rates for chlamydia and gonorrhoea varied between 10 and 30% over the study period, and were higher among clients aged 15–29 years and among females. Positivity rates for both infections varied by age, with clients aged 15–24 years having higher positivity than older clients. Gonorrhoea positivity rates decreased after 2016. Treatment and retesting practices also showed sex disparities, with men having a slightly higher treatment rate within 7 days, whereas females had significantly higher retesting rates within 2–4 months, indicating differences in follow-up care between sexes. Conclusion: The study emphasises the need for clinical and public health interventions within urban Aboriginal and Torres Strait Islander populations to further reduce chlamydia and gonorrhoea. Prioritising improved access to testing, timely treatment and consistent retesting can significantly contribute to lowering STI prevalence and enhancing sexual health outcomes in these communities.

Background: To gain an understanding of chlamydia (CT) and gonorrhoea (NG) testing conducted within an annual health check (AHC) and in standard clinical consultations for clients aged 15–29 years attending an urban Aboriginal Community Controlled Health Service in the period 2016–2021. Methods: De-identified electronic medical record data were extracted and analysed on CT and NG testing by sex, age, Indigenous status and the context of testing (conducted within an AHC or not). An access, testing, and diagnosis cascade for CT and NG, inclusive of an AHC, was constructed. Results: Combined testing within an AHC and outside an AHC for CT and NG ranged between 30 and 50%, except for the year 2021. Males were twice as likely to receive a CT and NG test within an AHC consultation as females. Females were almost equally likely to have a CT and NG test, both as part of an AHC consult and during other clinical consultations. Females had the highest CT positivity in 2018 (11%) and 2019 (11%), with a dip in 2020 (5%), whereas NG diagnoses remained stable at 2%. Conclusion: The study demonstrates the potential of the AHC to facilitate greater coverage of CT and NG testing in an urban Aboriginal Community Controlled Health Service. Screening conducted within an AHC alongside screening in clinical consultations might be enough to reduce CT prevalence over a sustained period.