{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T22:54:03Z","timestamp":1761519243141,"version":"build-2065373602"},"reference-count":22,"publisher":"CSIRO Publishing","issue":"6","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":2870,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,11,24]]},"abstract":"<jats:p>Background: This study aimed to examine trends in chlamydia and gonorrhoea testing and positivity in Aboriginal and non-Aboriginal women of reproductive age. Methods: A cohort of 318\u00a0002 women, born between 1974 and 1995, residing in Western Australia (WA) was determined from birth registrations and the 2014 electoral roll. This cohort was then probabilistically linked to all records of chlamydia and gonorrhoea nucleic acid amplification tests conducted by two large WA pathology laboratories between 1 January 2001 and 31 December 2013. Trends in chlamydia and gonorrhoea testing and positivity were investigated over time and stratified by Aboriginality and age group. Results: The proportion of women tested annually for chlamydia increased significantly between 2001 and 2013 from 24.5% to 36.6% in Aboriginal and 4.0% to 8.5% in non-Aboriginal women (both P-values &amp;lt;0.001). Concurrent testing was high (&amp;gt;80%) and so patterns of gonorrhoea testing were similar. Chlamydia and gonorrhoea positivity were substantially higher in Aboriginal compared with non-Aboriginal women; age-, region- and year-adjusted incidence rate ratios were 1.52 (95% confidence interval (CI) 1.50\u20131.69, P &amp;lt; 0.001) and 11.80 (95% CI 10.77\u201312.91, P &amp;lt; 0.001) respectively. Chlamydia positivity increased significantly in non-Aboriginal women aged 15\u201319 peaking in 2011 at 13.3% (95% CI 12.5\u201314.2%); trends were less consistent among 15\u201319-year-old Aboriginal women but positivity also peaked in 2011 at 18.5% (95% CI 16.9\u201320.2%). Gonorrhoea positivity was 9.7% (95% CI 9.3\u201310.1%), 6.7% (95% CI 6.4\u20137.0%), 4.7% (4.4\u20135.0%), and 3.1% (2.8\u20133.4%) among Aboriginal women aged respectively 15\u201319, 20\u201324, 25\u201329 and =30 years, compared with &amp;lt;1% in all age groups in non-Aboriginal women. Over time, gonorrhoea positivity declined in all age groups among Aboriginal and non-Aboriginal women. Conclusion: Between 2001 and 2013 in WA chlamydia and gonorrhoea positivity remained highest in young Aboriginal women despite chlamydia positivity increasing among young non-Aboriginal women. More effective prevention strategies, particularly for young Aboriginal women, are needed to address these disparities.<\/jats:p>","DOI":"10.1071\/sh16207","type":"journal-article","created":{"date-parts":[[2018,10,15]],"date-time":"2018-10-15T23:22:24Z","timestamp":1539645744000},"page":"574-580","source":"Crossref","is-referenced-by-count":6,"title":["Trends in chlamydia and gonorrhoea testing and positivity in Western Australian Aboriginal and non-Aboriginal women 2001\u20132013: a population-based cohort study"],"prefix":"10.1071","volume":"14","author":[{"given":"Joanne","family":"Reekie","sequence":"first","affiliation":[{"name":"AKirby Institute, UNSW Sydney, High Street, Sydney, NSW 2052, Australia."},{"name":"ICorresponding author. Email: jreekie@kirby.unsw.edu.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Basil","family":"Donovan","sequence":"additional","affiliation":[{"name":"AKirby Institute, UNSW Sydney, High Street, Sydney, NSW 2052, Australia."},{"name":"BSydney Sexual Health Centre, Sydney Hospital, Macquarie Street, Sydney, NSW 2000, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Guy","sequence":"additional","affiliation":[{"name":"AKirby Institute, UNSW Sydney, High Street, Sydney, NSW 2052, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane S.","family":"Hocking","sequence":"additional","affiliation":[{"name":"CSchool of Population and Global Health, University of Melbourne, Bouverie Street, Melbourne, Vic. 3053, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Kaldor","sequence":"additional","affiliation":[{"name":"AKirby Institute, UNSW Sydney, High Street, Sydney, NSW 2052, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna B.","family":"Mak","sequence":"additional","affiliation":[{"name":"DSchool of Medicine, The University of Notre Dame, Henry Street, Fremantle, WA 6160, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sallie","family":"Pearson","sequence":"additional","affiliation":[{"name":"EFaculty of Pharmacy and School of Public Health, University of Sydney, Sydney, NSW 2006, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Preen","sequence":"additional","affiliation":[{"name":"FCentre for Health Services Research, Stirling Highway, University of Western Australia, Perth, WA 6009, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Handan","family":"Wand","sequence":"additional","affiliation":[{"name":"AKirby Institute, UNSW Sydney, High Street, Sydney, NSW 2052, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Ward","sequence":"additional","affiliation":[{"name":"GSouth Australian Health and Medical Research Institute, North Terrace, Adelaide, SA 5000, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bette","family":"Liu","sequence":"additional","affiliation":[{"name":"HSchool of Public Health and Community Medicine, UNSW Sydney, Samuels Avenue, Sydney, NSW 2052, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Chlamydia and Reproductive Health Outcome Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2017,6,26]]},"reference":[{"key":"2025102419060366200_R1","doi-asserted-by":"crossref","first-page":"319","DOI":"10.33321\/cdi.2010.34.32","article-title":"A new national Chlamydia Sentinel Surveillance System in Australia: evaluation of the first stage of implementation.","volume":"34","author":"Guy","year":"2010","journal-title":"Commun Dis Intell Q Rep"},{"key":"2025102419060366200_R2","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1071\/SH11143","article-title":"Increasing chlamydia diagnoses but little change in hospitalisations for ectopic pregnancy and infertility among women in New South Wales from 2001 to 2008.","volume":"9","author":"Liu","year":"2012","journal-title":"Sex Health"},{"key":"2025102419060366200_R3"},{"key":"2025102419060366200_R4","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1071\/SH15171","article-title":"Prevalence of chlamydia, gonorrhoea, syphilis and trichomonas in Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis.","volume":"13","author":"Graham","year":"2016","journal-title":"Sex Health"},{"key":"2025102419060366200_R5"},{"key":"2025102419060366200_R6","unstructured":"Government of Western Australia Department of Health. Data Linkage Western Australia 2016 [updated 26 February 2016]. Available online at: http:\/\/www.datalinkage-wa.org.au\/."},{"key":"2025102419060366200_R7","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1111\/j.1467-842X.1999.tb01297.x","article-title":"Population-based linkage of health records in Western Australia: development of a health services research linked database.","volume":"23","author":"Holman","year":"1999","journal-title":"Aust N Z J Public Health"},{"key":"2025102419060366200_R8","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1002\/j.1839-4655.2014.tb00322.x","article-title":"Evidence for the use of an algorithm in resolving inconsistent and missing Indigenous status in administrative data collections.","volume":"49","author":"Christensen","year":"2014","journal-title":"Aust J Soc Issues"},{"key":"2025102419060366200_R9"},{"key":"2025102419060366200_R10","unstructured":"Government of Western Australia Department of Health. Notification of infectious diseases and related conditions. 2016. Available online at: http:\/\/ww2.health.wa.gov.au\/Articles\/N_R\/Notification-of-infectious-diseases-and-related-conditions [verified11 April 2016]."},{"key":"2025102419060366200_R11","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1086\/589883","article-title":"Coverage is the key for effective screening of Chlamydia trachomatis in Australia.","volume":"198","author":"Regan","year":"2008","journal-title":"J Infect Dis"},{"key":"2025102419060366200_R12","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1136\/sextrans-2011-050423","article-title":"Understanding trends in genital Chlamydia trachomatis can benefit from enhanced surveillance: findings from Australia.","volume":"88","author":"Ali","year":"2012","journal-title":"Sex Transm Infect"},{"key":"2025102419060366200_R13","doi-asserted-by":"publisher","first-page":"595","DOI":"10.5694\/mja13.10875","article-title":"High chlamydia positivity rates in Indigenous people attending Australian sexual health services.","volume":"200","author":"O\u2019Connor","year":"2014","journal-title":"Med J Aust"},{"key":"2025102419060366200_R14"},{"key":"2025102419060366200_R15","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1071\/SH14179","article-title":"Increased testing for Neisseria gonorrhoeae with duplex nucleic acid amplification tests in Australia: implications for surveillance.","volume":"12","author":"Donovan","year":"2015","journal-title":"Sex Health"},{"key":"2025102419060366200_R16","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1071\/SH14112","article-title":"Change and stasis in sexual health and relationships: comparisons between the First and Second Australian Studies of Health and Relationships.","volume":"11","author":"de Visser","year":"2014","journal-title":"Sex Health"},{"key":"2025102419060366200_R17","doi-asserted-by":"publisher","first-page":"1781","DOI":"10.1016\/S0140-6736(13)62035-8","article-title":"Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of Sexual Attitudes and Lifestyles (NATSAL).","volume":"382","author":"Mercer","year":"2013","journal-title":"Lancet"},{"key":"2025102419060366200_R18","doi-asserted-by":"publisher","first-page":"1795","DOI":"10.1016\/S0140-6736(13)61947-9","article-title":"Prevalence, risk factors, and uptake of interventions for sexually transmitted infections in Britain: findings from the National Surveys of Sexual Attitudes and Lifestyles (NATSAL).","volume":"382","author":"Sonnenberg","year":"2013","journal-title":"Lancet"},{"key":"2025102419060366200_R19","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1097\/OLQ.0b013e3181b12765","article-title":"Trends in chlamydia positivity over time among women in Melbourne, Australia, 2003 to 2007.","volume":"36","author":"O\u2019Rourke","year":"2009","journal-title":"Sex Transm Dis"},{"key":"2025102419060366200_R20"},{"key":"2025102419060366200_R21","doi-asserted-by":"publisher","first-page":"321","DOI":"10.5694\/mja14.00780","article-title":"Gonorrhoea notifications and nucleic acid amplification testing in a very low-prevalence Australian female population.","volume":"202","author":"Chow","year":"2015","journal-title":"Med J Aust"},{"key":"2025102419060366200_R22","unstructured":"Government of Western Australia Department of Health. Guidelines for Managing Sexually Transmitted Infections \u2013 WA 4th Edition 2015. Available online at: http:\/\/silverbook.health.wa.gov.au\/Default.asp?PublicationID=1&ParentSectionID=P1&SectionID=299 [verified 16 October 2016]."}],"container-title":["Sexual Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/14\/6\/574\/146982\/sh16207.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/14\/6\/574\/146982\/sh16207.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T23:06:09Z","timestamp":1761347169000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/sh\/article\/14\/6\/574\/21289\/Trends-in-chlamydia-and-gonorrhoea-testing-and"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,26]]},"references-count":22,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017,11,24]]}},"URL":"https:\/\/doi.org\/10.1071\/sh16207","relation":{},"ISSN":["1448-5028","1449-8987"],"issn-type":[{"type":"print","value":"1448-5028"},{"type":"electronic","value":"1449-8987"}],"subject":[],"published":{"date-parts":[[2017,6,26]]}}}