{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:19:07Z","timestamp":1761513547816,"version":"build-2065373602"},"reference-count":37,"publisher":"CSIRO Publishing","issue":"6","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":2142,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,26]]},"abstract":"<jats:title>Background<\/jats:title>\n                  <jats:p>Australian Aboriginal communities experience a high burden of sexually transmissible infections (STIs). Since 2009, a comprehensive sexual health program has been implemented at nine Aboriginal Community Controlled Health Services in South Australia. This study assessed trends in STI testing and positivity using deidentified diagnostic data from this period (2008\u201316). Methods: Testing data for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) from one urban, three regional and five remote Aboriginal health services were analysed using logistic regression. Results: From 2008 to 2016, testing increased for CT (twofold), NG (threefold) and TV (sixfold). On average, 30% of testing occurred during an annual 6-week screen. Fewer males were tested (range 27\u201338% annually). Mean annual STI testing coverage was 28% for 16- to 30-year-old clients attending regional or remote services (2013\u201316). Positivity at first testing episode for all three infections declined during the study period. From 2013 to 2016, when testing was stable and changes in positivity were more likely to indicate changes in prevalence, there were significant reductions in CT positivity (adjusted odds ratio (aOR) 0.4; 95% confidence interval (CI) 0.2\u20130.5) and TV positivity (aOR 0.6, 95% CI 0.4\u20130.9), although declines were statistically significant for females only. There was no significant decrease in NG positivity (aOR 0.9; 95% CI 0.5\u20131.5). Conclusions: Since the sexual health program began, STI testing increased and STI positivity declined, but significant reductions observed in CT and TV positivity were confined to females. These findings suggest evidence of benefit from sustained, comprehensive sexual health programs in Aboriginal communities with a high STI prevalence, but highlight the need to increase STI testing among men in these communities.<\/jats:p>","DOI":"10.1071\/sh18189","type":"journal-article","created":{"date-parts":[[2019,10,17]],"date-time":"2019-10-17T21:21:07Z","timestamp":1571347267000},"page":"566-573","source":"Crossref","is-referenced-by-count":1,"title":["Analysis of diagnostic data for sexually transmissible infections in South Australian Aboriginal Community Controlled Health Services (2008\u201316)"],"prefix":"10.1071","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7476-7106","authenticated-orcid":true,"given":"Salenna R.","family":"Elliott","sequence":"first","affiliation":[{"name":"AAboriginal Health Council of South Australia, Adelaide, SA 5000, Australia."},{"name":"BSouth Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia."},{"name":"CFlinders University, Bedford Park, SA 5042, Australia."},{"name":"DSA Health, Adelaide, SA 5000, Australia."},{"name":"GCorresponding author. Email: salenna.elliott@sahmri.com"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Betts","sequence":"additional","affiliation":[{"name":"AAboriginal Health Council of South Australia, Adelaide, SA 5000, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie","family":"Hobbs","sequence":"additional","affiliation":[{"name":"AAboriginal Health Council of South Australia, Adelaide, SA 5000, Australia."},{"name":"DSA Health, Adelaide, SA 5000, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Handan","family":"Wand","sequence":"additional","affiliation":[{"name":"EThe Kirby Institute, UNSW, Sydney, NSW 2052, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice R.","family":"Rumbold","sequence":"additional","affiliation":[{"name":"FThe Robinson Research Institute, University of Adelaide, North Adelaide, SA 5006, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Ward","sequence":"additional","affiliation":[{"name":"BSouth Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia."},{"name":"CFlinders University, Bedford Park, SA 5042, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"Johnson","sequence":"additional","affiliation":[{"name":"AAboriginal Health Council of South Australia, Adelaide, SA 5000, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2019,10,18]]},"reference":[{"key":"2025102617160214100_R1"},{"key":"2025102617160214100_R2","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1136\/sextrans-2014-051617","article-title":"Incidence of curable sexually transmissible infections among adolescents and young adults in remote Australian Aboriginal communities: analysis of longitudinal clinical service data.","volume":"91","author":"Silver","year":"2015","journal-title":"Sex Transm Infect"},{"key":"2025102617160214100_R3","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1071\/SH11074","article-title":"The impact of sexually transmissible infection programs in remote Aboriginal communities in Australia: a systematic review.","volume":"9","author":"Guy","year":"2012","journal-title":"Sex Health"},{"key":"2025102617160214100_R4","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1111\/hsc.12355","article-title":"Social determinants in the sexual health of adolescent Aboriginal Australians: a systematic review.","volume":"26","author":"MacPhail","year":"2018","journal-title":"Health Soc Care Community"},{"key":"2025102617160214100_R5","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1016\/j.ucl.2015.06.004","article-title":"Sexually transmitted infections.","volume":"42","author":"Smith","year":"2015","journal-title":"Urol Clin North Am"},{"key":"2025102617160214100_R6","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.pop.2014.02.003","article-title":"Screening and prevention of sexually transmitted infections.","volume":"41","author":"Hunter","year":"2014","journal-title":"Prim Care"},{"key":"2025102617160214100_R7","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1016\/j.idc.2013.08.004","article-title":"Pelvic inflammatory disease: current concepts in pathogenesis, diagnosis and treatment.","volume":"27","author":"Mitchell","year":"2013","journal-title":"Infect Dis Clin North Am"},{"key":"2025102617160214100_R8","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1097\/00007435-199707000-00008","article-title":"Trichomonas vaginalis associated with low birth weight and preterm delivery.","volume":"24","author":"Cotch","year":"1997","journal-title":"Sex Transm Dis"},{"key":"2025102617160214100_R9","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1097\/OLQ.0000000000000134","article-title":"Trichomonas vaginalis as a cause of perinatal morbidity: a systematic review and meta-analysis.","volume":"41","author":"Silver","year":"2014","journal-title":"Sex Transm Dis"},{"key":"2025102617160214100_R10","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1097\/00007435-199219020-00001","article-title":"Epidemiological synergy. Interrelationships between human immunodeficiency virus infection and other sexually transmitted diseases.","volume":"19","author":"Wasserheit","year":"1992","journal-title":"Sex Transm Dis"},{"key":"2025102617160214100_R11","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1086\/511278","article-title":"Infection with Trichomonas vaginalis increases the risk of HIV-1 acquisition.","volume":"195","author":"McClelland","year":"2007","journal-title":"J Infect Dis"},{"key":"2025102617160214100_R12","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1086\/526496","article-title":"Trichomonas vaginalis infection and human immunodeficiency virus acquisition in African women.","volume":"197","author":"Van Der Pol","year":"2008","journal-title":"J Infect Dis"},{"key":"2025102617160214100_R13","doi-asserted-by":"crossref","first-page":"442","DOI":"10.5694\/j.1326-5377.2008.tb02117.x","article-title":"Epidemiology of sexually transmitted infections on the Anangu Pitjantjatjara Yankunytjatjara Lands: results of a comprehensive control program.","volume":"189","author":"Huang","year":"2008","journal-title":"Med J Aust"},{"key":"2025102617160214100_R14","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1136\/sextrans-2014-051535","article-title":"Coinfection with Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis: a cross-sectional analysis of positivity and risk factors in remote Australian Aboriginal communities.","volume":"91","author":"Guy","year":"2015","journal-title":"Sex Transm Infect"},{"key":"2025102617160214100_R15","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1186\/s12879-015-1107-5","article-title":"A sexual health quality improvement program (SHIMMER) triples chlamydia and gonorrhoea testing rates among young people attending Aboriginal primary health care services in Australia.","volume":"15","author":"Graham","year":"2015","journal-title":"BMC Infect Dis"},{"key":"2025102617160214100_R16","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1186\/s12913-015-1116-5","article-title":"Incidence and predictors of annual chlamydia testing among 15\u201329 year olds attending Aboriginal primary health care services in New South Wales, Australia.","volume":"15","author":"Graham","year":"2015","journal-title":"BMC Health Serv Res"},{"key":"2025102617160214100_R17","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":"2025102617160214100_R18","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1186\/1472-6963-14-285","article-title":"Chlamydia among Australian Aboriginal and\/or Torres Strait Islander people attending sexual health services, general practices and Aboriginal community controlled health services.","volume":"14","author":"Ward","year":"2014","journal-title":"BMC Health Serv Res"},{"key":"2025102617160214100_R19","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1071\/SH06033","article-title":"A chlamydia prevalence survey of young women living in Melbourne, Victoria.","volume":"3","author":"Hocking","year":"2006","journal-title":"Sex Health"},{"key":"2025102617160214100_R20","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1186\/1471-2334-12-113","article-title":"The prevalence of Chlamydia trachomatis infection in Australia: a systematic review and meta-analysis.","volume":"12","author":"Lewis","year":"2012","journal-title":"BMC Infect Dis"},{"key":"2025102617160214100_R21","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1186\/1471-2334-14-325","article-title":"Analysis of laboratory testing results collected in an enhanced chlamydia surveillance system in Australia, 2008\u20132010.","volume":"14","author":"Dimech","year":"2014","journal-title":"BMC Infect Dis"},{"key":"2025102617160214100_R22","doi-asserted-by":"publisher","first-page":"166","DOI":"10.5694\/mja13.10108","article-title":"Trends in chlamydia positivity among heterosexual patients from the Victorian Primary Care Network for Sentinel Surveillance, 2007\u20132011.","volume":"200","author":"Lim","year":"2014","journal-title":"Med J Aust"},{"key":"2025102617160214100_R23","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1071\/MA09202","article-title":"Challenging STIs in remote central Australia.","volume":"Nov","author":"Huang","year":"2009","journal-title":"Microbiol Aust"},{"key":"2025102617160214100_R24","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1111\/j.1753-6405.2008.00309.x","article-title":"An assessment of the effectiveness of the Tiwi Sexual Health Program 2002\u20132005.","volume":"32","author":"Su","year":"2008","journal-title":"Aust N Z J Public Health"},{"key":"2025102617160214100_R25","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1071\/SH15077","article-title":"Community and clinic-based screening for curable sexually transmissible infections in a high prevalence setting in Australia: a retrospective longitudinal analysis of clinical service data from 2006 to 2009.","volume":"13","author":"Silver","year":"2016","journal-title":"Sex Health"},{"key":"2025102617160214100_R26"},{"key":"2025102617160214100_R27"},{"key":"2025102617160214100_R28","unstructured":"Australasian Sexual Health Alliance. Australian STI management guidelines for use in primary care. 2017. Available online at: http:\/\/www.sti.guidelines.org.au\/ [verified April 2019]."},{"key":"2025102617160214100_R29","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1071\/SH16123","article-title":"Patient, staffing and health centre factors associated with annual testing for sexually transmissible infections in remote primary health centres.","volume":"14","author":"Hengel","year":"2017","journal-title":"Sex Health"},{"key":"2025102617160214100_R30","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1186\/s12879-017-2241-z","article-title":"Wide variation in sexually transmitted infection testing and counselling at Aboriginal primary health care centres in Australia: analysis of longitudinal continuous quality improvement data.","volume":"17","author":"Nattabi","year":"2017","journal-title":"BMC Infect Dis"},{"key":"2025102617160214100_R31","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1071\/SH13205","article-title":"Epidemiology of gonorrhoea notifications in Australia, 2007\u201312.","volume":"11","author":"Roberts-Witteveen","year":"2014","journal-title":"Sex Health"},{"key":"2025102617160214100_R32","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1097\/OLQ.0b013e31826ae875","article-title":"Trichomonas vaginalis prevalence increases with remoteness in rural and remote New South Wales, Australia.","volume":"39","author":"Ryder","year":"2012","journal-title":"Sex Transm Dis"},{"key":"2025102617160214100_R33","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1071\/SH16046","article-title":"Gonorrhoea testing and positivity in non-remote Aboriginal Community Controlled Health Services.","volume":"14","author":"Harrod","year":"2017","journal-title":"Sex Health"},{"key":"2025102617160214100_R34","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1071\/SH16207","article-title":"Trends in chlamydia and gonorrhoea testing and positivity in Western Australian Aboriginal and non-Aboriginal women 2001\u20132013: a population-based cohort study.","volume":"14","author":"Reekie","year":"2017","journal-title":"Sex Health"},{"key":"2025102617160214100_R35","unstructured":"Fearnley E, Tribe I, Waddell R, Solly A. Surveillance of sexually transmitted infections and blood-borne viruses in South Australia, 2017 (epidemiological report 31). Adelaide: Communicable Disease Control Branch, SA Health, Government of South Australia; 2017. Available online at: https:\/\/www.sahealth.sa.gov.au\/SurveillanceNotifiableConditions [verified 3 August 2017]."},{"key":"2025102617160214100_R36"},{"key":"2025102617160214100_R37","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1071\/SH14240","article-title":"Reasons for delays in treatment of bacterial sexually transmissible infections in remote Aboriginal communities in Australia: a qualitative study of healthcentre staff.","volume":"12","author":"Hengel","year":"2015","journal-title":"Sex Health"}],"container-title":["Sexual Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/16\/6\/566\/1255707\/sh18189.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/16\/6\/566\/1255707\/sh18189.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:16:07Z","timestamp":1761513367000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/sh\/article\/16\/6\/566\/185054\/Analysis-of-diagnostic-data-for-sexually"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,18]]},"references-count":37,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,11,26]]}},"URL":"https:\/\/doi.org\/10.1071\/sh18189","relation":{},"ISSN":["1448-5028","1449-8987"],"issn-type":[{"type":"print","value":"1448-5028"},{"type":"electronic","value":"1449-8987"}],"subject":[],"published":{"date-parts":[[2019,10,18]]}}}