Sexually Transmitted Infections

Complacency putting Australians at risk from STIs

On the eve of the Christmas party season, sexual health experts have issued a timely warning that if high-risk behaviours and complacency towards safe sex continue, Australia is set to follow international trends towards increasing rates of sexually transmitted infections (STIs).

According to Professor Adrian Mindel, Chair of the Australian Herpes Management Forum (AHMF) and Director of the Sexually Transmitted Infection Research Centre, Westmead Hospital, increasing rates of STIs have come about as the positive behavioural changes adopted in the early days of the global HIV epidemic have not been sustained.

"While substantial declines in the incidence of both bacterial and viral STIs were observed throughout the 1980s and early 1990s, new diagnoses of STIs have risen continually since 1995. In the United Kingdom there has been a sustained increase in diagnoses of chlamydia, gonorrhoea, syphilis and herpes over the past five to seven years, with many of these more than doubling during this time."

"These statistics indicate that people have become complacent about safe sex and are increasingly engaging in high-risk behaviours such as multiple and concurrent partnerships and inconsistent condom use. There has also been a decrease in the age of sexual debut," he said.

Professor Mindel commented that local data combined with anecdotal evidence suggests these increases have also started to occur in Australia.

"The two most common STIs in Australia are believed to be human papillomavirus and genital herpes. However, both of these are difficult to monitor as they are not notifiable.

"According to data published earlier this year in the Australian Institute of Health and Welfare report, Australia's Health 2002, over the past five years, the rate of chlamydia diagnosis doubled from 46 per 100,000 population in 1996 to 88 in 2000. The rate of gonorrhoea diagnosis has also increased from 23 per 100,000 in 1996 to 30 in 2000.

"While part of this increase may be due to improvements in diagnostic testing, changes in sexual behaviour and complacency about safe sex are undoubtedly contributing factors," he said.

According to Professor Mindel, this renewed warning about STIs is particularly timely as the Christmas holiday and party season commences.

"As people let their hair down at the end of the year, be it teenagers on Schoolies Week or professionals at office Christmas parties, the potential for increased transmission of STIs is considerable. The consumption of alcohol at many of these events often causes people to make unwise and unsafe decisions when it comes to sex."

Recently returned from the Sixth International Congress on Drug Therapy in HIV Infection in Glasgow, Scotland and meetings with the Medical Society for the Study of Venereal Disease, Professor Mindel commented that the UK has adopted a very proactive approach to this recent increase and the British Government is currently working to implement a national sexual health strategy.

According to Professor Mindel, while there is much we can learn from the UK experience, Australia has some considerable way to come before such a strategy could be adopted here.

"At present Australia has no comprehensive national system for measuring increases in many STIs. Without this type of accurate information we are unable to identify the most urgent issues in sexual health or develop strategies to address them."

"In recent years much work in the area of sexual health has focused on HIV / AIDS. While very successful, the public health campaigns about this disease have tended to dominate the sexual health agenda making it difficult for messages about other STIs to be heard," he said.

Genital herpes is one such STI that has struggled for attention over the past two decades.

"Evidence suggests that up to 80 per cent of people infected with genital herpes who display symptoms are still not diagnosed and it despite being one of the most common sexually transmitted infections in developed countries."

According to Professor Mindel, the increase in STIs is a timely call for us to re-evaluate the need for further safe sex education.

"The trends we are beginning to see indicate the there is a need for us to return to more basic safe sex messages that are not only relevant to a range of groups but also encompass a broad range of STIs rather only focusing on those that can be life threatening," he said.

"People not only need to learn how to identify the symptoms of STIs but to be aware many of these infections can be passed from one individual to another without displaying any obvious signs of infection," he said.

However, until a national sexual health strategy is adopted in Australia the onus for preventing further increases in STIs must rest with the individual.

"At this time of increased risk, I encourage people to not become complacent, to always practice safe sex and to make use of the sexual health services available. People with STIs needn't suffer in silence or feel stigmatised. Effective antibiotics and antiviral treatments to help manage these conditions are readily available," Professor Mindel said.

Further information about herpes can be obtained confidentially by visiting the newly updated Australian Herpes Management Forum at www.ahmf.com.au