Australia’s annual report on sexually transmitted infections

Gonorrhoea and syphilis diagnoses are increasing in Australia, HIV is stable, and more than 30,000 Australians have been cured of hepatitis C.

 

The findings are according to the latest Annual Surveillance Report on HIV, viral hepatitis and sexually transmissible infections (STIs) in Australia, released today by the Kirby Institute at UNSW Sydney.

 

The latest data shows that gonorrhoea has increased by 63% over the past five years, with particular rises among young heterosexual people in major cities.

 

Between 2012 and 2016, gonorrhoea notification rates increased by 63% (62 to 101 per 100 000), with an increase in both males (72%) and females (43%). The gonorrhoea notification rate in 2016 was higher in males (146 per 100 000) than in females (56 per 100 000).

 

“Up until recently, gonorrhoea had been uncommon in young heterosexual people living in major cities. Rising rates in this group highlight the need for initiatives to raise awareness among clinicians and young people about the importance of testing,” said Associate Professor Rebecca Guy, head of the Surveillance, Evaluation and Research Program at the Kirby Institute. “With the national strategies for HIV, hepatitis and STIs up for review, reducing STIs in young people will be an important target.”

 

“Initiatives underway to address the syphilis resurgence include enhanced testing and treatment, and culturally appropriate health promotion campaigns,” said Associate Professor James Ward, head of Infectious Diseases Research, Aboriginal Health Infection and Immunity, South Australian Health and Medical Research Institute. “Comprehensive strategies are needed to reduce STIs in Aboriginal and Torres Strait Islander peoples.”

 

The report shows that HIV diagnoses have remained stable in Australia for the past five years, with 1,013 new diagnoses in 2016.

 

In 2016, 171 people aged 50 and over were first diagnosed with HIV and 9250 men and 667 women over 50 were living with HIV.

Of diagnosed people living with HIV in 1986, 5% were aged over 50 years compared with 43% aged over 50 years in 2016. In men the pattern was similar, whereas in women the proportion aged over 50 years in 2016 was 26% compared with 17% in 1986.

Of 21 529 people attending sexual health clinics in 2016 for whom vaccination documentation or pathology details were available, 22% were susceptible to hepatitis B. The proportion susceptible was highest in people aged 55 years or more (30%), 29% in those aged 50–54, and 20%–26% in people aged under 40.

 

Associate Professor Guy said, “We’re seeing increased uptake of HIV testing, particularly among gay and bisexual men, who are the population most affected by HIV in Australia.

 

“It is also encouraging that 86% of people diagnosed with HIV were on treatment in 2016.”

 

However, gaps in testing remain, particularly among heterosexual people, where one in five HIV diagnoses occurs. Nearly half of heterosexual people diagnosed with HIV were diagnosed late, meaning they were likely to have acquired HIV at least four years before diagnosis.

 

The report indicates that HIV diagnoses among Aboriginal and Torres Strait Islander people have increased by 39% since 2012, with a greater proportion of diagnoses due to injecting drug use and heterosexual sex, compared to non-Indigenous populations.

 

Associate Professor Ward said that this disparity highlights the need for culturally relevant HIV prevention programs for Aboriginal people. “We need enhanced community education, targeted testing and treatment initiatives – including access to PrEP, and greater access to sterile needle and syringes, and drug dependence treatment for people who inject drugs.”

Between March and December 2016, an estimated 30,434 people have been cured of hepatitis C due to the availability of new direct acting antiviral therapy for hepatitis C.

 

“The new therapies have been game-changing for hepatitis C in Australia”, said Associate Professor Jason Grebely from the Viral Hepatitis Clinical Research Program at the Kirby Institute. “Our estimates indicate that the number of people with hepatitis C who have advanced liver disease has fallen for the first time in 10 years.

 

Between March and December 2016, an estimated 30,434 people have been cured of hepatitis C due to the availability of new direct acting antiviral therapy for hepatitis C.

 

“The new therapies have been game-changing for hepatitis C in Australia”, said Associate Professor Jason Grebely from the Viral Hepatitis Clinical Research Program at the Kirby Institute. “Our estimates indicate that the number of people with hepatitis C who have advanced liver disease has fallen for the first time in 10 years.

 

The report also shows that over the past five years hepatitis B diagnoses have declined by 27% in people aged less than 25 years, reflecting the impact of the infant and adolescent vaccination programs. However, only 63% of the estimated 230,000 people living with chronic hepatitis B in Australia by the end of 2016 were diagnosed. Of those, only 27% were having appropriate clinical monitoring tests for their infection.

 

The decline in hepatitis B diagnoses is also evident in younger Aboriginal and Torres Strait Islander peoples. However, hepatitis B diagnoses in the population over 30 years remain high and a continued focus on testing and vaccination among this population is needed.

 

See the report HIV, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2017 at https://kirby.unsw.edu.au/report/annual-surveillance-report-hiv-viral-hepatitis-and-stis-australia-2017

6 November 2017.