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Review
. 2018 Dec;8(4):938-946.
doi: 10.1177/1925362118821492. Epub 2018 Dec 19.

A Review of Sexually Transmitted Infections in Australia - Considerations in 2018

Caroline Chun Mei Thng
Review

A Review of Sexually Transmitted Infections in Australia - Considerations in 2018

Caroline Chun Mei Thng. Acad Forensic Pathol. 2018 Dec.

Abstract

Sexually transmitted infections (STIs) bear a high burden of disease and, subsequently, high health costs globally. Chlamydia, gonorrhoea, syphilis, and trichomoniasis contribute to nearly one million infections every day worldwide. Sexually transmitted infections continue to be the most frequently notified condition to the Australian National Notifiable Diseases Surveillance System and the numbers continue to increase. Australia has achieved several significant successes in reducing STIs and blood-borne viruses (BBV) including the significant decrease in genital warts in those less than 30 years old since 2007 following the launch of human papillomavirus vaccines in women, the virtual elimination of mother to child transmission of HIV, and the increased uptake of successful hepatitis C treatment following the availability of direct acting antiviral treatment on the Pharmaceutical Benefits Scheme. However, several challenges remain, including the ongoing rise of chlamydia, gonorrhoea, and syphilis over the last five years; the emergence of antibiotic resistance; and the increasing disparity in the prevalence of STIs and BBV in men who have sex with men, young people, and Aboriginal and Torres Strait Islander people, and challenges in the delivery of services to rural and remote Australia. In this paper, we aim to provide a snapshot of the current landscape and challenges for chlamydia, gonorrhoea, mycoplasma, syphilis and HIV infections in Australia.

Keywords: Australia; Forensic pathology; Sexual Health; Sexually Transmitted Infections.

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Conflict of interest statement

Disclosures & Declaration Of Conflicts Of Interest: The author, reviewers, editors, and publication staff do not report any relevant conflicts of interest

Figures

Figure 1:
Figure 1:
World Health Organization (WHO) regions (1).
Figure 2:
Figure 2:
Chlamydia notification rate per 100 000, 2007-2016, by year and age group (9).
Figure 3:
Figure 3:
History of discovered and recommended antimicrobials and evolution of resistance in Neisseria gonorrhoeae, including the emergence of genetic resistance determinants, internationally. During the preantimicrobial era (before the 1930s), treatment consisted of, e.g. a healthier lifestyle, copaiba, cubebs, urethral irrigations, potassium permanganate, silver compounds, mercury compounds, and hyperthermia. Reproduced with permission from Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future (13).
Figure 4:
Figure 4:
Prevalence of macrolide resistance in M. genitalium (23).
Figure 5:
Figure 5:
The HIV diagnosis and care cascade in Australia, 2014-2016, females (29).
See this image and copyright information in PMC

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