Most young Australian with chlamydia don’t know they have it, leaving hundreds of thousands at risk of infertility, pelvic inflammatory disease and pregnancy complications
Most young Australian with chlamydia don’t know they have it, leaving hundreds of thousands at risk of infertility, pelvic inflammatory disease and pregnancy complications.
STI rates, including chlamydia, are on the rise. Now research shows that an estimated 250,000 Australians aged 15 to 29 years were infected with chlamydia in 2016.
But of these, only one in four were ever diagnosed, and a tiny proportion of these were re-tested to see if they had cleared the sexually transmitted disease, an analysis of surveillance and Medicare data suggests.
“It’s concerning that a lot of people are being affected and not diagnosed, because there are important ramifications down the track,” says lead author Dr Richard Gray, of the University of NSW’s Kirby Institute.
“Chlamydia can resolve itself without any complication,” Dr Gray says. “But I think it’s still important to be aware that our strategies and guidelines aim to ensure that every infection is diagnosed and appropriately treated and followed up.”
To do this, new strategies such as short message service reminders, point-of-care and postal test kits are needed, Dr Gray says.
Public health interventions focus on encouraging condom use and testing high risk individuals or those with symptoms. Management strategies also emphasise timely treatment, partner management and re-testing to detect re-infection.
To understand where care was falling short, Dr Gray and his colleagues analysed disease notification data, Medicare billing rates and estimates of its prevalence in young people.
They found that 70,000 were diagnosed in 2016, leaving three in four unaware that they had the disease. Of those who were diagnosed, 93% were treated but only 17% were re-tested within 42 to 180 days of diagnosis.
Diagnosis and re-testing were especially low among men. There were 1.6 times more new infections in young men than young women, but there were 1.6 times more diagnoses among young women than men, they estimated.
Re-testing is an important step, says Dr Gray. “There is a risk of people becoming treated and getting reinfected from their partners, who are also at risk of infection.”
Re-infection increases the risk of pelvic inflammatory disease among women.
Chlamydia notification rates rose alarmingly at the start of the century, jumping from 74 to 363 infections per 100,000 between 1999 and 2011. Since then, the rates have grown steadily to a high of 385 in 2016, data from the Kirby Institute shows.
Much of these increases are thought to be the result of more common and more accurate testing, however.
Australian Health Review
