6.7.1 Testing issues associated with gonorrhoea
Develop and encourage laboratory participation in an ongoing quality assurance mechanism to validate currently used gonorrhoea nucleic acid amplification tests (NAAT) against appropriate comparisons including gonococcal cultures. This is necessary to ensure the validity of currently used gonorrhoea NAAT.
In some Aboriginal and Torres Strait Islander populations, data suggest that trichomonal infections are endemic. While it is usually asymptomatic in men, this readily treatable infection causes under-reported, localised genital symptoms in women and is associated with adverse pregnancy outcomes and increased transmission of HIV. There is no commercially available diagnostic test for trichomoniasis in Australia. NAAT testing has been validated in adult women in Australia, but not in men or young people.
6.7.3 Human papilloma virus immunisation
The disproportionate rate of cervical cancer death among Aboriginal and Torres Strait Islander women is well reported and the need to address this preventable issue is an emerging problem. In particular a targeted vaccination program for girls, health promotion about and accessible services for Pap tests and local availability of treatment are action areas identified in this strategy. Consideration could also be given to reviewing the data in order to determine whether the funding of suitable vaccines should be extended to include Aboriginal and Torres Strait Islander men and boys as a priority population. Any review would have to be consistent with the roles of the Australian Technical Advisory Group on Immunisation and the Pharmaceutical Benefits Advisory Committee in making recommendations regarding eligibility for vaccine funding.
Priority actions regarding emerging issues
- Conduct a systematic review of the evidence and develop a national trichomoniasis action plan.
- Closely monitor coverage of HPV vaccination among young women. Any extension of HPV vaccination to boys and men should be evidence based and include actions that aim to reach all eligible cohorts.
- Explore the role of HPV immunisation in high-risk older women.
Continue with efforts to improve Pap smear testing in older women because of the very high rates of cervical cancer and death from cervical cancer in this group.