Improvements in the accuracy and completeness of the status of Aboriginal and Torres Strait Islanders in routine STI and BBV surveillance systems across all jurisdictions will improve the understanding of STIs and BBVs in these communities, facilitate prevention and clinical management strategies, and provide tools for monitoring and evaluation.

There are considerable gaps in the accuracy of reportable data for Aboriginal and Torres Strait Islander peoples. In 2008, for example, 52 per cent or more than 30 000 cases of notified chlamydia in Australia did not report Aboriginal and Torres Strait Islander status. Similarly, 2178, or 28 per cent, of all gonorrhoea cases did not report Aboriginal and Torres Strait Islander status. This missing data has the potential to underestimate the true prevalence and morbidity associated with these STIs in Australia among this population group. Accurate and complete reporting of Aboriginal and Torres Strait Islander status on communicable disease notifications is critical to improving the quality of data available. For almost two decades the main sources of information on the occurrence of STIs and BBVs among Aboriginal and Torres Strait Islander peoples have arisen from routine notifications required by public health legislation in Australia. Despite this, considerable gaps exist in the information available for Aboriginal and Torres Strait Islander peoples living in regional and urban areas (which is where the majority of this population group resides). This is especially true with reporting status on hepatitis C notifications, gonorrhoea and to a lesser extent chlamydia.

A number of initiatives have been recently introduced or are planned to provide a more comprehensive picture of trends in STI and BBVs in Aboriginal and Torres Strait Islander peoples. For example, the Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance reports on chlamydia infections outcomes in 90 clinical services across Australia and provides data specifically related to Aboriginal and Torres Strait Islander peoples. A data linkage project will be undertaken in 2010 to improve the accuracy and completion of STI and BBV data in New South Wales. These types of initiatives should be extended and supported, especially given the absence of a complete national surveillance system that can report on Aboriginal and Torres Strait Islander status.

Improving completeness and accuracy of Aboriginal and Torres Strait Islander status within the National Notifiable Diseases Surveillance System requires a number of agencies coming together to identify, develop and implement strategies to increase notification data. It is recommended that NACCHO, the Royal Australasian College of Physicians, the Royal Australian College of General Practitioners and the Royal College of Pathologists of Australia take a collaborative lead on this issue. The OATSIH-commissioned report—Improving Indigenous Identification in Communicable Disease Reporting Systems (2004)—on strategies to improve Aboriginal and Torres Strait Islander identifiers in communicable disease notifications also highlights this need. Complete and accurate data will also help with monitoring and evaluating interventions and increasing understanding about the prevalence and incidence of infections. This, in turn, will support strategic approaches to improving sexual health and reducing BBVs.

Priority action in surveillance

  • Support enhancement of existing data collection and surveillance strategies to improve the accuracy and completeness of Aboriginal and Torres Strait Islander and other demographic information required to underpin program development, monitoring and evaluation.
  • As part of the implementation planning process the following specific issues should be considered:
    • supporting the extension of enhanced sentinel surveillance programs such as the Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance project
    • investigating data linkage as a mechanism for improving the completeness and accuracy of data sets on Aboriginal and Torres Strait Islander status
    • following up the implementation of the Communicable Diseases Network Australia’s Improving Indigenous Identification in Communicable Disease Reporting Systems
    • ensuring that NACCHO, the Royal Australasian College of Physicians, the Royal Australian College of General Practitioners, the Royal College of Pathologists of Australia and other stakeholders identify, develop and implement strategies that will improve the completeness and accuracy of Aboriginal and Torres Strait Islander status in the National Notifiable Diseases Surveillance System.