National Women's Health Policy
Sexually transmitted infections (STIs) remain a major public health issue in Australia, particularly in regards to increasing rates of chlamydia. The Australian Study on Health and Relationships in 2001 found 16.9 per cent of Australian women have ever been diagnosed with an STI and 2.2 per cent had been diagnosed in the past year.229 Whilst similar proportions of men and women had been diagnosed with an STI in the last year, significantly more men had ever been diagnosed with an STI compared to women.230 The most common diagnosed STI for women was candida or thrush (57.6 per cent), wart virus on Pap smear (5.1 per cent), genital warts (4.4 per cent), pubic lice or crabs (4.2 per cent), chlamydia (3.1 per cent), and genital herpes (2.5 per cent).231
In 2009, chlamydia was the most frequently reported infection in Australia.232 Between 2000 and 2004 rates of chlamydia more than doubled for females, and increased by 40 per cent in 2009. 233 Overall diagnosis rates are higher for females than for males. This appears to be primarily due to significantly high rates of chlamydia in young females aged between 15–29 years.234 The sex difference then reverses for 30 years and older with rates being higher in males.235
Substantially higher rates of chlamydia are diagnosed among Aboriginal and Torres Strait Islander people, particularly those aged 15–29 years.236, 237 It is unclear if the increases in rates of chlamydia and the differences in rates across the population are due to increased testing (especially among some groups of Australians), rising infection rates, or a combination of these factors.
For gonorrhoea, the population rate of diagnosis among females increased by 36 per cent between 1999 and 2006 from 19.2 to 26.1 per 100,000 population; it then declined by 4 per cent in 2008 to 25 per 100,000 population.238 Like chlamydia, young people239 and Aboriginal and Torres Strait Islander people240 report higher rates of gonorrhoea.
Gender can affect women’s ability to insist on safe sex practices. Young women are generally at greater risk of contracting sexually transmitted infections than older women. Women who had lower levels of education and were younger had less knowledge of sexually transmitted infections.241 For example, rates of chlamydia are significantly higher among young females aged between 15 and 29 than for older women.242 In 2005 over half of the chlamydia notifications were from women (58 per cent), with 65 per cent of that group aged 16–24 years. This compares to 42 per cent of notifications from young men in the same age group.
Education about STIs and access to condoms are important aspects of tackling the issues of increasing rates of STIs such as chlamydia.
While knowledge among students about STIs has generally improved, it remains relatively poor about some diseases such as chlamydia, hepatitis A, B and C, human papillomavirus and cervical cancer.243 244
Between 2002 and 2008 there have been improvements in the knowledge that students have about STIs.245 But for some disease areas such as chlamydia, hepatitis A, B and C, HPV, and cervical cancer, knowledge remains relatively poor.246 247
While men with chlamydia rarely experience complications, if left untreated in women it can increase the risk of pelvic inflammatory disease, tubal infertility and chronic pelvic pain.248
Rates of infection vary across the population, with some groups reporting much higher rates. Aboriginal and Torres Strait Islander women report much higher rates of STIs than other Australians, with the most common being chlamydia, gonorrhoea and syphilis.249 Among lesbian and bisexual women, nine per cent reported having been diagnosed with an STI.250