Gonorrhea and syphilis cases rise in Australia

By Dr. Ananya Mandal, MDNov 5 2017

The Annual Surveillance Report on HIV, viral hepatitis and sexually transmissible infections (STIs) in Australia was released and it revealed that there is a rise in diagnosis of gonorrhea and syphilis but the number of people being affected by HIV has plateaued. In addition tens of thousands of people have been cured of hepatitis C. The report comes from the Kirby Institute at UNSW Sydney.

Data has shown that the number of people affected by gonorrhoea has risen by 63 percent in the past five years. The rise is particularly seen among the heterosexual urban youth. This was not seen in the recent past according to Associate Professor Rebecca Guy, head of the Surveillance, Evaluation and Research Program at the Kirby Institute. This is a signal that the young people need to be educated in prevention of gonorrhea and getting tested routinely. “With the national strategies for HIV, hepatitis and STIs up for review, reducing STIs in young people will be an important target,” she added.

This report finds that chlamydia and gonorrhea infection rates are three and seven times higher among the Aboriginal and Torres Strait Islander people respectively when compared to the non-Indigenous population. Syphilis that had been on the decline has started to rise since 2011 among the Aboriginal and Torres Strait Islander people living in remote areas of Northern Australia the report finds. Associate Professor James Ward, head of Infectious Diseases Research, Aboriginal Health Infection and Immunity, South Australian Health and Medical Research Institute called for more initiatives to combat the “resurgence” of syphilis. This would mean increased awareness regarding testing and treatment he explained. The awareness initiatives and health promotional campaigns need to be “culturally appropriate” and comprehensive he added.

Last year between March and December, 30,434 people have been cured of hepatitis C, this report finds. Associate Professor Jason Grebely from the Viral Hepatitis Clinical Research Program at the Kirby Institute called the newly available therapies for hepatitis C “game-changing” in Australia. He said that for the first time in a decade, the number of people with advanced liver disease caused by hepatitis C has fallen. He added that the efforts must be sustained to maintain this success. In the last five years, the number of new hepatitis B diagnosis has also reduced by 27 percent in persons aged less than 25 years. This reflects the effect of vaccinating infants he explained. Associate Professor Ben Cowie, director of the WHO Collaborating Centre for Viral Hepatitis, Doherty Institute said that there was a significant gap between diagnosis of the chronic liver disease patients who have hepatitis B. This calls for further efforts he said. In younger Aboriginal and Torres Strait Islander people too there is a decline in hepatitis B diagnosis which is probably due to the effective immunization programs.

HIV infection incidence however has remained stable over the last five years says the report. In 2016, there have been 1,013 new diagnoses. According to Associate Professor Rebecca Guy there are increased levels of testing and treatment for HIV especially among gay and bisexual men. This group of men is most commonly diagnosed with HIV in Australia she explained. “It is also encouraging that 86% of people diagnosed with HIV were on treatment in 2016,” she added. But one in five diagnoses of HIV is among heterosexual men and these individuals are commonly missed in the testing net says Dr. Guy says. An average four years delay is seen before a heterosexual man is diagnosed with HIV. She explained that although the numbers are encouraging, for these numbers to come down, a combination of prevention strategies are necessary that includes better testing and treatment initiatives. She said two things are likely to aid in this effort – self testing HIV and equal access to pre-exposure prophylaxis (PrEP) across Australia. PrEP involves treatment of a person at risk from getting HIV by giving them a combination of anti-HIV drugs. These two strategies, she explained, in a new survey from NSW Health, have shown a 31 percent reduction in new HIV diagnoses in gay and bisexual men in the first half of 2017 when compared to the last five years. This is one of the greatest reductions that have been recorded she said.

Despite these encouraging numbers among the non-indigenous populations, the Aboriginal and Torres Strait Islander people have not shown improvement. HIV diagnoses among them have risen by 39 percent since 2012. A large proportion of these are those who are using illegal injectable drugs and indulging in unsafe heterosexual sex. Associate Professor Ward pointed out this disparity and said culturally relevant HIV prevention programs for people at risk of HIV is necessary. Some of the steps in prevention he added are “access to PrEP, and greater access to sterile needle and syringes, and drug dependence treatment for people who inject drugs.”

The full Annual Surveillance Report is available on the Kirby Institute website from 6 November 2017 and would be officially launched tomorrow (7th November 2017) at the Australasian HIV & AIDS and Sexual Health conference in Canberra.