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. 2020 Jan;47(1):34-40.
doi: 10.1097/OLQ.0000000000001086.

Two Distinct Gonorrhea Trends and Risk Factors Among Women in Australia

Kate Whitford  1 , Denton Callander, Lucy Watchirs Smith  1 , Rebecca Guy  1 , Marlene Kong  1 , James Ward  2 , Basil Donovan  1 , Hamish McManus  1 , Stephen Bell, Skye McGregor  1 , Arun Menon  3 , Darren Russell, Catherine C O'Connor  1 ; ACCESS collaboration
Affiliations

Two Distinct Gonorrhea Trends and Risk Factors Among Women in Australia

Kate Whitford et al. Sex Transm Dis. 2020 Jan.

Abstract

Background: In recent years, gonorrhea notifications have increased in women in Australia and other countries. We measured trends over time and risk factors among Australian Aboriginal and Torres Strait Islander ("Aboriginal") and non-Aboriginal women.

Methods: We conducted a cross-sectional analysis of data from 41 sexual health clinics. Gonorrhea positivity at each patient's first visit (first-test positivity) during the period 2009 to 2016 was calculated. Univariate and multivariate analyses assessed risk factors for first-test positivity in Aboriginal and non-Aboriginal women.

Results: Gonorrhea positivity decreased among Aboriginal women (7.1% in 2009 to 5.2% in 2016, P < 0.001) and increased among non-Aboriginal women (0.6%-2.9%, P < 0.001). Among Aboriginal women, first-test positivity was independently associated with living in a regional or remote area (adjusted odds ratio [aOR], 4.29; 95% confidence interval [CI], 2.52-7.31; P < 0.01) and chlamydia infection (aOR, 4.20; 95% CI,3.22-5.47; P < 0.01). Among non-Aboriginal women, first-test positivity was independently associated with greater socioeconomic disadvantage (second quartile: aOR, 1.68 [95% CI, 1.31-2.16; P < 0.01]; third quartile: aOR, 1.54 [95% CI, 1.25-1.89; P < 0.01]) compared with least disadvantaged quartile: recent sex work (aOR, 1.69; 95% CI, 1.37-2.08; P < 0.01), recent injecting drug use (aOR, 1.85; 95% CI, 1.34-2.57; P < 0.01), and chlamydia infection (aOR, 2.35; 95% CI, 1.90-2.91; P < 0.01). For non-Aboriginal women, being aged 16 to 19 years (aOR, 0.62; 95% CI, 0.49-0.80; P < 0.01) compared with those ≥30 years was a protective factor.

Conclusions: These findings highlight 2 different epidemics and risk factors for Aboriginal and non-Aboriginal women, which can inform appropriate health promotion and clinical strategies.

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References

    1. Kirby Institute. HIV, Viral Hepatitis and Sexually Transmissible Infections in Australia: Annual Surveillance Report 2018. Sydney: Kirby Institute, UNSW Sydney, 2018.
    1. Misson J, Chow EPF, Chen MY, et al. Trends in gonorrhoea infection and overseas sexual contacts among females attending a sexual health centre in Melbourne, Australia, 2008–2015. Commun Dis Intell (2018) 2018; 42.
    1. Graham S, Guy RJ, Donovan B, et al. Epidemiology of chlamydia and gonorrhoea among Indigenous and non-Indigenous Australians, 2000–2009. Med J Aust 2012; 197:642–646.
    1. Detels R, Green AM, Klausner JD, et al. The incidence and correlates of symptomatic and asymptomatic Chlamydia trachomatis and Neisseria gonorrhoeae infections in selected populations in five Countries. Sex Transm Dis 2011; 38:503–509.
    1. Kirby Institute. Bloodborne Viral and Sexually Transmissible Infections in Aboriginal and Torres Strait Islander People: Annual Surveillance Report 2018. Sydney: Kirby Institute, UNSW Sydney, 2018.

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