Have you been tested?
By Rachael Mason
A study of sexually transmitted diseases among Australian adolescents.
Each year, there are an estimated 376 million new infections of sexually transmitted diseases worldwide. The sexual health of adolescents has been an important conversation amongst public health specialists for quite some time now. Sexually transmitted diseases (STDs) are a subset of communicable diseases; there are more than 30 infections known to fall under this category, with chlamydia being the most commonly contracted STD in Australia. Young adults and teenagers are the most susceptible demographic to contract chlamydia. In Australia over the past 10 years there has been a noticeable increase in the spread of chlamydia amongst adolescents.
Chlamydia is a bacterial infection which is contracted through sexual activities. Chlamydia often presents with little to no symptoms, although if left untreated can lead to long-term health consequences, especially in females. Untreated chlamydia can lead to the development of pelvic inflammatory disease, ectopic pregnancy and infertility. In rare cases, for males, chlamydia can spread to the testicles causing them to become swollen and painful. Because the disease is mostly asymptomatic people do not seek diagnosis and treatment, this is why it is important for sexually active individuals to get tested regularly.
The Australian government has implemented a number of strategies for battling the spread of STDs such as education campaigns and safe treatments. Although, the increase in the prevalence of STDs such as chlamydia, indicate these strategies are not effective.
Between 2009-2019 there was an increase in diagnosed cases of chlamydia from 1466 to 1934 per 100,000 people. In 2020, due to the influence of the COVID-19 outbreak and national lockdowns, there was a decrease to 846 diagnosed cases of chlamydia per 100,000. Although, post-lockdown, we are seeing numbers rise again. Of these statistics 75% are aged between 15-29. There are many determinants that influence the circulation of STDs among young people; these include not understanding the risks, financial costs, as well as societal and cultural barriers.
The Beveridge model of health is adopted in Australia; this provides an insurance program known as Medicare, that covers the entire population. There are also optional private health insurance sectors. Medicare attempts to provide equal access to health services across the country. In regards to STDs, this means that individuals are able to access general practitioners to receive diagnoses and/or treatment for free or with subsidised pricing. In a study conducted by Dr Adams, he found that 16.9% of adolescents in Australia do not seek testing due the cost. By subsiding or bulk-billing general practitioner appointments, Australian residences should be able to access testing. Although, there are many other determinants which factor in, such as the cost of medication, cost of travel, and possibly for the younger population, the ‘shame’ of asking your parents for financial assistance for such a personal subject.
Studies show that adolescents and young adults are aware of the rising rates of STDs, so why are adolescents and young adults not getting tested? Dr Adam found that 26% of adolescents don’t know where to get tested and only 58% have ever been tested. Research also shows that non-clinical testing achieves higher rates than general practice; this could be that adolescents find it less intimidating. This conveys a need for education on where to get tested, both clinical and non-clinical.
While sexual education has been enforced in Australian schools since the 1970’s, it has proven to no longer be effective. This is strongly related to educators not have sufficient training in the area as most educators only spend between 1-5 hours on sexual health. Youth and adolescent are being exposed to sexual activities from a much younger age than historically recorded, thus creating a demand for quality sex education in schools. In order to achieve this, schools could provide training to educators so they are able to appropriately and ethically teach about the topic.
Adolescents are generally the target of sexual education campaigns although, research shows they do not find these campaigns relevant to them. In order to communicate with this demographic, the government and other organisations should have more young people aged between 15-29 involved in developing campaigns and strategies. As this is the age bracket these campaigns are aiming to influence, having people from this demographic involved is important as they will be able to give insight into what engages this audience.
New technologies like the internet are resourceful tools for health promotion. Adolescents are the largest consumers of social media in Australia. Social media could be used to enhance STD testing and reinforce condom use; these being the two main preventive methods for STDs. By using the multitude of social media platforms such as Instagram, Facebook, Snapchat and Tiktok, we can reach the desired demographic and communicate important messages including: where to get tested, the importance of getting tested and symptoms, and signs of popular STDs such as chlamydia so young audiences know what to look out for.
To conclude, we see that the rates of chlamydia have risen significantly over the past 10 years, which is reflective of all STD rates. There are many social determinants which have influenced the increase in the circulation of STDs. Hence, it is important for the government to recognise these changes and make appropriate adjustments to education and promotion across Australia so that they are effectively targeting the desired demographic.