Committed leadership, effective partnerships and engagement with affected populations are key elements for successful and sustained implementation of this strategy. Chlamydia (serovars D-K and L1-3), gonorrhoea, syphilis and trichomonas infection, and the vaccine-preventable conditions, HPV and hepatitis B virus (which is the subject of a separate national strategy), are the highest priority infections. Their high priority relates to their prevalence and the associated and preventable complications, such as pelvic inflammatory disease, infertility, genital and other cancers, chronic liver disease and liver cancer, as well as the enhanced transmission of HIV. Inequity in health literacy, access to health services for testing, treatment and support are among the factors that contribute to the vast differences in the epidemiology of these infections between Aboriginal and Torres Strait Islander peoples and other Australians.
Three variables influence the spread of STIs:
- the risk of transmission
- the number of at-risk partners an individual has
- the period of infectiousness.
- health promotion and prevention
- patient and provider initiated testing
- early intervention and partner notification
- access to and delivery of clinical care and support
- surveillance and research.28
28 Huang R, Torzillo P, Hammond VA, Coulter ST & Kirby AC, 2008, ‘Epidemiology of sexually transmitted infections on the Anangu Pitjantjatjara Yankunytjatjara Lands: results of a comprehensive control program’, Medical Journal of Australia 189 (8): pp. 442–445, viewed 13 September 2009, <http://www.mja.com.au/public/issues/189_08_201008/hua11315_fm.html>.