Sexually Transmitted Infections (STIs) And Blood-Borne Viruses (BBVs) In Indigenous Australians

Sexually transmitted infection (STI) diagnosis is increasing at a considerable rate among the Indigenous Australian population, especially in the remote and rural communities, more than the general Australian population. The Chlamydia and gonorrhoea diagnosis rates in 2011 were 3.5 and 30 times higher, respectively among the Indigenous population than the non-Indigenous Australians. In the later part of 2016, at least 574 Aboriginal and Torres Islander individuals were living with HIV. These diseases affect the Australian population disproportionately (aihw.gov.au, 2022). HIV damages the immune system and makes the body weak and prone to incurable and serious diseases and infections leading to cancer (Roweet al., 2017). Sexually transmitted diseases including parasitic, viral and bacterial infections are cause by unprotected sexual contact such as oral, anal and vaginal sex. Some of the most common STIs that affect the Australian population are:

Blood-borne viruses (BBVs) are transmitted when virus infected blood enters the human bloodstream. There are several kinds of BBVs including:

Human immunodeficiency virus (HIV) – a virus targeting the immune system

Hepatitis B and C – a disease that causes liver inflammation caused due to viral infections.

The current challenges and barriers in decreasing the STI and blood-borne virus rates among the population of the Aboriginal and Torres Islanders include:

Absence of a customised and a culturally responsive services in handling STI and BBV

Effects of colonisation, and racial and ethnic experiences contributing towards the outcomes of ill health

Shame, discrimination and stigma connected with STIs and blood borne viruses, reducing the rates for testing

STIs and BBV can be found in every demographics and age group among the Australians and studies have shown that around 29,090 people in the country have been experiencing chronic HIV infections in 2020. 24% of the cases were outcomes of unprotected heterosexual sexual intercourse, 58% were attributed to sex between men, 10% of the cases were caused due to a combination of sex between men and injecting drugs, 3% due to injecting drugs, and 5% attributed to unspecified causes (Australian Federation of AIDS Organisation, 2022). The HIV rates increased to 6.3 per 100,000 from 3.6 between the years 2011 and 2016, among the Aboriginal and Torres Strait Islanders. In Australia around 200,000-220,000 individuals have experienced life with hepatitis C (Treloar et al., 2018), and about 16.5% of the population are estimated contracting STIs at some point in their lives. STIs And BBVs In The Indigenous Australian Population Discussion Paper  The younger generations in Australia have considerably high rates of STIs particularly Chlamydia

Education and increasing literacy around health is one of the major areas that the communities and population of Australia need to be aware of. They need to be provided with culturally responsive health education, treatment and prevention. Transmission of STIs can be hugely prevented through safe sex and others can be prevented by proper vaccination. Many communities in rural and remote areas have superstition and stigma around sexual intimacy Argento, Goldenberg & Shannon, 2019). These communities lack knowledge regarding the preventive measures of STI and BBV. Maintaining hygiene and using protection like condoms can drastically enhance their quality of life, including reducing the risks of contracting and developing diseases. Many strategies have been implemented in the past years to support safe sex practices among the Aboriginal and Torres Islander people, and other communities including the sex workers, by increasing and enhancing the funded programmes. However, sexual health education and community based health education involving clinical approaches in preventing STI and BBV are needed (McGrew et al., 2020). Providing health education requires an understanding and respecting the cultural sensitivities of the communities and using local languages while imparting health education. Nurses might help to play an essential role in providing community based education as they are well versed with the knowledge and can explain the causes, symptoms and treatments to the communities (Jimenez & Bregenzer, 2018). Nurses can utilise the visual aid representations to educate the people regarding the fundamentals of hygiene, and using protection during sexual intercourse (Gordon et al., 2018). Nurses have the opportunity and ability to impart information regarding sexual and reproductive health in care settings, communities and schools.

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Common STIs Affecting The Australian Population

To make enhancements at the population and community level, there must be a need for an action plan in order to implement the enhancements. This action plan is one of the steps and goals of the Health Promotion Planning Cycle and as per HPPC; there is a requirement that needs to be addressed. Part A of describes the target groups and the immediate health issues need to be tackled, and Part B describes the changes that are needed to be implemented. The Stage 2 of HPPC action plan strives to impart educations on a population and community level regarding preventative measures and healthy sexual practices that can be adopted by the people. This action plan will encourage the Australian population to engage in early diagnosis and treatment while improving the testing and diagnostic strategies of the Australian healthcare system.

Diseases or infections of any kind can be prevented if it can be identified during the first time of contracting it. Diagnosis and testing is the primary step of any treatment. The health system of Australia requires ample investment in the testing and diagnosis process for Hepatitis B, Hepatitis C, HIV, Chlamydia, gonorrhoea and syphilis. The healthcare facilities and organisations should take initiative in promoting testing and awareness by distributing self-testing kits among the populations. Nurses are primary carers of any treatment and they can aid in dispensing knowledge regarding how to use the kits at home by themselves. Furthermore, advertisements and promotional events can enlighten the people and provide them with information regarding the proper use of the self-testing kits. Health programmes can also be initiated where nurses can provide information to the sexually active people on how to maintain a healthy sex life and tell them the need for getting tested every 6 to 12 months (Callander et al., 2018).

Early diagnosis of BBV and STIs and consequent intervention programmes can improve the health of the population. Early diagnosis leads to early interventions and treatments. Some BBV and STIs remain asymptomatic during their early stages are can be difficult to detect, hence hospitals and clinics can aim at raising awareness regarding the health consequences of the disease if they go unchecked. Hospitals need better facilities and management in order to provide better tests and diagnosis for BBVs and STIs (Ghimire et al., 2019). There are various challenges related to the testing and diagnosis such as fear, shame and stigma and nurses are able to reduce these barriers by creating awareness and imparting proper education. People will need to comprehend the fact that late diagnosis can lead to further deterioration of health and the disease may become untreatable.

References

aihw.gov.au. (2022). Australia’s health performance framework – Australia’s health performance framework – Australian Institute of Health and Welfare. Australian Institute of Health and Welfare. Retrieved 3 April 2022, from https://www.aihw.gov.au/reports-data/australias-health-performance/australias-health-performance-framework.

Argento, E., Goldenberg, S., & Shannon, K. (2019). Preventing sexually transmitted and blood borne infections (STBBIs) among sex workers: a critical review of the evidence on determinants and interventions in high-income countries. BMC infectious diseases, 19(1), 1-19.https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-3694-z

Australian Federation of AIDS Organisation. (2022). HIV in Australia. Retrieved 8 April 2022, from https://www.afao.org.au/about-hiv/hiv-in-australia/.

Broady, T. R., Cama, E., Brener, L., Hopwood, M., de Wit, J., & Treloar, C. (2018). Responding to a national policy need: development of a stigma indicator for bloodborne viruses and sexually transmissible infections. Australian and New Zealand Journal of Public Health, 42(6), 513-515.

https://www.proquest.com/openview/e2072e88904ef5635b4d84720ca1e058/1?pq-origsite=gscholar&cbl=37917

Callander, D., Moreira, C., El-Hayek, C., Asselin, J., van Gemert, C., Smith, L. W., …& Guy, R. (2018). Monitoring the control of sexually transmissible infections and blood-borne viruses: protocol for the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS). JMIR research protocols, 7(11), e11028.https://www.researchprotocols.org/2018/11/e11028/

Ghimire, S., Hallett, J., Gray, C., Lobo, R., & Crawford, G. (2019). What works? Prevention and control of sexually transmitted infections and blood-borne viruses in migrants from Sub-Saharan Africa, Northeast Asia and Southeast Asia living in high-income countries: a systematic review. International journal of environmental research and public health, 16(7), 1287.

https://doi.org/10.3390/ijerph16071287

Gilchrist, G., Swan, D., Widyaratna, K., Marquez-Arrico, J. E., Hughes, E., Mdege, N. D., …& Tirado-Munoz, J. (2017). A systematic review and meta-analysis of psychosocial interventions to reduce drug and sexual blood borne virus risk behaviours among people who inject drugs. AIDS and Behavior, 21(7), 1791-1811.https://link.springer.com/article/10.1007/s10461-017-1755-0

Gordon, T., Power, C., Duck, T., Schmidt, H. M. A., & Holden, J. (2018). A priority-driven, policy-relevant research program to support a response to blood-borne viruses and sexually transmissible infections in NSW, Australia. Public Health Res Pract, 28(3), e2831820.

https://www.phrp.com.au/wp-content/uploads/2018/09/PHRP2831820.pdf

Jimenez, P., & Bregenzer, A. (2018). Integration of eHealth tools in the process of workplace health promotion: proposal for design and implementation. Journal of medical Internet research, 20(2), e8769.https://www.jmir.org/2018/2/e65/

McGrew, C., MacCallum, D. S., Narducci, D., Nuti, R., Calabrese, L., Dimeff, R. J., …& McKeag, D. (2020). AMSSM position statement update: blood-borne pathogens in the context of sports participation. British journal of sports medicine, 54(4), 200-207.  STIs And BBVs In The Indigenous Australian Population Discussion Paper