For almost two decades, higher notification rates for chlamydia and gonorrhoea have been reported among Aboriginal than non-Aboriginal Australians. We evaluated a tailored sexual health quality improvement program (QIP), implemented in four regional Aboriginal Community Controlled Health Services (ACCHS), to determine whether it had an effect on chlamydia and gonorrhoea testing in 15-29 year olds.
Method: The QIP involved extracting and analysing of STI clinic data from patient management systems; six-monthly service visits to discuss current testing rates and the development of action plans by ACCHS staff. Using a before-and-after design, we compared the proportion of 15-29 year olds tested for chlamydia and gonorrhoea in a 12-month baseline (March 2011-February 2012) to a 12-month QIP period (March 2012-February 2013), by age group and sex. We used a chi-squared test to assess if the percentage tested was different between the two periods. –
Results: There were 2,422 15-29 year olds who attended the services in the baseline and 2,559 in the QIP period. Overall chlamydia testing was 14% and increased from the baseline compared to in the intervention period (8% to 21%,p<0.01). In females, the greatest increase in chlamydia testing was in 15-19 year olds (8% to 24%, p<0.01) and for males the greatest increase was seen in 20-24 year olds (4% to 21%,p<0.01). Similar increases were seen for gonorrhoea testing. Over the study period, chlamydia positivity was 12%, highest in 15-19 year olds (15%), followed by 20-24 (12%) and 25-29 years olds (6%). There were 70 chlamydia diagnoses in the QIP compared to 31 in the baseline period. Less than five cases of gonorrhoea were detected.
Conclusion: Implementation of QIP was followed by an increase in chlamydia and gonorrhoea testing among 15-29 year olds and resulted in the detection of more infections, particularly in 15-24 year olds.
