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Chlamydia prevalence in adolescent Australians

Chlamydia prevalence in adolescent Australians

Most Australian guidelines for clinical screening of chlamydia infection advise testing sexually active individuals aged 16-24 years. Recent research shows that age at first sex in Australia is decreasing; a recent Victorian survey showed 29% of respondents reported being sexually active before age 16 years. There is also evidence that younger age at first sex is associated with risk behavior such as unprotected sex and having multiple sex partners.

We examined three years of laboratory testing data (2008-2010) collected via the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS). Data from 15 laboratories were used; five from Victoria, four each from New South Wales and Queensland, two from South Australia and one from Tasmania. Chlamydia test numbers and proportion positive were compared by age group.

In three years 286,020 tests were conducted in individuals aged 12-24 years, the majority occurring in females (3:1 ratio). Of total tests, 3.6% were in 12-15 year olds (n=10,296) compared to 32% in 16-19 year olds. The proportion chlamydia positive was highest in adolescent girls aged 12-15 years (13%) compared to 12% in those aged 16-19 years, 8% in those aged 20-24 years (p=.001) and 9% in boys aged 12-15 years (p<.001).

Chlamydia testing in 12-15 year olds was much lower than in other adolescents but this group had the highest chlamydia prevalence. This is possibly due to less routine chlamydia testing in 12-15 year olds or only testing those presenting with sexual risk. Testing young adolescents is complicated by legal policies relating to age of consent, and privacy is a potential barrier to testing. Also of concern is the sexual behaviour of younger adolescents potentially increasing their risk of infection. Research into sexual behaviours of this group is needed.

Speakers: Carol El-Hayek
Conference: ASHM 2013

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