NACCHO Aboriginal #SexualHealth : No point in a one-size-fits-all fix for #STIs in #remote communities @AMSANTaus @CAACongress @Apunipima @TheAHCWA @atsihaw

” The varying incidence of sexually transmitted infections in the ­Aboriginal populations in remote Australia presents a number of challenges to the Australian health system.

The identification of persons with STIs is not straightforward — and sometimes extremely difficult — in remote areas.

The diseases range from rare and difficult to treat, to endemic and even more difficult to treat. Those that are easy to treat remain a problem because of the ways in which the infectious burden develops in these populations.

These are difficult, long-term issues that only a few dedicated services are tackling.

These ser­vices are not helped by prurient and muddled media interest, the ­Aboriginal men and women who for their own reasons deny the existence of these problems and retreat to life-threatening but comfortable slogans, and least of all, the negligence of successive governments whose responsible leaders have responded too slowly and with too few resources for an effective response by the frontline workers.”

Marcia Langton is Redmond Barry Distinguished Professor, Australian Indigenous Studies, at the University of Melbourne.

Read over 38 NACCHO Aboriginal Sexual  Health articles published over past 6 years

Three animated education and awareness videos focus on HIV, STIs and PrEP (a daily medication that can prevent HIV), which aim to enhance awareness of HIV prevention. These are housed on the website  www.atsihiv.org.au,

Watch 1 of 3 Videos HERE

It is wrong to conflate the incidence of STIs with sexual abuse. To make this clear: it is not the case that all cases of STIs in ­minors are the result of sexual contact or abuse.

The rush to recommend removal of Aboriginal children from their families is an unwarranted response, and has become the catchcry of those building their careers on serious health issues that have become salacious fodder for the media and very significant threats to developing protocols for treating these continuing disease threats to ­extremely vulnerable people.

The question of whether to remove children is secondary to the question of immediate medical treatment.

Ascertaining how the STIs are being spread — by interviewing children — is the work of professionals and needs to be undertaken with caution and care.

Some proportion of the sexual activity involves only children and not adults. When only children are involved, different steps need to be taken.

When adults are involved in sexual activities with children, a different set of steps must be under­taken. Is the adult offender living in the household? Visiting the household? In what circumstances does the offender gain access to the child?

It would be ridiculous to have a one-size-fits-all approach to this very difficult problem. Medicos working in the Territory under the Northern Territory Emergency Response schemes were well aware of these problems but unable to speak because of the issues of confidentiality of patients and maintaining the confidence of ­patients and communities to present to clinics.

The rates of STIs among Aboriginal children in the NT must be treated as a medical matter for professionals. In the absence of a Centre for Disease Control (as recommended by the Australian Medical Association), the Office of Health Protection in the federal Department of Health has some responsibility for communicable diseases.

If I were in a responsible position, I would ask the Office of Health Protection to co-operate with the ­Aboriginal medical ser­vices bodies, such as Aboriginal Medical Services Alliance Northern Territory and the National Aboriginal Community Controlled Health Organisation and the Northern Territory and Queensland health departments, and put together medical teams to test and treat Aboriginal children in the affected areas in the Northern Territory, Queensland and Western Australia.

All children in school should have sex education and STI education, and the educational material should be in their own languages. They and their parents need to be aware of the consequences of untreated STIs: infertility, mortality, brain damage and others. Other infectious diseases, such as trachoma, have been treated with similar approaches involving better co-ordination of existing services.

The federal, Northern Territory and Queensland governments are negligent in the extreme in allowing this situation to worsen over the past 10 years. It has been reported regularly and extensively in the past decade by medical professionals from various health entities, including the Central Australian Aboriginal Congress, and the responsible ministers and officers run for cover rather than taking the necessary steps to treat children for these diseases.

In this context, I have previously said that the complaints from some Aboriginal male leaders about being labelled universally as abusers should be ignored and the complicity of the indigenous sector in protecting their sensitivities and strange complaints that result should also be ignored.

If they had taken positions of protecting children rather than outrage at John Howard’s nasty and ridiculous blame game in 2007, we would not have the increased rates (also greatly under-reported) that are reported now.

Blatant denialism has contributed to this terrible situation.

Marcia Langton is Redmond Barry Distinguished Professor, Australian Indigenous Studies, at the University of Melbourne.

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