NACCHO Aboriginal #SexualHealth #UandMeCanStopHIV Check out #ACCHO Events this week @atsihaw and we cover Minister @KenWyattMP Launches new TV and Social Media campaign to tackle First Nations #HIV


” A new television, social media and community campaign has been launched during Aboriginal and Torres Strait Islander HIV Awareness Week, to increase understanding of HIV and reduce new cases among First Nations people.

Part of a $3.4 million project funded by the Federal Government, through the South Australian Health and Medical Research Institute (SAHMRI), the campaign aims to capitalise on a reduction in new HIV diagnoses last year.”

To view or download the new campaign resources visit see link below 

Check out over NACCHO 40 Aboriginal Sexual Health Articles like this HERE 

 “ Each year in the first week of December, to coincide with World AIDS Day, we host Aboriginal & Torres Strait Islander HIV Awareness Week – “ATSIHAW”.

The inaugural ATSIHAW was held in November 2014 to get a conversation going in our community about HIV prevention and the importance of regular testing for HIV.

The theme of ATSIHAW is “U AND ME CAN STOP HIV”.

ATSIHAW has proven itself to be a popular event – engaging our communities, as well as HIV researchers, doctors, health workers and policy-makers. Each year ATSIHAW events that aim to promote awareness of HIV are run in local community based organisations. Engagement is continuing to grow with the number of events reaching over 60 during the week of ATSIHAW in 2016.

ATSIHAW 2018 will run from 27 November to 1 December 2018, with the official launch at Parliament House, Canberra, on 27 November 2018. Senator Dean Smith hosted the launch, in his capacity as Chair of the Parliamentary Liaison Group on HIV/AIDS, Blood Borne Viruses and Sexually Transmitted Diseases.” 

ATSIHAW community events and activities are held across Australia

See full list of events below or HERE 

The campaign has First Nations voices and people speaking directly to First Nations people – communicating with cultural understanding, to help ensure these lifesaving messages get through.

To view or download the new campaign resources visit 

In 2017 there were 31 new HIV cases diagnosed in Aboriginal and Torres Strait Islander people – 30 per cent less than in 2016 – but HIV among First Australians remains too high.

Aboriginal and Torres Strait Islander people are disproportionately affected by HIV and other sexually transmitted infections.

At 4.6 cases per 100,000, the per capita rate of HIV infection last year was still 1.6 times the rate for the non-Indigenous Australian-born population.

Although the majority of HIV cases in First Australians are in men who have sex with men, compared to other Australians, First Nations people are six times as likely to contract HIV as a result of injecting drugs, and more likely to contract it from heterosexual sex.

Aboriginal and Torres Strait Islander people are also more likely to have undiagnosed HIV.

This is particularly concerning as international evidence shows that people diagnosed with HIV who receive appropriate treatment can reduce HIV to levels so low that it is undetectable.

This reduces the risk of transmission significantly. This is known as ‘Treatment as Prevention’, and it is essential that it is better promoted and understood in Aboriginal and Torres Strait Islander communities.


As well as the SAHMRI education campaign, our Government is funding awareness raising about the use of HIV medicines to prevent HIV transmission – known as Pre-Exposure Prophylaxis, or PrEP.

We have committed $1.2 million over five years for education and awareness activities about PrEP for both doctors and other prescribers, and affected communities, including First Australians.

Since April, PrEP had been available through the Pharmaceutical Benefits Scheme, making it affordable for all. If taken daily, PrEP has been shown to be highly effective in protecting people from contracting HIV.

The Government will provide an estimated $180 million a year in subsidies for PrEP to reduce HIV, especially among First Australians, some migrant groups, and gay and bisexual men.

To continue the fight against HIV – among Aboriginal and Torres Strait Islander communities and across the whole country – we will shortly be announcing new national Blood Borne Viruses and Sexually Transmissible Infections strategies.

To view or download the new campaign resources visit 


NATSISN (National Aboriginal and Torres Strait Islander Staff Network)

HIV and community – Awareness event
26 Nov – 3 Dec
Department of Health foyer
51 Ellerston Ave
Isabella Plains ACT 2905

Contact: Kartika Medcraft
Awareness of rise of HIV/ STI in indigenous community, local services and prevention campaigns

Winnunga Nimmityjah Aboriginal Health and Community Services

Community BBQ
Winnunga Aboriginal Health Service
63 Boolimba Cres
Narrabundah ACT 2604

HIV Awareness

Contact: Christine Saddler,

New South Wales

Aboriginal Health & Medical Research Council of New South Wales (AH&MRC)

Redfern AMS
28 Nov – 5 Dec at Redfern AMS
U and Me can stop HIV

Raising awareness, treatment and support options for clients and families

Contact: Sophie Scobie:

Aboriginal Health & Medical Research Council of New South Wales (AH&MRC)

Rural Doctors Network

28 Nov – 5 Dec Rural Doctors Network – Conf. stall
U and Me can stop HIV
Raising awareness, treatment and support options for clients and families to GPs

Contact: Angela Draper

Aboriginal Health & Medical Research Council of New South Wales (AH&MRC) – Tharawal AMS

U and Me can stop HIV
28 Nov – 5 Dec Tharawal AMS

Raising awareness, treatment and support options for clients and families

Contact: Pauline Weldon-bowen

Albury Community Health

596 Smollett Street Albury NSW 2640

STIGMA Performance
8-Dec 7:20pm
Hothouse Theatre

Examining the prejudices, discrimination and stigma experiences by people living with HIV

Contact: Helen Best

Bega Sexual Health Clinic (SERH, SNSWLH)

4 Virginia Drive Beg NSW 2550

You and Me can Stop HIV
29 and 30 November 10:00 – 2:00
SERH foyer and Bega AMS Katungul waiting room

Promote HIV prevention, testing and treatment
HIV prevention, safe sex promotion, promote HIV testing. Promote awareness of HIV treatment to prevent transmission and PeP and PrEP

Contact: Fiona Mckenna

Griffith Community Health Centre Sexual Health

39 Yambil Street Griffith NSW 2680

World AIDS Day community Event
1-Dec 6:30pm – 8:30pm
Memorial Gardens Griffith

Remembrance and raising awareness of stigma of positive people. Community engagement and prevention, testing and treatment of HIV in the local region
Contact: Sally Davoren


Level 3, 34 Lowe Street Queanbeyan NSW 2620

Displays and Information Stalls – U and Me can stop HIV, come have a yarn
10am – 2pm on 23 Nov – 30 Nov
Queanbeyan Hospital Foyer and Goulburn Community Health Centre.

Prevention, testing and treatment and information of HIV to local community members and health care workers. 
Discussions on our free and confidential services in the local area which offers, information, screening, treatment and support

Contact: Kevin Schamburg

Illawara Aboriginal Medical Service

2/30 Princess highway Dapto NSW 2530

U and Me can stop HIV BBQ
29-Nov at Illawarra Aboriginal Medical Service (Wollongong)

Raising awareness, treatment and support options for clients and families

Contact: Debbie Gaudie

MLHD Brookong Centre Sexual Health

79 Brookong Avenue Wagga Wagga NSW 2650

Distribution to local Aboriginal services during week
26 Nov – 31 Nov at local Aboriginal and youth based services
That as a community we can all do our part in ending HIV as well as show our support for people living with HIV

Contact: Janine Sutton

Aboriginal Health Goulburn

Aunty Jeans Goulburn
6-Dec 10:00am – 2:00pm
Bourke Street Health Service

HIV prevention and awareness for the local Aboriginal community

Contact: Rick Shipp

Orange Aboriginal Medical Service

27-31 Perc Griffith Way Orange NSW 2800

HIV awareness week
28 Nov – 5 Dec
Orange Aboriginal Medical Service

Get tested more treatment options

Contact: Michael Halls

Riverina Aboriginal Medical & Dental Corp

14 Trail Street Wagga Wagga NSW 2650

11-Nov 8:30 – 4:00
Jack mission Oval, Ashmont

Caring for our community for 30 years

Contact: Latoya Terry

SNSWLHD – Eurobodalla

2 River street Moruya NSW 2537

1 December from 9:00 – 1:00
Batemans Bay and Moruya WAD Roadshow

Promotion and availability of HIV testing and treatment services in Eurobodalla 

Contact: Will Hooke

South East Regional Hospital, Health NSW

4 Virginia Drive Bega NSW 2550

Awareness of HIV
1-Dec 9:00am
Foyer of hospital

Heighten awareness

Contact: Jo Donovan,

Yoorana Gunya Aboriginal Family Healing Centre

40-70 Church Street Forbes NSW 2871

Health Awareness Day
14-Nov Main Street, Forbes
Knowledge of what testing can be done for HIV? AIDS and treatment

Contact: Deanne Anderson

Northern Territory

Marthakal Homelands Health Service

World AIDS Day
1-Dec at Mapurrui Health Clinic

We want to tell people about HIV – encourage testing & promote prevention

Contact: Peter Malavisi:

Royal Darwin Hospital – SHBBVU

Royal Darwin Hospital, Tiwi NT

Raising Awareness among community and staff around reducing the risk of infection.
29th Nov from 10am – 12:00pm at the Royal Darwin Hospital

Contact: Letishia Parter:

Royal Darwin Hospital – SHBBVU

Royal Darwin Hospital, Tiwi NT


Raising Awareness
Friday 30th Nov 7am- 9am – Casuarina shopping centre (Woolworth’s side under the carpark)
The Darwin Sexual Health Blood Borne Virus Unit will have an ATSIHAW BBQ in the Casuarina shopping centre carpark with the Larrakia Nations HEAL program for the homeless from 7am-9am. 
Come along learn about HIV and grab some free ATSIHAW merchandise.

Contact: Letishia Parter:

Central Australian Aboriginal Congress

32 Priest Street Alice Springs NT 870

Health Promotion event 
30-Nov 10:00am
Congress main clinic

Safe sex, preventative programs and health promotion including other services

Contact: Natalee Norsworthy:


Gar’ban’djee’lum Network

Brown Sugar
30-Nov 7:00pm til late
Australian National Hotel, 867 Stanley St, Woolloongabba QLD 4102
Raise awareness of HIV/AIDS and positive sexual health. 
Condoman and Lubelicious will be handing out condom and lube packs




50 George Street Bowen QLD

Together as a community we can stop HIV
29-Nov at Collinsville Town Park
To encourage all of community to be aware of HIV and how as a community we can stop HIV

Contact: Leanne Prise:


50 George Street Bowen QLD

Together as a community we can stop HIV
27-Nov at Proserpine Town Park

To encourage all of community to be aware of HIV and how as a community we can stop HIV

Contact: Leanne Prise:

Mamu Health Service 23 Glady Street Innisfail QLD

HIV awareness week 
7-Dec at Main Clinic, Innisfail

Keep you clean, palya, Keep you safe

Contact: Teayana Salter:

Giradula, Bowen QLD

Together as a community we can stop HIV
28-Nov at Bowen Town Square

To encourage all of community to be aware of HIV and how as a community we can stop HIV

Contact: Leanne Prise:

Mens and Womens Health Torres NPA

WAD Ball
1-Dec evening
Thursday Island Bowling Club

To inform and educate the indigenous and non-indigenous people living in the Torres Strait communities about the risks involved with unsafe sex, having more than one partner and the importance of regular screening and testing. We need to let the community know about the importance of knowledge and understanding in regard to sexual health, also the Men’s and Women’s health staff will be promoting HIV Awareness Week leading up to world AIDS day

Contact: Sandra or Richard: or

South Australia

Aboriginal Health Council of SA

220 Franklin Street Adelaide SA 5000

HIV is Everybodys business!
You and me can stop HIV
Information Stall 28 Nov – 5 Dec all day
Reception area of Aboriginal Health Council of SA

Contact: Sarah Betts:

Ceduna Koonibba Aboriginal Health Service

1 Eyre Highway Ceduna SA 5690

CKAHSAC HIV awareness day
HIV day 22-Nov 10:30am – 1:00pm

Contact: Con Miller

Drug and Alcohol Services SA

91 Magill Road Stepney SA 5069

ATSIHAW promotion through our clean needle exchange program 
26-Nov from 9:00am  at 91 Magill Road Stepney 
Promoting ATSIHAW to all clean needle program clients, making them aware of the importance of the week

Contact: Kendall Robertson

Nunkuwarrin Yunti

182 – 190 Wakefield St Adelaide SA 5000

ATSIHIV awareness week 
31 Nov – 4 Dec 9:00am – 5:00pm at Nunkuwarrin Yunti Health Service 
You and Me can stop HIV

Contact: Jorge Carvajal

Pangula Mannamurna Aboriginal Corporation

191 Commercial St West Mt Gambier SA 5291

Community Awareness 28 Nov – 5 Dec 9am – 5pm 
Pangula Mannamurna reception area and clinic treatment room 
By getting information out to all community in the hope to raise awareness and start the conversation

Contact: Narelle Winterfield

Pika Wiya

40-44 Dartmouth Street Pt Augusta SA 5700

Lets talk about HIV
28-Nov Pika Wiya Health Service – Well Womens House
A lot of education on HIV, risk what treatment, STI’s, give out pamphlets

Contact: Kerryn Dadleh


57 Hyde street Adelaide SA 5000

ATSIHAW Red Ribbon Appeal
28-Nov 7:00am – 9:00am
Adelaide Railway Station and Tram stops 
Aboriginal people are effected by HIV percentage wise more than the rest of the population.

Contact: Daniel Jeffries


220 South Rd Mile End SA 5031

HIV awareness week at SIN 
28 Nov – 5 Dec daily 
HIV awareness, decreasing stigma



303 Tullawon Square, Yalata Community Ceduna SA 5690

HIV awareness day 
10-Dec Yalata Clinic 
With HIV awareness we can prevent disease prevalence

Contact: Natasha Desai

Nungay Night 2018 – Get your Glitter on Gurl

Saturday 24th November 2018 at Chateau Apollo, 74 Frome Street, Adelaide

Black n Deadly Live Acts, food, drinks, laughs, DJ
Special guests, door prizes and silent auction
Due to Adult Themes, the event is 16+

Order your tickets here:


Mallee District Aboriginal Services (MDAS)

9 Nolan Street Kerang VIC 3579

HIV Awareness and Support Services
U and Me can stop HIV BBQ Event 
30-Nov 11:30am at MDAS Kerang

Contact: Melanie Lane

Mallee District Aboriginal Services (MDAS)

70 Nyah Road Swan Hill VIC 3585

HIV statistics and stigma, sexual health and support services
U and me, HIV community BBQ 
30-Nov 12:00pm at MDAS Community Hall

Contact: Djallarna Hamilton

Victorian Aboriginal Health Service

186 Nicholson Street Fitzroy VIC 3065

HIV & AIDS Awareness day 
30-Nov 9:00 – 5:00 at VAHS Medical clinic 
Fitzroy HIV and awareness information

Contact: Jermaine Charles

Thorne Harbour Health

Level 5, 615 St Kilda road Melbourne VIC

HIV awareness 
30-Nov 11:00 – 1:00 at Dandenong Aboriginal Health Service 
Be aware of the rising rates of HIV in the Aboriginal community and the new options for prevention, care and treatment

Contact: Peter Waples-Crow

Western Australia

Aboriginal Health Council of WA
450 Beaufort Street Highgate WA

Be STI and BBV free
Encouraging health checks in your people, normalising STI and BBV testing with any presentation, showing the new animation for STI/BBV including what HIV and AIDS is
26/27/28 Nov 9:30 – 10:30 at  AHCWA offices for staff inviting DYHS and MC staff

Contact: Jen Needham

Bega Gambirringu

16-18 Mcdonald Street Kalgoorlie WA 6430

HIV awareness week at Bega
Testing availability at Bega – confidentiality and culturally appropriate
3 – 7 Dec 8:30am – 4:30pm at the Aboriginal Health Service Courtyard at Bega

Contact: Alicia Sheridan

Bega Gambirringu

16 – 18 McDonald Street Kalgoorlie WA 6430

HIV Awareness
10-Nov 8:30am at the Community Health Service HIV awareness within the indigenous community of the goldfields

Contact: Sonia Talamo


1 Stanley Street Derby WA 6728

World AIDS Day 
7-Dec 8am – 12:30pm at DAHS waiting room 
World AIDS day messages/ yarning. We can walk hand in hand together

Contact: Theresa Kitaura

Derbal Yerrigan Health Service

156 Wittenoom Street East Perth WA 6004

No shame in getting a test 
19-Nov 12:00pm Derbarl Yerrigan Aboriginal Health Service 
No shame in getting a test

Contact: Jarrod Minnecon

Great southern Aboriginal Health Service

61 Serpentine Road Albany WA 6330

Family Fun Day 
28-Nov 11:00 – 2:00pm at the local Park 
To increase community awareness of HIV and other BBVS and STI’s and to promote safer sex and injecting practices and testing and treatment

Contact: Megan Robson

Nullagine Clinic

Cooke Street Nullagine WA 6758

Random talks at the clinic when people present daily opening hours 
Informal meetings to be held at Nullagine Clinic Screen and stay safe. 

Contact: Mary Anne Hanson

Ord Valley Aboriginal Health Service

1125 Ironwood Dr Kununurra WA 6743

Yarning HIV over Billy Tea 
27-Nov tbc at Ski Beach, bush location 
General education regarding HIV/ AIDS – so many young peoople have never hear of HIV much less understand it

Contact: Jane Anglis

Pilbara Population Health

62 Balmoral Road Karratha WA 6714

School HIV awareness day in class with Girls Academy/ CLONTARF indigenous students at Karratha Senior High School 
The focus will be on de-stigmatising HIV and the testing process. 
How pilbara polulation health has free and easy testing available as well as free access to clean needles and condoms.

Contact: Chantelle Pears

WACHS Public Health Karratha Health Campus 

63 Balmoral Road Karratha WA 6714

School Health Promotion 
26-Nov all day School, community HIV education including prevention and safe sex messages

Contact: Jan Marie Grantham

NACCHO Aboriginal #SexyHealth #ATSIHAW : Aboriginal and Torres Strait Islander #HIV Awareness Week



 This year’s ATSIHAW is themed ‘You and me can stop HIV’ and the focus is on taking personal responsibility, and helping others, to end the spread of once-deadly disease.

ATSIHAW is designed to get people talking about HIV, to raise awareness of prevention methods, and testing and treatment options and to slow the rate of new infections to zero.

ATSIHAW leads into World AIDS Day on 1 st December 

These 4 article from Page 12 and 13  NACCHO Aboriginal Health Newspaper out Wednesday 16 November , 24 Page lift out Koori Mail : or download

naccho-newspaper-nov-2016 PDF file size 9 MB

” Since we started collecting HIV data among Aboriginal and Torres Strait Islander people in the early 1990s rates of diagnosis have been similar or lower than for non-Indigenous people. It’s been one of the good news stories of Aboriginal health for over two decades. But is this all at risk?

Aboriginal people are at higher risk of HIV because of high rates of other STIs, because of increasing injecting drug use within communities including sharing of injection equipment between people, lower health literacy regarding HIV, less access to primary health care and HIV specialist services “

A/Prof James Ward South Australian Health and Medical Research Institute Adelaide : Dr David Johnson, Public Health Medical Officer, Aboriginal Health Council of South Australia :Dr Salenna Elliott, Public Health Registrar, Aboriginal Health Council of South Australia

 “Hepatitis C is a virus that affects the liver. It is thought that 95% of the Hep C in Australia is acquired through sharing of injecting equipment or other equipment that transfers blood from one person to another, such as for tattooing.

Aboriginal and Torres Strait Islander people are overrepresented in hep C diagnoses in Australia, with an estimated 20,000-30,000 diagnoses in our population.  Without treatment hep C damages the liver, and can result in cancer and death. ”

A/Prof James Ward Head Infectious Diseases Research Aboriginal Health South Australian Health and Medical Research Institute :

See Article 4 below

Each year data are reported for all HIV diagnoses made in the previous year. This data are based on people reporting how they think they acquired HIV, e.g. via heterosexual sex, male-to-male sex, mother to child transmission, sharing injecting drug equipment. Data are also collected on Aboriginal and Torres Strait Islander status.

Over the last five years a worrying trend has emerged: HIV rates are stabilising in the non-Indigenous Australian-born population, while rates are increasing for our population. The rate of HIV diagnosis among Aboriginal and Torres Strait Islander people is now for the first time ever more than double the non-Indigenous rate.

There are also important differences in how HIV is transmitted, with more cases among Aboriginal people attributed to heterosexual sex and injecting drug use.

In the past five years:

  • 21% of cases in the Aboriginal population were attributed to heterosexual sex, compared to 14% amongst non-Indigenous people
  • 16% of cases among Aboriginal people were attributed to injecting drug use compared to 3% of cases in the non-Indigenous population .
  • 58% of new cases in the Aboriginal population were attributed to anal sex between men, compared to 80% among non-Indigenous people

These rising rates and different transmission patterns are of concern. At the global level we have seen that HIV can escalate quickly once it takes hold in marginalised populations such as Indigenous peoples, people who inject drugs, sex workers and prisoners.

This has happened among Canada’s First Nations peoples and in Saskatchewan, clinicians and communities are calling for a state of emergency to be declared because of rapidly escalating HIV rates.  Factors that place our communities at risk of an HIV epidemic include the high prevalence  of other sexually transmissible infections (STIs) that increase risk of HIV transmission, limited access to sexual health services, education  and prevention programs (particularly in regional and remote communities) and

HIV-related stigma and shame. For us to turn about the clear divergence in HIV rates between our population and the non-Indigenous we must act now.

While community education and awareness, condoms and safe sex are still the mainstay of HIV prevention – as are clean needles and syringes, detox services and drug rehabilitation for people who inject drugs – the use of HIV treatment medications is also now a major component of prevention strategies. We need to understand these new prevention tools and work out how to ensure their benefits reach our communities.

Treatment as prevention – the game-changer

Advances in HIV treatment medications mean that it’s now possible for someone with HIV to live as long as the person next to them who doesn’t. Modern treatments also mean that the amount of HIV in the blood of a person with HIV can be reduced to an undetectable level.

This is not a cure, but a person with an undetectable viral load is virtually non-infectious. At a community wide level, the more people with HIV who reach an undetectable viral load the less chance there is for people to acquire HIV.  This is called ‘treatment as prevention’.

A drug to prevent HIV

There’s also now a pill that can protect against HIV. Called Pre-Exposure Prophylaxis or PrEP for short,  PrEP involves HIV-negative people taking an HIV treatment antiretroviral drug before risk exposure, for example before having sex, to protect against contracting HIV. PrEP is only recommended for people most at risk of HIV – including men who have anal sex with men, and HIV-negative men or women with an HIV-positive partner.

Don’t forget PEP

Post exposure prophylaxis is a tablet you take after a high risk exposure to HIV. PEP works by preventing HIV entering the lymph system- but only if it is given within 72 hours after the exposure. PEP is available at most hospital Emergency departments and at sexual health services nationally.

For us to turn around rising HIV rates among Aboriginal people we need:

  1. Enhanced community education and awareness about HIV and sexual health at both national and local level, such as Aboriginal and Torres Strait Islander HIV Awareness Week which has just completed its third year of activities
  2. Continued promotion of safe sex and safe injecting, with improved community access to condoms, testing and treatment for STIs, Needle and syringe programs
  3. Capacity for referrals to appropriate drug treatment services
  4. Appropriate testing for HIV in Aboriginal primary care services for people at risk of HIV, including people who have a recent other STI diagnosis
  5. Enhanced early diagnosis and treatment rates, and education regarding the personal and community benefits of treatment as prevention.
  6. Community education on HIV, including on ‘treatment as prevention’, PrEP and to address HIV-related stigma and shame.

The cure for HIV is still a long way off, so we all need to do our bit to ensure HIV doesn’t take hold in our communities.

We acknowledge Ms Linda Forbes, of SAHMRI (proof read articles on Pages 12/13 ).

STI rates remain unacceptably high in our communitites

A/Prof James Ward Head Infectious Diseases and Sarah Betts STI Coordinator Aboriginal Health Council of South Australia

Rates of common sexually transmissible infections (STIs) among our communities remain grossly disproportionate to rates among non-Indigenous Australians.

In the policy and programming context, it could be said that in the scheme of things, persisting high rates of STIs are alarming but not requiring more urgent attention than other areas of Aboriginal health, such as diabetes, cardiovascular and child and maternal health-but should it be that way?

The failure to address high rates of STIs in has immediate and long-term implications for our communities. Poor outcomes in pregnancy, shame and stigma, interpersonal violence as an outcome of STI transmission, infertility and a much higher chance that HIV will be transmitted are just some of these. Those most affected are young people, and the more remote a young Aboriginal person’s community, the more likely they are to have not just one STI but multiple STIs. Young people in our remote communities face many challenges – let’s at least act to reduce the pervasive risk of STIs.

The main STIs

Let’s take a look at some of the most common infections:

  • Chlamydia is the most common STI in Australia, affecting both Aboriginal and non-Indigenous Australians, predominantly in the age group 15-25 years. Rates among Aboriginal people are between 3 and 5 times that of the non-Indigenous population, whether in cities, regional and remote areas. Chlamydia rarely has symptoms. It is easily tested for and treated with a one-off dose of antibiotics. If not detected and treated chlamydia can cause pelvic inflammatory disease and other serious complications in women, including poor outcomes in pregnancy.
  • Gonorrhoeae and syphilis disproportionately affect young Aboriginal people, particularly in remote and isolated communities. Rates of gonorrhoeae are 30 times higher for the Aboriginal population compared to the non-Indigenous population; and syphilis rates are five times higher. An outbreak of syphilis that started in 2011 and has spread across northern and central Australian remote communities has us way out of reach of once was thought to be possible; eliminating syphilis from our communities. Both STIs can cause major issues in pregnancy, including loss of the baby, and babies can be born with both infections. Both conditions are relatively easy tested for and treated with antibiotics.
  • Trichomonas is another STI very prevalent among Aboriginal and Torres Strait Islander people. In remote communities we have found that around 25% of women found to have trichomonas. Untreated Trichomonas can cause premature birth and low birth weight and of course facilitate HIV transmission

Upping STI testing and treatment rates

So testing and treating STIs is straightforward if they’re diagnosed early, but the consequences of failing to detect and treat infections are huge. We need to understand what’s stopping people getting tested. Shame and stigma obviously play a part, including for young people – how can we get to the point that young people in our communities see sexual health checks as a normal part of living a healthy life?  How can we ensure that babies aren’t born with STIs?

The work happening at the individual health service and NACCHO affiliate level as well as in mainstream, is great. But we need to intensify our focus on:

  1. Developing innovative community education and awareness to make sure young people are aware of these STIs and the need to test
  2. Equipping young people with skills and tools to prevent STIs
  3. Ensuring we are all aware that STIs often don’t have symptoms but are easily tested for and cured
  4. Ensuring our health services are offering regular testing as per clinical guidelines
  5. Normalising STI testing, including by making sure that that STI testing is offered as part of Adult Health Assessments, particularly for young people between 16 and 29 years.
  6. At a broader systemic level I believe an additional two national KPIs would be beneficial for raising the profile of this issue, in addition to a special PIP for full STI and BBV testing and elevation of STI testing in the Adult health check.

We have been working hard in research, trying to make sense of why STIs are still so common and to develop strategies bring down these unacceptably high rates. But much more work is required. The recent defunding of 20 or so Aboriginal sexual health worker positions in NSW should not even have been.

Hyper-vigilance is needed. Let’s all get onto this together – our young people have the right to enjoy full and healthy sexual relationships with their loved ones now and into the future.


Hepatitis B – improving access to vaccination, diagnosis and treatment

A/Prof Benjamin Cowie, Director of the WHO Collaborating Centre for Viral Hepatitis, Doherty Institute

Aboriginal people were among the first groups in who hepatitis B was discovered in the 1960s – which is why for a while the virus was known as ‘The Australia Antigen’.

The proportion of Aboriginal and Torres Strait Islander people living with chronic (long-term) hep B is around 10 times that of non-Indigenous people born in Australia. Of the 230,000 Australians estimated to be living with hep B, around 20,000 are thought to be Aboriginal or Torres Strait Islander people, and new infections with hep B are still occurring at 4 times the rate in Indigenous Australians.

Most people living with chronic hep B were infected as babies or young children, with infection being passed from mother to child or between young children. Someone infected as a baby has a 90% chance of going on to chronic hep B; while someone infected as an adult only has a 5% chance of going on to long term infection, but can still get very sick in the short term. In Australia, most infections in adults are caused through sexual contact with someone with hep B, or through unsafe injecting drug use.

Chronic hep B infection usually causes no symptoms and for most people will cause no long-term health problems – but for around 1 in 4 people living with hep B, the virus can cause severe liver scarring (cirrhosis) or liver cancer. We know that liver diseases are one of the important causes of the life expectancy gap experienced by Indigenous Australians – hep B is one of the conditions responsible for this. Recent evidence from research in the Northern Territory suggests that Aboriginal people have a unique strain of the hep B virus passed on over many years that could explain why hep B in some Indigenous people might have a more severe course.

Unlike the other STIs and BBVs, hep B can be prevented by a safe, effective vaccine which has been provided for all infants in Australia since 2000 (and in the Northern Territory since 1990). As a result, new hep B infections in children born since 2000 (and in those who received adolescent catch-up vaccination from 1998 onwards) have fallen substantially. However funded hepatitis B vaccine for Indigenous adults is available only in some states and territories, which limits access for Aboriginal and Torres Strait Islander people who remain at much higher risk of hep B infection. This inequality in access cannot continue.

For people who already have hep B infection, vaccination has no effect. We know many people living with hep B, including Indigenous people, have never been diagnosed. However being tested for hep B is easy – it’s a simple blood test which can tell whether someone has hep B, is immune through past infection or vaccination, or if a person needs vaccination. National guidelines suggest all Aboriginal and Torres Strait Islander adults whose hep B status isn’t known should be offered testing.

If someone is found to have hep B, they should receive counselling and household and sexual partners should be tested and vaccinated if not immune. Highly effective treatments for hep B are available in Australia that greatly reduce the chance of developing liver scarring or cancer, and involve taking a tablet once a day. However unlike for hep C, these are not cures – treatment needs to continue, often for many years. We know that in many areas of Australia where most people living with hep B are Indigenous people, treatment uptake is very low – this needs to be changed urgently. With better access to prevention, diagnosis and treatment, the burden of hep B on Indigenous health can be eliminated in coming years.


Hepatitis C – the bad news and the good

A/Prof James Ward Head Infectious Diseases Research Aboriginal Health South Australian Health and Medical Research Institute

Hepatitis C is a virus that affects the liver. It is thought that 95% of the Hep C in Australia is acquired through sharing of injecting equipment or other equipment that transfers blood from one person to another, such as for tattooing. Aboriginal and Torres Strait Islander people are overrepresented in hep C diagnoses in Australia, with an estimated 20,000-30,000 diagnoses in our population.  Without treatment hep C damages the liver, and can result in cancer and death.

The bad news is that over the last five years rates of hep C diagnoses have increased by 43% in our community, yet the in the non-Indigenous community have been stable. Particularly concerning are rates of diagnosis among people in the age group 15-24 years of age with rates 8 times higher than non-Indigenous people in the same age group.  This age group is concerning because it is most likely that these infections are new infections given the nature of Hepatitis C being transmitted primarily through injection drug use.  Also of concern because of the high and rising Indigenous incarceration rates is the proportion of people in Australian prisons who are diagnosed with hep C, with an estimated 50-65% of all prisoners diagnosed with Hep C.

The good news however is there is now a cure for Hep C

But there is great news about hep C treatment:

  • There is now a cure for hep C. Daily tablets for 10-12 weeks are more than 90% effective of curing hep C
  • The cost of these tablets is subsidised by the Government – a full script costs around $40
  • Hep C treatment can be organised by Aboriginal Community Controlled Health Services or any GP practice.
  • There are very few side effects from these new tablets that cure hep C.

In the first 6 months since the Australian Government approved this new medication for treating hep C almost 20,000 Australians have been cured. Of these we do not know how many Aboriginal and or Torres Strait Islander people have been cured but our suspicion is relatively low numbers.

Aboriginal and or Torres Strait Islander people who have been diagnosed with Hep C have the right to get the advantage of this major breakthrough in Hep C treatment. Now is the time to encourage someone you know who is living with hep C to take treatment for this condition.   The more people we can get cured of hep C the better the chances are of reducing new infections in the community.