Abstract
BackgroundSexually transmitted infections (STIs) have been increasing among Australian Indigenous young people for over two decades. Little is known about the association between alcohol and other drug use and sexual risk behaviours and diagnosis of STIs among this population.MethodsA cross-sectional, community based self-administered survey was conducted among young Aboriginal people aged 16–29 years of age. Questionnaires included socio-demographic characteristics, knowledge, sexual risk behaviours alcohol and other drug use and health service access including self-reported history of diagnosis with a STI. Logistic regression models and population attributable risks were used to assess individual and population level impacts of illicit drug use on high risk sexual behaviours and ever reported diagnosis of an STI.ResultsOf the 2877 participants, 2320 (81 %) identified as sexually active and were included in this study. More than 50 % of the study population reported that they had used at least one illicit drug in past year. Cannabis, ecstasy and methamphetamines were the three most commonly used illicit drugs in the past year. The prevalence of self-reported STI diagnosis was 25 %. Compared with people who did not report using illicit drugs, risky alcohol use and sexual behaviours including inconsistent condom use, multiple sexual partners in the past year and sex with casual partners were all significantly higher among illicit drug users. In adjusted analysis, participants who reported using illicit drugs were significantly more likely to engage in sexual risk behaviours and to ever have been diagnosed with an STI. Adjusted Odds Ratios ranged from 1.86 to 3.00 (males) and from 1.43 to 2.46 (females). At the population level, more than 70 % of the STI diagnoses were attributed to illicit drug-use and sexual risk behaviours for males and females.ConclusionIllicit drug use in this population is relatively high compared to other similar aged populations in Australia. Illicit drug use was associated with risky sexual behaviours and STI diagnoses among this study population. Developing and implementing effective STI prevention strategies should include not only safe sex messages but also include drug and alcohol harm reduction messages.
Highlights
Transmitted infections (STIs) have been increasing among Australian Indigenous young people for over two decades
Cocaine use was reported by 11 % (n = 116) of illicit drug use participants and the least reported drugs were Lysergic acid diethylamide (LSD) (5 %), fantasy (4 %), benzodiazepines (2 %) and ketamine (2 %)
Characteristics of the participants by patterns of drug-use categories Table 1 presents the characteristics of the study participants across the 5-drug use categories for women and men separately
Summary
Transmitted infections (STIs) have been increasing among Australian Indigenous young people for over two decades. Representing just 3 % of the total population, yet accounting for 38 and 16 % of all gonorrhoea and chlamydia notifications in 2013, there remains an enormous gap between Aboriginal and non-Indigenous Australians. Further these rates have been disparate for over two decades, despite many program and policy interventions [1]. In addition to the high rates of STIs, previous studies have reported a relatively higher use of licit and illicit drugs such as alcohol, cannabis, ecstasy and methamphetamines among young Aboriginal people compared to non-Indigenous Australians [2]. Methamphetamine has been previously reported to increase sexual pleasure and function and as such is associated with higher sexual risk behaviour and potential for STI including human immunodeficiency virus (HIV) transmission [6]
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