P162 Increasing trends of infectious syphilis in women of childbearing age in Australia

Abstract

<h3>Background</h3> Syphilis in pregnancy can have devastating consequences with over half of untreated infections leading to serious complications. In Australia, an outbreak was detected in remote Indigenous communities in 2011, with recent increases in non-Indigenous heterosexuals. To understand the distribution and impact of these increases, we analysed notification trends in women of childbearing age. <h3>Methods</h3> National infectious syphilis notification data (2011–2018) for women aged 15–44 years were used to calculate notification rates per 100,000 by Indigenous status, age, remoteness and year, and congenital syphilis cases per 100,000 live births by Indigenous status and year. We determined trends in notification rates using Poisson regression. <h3>Results</h3> Between 2011–2018, there were 1391 and 909 notifications in Indigenous vs non-Indigenous women, with the rate 31 times higher (188 vs 6 per 100,000) in 2018, respectively. For Indigenous women, the highest rate was among women living in remote areas (522 per 100,000 in 2018) with increases in remote (174%), regional (808%) and urban areas (475%), p&lt;0.001; and by age group the highest rate was in 15–24 year olds (214 per 100,000 in 2018), with increases in all age groups (130%-971%) p&lt;0.001. For non-Indigenous women, the highest rate was in urban areas (6 per 100,000 in 2018) with increases in urban (474%), and regional areas (475%) (p&lt;0.001); and by age group the highest rate was in 25–34 year olds (7 per 100,000 in 2018), with increases in all age groups (383–541%) (p&lt;0.001). In 2018, congenital syphilis rates were 14 times higher (19.6 vs 1.4 per 100,000 live births) in Indigenous women vs non-Indigenous women, respectively. <h3>Conclusion</h3> Rates of infectious syphilis are increasing for Indigenous and non-Indigenous women of child-bearing age, with the greatest burden of disease in Indigenous women living in remote areas. Responses need to be delivered with further potency to control syphilis in Australia.