Individual and population level impacts of illicit drug use, sexual risk behaviours on sexually transmitted infections among young Aboriginal and Torres Strait Islander people: results from the GOANNA survey

BMC Public Health - Tập 16 - Trang 1-9 - 2016
Handan Wand1, James Ward2, Joanne Bryant3, Dea Delaney-Thiele4, Heather Worth5, Marian Pitts6, John M. Kaldor1
1Kirby Institute, University of New South Wales, Kensington, Australia
2South Australian Health and Medical Research Institute, Adelaide, Australia
3Centre for Social Research in Health, University of New South Wales, Kensington, Australia
4Aboriginal Medical Service, Mount Druitt, Australia
5School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia
6Australian Research Centre in Sex, Health and Society, Latrobe University, Melbourne, Australia

Tóm tắt

Sexually 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. A 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. Of 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. Illicit 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.

Tài liệu tham khảo

Institute, T.K., Bloodborne viral and sexually transmitted in Aboriginal and Torres Strait Islander people: Surveillance and Evaluation Report, University of New South Wales, Editor. 2013 Substance use among Aboriginal and Torres Strait Islander people http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737418265 (accessed 10 Oct 2015) Molitor F, Truax SR, Ruiz JD, Sun RK. Association of methamphetamine use during sex with risky sexual behaviors and HIV infection among non-injection drug users. Western J Med. 1998;168(2):93–7. Catto M, Thomson N. Review of illicit drug use among Indigenous people. Australian Indigenous HealthBulletin. 2008;8(4):Article 1. Halkitis PN, Parsons JT, Stirratt MJ. A double epidemic: crystal methamphetamine drug use in relation to HIV transmission among gay men. J Homosex. 2001;41(2):17–35. Cheng WS, Garfein RS, Semple SJ, Strathdee SA, Zians JK. Increased Drug Use and STI Risk with Injection Drug Use Among HIV-Seronegative Heterosexual Methamphetamine Users. J Psychoactive Drugs. 2010;42(1):11–8. Ward J, Bryant J, Wand H, Kaldor J, Delaney-Thiele D, et al. Methods of a national survey of young Aboriginal and Torres Strait Islander people regarding sexually transmissible infections and bloodborne viruses. Aust NZ J Public Health. 2015; doi: 10.1111/1753-6405.12427 Hosmer DW, Lemeshow S. A goodness-of-fit test for the multiple logistic regression model.”. Commun Stat. 1980;A10:1043–69. Wand H, Ramjee G. Combined impact of sexual risk behaviors for HIV seroconversion among women in Durban, South Africa: Implications for prevention policy and planning. AIDS Behav. 2011;15(2):479–86. Shoptaw S, Reback C. Methamphetamine Use and Infectious Disease Related Behaviors In Men Who Have Sex With Men: Implications for Interventions. Addiction. 2007; 102(Suppl. 1), 130–135 Cheng SW, Garfein RS, Semple SJ, et al. HIV-Seronegative Heterosexual Methamphetamine Users. J Psychoactive Drugs. 2010;42(1):11–8. Satterwhite CL, Torrone E, Meites E, et al. Sexually transmitted infections among US women and men: Prevalence and incidence estimates. Sex Transm Dis. 2013;40:187e93. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2010. Atlanta: Department of Health and Human Services; 2011. Upchurch DM, Mason WM, Kusunoki Y, Kriechbaum MJ. Social and behavioral determinants of self-reported STD among adolescents. Perspect Sex Reprod Health. 2004;36:276e87. Halkitis PN, Palamar JJ, Mukherjee PP. Poly-club-drug use among gay and bisexual men: a longitudinal analysis. Drug Alcohol Depend. 2007;89:153–60. Rotheram-Borus MJ, Swendeman D, Chovnick G. The Past, Present, and Future of HIV Prevention: Integrating Behavioral, Biomedical, and Structural Intervention Strategies for the Next Generation of HIV Prevention. Annu Rev Clin Psychol. 2009;5:143–16. Kinnane, S. Alcohol restrictions in the Kimberley: Findings of two year evaluations of alcohol restrictions in Fitzroy Crossing and Halls Creek – Why Kimberley restrictions have been largely successful. UNSW Seminar Series. (accessed Oct 10 2015) (http://researchonline.nd.edu.au/arts_conference/49/. 2012