Aboriginal health - sexually transmissible infections

In Australia, Indigenous people have a higher rate of sexually transmissible infection (STI) than the rest of the community. The most common STIs in Aboriginal communities include chlamydia, gonorrhoea and syphilis.

About 1,207 per 100,000 Indigenous Australians are infected with chlamydia, compared to 95 per 100,000 in the non-Indigenous population.

Nationally, the Northern Territory has the highest infection rate among people aged 15 to 19 years – 2,500 teenagers per 100,000 contracted gonorrhoea in 2001, and most of the infections occurred in Aboriginal teenagers.

Condom use
The teenage pregnancy rate is five times higher among Indigenous women. Condoms are an effective way to protect against STIs and unwanted pregnancy. However, condom use in Aboriginal communities is comparatively low because of cultural, socioeconomic and environmental factors.

Barriers to sex education
Most public health messages about safe sex are targeted at the general population and they are not always appropriate for Indigenous Australians. Some of the reasons for this include:

• English is not always the first language of some Indigenous people.
• Aboriginal and Torres Strait Islander terms for sexual acts are sometimes different to English terms. This can easily cause confusion and misunderstanding.
• Access to health information is often limited. For example, people living in remote areas have reduced opportunities to consult with doctors and other health care professionals.

• Oral contraceptives may not be appropriate because of the cost, and the necessity to take the pill at the same time every day.
• Many Indigenous people consider talking about sex to be shameful. It is particularly shameful for a man and woman to talk about sexual issues, so the subject of contraception or condom use may not be brought up. As in most cultures, it is also difficult for Indigenous youth to talk to adults about sex.
• Intrauterine devices (IUDs) increase the risk of pelvic inflammatory disease. This risk is higher in women with STIs. IUDs are generally not recommended given the high STI rate in Aboriginal communities.

• Access to doctors can be difficult. According to an Australian Bureau of Statistics survey in 1996, the nearest doctor is at least 25km away for one in every seven Indigenous Australians.
• Most doctors are non-Indigenous. Indigenous people may not want to visit a doctor for fear of racism or unfamiliar medical practices.

• Delivery by Aboriginal health workers who are sensitive to the customs and protocols of particular communities.
• The use of ‘story-telling’ to explain safe sex practices.
• Community involvement in sexual health issues and campaigns.
• The provision of affordable contraception.
• The availability of contraceptive devices specifically designed for and marketed to Indigenous Australians, such as the Snake condom that features traditional Aboriginal colours, symbolism and art in the packaging.

• Your doctor
• Family planning clinic
• Family Planning Victoria Tel. (03) 9257 0100
• Victorian Aboriginal Health Service Co-op Tel. (03) 9419 3000
• Marie Stopes International Australia freecall number Tel. 1800 003 707 (24 hours)

• Public health messages about safe sex target the general population and may not be appropriate for Indigenous Australians.
• Research suggests that safe sex messages for Indigenous Australians have to be culturally appropriate if they are to be effective.

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