title: High chlamydia positivity rates in Indigenous people attending Australian sexual health services.
abstract: OBJECTIVE
  To assess the clinical epidemiology of chlamydia among Aboriginal and Torres Strait Islander (Indigenous) people attending sexual health services around Australia.
  
  
  METHODS
  Retrospective analysis of routine demographic, behavioural and clinical data, between 1 January 2006 and 31 December 2011.
  
  
  METHODS
  18 sexual health services in major cities and regional centres in five jurisdictions.
  
  
  METHODS
  Attendance, chlamydia testing and positivity rates in patients visiting for the first time, and factors associated with chlamydia positivity.
  
  
  RESULTS
  Of 168 729 new patients, 7103 (4.2%) identified as Indigenous, of whom 74.3% were tested for chlamydia. Chlamydia positivity was 17.0% in Indigenous women (23.3% in 15-19-year-olds and 18.9% in 20-24-year-olds) and 17.3% in Indigenous men (20.2% in 15-19-year-olds and 24.2% in 20-24-year-olds). There was an increasing trend in chlamydia positivity in Indigenous women from 2006 to 2011 (P for trend = 0.001), but not in Indigenous men. In Indigenous women, factors independently associated with positivity were: younger age, being heterosexual, living in Queensland and attending the service in 2010. In Indigenous men, independent factors associated with chlamydia positivity were younger age, being heterosexual, having sex only in Australia and living in a regional area.
  
  
  CONCLUSIONS
  The high and increasing chlamydia positivity rates highlight the need for enhanced prevention and screening programs for Indigenous people.
authors.affiliation: RPA Sexual Health, Sydney Local Health District, Sydney, NSW, Australia. catherine.oconnor@unsw.edu.au.
authors.forename: Catherine C
authors.initials: CC
authors.lastname: O'Connor
authors.affiliation: Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Hammad
authors.initials: H
authors.lastname: Ali
authors.affiliation: Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Guy
authors.affiliation: RPA Sexual Health, Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Templeton
authors.affiliation: Melbourne Sexual Health Centre, Melbourne, VIC, Australia.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Fairley
authors.affiliation: Melbourne Sexual Health Centre, Melbourne, VIC, Australia.
authors.forename: Marcus Y
authors.initials: MY
authors.lastname: Chen
authors.affiliation: CaraData Pty Ltd, Brisbane, QLD, Australia.
authors.forename: Bridget M
authors.initials: BM
authors.lastname: Dickson
authors.affiliation: Sexual Health Service, Fremantle Hospital, Perth, WA, Australia.
authors.forename: Lewis J
authors.initials: LJ
authors.lastname: Marshall
authors.affiliation: Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Grulich
authors.affiliation: Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Hellard
authors.affiliation: Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
authors.forename: John M
authors.initials: JM
authors.lastname: Kaldor
authors.affiliation: Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Basil
authors.initials: B
authors.lastname: Donovan
authors.affiliation: Baker IDI Heart and Diabetes Institute, Alice Springs, NT, Australia.
authors.forename: James S
authors.initials: JS
authors.lastname: Ward
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001315:Australia / Q000453:epidemiology; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult; D000095283:Australian Aboriginal and Torres Strait Islander Peoples