Background Chlamydia trachomatis (CT) and Neisseria gonorrhoea (NG) are endemic in many remote Australian Aboriginal communities. Clinical guidelines in remote areas recommend annual sexual health testing generally in 15 – 35 year olds, yet little is known about the extent of annual testing in remote health services or factors that predict it.
Methods We used baseline 2009–2010 laboratory data from 67 remote Aboriginal communities in four regions participating in a cluster randomised trial aiming to improve sexual health service delivery. We defined and calculated annual testing as the percentage of individuals with an initial negative CT/NG test that had a repeat test at 12 months, +/- 3 months. Using logistic regression we determined client and health service factors associated with an annual test.
Results Among 6318 females recorded as testing negative for CT/NG, 24% had an annual test (highest in 16 –19 year olds at 26%), compared with 15% of 4241 males (highest in 20–24 year olds at 19%). Factors independently and significantly (p < 0.05) associated with annual testing were female gender (adjusted odds ratio (AOR): 1.7, 95% CI: 1.5–1.9), age 20–24 years (AOR:1.5, 95% CI: 1.2–1.9), services with > 90% of clients
Aboriginal (AOR:1.4.95% CI: 1.2–1.6), services having an electronic medical record system (AOR:1.7.95% CI: 1.4–2.1), services using a centralised recall system (AOR:1.3.95% CI: 1.1–1.6), services being community controlled (health centre governance controlled by a local Aboriginal board) (AOR:1.4, 95% CI: 1.2–1.6) and Aboriginal health worker/s employed (AOR1.4.95% CI: 1.0 –1.9).
Conclusions Our analysis identified both client and service related factors associated with higher levels of annual testing. Having Aboriginal staff members and systems which support patient recall were key factors identified for services that are amenable to change. While some factors may be indirect markers of other characteristics of the health centres or clients, these findings will help guide support to services in remote areas.
- Annual testing
- Chlamydia trachomatis