Thng Caroline Chun Mei
Acad Forensic Pathol. 2018 Dec;8(4):938-946. doi: 10.1177/1925362118821492. Epub 2018 Dec 19.
Sexually transmitted infections (STIs) bear a high burden of disease and, subsequently, high health costs globally. Chlamydia, gonorrhoea, syphilis, and trichomoniasis contribute to nearly one million infections every day worldwide. Sexually transmitted infections continue to be the most frequently notified condition to the Australian National Notifiable Diseases Surveillance System and the numbers continue to increase. Australia has achieved several significant successes in reducing STIs and blood-borne viruses (BBV) including the significant decrease in genital warts in those less than 30 years old since 2007 following the launch of human papillomavirus vaccines in women, the virtual elimination of mother to child transmission of HIV, and the increased uptake of successful hepatitis C treatment following the availability of direct acting antiviral treatment on the Pharmaceutical Benefits Scheme. However, several challenges remain, including the ongoing rise of chlamydia, gonorrhoea, and syphilis over the last five years; the emergence of antibiotic resistance; and the increasing disparity in the prevalence of STIs and BBV in men who have sex with men, young people, and Aboriginal and Torres Strait Islander people, and challenges in the delivery of services to rural and remote Australia. In this paper, we aim to provide a snapshot of the current landscape and challenges for chlamydia, gonorrhoea, mycoplasma, syphilis and HIV infections in Australia.
性传播感染(STIs)在全球范围内造成了沉重的疾病负担,进而带来了高昂的医疗成本。衣原体、淋病、梅毒和滴虫病每天在全球导致近100万例感染。性传播感染仍然是澳大利亚国家法定传染病监测系统中报告最为频繁的疾病,且感染人数持续增加。澳大利亚在减少性传播感染和血源性病毒(BBV)方面取得了多项重大成功,包括自2007年女性接种人乳头瘤病毒疫苗后,30岁以下人群的尖锐湿疣显著减少;几乎消除了艾滋病毒的母婴传播;以及在药品福利计划提供直接作用抗病毒治疗后,丙型肝炎成功治疗的接受率有所提高。然而,仍存在一些挑战,包括衣原体、淋病和梅毒在过去五年中持续上升;抗生素耐药性的出现;以及男男性行为者、年轻人、原住民和托雷斯海峡岛民中性传播感染和血源性病毒患病率的差距不断扩大,以及为澳大利亚农村和偏远地区提供服务面临的挑战。在本文中,我们旨在概述澳大利亚衣原体、淋病、支原体、梅毒和艾滋病毒感染的现状及挑战。