Sexually transmitted infections in Melbourne, Australia from 1918 to 2016: nearly a century of data

Emile Jasek, Eric PF Chow, Jason J Ong, Catriona S Bradshaw, Marcus Y Chen, Jane S. Hocking, David Lee, Tiffany Phillips, Meredith Temple-Smith, Glenda Fehler, Christopher K Fairley

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Introduction
Our aim was to describe trends in the number of bacterial sexually transmitted infections (STIs) diagnosed at Melbourne’s sexual health clinic over a century.

Methods
A retrospective analysis of STI diagnoses (gonorrhoea, infectious syphilis and chancroid) among individuals attending Melbourne’s sexual health service over 99 years between 1918 and 2016.

Results
Substantial increases in STI rates coincided with World War II, the ‘Sexual Revolution of the 1960s and 1970s’, and the last 10 years. Substantial declines coincided with the advent of antibiotics and the HIV/AIDS pandemic. There were also key differences between STIs. Chancroid virtually disappeared after 1950. Syphilis fell to very low levels in women after about 1950 and has only rebounded in men. The declines in gonorrhoea were less marked. A substantial peak in gonorrhoea occurred in women in the early 1970s and rates are currently rising in women, albeit much less than in men.

Conclusions
Both antibiotics and changing sexual behaviour have had a powerful effect on STI rates. These data suggest gonorrhoea is more difficult to control than syphilis or chancroid. Indeed, the past rates suggest substantial endemic gonorrhoea transmission in heterosexuals occurred in the third quarter of last century before the appearance of the HIV pandemic. Worryingly, there is a suggestion that endemic heterosexual gonorrhoea may be returning. The data also suggest that future control of gonorrhoea and syphilis in men who have sex with men is going to be challenging.
Original languageEnglish
Pages (from-to)E212-E222
Number of pages11
JournalCommunicable Diseases Intelligence Quarterly Report
Volume41
Issue number3
Publication statusPublished - Sep 2017

Keywords

  • Sexually transmissible infection
  • Gonorrhoea
  • Syphilis
  • Melbourne
  • Australia

Cite this

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title = "Sexually transmitted infections in Melbourne, Australia from 1918 to 2016: nearly a century of data",
abstract = "IntroductionOur aim was to describe trends in the number of bacterial sexually transmitted infections (STIs) diagnosed at Melbourne’s sexual health clinic over a century.MethodsA retrospective analysis of STI diagnoses (gonorrhoea, infectious syphilis and chancroid) among individuals attending Melbourne’s sexual health service over 99 years between 1918 and 2016.ResultsSubstantial increases in STI rates coincided with World War II, the ‘Sexual Revolution of the 1960s and 1970s’, and the last 10 years. Substantial declines coincided with the advent of antibiotics and the HIV/AIDS pandemic. There were also key differences between STIs. Chancroid virtually disappeared after 1950. Syphilis fell to very low levels in women after about 1950 and has only rebounded in men. The declines in gonorrhoea were less marked. A substantial peak in gonorrhoea occurred in women in the early 1970s and rates are currently rising in women, albeit much less than in men.ConclusionsBoth antibiotics and changing sexual behaviour have had a powerful effect on STI rates. These data suggest gonorrhoea is more difficult to control than syphilis or chancroid. Indeed, the past rates suggest substantial endemic gonorrhoea transmission in heterosexuals occurred in the third quarter of last century before the appearance of the HIV pandemic. Worryingly, there is a suggestion that endemic heterosexual gonorrhoea may be returning. The data also suggest that future control of gonorrhoea and syphilis in men who have sex with men is going to be challenging.",
keywords = "Sexually transmissible infection, Gonorrhoea, Syphilis, Melbourne, Australia",
author = "Emile Jasek and Chow, {Eric PF} and Ong, {Jason J} and Bradshaw, {Catriona S} and Chen, {Marcus Y} and Hocking, {Jane S.} and David Lee and Tiffany Phillips and Meredith Temple-Smith and Glenda Fehler and Fairley, {Christopher K}",
year = "2017",
month = "9",
language = "English",
volume = "41",
pages = "E212--E222",
journal = "Communicable Diseases Intelligence Quarterly Report",
issn = "1447-4514",
publisher = "Australian Government Department of Health and Ageing",
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}

Sexually transmitted infections in Melbourne, Australia from 1918 to 2016: nearly a century of data. / Jasek, Emile; Chow, Eric PF; Ong, Jason J; Bradshaw, Catriona S; Chen, Marcus Y; Hocking, Jane S.; Lee, David; Phillips, Tiffany; Temple-Smith, Meredith; Fehler, Glenda; Fairley, Christopher K.

In: Communicable Diseases Intelligence Quarterly Report, Vol. 41, No. 3, 09.2017, p. E212-E222.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Sexually transmitted infections in Melbourne, Australia from 1918 to 2016: nearly a century of data

AU - Jasek, Emile

AU - Chow, Eric PF

AU - Ong, Jason J

AU - Bradshaw, Catriona S

AU - Chen, Marcus Y

AU - Hocking, Jane S.

AU - Lee, David

AU - Phillips, Tiffany

AU - Temple-Smith, Meredith

AU - Fehler, Glenda

AU - Fairley, Christopher K

PY - 2017/9

Y1 - 2017/9

N2 - IntroductionOur aim was to describe trends in the number of bacterial sexually transmitted infections (STIs) diagnosed at Melbourne’s sexual health clinic over a century.MethodsA retrospective analysis of STI diagnoses (gonorrhoea, infectious syphilis and chancroid) among individuals attending Melbourne’s sexual health service over 99 years between 1918 and 2016.ResultsSubstantial increases in STI rates coincided with World War II, the ‘Sexual Revolution of the 1960s and 1970s’, and the last 10 years. Substantial declines coincided with the advent of antibiotics and the HIV/AIDS pandemic. There were also key differences between STIs. Chancroid virtually disappeared after 1950. Syphilis fell to very low levels in women after about 1950 and has only rebounded in men. The declines in gonorrhoea were less marked. A substantial peak in gonorrhoea occurred in women in the early 1970s and rates are currently rising in women, albeit much less than in men.ConclusionsBoth antibiotics and changing sexual behaviour have had a powerful effect on STI rates. These data suggest gonorrhoea is more difficult to control than syphilis or chancroid. Indeed, the past rates suggest substantial endemic gonorrhoea transmission in heterosexuals occurred in the third quarter of last century before the appearance of the HIV pandemic. Worryingly, there is a suggestion that endemic heterosexual gonorrhoea may be returning. The data also suggest that future control of gonorrhoea and syphilis in men who have sex with men is going to be challenging.

AB - IntroductionOur aim was to describe trends in the number of bacterial sexually transmitted infections (STIs) diagnosed at Melbourne’s sexual health clinic over a century.MethodsA retrospective analysis of STI diagnoses (gonorrhoea, infectious syphilis and chancroid) among individuals attending Melbourne’s sexual health service over 99 years between 1918 and 2016.ResultsSubstantial increases in STI rates coincided with World War II, the ‘Sexual Revolution of the 1960s and 1970s’, and the last 10 years. Substantial declines coincided with the advent of antibiotics and the HIV/AIDS pandemic. There were also key differences between STIs. Chancroid virtually disappeared after 1950. Syphilis fell to very low levels in women after about 1950 and has only rebounded in men. The declines in gonorrhoea were less marked. A substantial peak in gonorrhoea occurred in women in the early 1970s and rates are currently rising in women, albeit much less than in men.ConclusionsBoth antibiotics and changing sexual behaviour have had a powerful effect on STI rates. These data suggest gonorrhoea is more difficult to control than syphilis or chancroid. Indeed, the past rates suggest substantial endemic gonorrhoea transmission in heterosexuals occurred in the third quarter of last century before the appearance of the HIV pandemic. Worryingly, there is a suggestion that endemic heterosexual gonorrhoea may be returning. The data also suggest that future control of gonorrhoea and syphilis in men who have sex with men is going to be challenging.

KW - Sexually transmissible infection

KW - Gonorrhoea

KW - Syphilis

KW - Melbourne

KW - Australia

M3 - Article

VL - 41

SP - E212-E222

JO - Communicable Diseases Intelligence Quarterly Report

JF - Communicable Diseases Intelligence Quarterly Report

SN - 1447-4514

IS - 3

ER -