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Development of a Risk Algorithm to Better Target STI Testing and Treatment Among Australian Aboriginal and Torres

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Summary

This study developed a risk prediction tool to identify young Aboriginal people at high risk of sexually transmissible infections (STIs). The algorithm helps prioritize targeted STI screening, improving prevention program efficiency.

Keywords:
Aboriginal and Torres Strait IslanderIndigenous AustraliansRisk predictionSexual risk behaviorsSexually transmitted infections

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Area of Science:

  • Public Health
  • Epidemiology
  • Health Informatics

Background:

  • Sexually transmissible infections (STIs) pose a significant public health challenge, particularly among young, sexually active populations.
  • Efficient and cost-effective STI prevention programs require accurate identification of individuals at greatest risk.
  • Targeted screening strategies are crucial for managing STIs, especially when universal screening is impractical.

Purpose of the Study:

  • To develop and validate a risk prediction algorithm for identifying young Aboriginal and Torres Strait Islander people at increased risk of STIs.
  • To inform the development of targeted STI prevention and screening strategies within this population.

Main Methods:

  • A cohort of 2320 young, sexually active Aboriginal and Torres Strait Islander people was studied.
  • A logistic regression model was used to create a risk prediction algorithm, with the data randomly split into development (67%) and validation (33%) sets.
  • The algorithm was developed separately for males and females, using self-reported high-risk sexual behaviors and past STI diagnosis as primary outcomes.

Main Results:

  • Older age, substance use (methamphetamine, ecstasy, cannabis), frequent alcohol intake, and identifying as gay/bisexual (in males) were associated with high-risk sexual behaviors and past STIs.
  • A significant proportion of participants had never been tested for STIs (52% males, 66% females).
  • Estimated prevalence of undiagnosed STIs ranged from 30% to 40%.

Conclusions:

  • The developed risk prediction tool can aid in prioritizing STI screening among young Aboriginal people.
  • Targeted screening, informed by risk prediction, is an effective approach to managing STIs in this demographic.
  • This approach enhances the efficiency and cost-effectiveness of STI prevention programs.