Regional & remote

Overview

  • People in regional and remote populations differ from urban populations in having less access to medical care. Specialist STI services are less likely to be available and there may be considerable waiting times for appointments with GPs.
  • Gay, lesbian, bisexual and transgender and intersex (GLBTI) communities may be less visible in rural and remote areas and people may be reluctant to identify as GLBTI.
  • Aboriginal and Torres Strait Islander people represent a higher proportion of the population in many remote areas.
  • Clinicians in regional and remote areas should have a low threshold for offering STI testing opportunistically.
  • Potential barriers include regional and remote health professionals knowing patients in a social context, or they may be locums and have little opportunity to build a relationship with patients.

Testing advice

In addition, testing for gonorrhoea is recommended in this population.

InfectionConsideration
Gonorrhoea Consider
self-collection of samples for testing.

If NAAT test result is positive, take swab at relevant site(s) for culture, before treatment. Cultures are the preferred test for samples from non-genital sites.
NAAT – Nucleic Acid Amplification Test

Specimen collection

Clinician collected
Self-collection 

Clinical indicators for testing

  • All sexually active young people <30 years should be offered a chlamydia test, at least annually.
  • Contacts of an STI should be offered STI check and treated presumptively for the STI.
  • STI check should be offered when an STI is diagnosed or when a person requests STI check.
  • It is not recommended to routinely test for herpes and genital warts with serology. Consider testing for herpes and genital warts only if there are clinical signs and symptoms.

Special considerations

  • Time until test results are available may be longer than in urban areas. As a result failure to return for results may be more common in regional/remote areas. A lower threshold for presumptive treatment may be appropriate.
  • Gonorrhoea may be treated differently in regional/remote areas.
  • Cervical screening should be offered, according to the national screening guidelines.
  • The CARPA Manual has advice specifically for health professionals working in central and northern Australia.

Follow up

If screening test results are positive, refer to STI management section for advice:

Even if all test results are negative, use the opportunity to:

  • Educate about condom use and risk minimisation
  • Vaccinate for hepatitis B
  • Discuss and activate reminders for regular testing according to risk, especially if their behaviors indicate the need for more frequent testing.

 

Auditable outcomes

100% young people (<30 years) in regional and remote areas are offered a chlamydia test annually.

Last Updated: Friday, 27 November 2015