Sexual risk and testing for sexually transmissible infections in Aboriginal and Torres Strait Islander peoples and non-Indigenous young South Australians: results of an online survey.

Background: Disproportionate rates of sexually transmissible infections (STIs) among Aboriginal and Torres Strait Islander young people are often attributed to risk-taking behaviours, but research rarely conducts direct comparison with their non-Indigenous peers to address this negative discourse. Methods: 'Let's Talk About It 2019' was a cross-sectional online survey of South Australians (16–29 years). It prioritised recruitment of Aboriginal and Torres Strait Islander respondents to compare behaviours with non-Indigenous peers using multivariable Poisson regression models. Results: Aboriginal and Torres Strait Islander (n = 231) and non-Indigenous (n = 2062) respondents reported similar condom use (40% vs 43%, P = 0.477) and sexual debut median ages (16 years vs 17 years). Higher proportions of Aboriginal and/or Torres Strait Islander respondents reported a recent health check (48% vs 38%, P = 0.002), STIs (60% vs 49%, P < 0.001) and HIV (37% vs 28%, P = 0.006) testing, STI diagnosis (29% vs 21%, P = 0.042), and intoxication during last sex (30% vs 18%, P < 0.001). Conclusions: Behaviours associated with STI transmission were mostly similar among Aboriginal and Torres Strait Islander and non-Indigenous respondents. Higher STI/HIV testing among Aboriginal and Torres Strait Islander respondents suggests effectiveness of targeted programs. Interventions targeting substance use and condom use among all young people are needed. Future interventions need to focus beyond behaviours and explore social determinants of health and sexual networks as contributors to disproportionate STI rates. Sexually transmissible infections (STIs) rates among young Australians are increasing with young Aboriginal and Torres Strait Islander peoples disproportionately affected. Similar patterns of key risk behaviours, and greater engagement in sexual health care among young Aboriginal and/or Torres Strait Islander peoples, refute suggestions that higher STI rates are caused by this population engaging in more risky behaviour compared to their non-Indigenous peers. Social determinants of health and STI rates among sexual networks should be priorities for future research and intervention. [ABSTRACT FROM AUTHOR]