1887
  1. Home
  2. Eurosurveillance
  3. Volume 24, Issue 44, 31/Oct/2019
  4. Article
Research Open Access
Like 0
Download

Abstract

Background

International travel is considered a risk factor for acquiring ; however, there are little empirical data to support this.

Aim

To examine the prevalence and risk factors for infections among heterosexual international travellers (n = 28,786) attending the Melbourne Sexual Health Centre (MSHC), Australia, compared to Australian residents (n = 20,614).

Methods

We conducted a repeated cross-sectional study and analysed sexual behaviours and chlamydia positivity among heterosexual males and females aged ≤ 30 attending MSHC for the first time between January 2007 and February 2017. ‘Travellers’ were defined as individuals born outside of Australia who had resided in the country < 2 years. Associations between patient characteristics and chlamydia positivity were examined.

Results

Chlamydia positivity was higher among travellers (11.2%) compared with Australian residents (8.5%; p < 0.001). Male travellers had higher chlamydia positivity (12.1%) than Australian males (9.3%; p < 0.001), as did female travellers (10.4%) compared with Australian females (7.7%; p < 0.001). Travellers had a higher mean number of sexual partners than Australian residents among males (5.7 vs 4.7; p < 0.001) and females (3.6 vs 3.2; p < 0.001). Travellers from the United Kingdom, Europe, Ireland and New Zealand accounted for 29.6%, 21%, 8.5% and 5.8% of infections, respectively. Chlamydia in males and females was associated with younger age (≤ 25), inconsistent condom use, a higher number of sexual partners (≥ 4 partners) and being a traveller (p < 0.001).

Conclusions

We found that international travel is an independent risk factor for chlamydia among young heterosexual travellers in Australia, who should therefore be a target group for chlamydia prevention.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2019.24.44.1900219
2019-10-31
2024-11-19
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.44.1900219
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/24/44/eurosurv-24-44-3.html?itemId=/content/10.2807/1560-7917.ES.2019.24.44.1900219&mimeType=html&fmt=ahah

References

  1. World Health Organization (WHO). WHO guidelines for the treatment of chlamydia trachomatis. Geneva: WHO; 2012. Available from: http://www.who.int/reproductivehealth/publications/rtis/chlamydia-treatment-guidelines/en/
  2. Bradshaw CS, Tabrizi SN, Read TRH, Garland SM, Hopkins CA, Moss LM, et al. Etiologies of nongonococcal urethritis: bacteria, viruses, and the association with orogenital exposure. J Infect Dis. 2006;193(3):336-45.  https://doi.org/10.1086/499434  PMID: 16388480 
  3. Reekie J, Donovan B, Guy R, Hocking JS, Jorm L, Kaldor JM, et al. Hospitalisations for pelvic inflammatory disease temporally related to a diagnosis of Chlamydia or gonorrhoea: a retrospective cohort study. PLoS One. 2014;9(4):e94361.  https://doi.org/10.1371/journal.pone.0094361  PMID: 24743388 
  4. Newman L, Rowley J, Vander Hoorn S, Wijesooriya NS, Unemo M, Low N, et al. Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting. PLoS One. 2015;10(12):e0143304.  https://doi.org/10.1371/journal.pone.0143304  PMID: 26646541 
  5. Cabada MM, Echevarria JI, Seas C, Gotuzzo E. High prevalence of sexually transmitted infections among young Peruvians who have sexual intercourse with foreign travelers in Cuzco. J Travel Med. 2009;16(5):299-303.  https://doi.org/10.1111/j.1708-8305.2009.00324.x  PMID: 19796098 
  6. Sundbeck M, Agardh A, Östergren P-OO. Travel abroad increases sexual health risk-taking among Swedish youth: a population-based study using a case-crossover strategy. Glob Health Action. 2017;10(1):1330511.  https://doi.org/10.1080/16549716.2017.1330511  PMID: 28598729 
  7. McNulty AM, Egan C, Wand H, Donovan B. The behaviour and sexual health of young international travellers (backpackers) in Australia. Sex Transm Infect. 2010;86(3):247-50.  https://doi.org/10.1136/sti.2009.038737  PMID: 20237395 
  8. Vivancos R, Abubakar I, Hunter PR. Foreign travel associated with increased sexual risk-taking, alcohol and drug use among UK university students: a cohort study. Int J STD AIDS. 2010;21(1):46-51.  https://doi.org/10.1258/ijsa.2009.008501  PMID: 19933205 
  9. Lewis CT, de Wildt G. Sexual behaviour of backpackers who visit Koh Tao and Koh Phangan, Thailand: a cross-sectional study. Sex Transm Infect. 2016;92(6):410-4.  https://doi.org/10.1136/sextrans-2015-052301  PMID: 27272532 
  10. Hughes K, Downing J, Bellis MA, Dillon P, Copeland J. The sexual behaviour of British backpackers in Australia. Sex Transm Infect. 2009;85(6):477-82.  https://doi.org/10.1136/sti.2009.036921  PMID: 19826066 
  11. Misson J, Chow EPF, Chen MY, Read TRH, Bradshaw CS, Fairley CK. Trends in gonorrhoea infection and overseas sexual contacts among females attending a sexual health centre in Melbourne, Australia, 2008-2015. Commun Dis Intell (2018). 2018;42: S2209-6051(18)00024-6. PMID: 30626294 
  12. Matteelli A, Schlagenhauf P, Carvalho ACC, Weld L, Davis XM, Wilder-Smith A, et al. GeoSentinel Surveillance Network. Travel-associated sexually transmitted infections: an observational cross-sectional study of the GeoSentinel surveillance database. Lancet Infect Dis. 2013;13(3):205-13.  https://doi.org/10.1016/S1473-3099(12)70291-8  PMID: 23182931 
  13. Hawkes S, Hart GJ, Bletsoe E, Shergold C, Johnson AM. Risk behaviour and STD acquisition in genitourinary clinic attenders who have travelled. Genitourin Med. 1995;71(6):351-4.  https://doi.org/10.1136/sti.71.6.351  PMID: 8566971 
  14. Davies SC, Karagiannis T, Headon V, Wiig R, Duffy J. Prevalence of genital chlamydial infection among a community sample of young international backpackers in Sydney, Australia. Int J STD AIDS. 2011;22(3):160-4.  https://doi.org/10.1258/ijsa.2010.010354  PMID: 21464454 
  15. Fischer JA, Debattista J, Rostami S, Peet AR, Dean JA, Allen KE, et al. Sexual risk taking in a community sample of international backpackers visiting Brisbane, Australia. Asia Pac J Public Health. 2015;27(2):NP2400-9.  https://doi.org/10.1177/1010539513483822  PMID: 23572374 
  16. Veličko I, Ploner A, Sparén P, Marions L, Herrmann B, Kühlmann-Berenzon S. Sexual and testing behaviour associated with Chlamydia trachomatis infection: a cohort study in an STI clinic in Sweden. BMJ Open. 2016;6(8):e011312-011312.  https://doi.org/10.1136/bmjopen-2016-011312  PMID: 27566631 
  17. Navarro C, Jolly A, Nair R, Chen Y. Risk factors for genital chlamydial infection. Can J Infect Dis. 2002;13(3):195-207.  https://doi.org/10.1155/2002/954837  PMID: 18159391 
  18. Wand H, Guy R, Donovan B, McNulty A. Population attributable risk for chlamydia infection in a cohort of young international travellers (backpackers) and residents in Australia. BMJ Open. 2011;1(1):e000004.  https://doi.org/10.1136/bmjopen-2010-000004  PMID: 22021720 
  19. Svensson P, Sundbeck M, Persson KI, Stafström M, Östergren PO, Mannheimer L, et al. A meta-analysis and systematic literature review of factors associated with sexual risk-taking during international travel. Travel Med Infect Dis. 2018;24(March):65-88.  https://doi.org/10.1016/j.tmaid.2018.03.002  PMID: 29567294 
  20. Ward BJ, Plourde P. Travel and sexually transmitted infections. J Travel Med. 2006;13(5):300-17.  https://doi.org/10.1111/j.1708-8305.2006.00061.x  PMID: 16987130 
  21. Ericsson CD, Steffen R, Matteelli A, Carosi G. Sexually transmitted diseases in travelers. Clin Infect Dis. 2001;32(7):1063-7.  https://doi.org/10.1086/319607  PMID: 11264035 
  22. Chow EPF, Read TRH, Law MG, Chen MY, Bradshaw CS, Fairley CK. Assortative sexual mixing patterns in male-female and male-male partnerships in Melbourne, Australia: implications for HIV and sexually transmissible infection transmission. Sex Health. 2016;13(5):451-6.  https://doi.org/10.1071/SH16055  PMID: 28636867 
  23. Australasian Society for HIV (ASHM). Viral Hepatitis and Sexual Health Medicine. HIV, viral hepatitis and STIs: Australian STI management guidelines for use in primary care. Sydney: ASHM; 2018. [Accessed: 1 Dec 2018]. Available from: http://www.sti.guidelines.org.au
  24. The Australian Trade and Investment Commission (Austrade). Tourism Research Australia. Results of international visitor survey, year ending September, 2017 data. Canberra: Austrade. [Accessed: 1 Dec 2018]. Available from: https://www.tra.gov.au/data-and-research
International travel as risk factor for Chlamydia trachomatis infections among young heterosexuals attending a sexual health clinic in Melbourne, Australia, 2007 to 2017
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Ei+T+Aung&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Aung Ei T</a>, <a href="/search?value1=Eric+PF+Chow&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chow Eric PF</a>, <a href="/search?value1=Christopher+K+Fairley&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fairley Christopher K</a>, <a href="/search?value1=Jane+S+Hocking&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hocking Jane S</a>, <a href="/search?value1=Catriona+S+Bradshaw&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bradshaw Catriona S</a>, <a href="/search?value1=Deborah+A+Williamson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Williamson Deborah A</a>, <a href="/search?value1=Marcus+Y+Chen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chen Marcus Y</a></span>. International travel as risk factor for Chlamydia trachomatis infections among young heterosexuals attending a sexual health clinic in Melbourne, Australia, 2007 to 2017. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(44):pii=1900219. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.44.1900219" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.44.1900219</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 31 Mar 2019;&nbsp;&nbsp; <span class="generated">Accepted</span>: 17 Sept 2019 </span> </p>
/content/10.2807/1560-7917.ES.2019.24.44.1900219
/content/10.2807/1560-7917.ES.2019.24.44.1900219
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error