Sexually transmitted infections, blood-borne viruses and risk behaviour in an Australian senior high school population - The SHLiRP study

Objectives: To determine the feasibility and acceptability of screening for sexually transmitted infections and blood-borne viruses and to study the profile of sexual activity and other risk behaviours in a senior high school population. Methods: In this descriptive study we provided sexual health education and screening to students from two senior high schools in the Australian Capital Territory. We collected behavioural data using a self-administered questionnaire. Urines and swabs were tested for Chlamydia trachomatis (Ct), Neisseria gonorrhoea (Ng), Trichomonas vaginalis(Tv) and human papilloma virus (HPV). Blood specimens were tested for hepatitis B and C, HIV herpes simplex viruses (HSV-1 and HSV-2) and syphilis. Results: A total of 795 students participated (31% of the enrolled population; female to male ratio 60:40) and 67.0% were sexually active. Of 795 students, 644 (81.0%) were screened. Rates of infection were Ct 1.1% (95% CI: 0.4-2.6), HPV 11.7% (95% CI: 7.4-17.3), HSV-1 32.5% (95% CI: 28.9-36.3), HSV-2 2.4% (95% CI: 1.3-3.9), hepatitis B surface antigen 0.3% (95% CI: 0.04-1.1) and hepatitis C antibodies 0.7% (95% CI: 0.07-1.6). Only 22.3% (95% CI: 19.3-25.7) of students had immunity to hepatitis B. There were no cases of HIV gonorrhoea, trichomoniasis or syphilis. Of the sexually active students, 49.2% (95% CI: 38.9-59.2%) reported never or only sometimes using condoms, 41.5% (95% CI: 32.2-52.3%) reported unsafe drinking, 33.3% (95% CI: 23.9-43.1%) were smokers and 1.9%i (95% CI: 0.2-7.0%) reported injecting drug use. Conclusions: Rates of STI and blood-borne viruses and iimnunity to hepatitis B were low in this population, but unsafe sex and other risk behaviours were common. We have demonstrated that STI screening, including serological testing, was well accepted in a senior high school population.