Interventions for young people in Australia to reduce HIV and sexually transmissible infections: a systematic review

Background: Like young people in other developed countries, sexually active young Australians can have an increased risk of acquiring sexually transmissible infections (STIs). This paper reviews intervention programs that aim to reduce the incidence and transmission of HIV and STIs among young people in Australia. Methods: Articles were identified from seven databases. Intervention studies conducted in Australia that included young people aged 12-25 years were reviewed. A two-dimensional matrix consisting of 'setting' and 'intervention type' was developed to categorise each study. Results: Forty-two studies met the inclusion criteria, and the majority were uncontrolled intervention studies. Of these, 23/42 studies measured participation in chlamydia +/- other STI testing and found that the highest participation rates took place in non-clinical and non-general practice health care settings. Four studies facilitated access to testing indirectly, through the internet or other media. Ten studies involved the provision of education and measured its impact on factors such as knowledge, attitudes and/or behaviour. Three studies involved novel immunisation strategies for either hepatitis B or human papillomavirus vaccines. Two studies evaluated the impact of enhanced STI surveillance programs on prevalence rates. Conclusions: Proactive STI testing in non-clinical and some health settings appears feasible and achieves higher testing rates than in general practice; however, more evaluation of testing strategies in general practice settings is required. New technologies such as the internet and SMS are useful adjuncts for influencing behaviours such as condom use and STI testing. Media campaigns that promote STI testing can have a positive impact on testing rates.