All Posts tagged STI
OK, so as promised in our previous blog from the #WorldSTICongress2015, we had our in-house gamers review the new STI game developed by WA Health Infection Protection.
Introducing Gamer 1: At 14 years old, this gamer has had 12 years gaming experience. Starting out at 2 playing Freddie Fish, he moved into Star Wars Lego games at 6, loved Mario Kart, built hundreds of architecturally designed cities in Minecraft (still a gold favourite) peppering these games with bouts of Team Fortress 2 and FIFA, until he discovered Assassins Creed and shoot-em-up games like Call of Duty.
The game has a really good concept. I like how they’ve integrated Minecraft a popular and well known video game into something that educates children about STIs and health. It’s pretty funny at first, because everyone is having sex and that’s a bit weird. I’ve never seen Minecraft people having sex before. This made me laugh but it could make some people feel uncomfortable. After a while you get used to it and then you realise that it’s actually quite serious that the more sex they have the more diseases they can get.
You feel you’re responsible for these people having sex and spreading diseases as quickly as they do. So you have to stop the spread of disease by giving them safe sex packs and treating them.
Sending them to the clinic to get tested is really good because you learn about the symptoms and the treatments that are available.
The only thing is that you can’t really tell if the person has symptoms - but they should still go to the clinic to get tested just in case they just caught something from the last person they had sex with.
The way the game could be improved would be to give the characters more personality. Perhaps a picture of them (avatar) and a description eg; Brown hair, blue eyes, likes girls, likes boys, likes both, only has sex with one person, has lots of sex, has symptoms, has no symptoms. Make it more personal. You have to take care of them so you might as well know who they are.
Introducing Gamer 2: At 12, this gamer likes to play SIMS, Minecraft, Super Mario Bros, Nintendogs, Wii Sports, Kitty Powers Match Maker. She is an app queen with an iPhone and an attitude.
It’s weird for a 12 year old to see Minecraft characters doing that with each other. We still haven’t had “The Talk” at school but my Mum has told me about all that stuff. I know it’s normal, but it’s still weird. I like the way it looks like Minecraft. The graphics were pretty good. I played for a while and treated some people at the Clinic but I got bored after a while. I didn’t really want to learn about sex and diseases so I stopped playing. I don’t think I’d play again unless the characters were more interesting. Maybe if they had pets or did other stuff.
Play Infection Protection by going to www.getthefacts.health.wa.gov.au
Download Infection Protection from www.getthefacts.health.wa.gov.au
The Australian Federation of AIDS Organisations (AFAO) has welcomed news of the early results of a major international study that found that early treatment halved the risk of people with HIV developing a range of serious illnesses.
The Strategic Timing of Antiretroviral Treatment (START) study looked at the risks and benefits of early versus delayed antiretroviral treatment. The study has been wound up ahead of time due to the conclusive findings. These results offer further support to Australia’s efforts to increase treatment uptake among all people with HIV. Evidence has existed for several years that HIV treatments dramatically reduce the infectiousness of people with HIV. The START study now indicates there is a clear benefit to individual health, even among people with high CD4 counts.
Clear Support for Initiating Early Treatment
AFAO Executive Director Rob Lake said it was great news, offering strong evidence to support what many health professionals have believed for some time. “We’ve thought for some time early treatment – rather than waiting – was beneficial,” Rob Lake said. “For health professionals, these results offer clear support for initiating treatment as soon as patients are ready. For people with HIV, who may be delaying treatment until their CD4 count starts to fall or who may be apprehensive for other reasons, these results should offer confidence that starting now is the best decision for long-term health,” said Rob Lake.
Australia is considered to have fairly high rate of antiretroviral treatment uptake among people living with HIV, thanks to the strong community support and education and the PBS scheme which subsidises the costs of medications. “In a country like Australia with a strong health system and PBS, the study results are great news because people with HIV can take advantage of the medicines straight away.”
AFAO said the study’s results would strengthen the fight for treatment in countries where access is poor. Globally only about 40% of people with HIV are able to access HIV treatments.
Join our coverage of the World STI Congress together with the Australian HIV & AIDS Conference from 13 - 18 September 2015
The past decade has seen a steady rise in sexually transmitted infections (STIs) in Australia.1 In 2010, young people aged 15-24 accounted for 42% of new HIV infections in people aged 15 and older.2
The adolescent population presents a unique set of challenges when it comes to sexual health education and behaviour change. Adolescence is a time for exploring sexuality, experimenting with risk-taking behaviour and finding new ways to connect that sets them apart from the adult world.
How do we reach young people to prevent STIs?
Moving health messaging into the digital gaming space, says Lynn Fiellin and colleagues at Yale University who presented their results at the Young People Epidemiology and Prevention Strategies oral abstract session at AIDS 2014 today.
Digital health technologies are growing at an unprecedented rate, particularly in the smart phone and tablet space. Mobile phone networks are now reaching up to 85% of the global population and the World Health Organisation estimates close to 5 billion mobile subscriptions worldwide.2
A recent infographic reported the State of the Mobile 2013:
• 91% of all people on earth have a mobile phone
• 56% of people own a smart phone
• 80% of time on mobile devices is spent inside games or apps
• Majority of teens play video games as long as they have access to them.3
And the largest audience of apps and video games? Adolescents - the digital natives or our techno world.
Serious Gaming delivers serious health messages
‘Serious Gaming’ is an emerging platform for imparting health messages and delivering health education. Serious gaming holds the promise of delivering STI prevention messages to teenagers through game-based learning.
Anyone who has talked to a teenager lately knows that gaming experiences can be engaging, immersive and educational. Many Australian schools now set homework where students are using video gaming platforms and apps to entice and encourage literacy and numeracy and to connect and collaborate with remote schools.
Applying health messages to video games has the potential to improve health literacy around STIs and may go some way towards prevention.
Studies into serious gaming cite neuroplasticity improvements, faster processing, increased cognitive flexibility and a deeper creative learning experience as just some of the results reported by young people who took part in serious gaming compare to those who played non-educational games.4
Today, Fiellin and colleagues showed that when teens were randomly assigned to 10 hours of gaming sessions that included: Sexual health and HIV knowledge, self efficacy, risk perception scenarios, short vs. long term priorities and an epilogue illustrating the consequences of their choices, their HIV risk knowledge had improved at 6 weeks, with knowledge levels maintained at 3 and 6 months.
Participants enjoyed the gaming experience, found it challenging, and reported that they felt responsible for the decisions made during game.
During question time, criticism of the study was aimed at the game’s apparent representation of heteronormative and gender-based stereotypes. Ms Fiellin agreed that the video game was limited in its choice of characters and diverse sexual orientation but that the research group now have proof of concept to develop the game further including the potential for a multiplayer platform.
Read our blog Chlamydia in Teens: What’s working…What isn’t?
- Australian Bureau of Statistics ABS June 2012
- UNAIDS Fact sheet Adolescents, young people and HIV www.unaids.org/
- World Health Organisation (WHO) Website. Tobacco Free Initiative. www.who.int/tobacco/mhealth/
- www.digitalbuzzblog.com/State of the Mobile
- Glass BD et al (2013) Real-Time Strategy Game Training PLoS ONE 8(8): e70350. doi:10.1371/
Chlamydia in Teens
Health experts warn that an epidemic of chlamydia may cause a wave of infertility in young Australians.1
The past decade has seen a steady rise in sexually transmitted infections (STIs) in Australia.2 Professor David Wilson, from the Kirby Institute estimates that rates of chlamydia have tripled over a ten-year period.3 Chlamydia is the most frequently notified infection in Australia with almost 83,000 cases diagnosed in 2012. The rise in chlamydia diagnosis is partly due to increased testing however, the Kirby Institute estimate that one in twenty young Australians have chlamydia and many don’t even know they have it.
The Burnet Institute recently reported that the group who have the highest percentage of positive test results are girls aged 12-15 years (13%) compared with females 16-19 years (12 %) and 20-24 years (8%).4 In males, the highest percentage of positive chlamydia tests were in those aged 16-19 years (15%) followed by 20-24 year olds (13%) and 12 to 15 year olds (9%).4 These figures may come as a surprise, but according to Carol El-Hayek, 12 to 15 year olds are definitely sexually active - and many of this age group are practising unsafe sex. Add to this the confounding factor that around 70% of females and 50% of males with chlamydia have no symptoms, so may pass on infection without knowing.5
For information about chlamydia symptoms, testing and treatment see What is Chlamydia?
Getting more Teens to Screen
Clearly, Australian teenagers as young as 12 years old are vulnerable to STIs, and the younger they are, the less likely they are to be tested. This age group are more likely to seek a test only after symptoms appear, or if they are identified as being at risk of unprotected sex by their GP, parent/carer or school counsellor.3
Chlamydia & Cyberspace
What’s also clear, is that young people are getting much of their health information from cyberspace. The internet plays a vital role in educating young people about STIs in a way that is familiar, non-judgemental and easily accessible. So how effective is cyberspace in reducing the rates of chlamydia in young people?
A recent study by Melissa Kang and colleagues from the University of Sydney GP Medical School, used the internet to engage sexually active young Australians aged 16-25 years in confidential, email interactions with a sexual health nurse or doctor. The goal was to educate and facilitate access to chlamydia testing services for young people. Subjects were invited to visit a specifically designed website to discuss chlamydia and the importance of testing.6
Young people were more likely to report having a chlamydia test after 6 months of email interaction with a clinician than those who were not offered such contact. The authors concluded that the internet and eTechnology may be useful in promoting chlamydia testing and healthcare seeking behaviour in young people.6
It goes without saying that cyberspace is a good place to start when designing public health messages about STIs for young people. There remain gaping research holes, sure to be filled over the next few years with studies on the extent and efficacy of internet-based education programs for young people. At this stage, and with little evidence to back up social media and internet-based programs, the most effective way to change behaviour are the still traditional methods of school-based programs, community health centres
In July 2013, The Australian Research Centre in Sex, Health & Society issued a report outlining the most effective (and ineffective) methods of delivering STI education programs.7
- Comprehensive one-on-one counselling with sexually active young people has shown to be effective in changing behaviour and reducing risky sexual practices;
- Generally, interactive internet-based programs are comparable to face-to-face counselling for increasing sexual health knowledge and improving attitudes towards practising safe sex
- Targeted outreach screening in community health settings and non-GP health services show high acceptance and participation in STI screening;
- Sexual health education via the internet and social media may improve young people’s sexual health knowledge and attitudes;
- Programs for Aboriginal and Torres Strait Islander youth that follow good cultural practices such as community consultation and ownership, collaborative development and engagement using multidisciplinary and interagency approaches are effective;
- Peer-led programs and youth development with at-risk young people and minority youth are effective in increasing knowledge and improving attitudes and motivations.
And what isn’t…
Programs focusing on abstinence were ineffective in reducing risk or delaying sexual behaviour. There is also indicative evidence that abstinence based programs may increase STI risk.7
There has been minimal success in increasing STI screening rates in general practice contexts, in particular for chlamydia. However, young people will respond positively to an offer from a clinician or GP for an STI test and many would prefer this to having to initiate the request.7
Take-home message for health practitioners:
- Offer confidential STI screening to young people.
- Make sure a list of sexual health clinics and youth health centres is available for young people from the age of 12 years.
- Avoid talk of abstinence. Young people are sexually active and need support not judgement.
- Keep up to speed on culturally appropriate, locally relevant, interactive sexual health education sites, apps and community programs.
In the meantime, there are plenty of informative, locally relevant websites, campaigns and Twitter feeds:
Red Aware YEAH is a youth driven health promotion organisation aimed at empowering youth to become involved in improving sexual health awareness in their local communities.
Get The Facts is a youth focused website about sexual health (Department of Health, WA).
Could I Have It? is a comprehensive site all about Chlamydia with information for young people and travellers. It even features online Chlamydia self-assessment and testing (WA based).
Better to Know is a website for Aboriginal and Torres Strait Islander people with information on STIs, how and where to test for STIs and how to tell a partner that you have an STI.
1. Brewster, K. Chlamydia epidemic may cause a rise in infertility among young Australians - experts warn. ABC News 24 October, 2013
2. Australian Bureau of Statistics ABS June 2012
3. Hagan, K. Chlamydia rates rise for younger girls. The Age, 24 October 2013
4. Somerville, C. Burnet Institute News, 24 October 2013
5. Better Health Channel: Chlamydia
6. Kang M, Rochford, A, Skinner R. et al. Facilitating chlamydia testing among young people: a randomised controlled trial in cyberspace. Sex Trans Infect. 2012;88:568-573.
7. Brown G, Croy S, Johnston K, Pitts, M., & Lewis, V. (2013). Rapid Review: Reducing sexually transmissible infections in young people. Melbourne: Australian Institute for Primary Care & Ageing (AIPCA) and Australian Research Centre in Sex, Health & Society (ARCSHS), La Trobe University.
Chlamydia is a bacterial infection that can infect the prostate, urethra and testes in men and the cervix, uterus and pelvis in women. Chlamydia is spread through unprotected vaginal, anal or oral sex and is often asymptomatic; most people are unaware that they have the infection and that they need treatment. If left untreated, chlamydia can cause serious long-term complications:
- Inflammation of the upper genital tract and infertility in men;
- Pelvic inflammatory disease (PID), ectopic pregnancies, chronic pelvic pain and infertility in women;
- Increases the possibility of contracting other infections such as HIV.1
One in 20 young Australians have chlamydia - most don’t even know
It’s estimated that rates of chlamydia have tripled over a ten-year period. Chlamydia is the most frequently notified infection in Australia with almost 83,000 cases diagnosed in 2012.2
Girls aged 12-15 years have the highest percentage of positive chlamydia test results followed by 16-19 year olds and 20-24 year olds.3
Young men aged 16-19 years old have the highest percentage of positive chlamydia test results in Australia followed by 20-24 year olds and 12-15 year olds.3
Around 70% of females and 50% of males with chlamydia have no symptoms, so may pass on infection without knowing.4
If symptoms are present they may include:
- Abnormal or increased vaginal discharge
- Vaginal bleeding or spotting between periods or after sex
- Painful sexual intercourse
- Pelvic pain like period pain
- Discomfort or pain when urinating
- Discomfort or pain when urinating
- Discharge from the penis
- Redness around the urethra
Testing is simple, what does it involve?
There is no single test to detect all sexually transmitted infections (STIs). Chlamydia, however, is an easily diagnosed and curable STI. Tests are painless and usually involve a simple urine test in men or women. Alternatively, a cotton swab may be used to test for chlamydia from the vagina, cervix, anus or penis. The specimen is then sent to a laboratory for testing.
What’s the Treatment?
Treatment for chlamydia is usually straightforward and involves a course of antibiotics.
Find out More
Young sexually active people are particularly vulnerable to STIs including chlamydia. Find out more about What’s working and What Isn’t when it comes to reducing the rates of Chlamydia in young Australians.
1. Australian Bureau of Statistics ABS June 2012
2. Hagan, K. Chlamydia rates rise for younger girls. The Age, 24 October 2013
3. Somerville, C. Burnet Institute News, 24 October 2013
4. Better Health Channel: Chlamydia