AS international travel expands to unprecedented levels globally, Australian public health experts are warning that the increase in importation of sexually transmitted infections is presenting a significant public health challenge.
Writing in the journal Sexual Health, the team from the University of Queensland is urging clinicians who provide travel health advice and vaccinations to initiate opportunistic sexual health discussions, take sexual histories, conduct STI testing, and provide advice on safer sex practices for those travelling to high-risk settings.
They noted that the growing number of travellers has created diverse pathways for STI transmission, with chlamydia a concern among backpackers, syphilis among those visiting friends and relatives, and gonorrhoea and HIV among men who have sex with men.
"Situational disinhibition that may occur during travel, such as a sense of liberation from usual social norms, the excitement of meeting new people or being in unfamiliar environments, anonymity, a fun-oriented mindset, and the use of alcohol or recreational drugs, can contribute to less safe sexual practices among travellers, thereby increasing the risk of acquiring and transmitting STIs," they said.
Specific concerns are related to drug-resistant gonorrhoea, particularly among visitors to Southeast Asia, a popular sex tourism destination.
The experts also pointed out that the use of doxy-post-exposure prophylaxis for the prevention of syphilis and chlamydia among men who have sex with men and transgender people may contribute to drug-resistant STIs.
Meanwhile, they suggested that travellers may be hesitant to seek pre-travel sexual health advice or post-travel screening due to perceived discomfort and stigma associated with STIs/HIV or with identifying as a sexual and/or gender minorities, while access to sexual health services may also be limited in some areas.
"To tackle these issues, it is very important to integrate sexual health into travel medicine and provide care throughout the travel journey, rather than treating it as a one-off event," the team stated.
"Travel medicine practitioners could raise awareness, offer tailored and personalised sexual health services, and encourage responsible behaviours during travel," they proposed.
Read the paper HERE. KB
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