David Brill
 
Backpackers’ promiscuity and reluctance to use condoms is fuelling the spread of chlamydia, say Sydney experts, who want health campaigns to get serious about targeting bars and hostels.

 

Reviewing almost 13,000 tests at a Sydney sexual health clinic, researchers found the proportion of backpackers testing positive for Chlamydia has more than doubled over eight years.

And while Chlamydia rates also rose among residents, it was the risky behaviour of backpackers that carried the greatest threat at a population level.

Over 80% of Chlamydia infections among male backpackers were in those who used condoms inconsistently and reported multiple recent partners, the researchers said, suggesting that boosting condom use would dramatically reduce infection rates.

Almost 70% of female backpackers who tested positive for Chlamydia reported inconsistent condom use and multiple recent partners.

Writing in the BMJ Ope, the Sydney Sexual Health Clinic researchers said there was “little evidence” that current health promotion campaigns had done anything to increase condom use in Australia.

They called for a fresh approach, targeting selected pubs and clubs, backpacker hostels, domestic airports and backpacker publications.

“Health promotion and other prevention strategies targeting young people need to be more innovative than just social marketing and include information about the various risk factors for Chlamydia, which in turn may then lead to increased testing and treatment,” they said.

“With widespread use of the internet and mobile phones, electronic-based health promotion may be more effective at changing sexual and healthcare seeking behaviour.”

Some 545,000 backpackers visited Australia in 2006, staying for 72 days on average. Sydney alone hosted around 407,000, the researchers wrote.

The study reviewed data from 12,958 heterosexuals aged 18-30 who attended the clinic for the first time between 1998 and 2006.

A total of 731 tests returned positive for Chlamydia, giving an overall rate of 5.6%.

Among backpackers alone, however, the proportion of tests returning positive rose from 5% in 1998 to 12% in 2006, with the rise statistically significant for both sexes. Among residents, this figure rose from 3% to 8% over the same period.

Male backpackers reported significantly more risk factors than non-backpackers: 17% reported excess alcohol consumption, 26% reported having three or more sexual partners in the past three months, 22% reported having had sex in Thailand in the preceding year and 15% reported a previous diagnosis of Chlamydia.

Condom use however was similarly patchy among male backpackers and residents, with 31% of each group reporting inconsistent use over the preceding three months.

Female backpackers were significantly more likely than residents to report all of the above risk factors, with 27% reporting excess alcohol consumption, 31% reporting two or more sexual partners in the past three months, 7% reporting sex in Thailand in the preceding year, 14% reporting a previous diagnosis of Chlamydia, and 31% reporting inconsistent condom use.

BMJ Open 2011; online