Innovative ways to improve STI testing among young people living in remote areas of the Northern Territory: behavioural insights (“nudges”)

Australia has made notable progress in the management of sexually transmissible infections (STIs) in recent years. Despite these measures, some STIs including chlamydia, gonorrhoea and syphilis continue to rise. This translation project wants to improve STI testing among young people by developing a video based “nudge” that is culturally and age appropriate for the target population.

The highest rates are seen among young people aged 15-29 years and the rates are much higher among those who live in remote regions and among Aboriginal and Torres Strait Islander people compared to non-Indigenous populations. In addition, awareness of STI and STI testing rates are also quite low among young people. Therefore, it is important to obtain the views and needs of young people when developing educational programs to increase awareness of STIs as well as methods to increase STI testing.

The B part of it NT study, which will commence throughout the NT in 2020, aims to evaluate the effectiveness of the meningococcal B vaccine against meningococcal disease and gonorrhoea among 14-19 year olds. We propose “nudges” as as a strategy to increase awareness of sexually transmitted infections (STI) and STI testing to be carried out as part of the B Bart of it NT Study.

Focus group discussions will be held for young people aged 14-19 years to obtain their views on how to develop a video based “nudge” that is culturally and age appropriate for the target population. This will be used during the B Bart of it NT Study to increase awareness of STI testing and to engage people in participating in the study. STI testing rates before and after the B Bart of it NT Study will be used to evaluate the effectiveness of the “nudge” communication strategy to improve STI testing among young people.

Meningococcal disease and gonorrhoea cause severe morbidity in Australian adolescents, particularly among Aboriginal people. In 2018, invasive meningococcal disease was reported in all states of Australia with a notification rate of 4.4/100,000 in the NT. The notification rates for gonorrhoea among 15-19 year olds range from 1924/100,000 to 17,022/100,000 in Aboriginal young people and from 106/100,000 to 1081/100,000 in non-Aboriginal people over different areas of the Territory (averaged over 2014-2018).

At present there is no vaccine to provide protection against gonorrhoea. Emerging evidence shows that the meningococcal B vaccine may provide some protections against gonorrhoea due to genetic similarities that exist between the two organisms that cause meningitis and gonorrhoea. If the effectiveness of the meningococcal vaccine against gonorrhoea can be demonstrated at a population level it would have substantial health benefits to be gained world-wide, but particularly for Aboriginal people and can result in a reduction in the incidence of gonorrhoea, a reduction in antibiotic prescription for treatment and potentially antimicrobial resistance.