Leading the Way in STI Testing Recovery Post-COVID

Aboriginal Community Controlled Health Services (ACCHS) in South Australia are setting the standard in the recovery of sexual health services following the COVID-19 pandemic. In a remarkable show of resilience, ACCHS have not only returned to pre-COVID levels of STI testing — they’ve significantly expanded targeted testing for HIV and syphilis, reinforcing the strength and impact of community-led health care.

This progress has been supported by ongoing efforts from our Sexual Health & BBV Program, who have worked alongside our Member Services to provide tailored health promotion materials, support local testing initiatives, and respond to community requests during and after the pandemic.

The Impact of COVID-19

From 2020 to 2022, the COVID-19 pandemic caused a widespread drop in STI testing across Australia. This included sharp declines across general practice, sexual health clinics, prisons, and Aboriginal health services. The disruption delayed diagnosis and treatment of STIs, increasing the risk of transmission, particularly in high risk communities.

While the overall health system is still recovering, the ACCHS experience demonstrates how a culturally informed, community-led approach can accelerate the return to routine care and even improve it.

Our Sexual Health & BBV Program has continued to assist member services through a mix of community outreach, engagement, and the distribution of health education resources designed to keep conversations about testing active and accessible.

Figure 1: Claims for MBS items related to chlamydia/gonorrhoea testing, by year, South Australia.

Recovery in SA ACCHS

In 2023, STI testing across South Australian ACCHS was just 5% below the pre-pandemic peak recorded in 2019. This near-complete recovery reflects the success of community-driven responses and the dedication of ACCHS staff, who have continued to prioritise accessible and culturally safe sexual health services in the wake of the pandemic.

While many health services are still rebuilding, ACCHS have demonstrated that trusted, community-based care can rebound quickly and effectively, even after major disruptions.

Member service data have played a key role in guiding STI and BBV testing efforts, particularly in identifying community-level patterns in HIV and syphilis. Using these data, our Sexual Health & BBV Program has developed visual dashboards to support member services in planning targeted responses and monitoring testing uptake over time.

Figure 2: Number of STI testing episodes*, by year, Aboriginal Community Controlled Health Services, South Australia

Continued Growth in Testing for Syphilis and HIV

One of the most encouraging outcomes has been the sharp increase in concurrent HIV and syphilis testing at ACCHS. Through ongoing quality improvement efforts and targeted investment, testing protocols have strengthened substantially:

• In 2016, only 19% of STI testing episodes at ACCHS were followed by an HIV or syphilis test within 30 days.
• By 2023, this figure had jumped to 70%. This is a testament to integrated care and proactive screening.

This increase in targeted testing isn’t just a metric, it has led to real public health gains. Since the 2018 peak, infectious syphilis notifications among Aboriginal people in Country SA have declined, even as cases have risen in metropolitan areas. This shows that community-led strategies are essential.

Figure 3: Proportion of STI testing episodes with a follow up HIV/syphilis test within 30 days, by year, Aboriginal Community Controlled Health Services, South Australia

Campaigns, Training and Local Action

Campaigns and public health messaging developed by AHCSA have played a key role in supporting STI testing uptake. In 2022, when national coordination of Aboriginal and Torres Strait Islander HIV Awareness Week (ATSIHAW) paused, our program worked alongside SHINESA to develop and deliver a state-based campaign to ensure communities still received relevant and timely HIV prevention messaging.

AHCSA and the Sexual Health & BBV Program would like to thank SA ACCHS for their vital role in distributing these resources, engaging with community members, and hosting local events to raise awareness about HIV prevention, testing, and available treatments.

Our program also continues to contribute to the training of future Aboriginal Health Practitioners by supporting the delivery of the Sexual Health module in the Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care Practice. This includes a strong focus on syphilis and HIV and is complemented by regular professional development workshops tailored to ACCHS staff across the state.

The ACCHS-led recovery in STI testing is a powerful example of what’s possible when communities are at the heart of healthcare. With strong relationships, responsive service delivery, and culturally safe practices, ACCHS have emerged stronger post-COVID.

As we look ahead to building a more resilient and equitable health system, ACCHS provide a clear model: community-controlled care works. Our Sexual Health & BBV Program will continue to work alongside Member Services and Community to provide responsive, community-informed support, from resource development and workforce training to campaign messaging and regional planning.