Sexually transmissible infections (STI) and HIV testing and diagnosis among Aboriginal and non-Aboriginal adolescents in contact with the Australian justice system: a cross-sectional study

Background It is unclear what factors are associated with sexually transmissible infections (STI) and HIV testing and diagnosis among justice-involved adolescents, and if these differ for Aboriginal or Torres Strait Islander peoples. Methods A cross-sectional survey of 465 justice-involved adolescents (aged 14–17 years) from Australia was conducted between 2016 and 2018. Participants were asked about sexual behaviours, STI/HIV knowledge, and prior STI diagnoses and testing. Results Approximately 38% (n = 130) of those sexually active had ever been screened for STI/HIV and 17.8% (n = 23) had been diagnosed with an STI. No participant reported living with HIV. For Aboriginal participants, being male (aOR 3.6, 95% CI 1.3–10.1) and having under three sexual partners in the past 12 months (aOR 3.1, 95% CI 1.2–8.0) was associated with never having had an STI/HIV test. For non-Aboriginal participants, being male (aOR 2.7, 95%CI 1.2–5.7), single (aOR 2.4, 95% CI 1.2–4.9), attending school (aOR 2.4, 95% CI 1.1–5.1), not having sought sexual health information (aOR 2.8, 95% CI 1.4–5.8), and having a lower STI/HIV knowledge score (aOR 2.3, 95% CI 1.1–5.0) were associated with never having had an STI/HIV test. Factors associated with STI diagnosis were non-heterosexual sexual orientation (aOR 5.6, 95% CI 1.1–28.2), transactional sex (aOR 11.2, 95% CI 3.0–41.3), and having sought sexual health information (aOR 3.5, 95% CI 1.0–12.5). Conclusions Males, particularly Aboriginal male adolescents, should be engaged with sexual health promotion and testing services as soon as they come into contact with the justice system. Approaches should consider different cultural, gender and sexual orientations.