Sexual risk and healthcare seeking behaviour in young Aboriginal and Torres Strait Islander people in North Queensland Robert Scott A , Regina Foster A , Lisa N. Oliver A , Anna Olsen B , Julie Mooney-Somers C , Bradley Mathers B , Joanne M. Micallef B , John Kaldor B and Lisa Maher B,D A Townsville Aboriginal and Islander Health Service, 57–59 Gorden Street, Garbutt, Qld 4814, Australia. B The Kirby Institute, UNSW Australia, Sydney, NSW 2052, Australia. C Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW 2006, Australia. D Corresponding author. Email: Lmaher@kirby.unsw.edu.au Abstract. Background: Compared with non-Indigenous Australians, Aboriginal and Torres Strait Islander people have higher rates of sexually transmissible infections (STI). The identification of the sexual risk and healthcare seeking behaviours of young Aboriginal and Torres Strait Islander people in a regional Australian setting was sought. Methods: A cross-sectional survey of 155 young Aboriginal and Torres Strait Islander people (16–24 years) in Townsville was conducted. Results: Most participants (83%) reported ever having had sex, with a median age of 15 years at first sex and a range from 9 to 22 years. While young men reported more sexual partners in the last 12 months than young women, they were also more likely to report condom use at the last casual sex encounter (92% vs 68%, P = 0.006). Young women were significantly more likely than young men to report never carrying condoms (35% vs 16%); however, they were more likely to have had STI testing (53% vs 28%, P = 0.004). Of those reporting previous STI testing, 29% reported ever being diagnosed with an STI. Conclusions: The sample of young Aboriginal and Torres Strait Islander people reported an early age at first sex, variable condom use and low uptake of STI testing. The high prevalence of self-reported STI diagnoses indicate a need for opportunistic sexual health education and efforts designed to promote the uptake of STI screening in this group. Additional keywords: Aboriginal and Torres Strait Islander, condoms, regional, sexually transmitted infections, testing, youth. Received 24 May 2014, accepted 22 October 2014, published online 15 December 2014 Introduction Aboriginal and Torres Strait Islander people have poorer health outcomes than non-Indigenous Australians. 1,2 Among several areas of health disparity, sexually transmissible infections (STIs) stand out, based on notified diagnoses of chlamydia, gonorrhoea and syphilis. 3 Barriers to sexual health among young Aboriginal and Torres Strait Islander people include cultural factors such as shame and difficulty with an open discussion of sex, 4 negative attitudes to condoms 5,6 and alcohol use. 6 More general determinants of poor health include low socioeconomic status, 7 remoteness and the adequacy of services. 8 The delivery and uptake of sexual health services by young Aboriginal and Torres Strait Islander people could be enhanced by a greater understanding of their sexual behaviours, attitudes to safe sex and current use of health services. This paper aims to explore these specific factors in a regional community with the intention of directing future health promotion and intervention strategies. Townsville is one of the largest regional cities in Australia, with 6% of residents identifying as Aboriginal or Torres Strait Islander or both, 9 compared with 2.5% nationally. 10 The Townsville Aboriginal Islander and Health Service (TAIHS) is a community-controlled health service, established in 1974 that provides comprehensive primary health care and community services. Previous research addressing the sexual health of young Aboriginal and Torres Strait Islanders in Townsville found self-reported rates of consistent condom use at ~60%, similar to other populations of young people in Australia, 5 but the prevalence of chlamydia was considerably higher. 11 This paper presents findings from work funded via a research grant awarded by the National Health and Medical Research Council, through the International Collaborative Indigenous Health Research Partnership (ICIHRP), which had the overall goal of examining the role of resilience in protecting Indigenous populations against sexually transmissible and blood-borne infections. 12,13 Methods A cross-sectional survey was developed by TAIHS staff in collaboration with researchers based at the Kirby Institute at the University of New South Wales, Australia. CSIRO PUBLISHING Sexual Health http://dx.doi.org/10.1071/SH14092 Journal compilation Ó CSIRO 2014 www.publish.csiro.au/journals/sh