Conventional surveillance of sexually transmissible infections (STIs) and blood-borne viruses (BBVs) is based on notification of diagnoses; by age, sex and place of residence only. However, the number of diagnoses for conditions that are mainly symptomless is highly dependent on the number of tests performed and how well those tests are targeted. Many priority populations – gay men, Indigenous people, sex workers, injecting drug users, travellers and migrants – are not identifiable by conventional surveillance.
The Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Sexually Transmissible Infections and Blood-borne Viruses – ACCESS – is a national sexual health surveillance network. ACCESS collects and collates de-identified data from over 120 sexual health clinics, general practice clinics, hospitals, community health services and pathology laboratories across Australia.
The ACCESS project is a collaboration between the Kirby Institute, the Burnet Institute and the NRL in Melbourne.
ACCESS complements population-based reporting by using routine and anonymous clinical service and laboratory data to determine the numbers of people from priority populations attending clinical services, their risk behaviours, testing rates, and positivity rates. This data can be used to design interventions to control STIs and BBVs, and can also be used to determine incidence rates in order to evaluate the impact of those public health interventions.
The ACCESS project regularly reports on STI and BBV testing and outcomes in priority populations to state and national governments, and in the Kirby Institute’s Annual Surveillance Reports. The ACCESS data also supports other research projects such as TAIPAN, EPIC, and Deadly Liver Mob: enhancing access to STI and BBV services for Indigenous people.
The ACCESS project has become the backbone of enhanced national surveillance in priority populations and is essential to evaluating the National Strategies.