Aboriginal and Torres Strait Islander STI Drug Replacement Program
The Aboriginal and Torres Strait Islander sexually transmissible infections (STI) drug replacement program facilitates providing eligible patients with free observed and immediate treatment for chlamydia, gonorrhoea and trichomoniasis within participating health services. The program aims to provide an alternative to sending patients away with a script that may not be filled, which could lead to delayed treatment or untreated infections.
Introduced in 1998, the program is coordinated and funded by the Communicable Diseases Branch. The program is supported by the Queensland Sexual Health Framework and was remodelled in 2021 following a review and consultation with participating services and internal stakeholders.
How the program works
Enrolled health services are provided with single dose treatment quantities of azithromycin, ceftriaxone and metronidazole for the treatment of chlamydia, gonorrhoea and trichomoniasis, free of charge to First Nations patients, their partners and other people at high-risk of not receiving treatment. From January 2023, a small amount of doxycycline for 7-day treatment of chlamydia is also available. Clinician feedback during consultation in 2022, although mixed, was consistent in emphasising that 7-day treatment was unlikely to be suitable for most clients. What treatment is provided to a patient is a clinical decision by the treating practitioner. Diagnosis can be based on symptoms, sexual contact with individuals with an STI, and positive pathology results.
The program replaces medication used during the preceding 6 months by dispatch from Queensland Health's Central Pharmacy twice a year. Services must be able to appropriately store and administer the medication in accordance with Medicines and Poisons (Medicines) Regulation 2021, relevant extended practice authority, and sexual health clinical management and treatment guidelines.
The maximum quantity that can be requested by services every 6 months is determined by the Communicable Diseases Branch in consultation with the enrolled services. Quantities are based on de-identified past pathology test results, treatment tracking or clinical management software information, and the service’s estimate for the number of infections to be treated.
Health service eligibility
A list of eligible Queensland Health facilities has been compiled from recent pathology data.
Eligibility is based on having an average of 5 or more positive chlamydia, gonorrhoea or trichomoniasis pathology results for Aboriginal and Torres Strait Islander patients in a 6-month period.
Non-Queensland Health services with a large number of Aboriginal and Torres Strait Islander patients, or who offer STI testing to patients who are at high-risk of not accessing treatment, are invited to enrol.
Services in remote areas participating in the Commonwealth Remote Area Aboriginal Health Services and Pharmaceutical Benefits Scheme (RAAHS) to provide free medication without prescription are not eligible for the Queensland program. If a service is uncertain whether they participate in or are eligible for the RAAHS program they can enquire with the Department of Health by emailing S100email@example.com.
How to enrol in the program
Queensland Health facilities
Queensland Health facilities in non-remote areas can enrol in the program by completing the opt-in form and emailing it to firstname.lastname@example.org. At enrolment, the Communicable Diseases Branch checks data from Pathology Queensland results from Aboriginal and Torres Strait Islander patients tested at the facility to determine the maximum replacement quantity that can be requested. The Pathology Queensland data is scheduled to be reassessed every 5 years.
Facilities using private pathology providers
Services with a large number of Aboriginal and Torres Strait Islander patients that use private pathology testing can enrol in the program by completing an enrolment form and emailing it to email@example.com.
The enrolment form asks for an estimated number of chlamydia, gonorrhoea and trichomoniasis infections in eligible clients expected to be treated in a 6-month period. Services can submit de-identified private pathology or treatment data for Aboriginal and Torres Strait Islander patients to help determine an appropriate maximum medication quantity for the service.
Please note, pathology request forms for samples processed by Pathology Queensland have an Aboriginal and Torres Strait Islander identification field, which the program relies on for data. Private laboratories do not have a standard data field for identifying Aboriginal and Torres Strait Islander patients, so other mechanisms need to be used to determine the maximum quantity that can be requested. For services using private pathology testing, the Communicable Diseases Branch can refresh the maximum quantities if requested and if new data is available, or if there is a local increase in STI testing and treatment.
Specialist services offering STI testing and treatment to patients who are at high-risk of not accessing treatment are considered on a case-by-case basis. Please complete an enrolment form and email it to firstname.lastname@example.org. A member of the Communicable Diseases Branch will contact you to discuss how your service could implement the program to reduce transmission of chlamydia, gonorrhoea and trichomoniasis in your client group.
Process for requesting replacement medication
To receive medication from the program, enrolled services must submit a drug replacement purchase order form that includes the signature of a person authorised (PDF 222 kB) under the Medicines and Poisons (Medicines) Regulation 2021. The purchase order form is to be emailed to the Communicable Diseases Branch twice a year in January and July. Services are encouraged to check their stock, only order what is needed for 6 months, and be aware of expiry date issues.
The Communicable Diseases Branch compiles the orders to request dispatch by Central Pharmacy. Services then receive replacement medication from Central Pharmacy and the Communicable Diseases Branch is invoiced. An information sheet for participating services will accompany the replacement medication.
Previous information sheets from recent medication dispatches:
If testing and treatment for eligible clients increases and the approved medication quantity is no longer sufficient, please contact the Communicable Diseases Branch at email@example.com.
Download the program flowchart to review the overview of enrolment and data administration.
Health service obligations
From 27 September 2021, the Medicines and Poisons Act 2019 and supporting regulations introduced a new legislative framework in Queensland. Participating health services must be able to appropriately store and administer the medication in accordance with the Medicines and Poisons (Medicines) Regulation 2021, relevant extended practice authority, and sexual health clinical management and treatment guidelines.
- Queensland Health eligible facilities list (PDF 207 kB)
- Opt-in form for Queensland Health facilities in non-remote areas (PDF 348 kB)
- Enrolment form for private pathology users (PDF 479 kB)
- Drug replacement purchase order form (PDF 281 kB)
- Enrolment and data administration flow chart (PDF 2125 kB)
For more information about the program, please email the Communicable Diseases Branch: firstname.lastname@example.org