Women Receiving Opioid Treatment Face Higher STI Infection Rates
30 Oct 2026
The study found higher rates of chlamydia and gonorrhoea among women with a history of OAT prescriptions. Researchers have called for better access to testing and treatment, with a focus on reducing stigma, costs and other barriers.
Researchers examined health data from more than 6,800 women aged 15–55 who had received prescriptions for opioid treatments, including methadone and buprenorphine. The data covered services participating in Australia's ACCESS surveillance network between 2012 and 2025.
Only around one-third of the women had a recorded chlamydia or gonorrhoea test at an ACCESS service during the study period.
Among those tested, 3% had positive gonorrhoea results and 4% tested positive for chlamydia. Infection rates were higher among women under 30, reaching around 7%.
Senior study author Jason Asselin said women who use drugs often experience several health and social challenges, which can make sexual healthcare harder to access.
He said STI testing should become a more routine part of services that women already use, including alcohol and other drug services, needle and syringe programs and harm-reduction services.
Barriers to Sexual Healthcare Remain
Associate Professor Marguerite Tracy, a member of the RACGP Expert Committee – Quality Care, said many women may have undiagnosed infections because they have not been tested.
She identified stigma, discrimination, cost and limited access to services as major barriers to sexual healthcare.
Around 60,000 Australians receive OAT each day, with women making up approximately one-third of this group.
Treatment is available through GPs, addiction medicine specialists and addiction psychiatrists. Australia had 3,123 authorised OAT prescribers in 2023.
Associate Professor Tracy said general practice plays an important role in providing continuous and comprehensive care for people receiving opioid treatment.
She added that GPs already have the skills to provide sexual health screening and treatment, making these services an important part of care for patients receiving OAT.
Repeat Infections Highlight Need for Follow-Up
The research also identified repeat infections among women who had previously tested positive.
Among women who were retested after a positive chlamydia result, 21% had at least one further positive result.
For women retested after gonorrhoea, 18% had another positive result.
Current Australian STI management guidelines recommend considering chlamydia and gonorrhoea testing for people who use drugs.
The researchers stressed that sexual healthcare must be accessible and free from stigma for women who inject drugs.
Researchers Call for Better Support in General Practice
Associate Professor Tracy said providing STI screening and treatment through drug and alcohol services could improve access. However, she warned that this approach could also lead to fragmented care if services are not properly connected.
She said comprehensive healthcare should remain a priority, with general practice playing a central role.
She also highlighted the need for better support for GPs and medical practices, including appropriate payments for longer and more complex consultations, timely advice from alcohol and drug services, and stronger shared-care arrangements.
Women Receiving Opioid Treatment Face Higher STI Infection Rates
Source: Australian research published in Sexual Health; Australian STI Management Guidelines; Australian Institute of Health and Welfare.