National HIV strategy 'coordinated, holistic'
Australia has made great progress in addressing HIV over the last three decades, but it is a challenge that must be continually met, says Australia's chief medical officer, Professor Chris Baggoley.
With an estimated 26,800 people living with HIV infection in Australia at the end of 2013, mainly concentrated among men who have sex with men, Baggoley is optimistic but realistic about the nation's HIV status.
Speaking at the 20th International AIDS Conference in Melbourne about Australia's response to the pandemic, Professor Baggoley said Australia's HIV prevalence was eight to 12 per cent among gay community-attached men, 2.1 per cent among people who inject drugs, 0.1 per cent among female sex workers, 0.15 per cent in the Aboriginal and Torres Strait Islander population and with mother to child transmission very rare.
"Comparatively with the rest of the world this is a good result, however the rate of new diagnoses of HIV in Australia is increasing, and has been doing so for about 14 years," Professor Baggoley said.
"There were 1,236 cases of HIV infection newly diagnosed in Australia in 2013, similar to the number in 2012, and the highest rates we have seen since the early 1990s – almost 20 years ago.
"While 70 per cent of new diagnoses in 2013 were attributed to sexual contact between men we are also seeing increasing numbers of HIV transmission through heterosexual contact. Nearly half of the new diagnoses in 2013 attributed to heterosexual transmission were in migrant communities from high HIV-prevalence countries and their partners," Prof Baggoley said.
At a crossroads
"The reality is that we are doing many things right in responding to HIV in this country, but that we are not doing everything right. We are at a crossroads. If we continue as before we could see our upward trend continuing. That is not an option."
Professor Baggoley said Australia's new national HIV strategy takes up this challenge head on, and aims to turn the trend around.
"This is no easy task, but something we are determined to achieve," he said.
"We understand in Australia that HIV is not addressed – cannot be addressed – in isolation from other blood borne viruses and sexually transmissible infections. That is why since 2010, Australia's national strategies for HIV, hepatitis B, hepatitis C, sexually transmissible infections, and blood borne viruses and sexually transmissible infections in the Aboriginal and Torres Strait Islander population have been brought together as a suite. This approach continues with the 2014-2017 strategies.
"Together, the strategies support a coordinated, holistic effort across all conditions. Together, they respond to the intrinsic links through co-infections, common risk factors and priority populations.
"These strategies set the direction for the Australian response to blood-borne viruses and sexually transmissible infections until 2017."
"For the first time they include concrete targets that will drive action and hold us to account.
"The strategies are endorsed by all Australian health ministers and were recently launched by Australia's Commonwealth Health Minister, the Hon Peter Dutton at a function with Professor Sharon Lewin who is, of course, co-chair of this International AIDS conference."
Professor Baggoley said Australia's new HIV strategy has been developed at a time of unprecedented opportunity – new scientific advances in preventing and treating HIV - but also in the context of rising rates of HIV.
Prevention and research
"However, while Australia has always been a world leader in responding to HIV and AIDS with consistently one of the lowest rates of HIV in the world, we recognise we need to intensify our efforts in prevention, testing, surveillance, research and evaluation and management, care and support for people affected by the disease.
"We clearly need to do something different to reverse the trend of increasing HIV rates.
"To this end our new national strategies contain agreed timeframes, goals and targets that would be a call to action for governments, individuals and all those working within the HIV response."