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HIV rates falling overall – but not for everyone

HIV rates falling overall – but not for everyone - Featured Image

HIV rates in Australia have dropped overall to a seven-year low, but a concerning increase in infection rates has been observed among heterosexual males and Aboriginal and Torres Strait Islander people.

According to the latest HIV surveillance report released by the Kirby Institute at UNSW, there were 963 new HIV diagnoses in Australia in 2017, representing a 7% decline over five years

The reductions were greatest among gay and bisexual men, with a 15% reduction in the past year alone.
Associate Professor Darryl O’Donnell, CEO of Australian Federation of AIDS Organisations, told doctorportal that “this is some really good news.”

“There have been strong increases in regular HIV testing in this population, along with incredible enthusiasm for the pre-exposure prophylaxis (PrEP) drug, and people taking treatment very early on in their diagnosis. All three things are really helping us get those diagnoses down.”

HIV rates among heterosexual males on the rise

The results of the report are not all good news, however. There was a 10% increase between 2013 and 2017 in HIV diagnoses among heterosexuals, with a 14% increase between 2016 and 2017 alone. In men, the number of diagnoses attributable to heterosexual sex has increased by 19% in the last five years yet has remained relatively stable in women.

Professor O’Donnell said that this data was concerning. “This is a much smaller proportion we’re talking about here – around 20-25% of all diagnoses are among heterosexuals – but we do want to keep an eye on this”

“It’s important for us to understand that not everyone who is a heterosexual is equally at risk for HIV. The sorts of things emerging from the data are that a person who is at relatively low risk in Australia might be at higher risk when they’re travelling overseas if they’re having sex with partners there.”

Another factor behind the rise in HIV among heterosexuals has been the increase in the number of people with HIV coming to Australia from countries with a high prevalence.

“The third category is people who are heterosexual whose partner is at high risk of HIV – maybe their partner is someone who injects drugs, or their partner is from a high risk country”, Professor O’Donnell said.

HIV among Indigenous Australians nearly double the rate of non-Indigenous Australians

HIV diagnoses among Aboriginal and Torres Strait Islander people have also increased in the past five years. In 2017 the notification rate was 1.6 times higher than the Australian‑born, non‑Indigenous population.

“The rate of HIV among Aboriginal and Torres Strait Islander people has been increasing since 2008. This is very concerning, because once HIV is established in these communities, it is much harder to achieve the type of outcomes we see elsewhere”, Professor O’Donnell said.

He added that for this reason, prevention and testing for early diagnosis are key. “We need to be sure that our workforce, including Aboriginal health workers and staff working within Aboriginal medical services, are fully supported to be able to offer HIV screening.”

Return to Grim Reaper-style campaigns not the answer

“We certainly don’t want to go back to the grim reaper. It certainly raised awareness, but also frightened people and made people think that HIV was about someone who wasn’t like them”, Professor O’Donnell said.

The goal of any HIV campaign should not be to make people fear each other, but instead build their understanding of their individual level of potential risk, and encourage them to take positive steps based on that.

“We need awareness and to intensify educational efforts with those most at risk and across the whole community. But we need to do it in a mature way, and work with people as adults who are confident and capable of making sensible choices.”

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