‘AIDS epidemic’ may be over but the ‘HIV epidemic’ is not: experts

Public Health

11 Jul 2016

AIDS in Australia has been virtually eliminated, an Australian-led international team of researchers reports this week. However, as the experts point out, the HIV epidemic remains, with over 1000 new HIV diagnoses a year.

Here’s what they had to say:

Professor Andrew Grulich is a Professor and Program Head of the HIV Epidemiology and Prevention Program at the Kirby Institute for Infection and Immunity in Society at the University of New South Wales:

“AIDS in Australia has become uncommon, and we are doing better than almost anywhere else on earth  but it is not over. 150 people a year present with severe immune deficiency, and while most improve with treatment, they are at risk of dying. This particularly effects people who don’t test for HIV – e.g.  people who don’t speak English, women, some gay men. Continued focus on increasing HIV testing is critical to get these numbers down.

Australia’s success is due to high level continuing investment in the community response, research and clinical services. The strength of our surveillance monitoring system, which alerts us to changing trends in infection so that we can respond swiftly has also played an extremely important role. While we have no vaccine or cure – we need continued high level investment in HIV research, community organisations and clinical services.

Unfortunately, while AIDS is under control, we are seeing over 1000 new HIV diagnoses a year which is about 30% higher than a decade ago.

New HIV prevention technologies give us a realistic chance of driving HIV infections down in the next few years: we need to rollout PrEP (pre exposure prophylaxis*) to high-risk gay men, and to do this, we need the PBS to fund the use of the drug.

If we invest in PrEP, HIV testing, and early HIV treatment, we can work towards the virtual elimination of HIV by 2020.

With PrEP we have targets to virtually eliminate HIV transmissions in Australia for 2020. These targets may seem ambitious, but with continued investment, Australia is well positioned to make it happen.”

Darryl O’Donnell is Chief Executive Officer of the Australian Federation of AIDS Organisations (AFAO):

“Australia’s progress against AIDS is tremendous. We will never again in our communities have the horror of so many loved ones dying. We don’t have to worry that HIV will inevitably lead to illness and death. Good access to treatment and testing and a community-led approach is critical to maintaining Australia’s effective response to HIV.

But the job isn’t done. Too many people are still being diagnosed with HIV, and often they’re being diagnosed much later than we’d like. The virtual elimination of new HIV infections requires long-term investment in the organisations that have responded to the needs of HIV in our affected communities for thirty years. These are the community organisations that have supported gay men and communicated honestly about new research into treatment and prevention.

Successive governments have invested in the HIV/AIDS response since the early 1980s. Australia’s success in fighting AIDS is globally recognised. Now we must go the next step and end new HIV infections.”

Susan Kippax is Emeritus Professor at the Social Policy Research Centre at the University of New South Wales:

“While the ‘AIDS epidemic’ may be over in Australia, as reported in the Sydney Morning Herald today, the ‘HIV epidemic’ is not. Antiretroviral drugs mean that the majority of those who are infected with HIV are likely to live healthy lives and are unlikely to succumb to AIDS: it is in this sense that one might say that the ‘AIDS epidemic’ is over.

However HIV infections continue to occur and over the past ten years in Australia new HIV diagnoses have increased by 13% (HIV, viral hepatitis, and  sexually transmissible infections in Australia. Annual Surveillance Report 2015.  Kirby Institute, University of New South Wales, Sydney. 2016.)  Indeed worldwide there is growing concern that HIV prevention has stalled (see papers in the latest issue of the Lancet HIV2016; 3, e283-332).”

Rebecca Guy is an Associate Professor and Program Head at the Surveillance Evaluation and Research Program at the Kirby Institute for Infection and Immunity in Society at the University of New South Wales:

“Before 1996, virtually everyone with HIV eventually developed AIDS. In those days, many people with HIV did not get tested while they were well, so could never be counted in the statistics. But once they started to become ill with AIDS, they inevitably saw at doctor, and got tested and diagnosed. So back then, tracking AIDS cases gave a much clearer picture of how the epidemic was going than tracking HIV. All this changed in 1996, when effective treatments were introduced, and people with HIV stopped getting AIDS. Now a much higher proportion of people with get tested and diagnosed while they are well.

And they are encouraged to start treatment immediately, which stops them from getting AIDS. But there are still about 15% of people in Australia with HIV who have not been tested and diagnosed. AIDS cases still develop in this group, but virtually all can now be quickly and effectively treated.”

The comments were put together by The Australian Science Media Centre (AusSMC)  – an independent, not-for-profit service for journalists, working to improve links between the news media and the scientific community.

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