Reversing the trend in HIV
The reported 8 per cent increase in new HIV infections in Australia, issued from ASHM's Australasian HIV Conference in October, surprised few who work in the sector. There has been concern for some time now we are “dropping the ball” on HIV. The Melbourne Declaration, a joint call to action issued by community organisations, research institutes and health care workers to curb HIV in Australia, was organised before the new infection statistics were released. So recognition of the need for more concerted action has existed for a while.
But whether anticipated or not, these statistics do raise the fundamental questions of why this is happening and what can be done.
Why is not easy to answer. There is some evidence to suggest that many young Australians do not consider HIV to be relevant to them any more, and/or – and rightly so – do not see it as the death sentence it once was and are consequently less vigilant. Australians having unprotected sex overseas is another contributing factor.
What we are very clear on is what needs to be done to address it. The Melbourne Declaration provides a road map for this.
Between 15-30 per cent of people living with HIV do not know their status. So if we want to curb new infections in Australia then an immediate and obvious first step is to increase testing for people at risk. The importance of this is compounded by the fact that HIV is most infectious in its early stages, when a person may have few symptoms. Testing will enable them to know their status and take precautions to protect their health and that of others. So regular testing, or testing at a frequency in-line with risk of exposure, is warranted.
This World AIDS Day, ASHM, an organisation working with and representing health care professionals, is focusing on encouraging primary health care providers to adopt a more proactive stance in their approach to sexual health. To make this possible we need better training, tools and support for our clinics. ASHM is currently advocating hard for rapid HIV tests, which have been widely available internationally for years, to be adopted in Australia.
It is also essential that HIV is not viewed in isolation. Chlamydia remains the most commonly reported STI in Australia, with huge swathes of youth unaware they are infected. Rates of gonorrhea are also increasing. This is important in and of itself. The presence of other STIs also increases the risk of HIV transmission therefore if we want to be effective in reducing rates of HIV, then it must be as part of a broader strategy to address – and screen for – STIs as a whole.
Australia has committed to the United Nations 2011 Political Declaration on HIV/AIDS, committing to bold actions and targets including, by 2015, reducing the sexual transmission of HIV by 50 per cent. Australia is better placed than most countries to meet these targets, but concerted action is urgently required. Signatories to the Melbourne Declaration are calling on the Australian Government to seize the opportunity and work with State and Territory governments to remove several current barriers to enhanced HIV testing, treatment and prevention. We can and should see rates of new HIV infections decreasing, not increasing.
Levinia Crooks is the Chief Executive Officer of ASHM (the Australasian Society for HIV Medicine). She has worked in the HIV and related diseases sector for over 20 years in a range of areas, including policy development, social research, service planning, and treatments access areas. She joined ASHM in 1999 when she moved from the NSW HIV Prescriber Project. ASHM manages a broad program education and professional support for health professionals. Levinia has been instrumental is rolling out the viral hepatitis program at ASHM and establishing the ASHM international program.
