Summary

  • The number of HIV notifications newly diagnosed in Australia has remained stable for the past five years, with 963 new diagnosis in 20171.
  • Based on tests for immune function, a third (36%) of the new HIV notifications in 2017 were determined to be late, meaning that they were in people likely to have had their infection for at least four years without being tested1.
  • HIV is identified through blood tests with a variety of testing options now available.
  • HIV is a manageable chronic condition necessitating lifelong treatment.
  • Modern treatments have simplified the clinical management of HIV, increasing the role of primary care in patient care.

 


About HIV

It is estimated that there were 27,545 people living with HIV in Australia in 2017. Of these an estimated 24,646 (89%) were diagnosed, 23,414 (95% of those diagnosed) were retained in care (having had a viral load or CD4+ cell
count in the past year), 21,560 (87% of those diagnosed) were receiving antiretroviral therapy, and 20,412 (95% of those on antiretroviral therapy) had achieved viral suppression1.

 

The rate of HIV notifications increased by 41% in the Aboriginal and Torres Strait Islander population between 2013 and 2016, compared with a 12% decline in Australian‑born non‑Indigenous people, and in 2017 remains 1.6 times as high as the Australian‑born non‑Indigenous population.1

 

The prevalence of HIV among injecting drug users in Australia is very low, approximately 1.4%1.

 

Mother-to-child transmission is rare in Australia.

 

The advances in antiretroviral (ARV) treatment have meant that HIV is now considered a chronic condition. Antiretroviral (ARV) treatments have evolved and are now effective, simple and cause fewer side effects.

 

Antiretrovirals work to inhibit viral replication. The goal of ARV treatment is to achieve an undetectable viral load in plasma.

 

Although plasma is normally tested for viral activity, a reduction also occurs in other body fluids associated with HIV transmission (notably semen and vaginal fluid).

Immediate initiation of HIV treatment is clinically superior to deferred treatment among people with HIV infection, regardless of CD4 count or stage of disease.

 

HIV treatment is highly effective in the prevention of the sexual transmission of HIV.

 

Pre-exposure prophylaxis (PrEP) is a highly effective tool for preventing HIV infection in high risk HIV negative individuals. During 2017, pre‑exposure prophylaxis (PrEP) implementation projects continued in New South Wales, Queensland and Victoria and commenced in the Australian Capital Territory, Western Australia, South Australia, and Tasmania. By the end of 2017, a total of 15 895 gay and bisexual men at high risk of HIV were enrolled in PrEP implementation projects in these jurisdictions.1

 

Current priorities in HIV include:

  • Renewed efforts to identify individuals with both established undiagnosed HIV and newly acquired HIV
  • Renewed prevention of transmission messages including commencement of Pre-Exposure Prophylaxis (PrEP) pilots in a number of Australian cities
  • Faster initiation onto treatment based on patient preparedness and clinical indication

 

References

1. The Kirby Institute HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2018. The Kirby Institute, the University of New South Wales, Sydney