New data released at the 12th IAS Conference on HIV Science (IAS 2023) has revealed a remarkable 88% reduction in new HIV acquisitions in Inner Sydney, positioning the region as a potential candidate to become the world’s first locality to achieve the UN target of ending AIDS as a public health threat by 2030.
The findings were presented by Andrew Grulich of the Kirby Institute at the University of New South Wales and a member of the International AIDS Society (IAS) Governing Council.
Inner Sydney, which was once the epicentre of HIV in Australia, has made significant strides in stopping new HIV transmissions, primarily attributed to successful community outreach and prevention efforts, including the widespread availability and use of HIV pre-exposure prophylaxis (PrEP).
The recent announcement follows the release of national surveillance data by the Kirby Institute, showing a 57% decline in new HIV diagnoses among gay and bisexual men in Australia over the past decade. These achievements have been made possible through decades of government leadership working with community and clinical organisations, implementing effective research-based interventions.
Sharon Lewin, IAS President and Director of the Peter Doherty Institute for Infection and Immunity at the University of Melbourne acknowledged the tremendous progress in HIV prevention in the gay neighborhoods of Sydney. She emphasised the necessity of a cure and vaccine to achieve a durable end to Australia’s HIV epidemic, vowing that the scientific community would continue its relentless pursuit until these goals are realised.
Skye McGregor, from the Kirby Institute, also presented a study showcasing Australia’s progress towards achieving the UNAIDS 95-95-95 targets by 2025. The targets aim for 95% of all people living with HIV to know their status, 95% of those diagnosed to receive sustained antiretroviral therapy, and 95% of those receiving treatment to achieve viral suppression.
While the country successfully met the 90-90-90 targets in 2020 and witnessed declines in new HIV diagnoses during the COVID-19 crisis, reaching the more ambitious 95-95-95 targets will require enhanced efforts to diagnose individuals with HIV earlier and ensure they receive continuous care and treatment.
Charles Gilks, IAS 2023 Local Chair, highlighted the key to Australia’s national success in HIV prevention—focusing on prevention and equitable access to care for all individuals at risk. This strategy has been essential in reducing new HIV infections and could serve as a valuable lesson for the global HIV response.
Heather Ellis, a woman living with HIV and communications and engagement coordinator for Positive Women Victoria, emphasised the importance of tailoring interventions to reach women and raising awareness about new prevention tools like long-acting injectable PrEP among the heterosexual community.
Martin Holt, from the University of New South Wales, presented a study demonstrating that effective HIV prevention tools among gay and bisexual men in Australia increased from 69.8% to 75.1% from 2017 to 2021. The rise in HIV prevention tool usage was associated with a decline in HIV risk, primarily influenced by the growing use of PrEP.
The study revealed that younger men were more vulnerable to HIV acquisition but also exhibited higher rates of consistent condom use. On the other hand, older men were more likely to rely on “treatment as prevention,” utilising their undetectable HIV viral load to reduce transmission risk.
Australia’s progress in reducing HIV transmissions in Inner Sydney and nationwide serves as a beacon of hope for achieving the goal of ending the AIDS epidemic. The success of comprehensive prevention efforts, community engagement, and innovative approaches like PrEP highlights the potential for other regions to follow suit. As the world continues its fight against HIV, Australia’s experience provides valuable insights that can inform global HIV responses and ultimately lead to a future where HIV is no longer a public health threat.
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