HIV diagnoses in Australia drop to lowest number in 18 years: report

Kirby Institute, July 3rd, 2019

Australia continues to lead the world in HIV prevention and in 2018 recorded the lowest number of HIV diagnoses since 2001.

According to a report released today by the Kirby Institute at UNSW Sydney, last year there were 835 HIV diagnoses across the country, which represents a decline of 23% over five years.

The declines reported today are largely due to reductions in the number of HIV diagnoses that are reported as attributable to sex between men. Over the past five years, HIV diagnoses have reduced by 30% among this population.

The report reveals no declines among heterosexual populations, with new diagnoses relatively stable among this group.

Similarly, there have been no declines in HIV diagnoses among Aboriginal and Torres Strait Islander populations.

Lastest Gay Community Periodic Survey for Adelaide released

Centre for Social Research in Health, UNSW, June 2019

Gay Community Periodic Survey: Adelaide 2018

Authors: Broady, T., Mao, L., Bavinton, B., Jeffries, D., Bartlett, S., Calabretto, H., Narciso, L., Prestage, G., & Holt.

The Adelaide Gay Community Periodic Survey is a cross-sectional survey of gay and homosexually active men recruited at a range of gay community sites in Adelaide, and online throughout South Australia. The major aim of the survey is to provide data on sexual, drug use, and testing practices related to the transmission of HIV and other sexually transmissible infections (STIs) among gay men. The most recent survey, the twelfth in South Australia, was conducted in November and December 2018 to coincide with the Adelaide Feast Festival.

Key points

– The proportion of men who reported ever having been tested for HIV increased from 83% in 2011 to 87% in 2018.

– The percentage of non-HIV-positive men who reported testing for HIV in the 12 months prior to the survey remained stable (and was reported by 71% in 2018), although the percentage reporting three or more HIV tests in the previous year increased (from 11% in 2014 to 22% in 2018).

– The use of HIV treatment by HIV-positive men has remained stable over time (and was reported by 93% of HIV-positive men in 2018). The percentage of men on antiretroviral treatment who reported an undetectable viral load also remained stable (reported by 94% in 2018).

Mobile phone apps remained the most common way that men met male sex partners, reported by 44% in 2018.

– The proportion of men with regular male partners reporting condomless anal intercourse with those partners (CAIR) increased from 55% in 2011 to 65% in 2018.

– The proportion of men with casual male partners reporting condomless anal intercourse with those partners (CAIC) increased from 38% in 2011 to 51% in 2018.

– Most of the recent increase in CAIC appears to be attributable to the growing proportion of HIV-negative men using pre-exposure prophylaxis (PrEP).

STI testing among HIV-negative men has remained stable over time, with 74% reporting any STI test in the year prior to the 2018 survey. The proportion of HIV-positive men reporting any STI test in the previous year decreased from 91% in 2011 to 72% in 2018.

Use of PrEP increased between 2014 and 2018 from 1% to 16% of non-HIV-positive men.

“No‐one’s driving this bus” – qualitative analysis of PrEP health promotion for Aboriginal gay and bisexual men

“No‐one’s driving this bus” – qualitative analysis of PrEP health promotion for Aboriginal and Torres Strait Islander gay and bisexual men

Aust NZ J Public Health,  2019; 43:18-23; doi: 10.1111/1753-6405.12852
Objective: HIV prevention tools such as pre‐exposure prophylaxis require equitable access and uptake to protect all at‐risk populations. This project assessed the perceived barriers to accessible HIV prevention for Aboriginal and Torres Strait Islander gay and bisexual men (GBM) and evaluated the presence of health promotion for pre‐exposure prophylaxis (PrEP) for this population from the perspective of service providers.

Methods: Eighteen semi‐structured interviews with healthcare providers, researchers and AIDS Council employees were qualitatively analysed for themes and concepts related to PrEP‐specific health promotion.

Results: Respondents noted AIDS Councils and affiliated sexual health clinics had been instrumental in promoting PrEP to at‐risk GBM. However, many Aboriginal gay and bisexual men who are not well connected with these communities and services may not have been exposed to this health promotion and therefore have not accessed PrEP effectively.

Conclusions: Aboriginal community and gay community controlled health organisations need to collaborate to ensure they deliver effective and tailored health promotion to Aboriginal communities.

Implications for public health: The rising HIV notification rates in Aboriginal Australians is an example of the health gap experienced by First Nation people. Effective HIV prevention is required to ensure this gap does not widen further, and that Australia meets its goal of preventing all new HIV infections. However, these efforts will be hampered by ineffective health promotion of HIV prevention tools, such as PrEP, for Aboriginal Australians.

Australia will never be HIV-free if access to prevention requires a medicare card

The Conversation, January 23, 2019 12.21pm AEDT

by Nicholas Medland, Sexual health physician and senior researcher, UNSW

Australia aims to “virtually eliminate” HIV transmission by 2022, according to the health minister’s new national HIV strategy. This ambitious goal has been made possible by biomedical HIV prevention, a new and highly effective way of preventing HIV using medications.

But new inequalities are emerging between those who can and can’t access these medications because of their Medicare eligibility. These inequalities may undermine the success of HIV elimination in Australia and threaten Australia’s international reputation as a safe place to study, work and live.

Read more of Australia will never be HIV-free if access to prevention requires a medicare card

 

Transgender women taking PrEP have lower levels of PrEP drugs than cisgender men

aidsmap/nam, November 9th 2018

A study presented at October’s HIV Research for Prevention conference (HIVR4P) in Madrid shows that transgender women who are taking feminising hormones and also taking pre-exposure prophylaxis (PrEP) have levels of the PrEP drugs tenofovir and emtricitabine in their blood that are about 25% lower than those in cisgender men, and levels in rectal tissue cells about 40% lower. Tenofovir levels in rectal tissue were 44% lower.

However, the study also confirmed that the interaction between hormones and PrEP did not appear to go the other way; blood levels of estradiol, the one hormone all of the transgender women took in one form or another, do not appear to be affected by PrEP.

 

Support for ending and managing HIV

Australian Government Department of Health, 29 November 2018

The Australian Government is strengthening its commitment to ending HIV with the announcement of funding for a new strategy that aims to virtually eliminate the transmission of HIV, the approval of the first HIV self-testing kit and the listing of a new medicine on the PBS.

The first HIV self-testing kit, the Atomo Self Test was approved for use by the TGA yesterday. The test is a single-use rapid finger stick test for the detection of antibodies to HIV and will enable people to test for HIV in their own home.

This will make testing accessible and convenient especially for people that need to test frequently or do not test at all.

The medicine Juluca® (dolutegravir and rilpivirine), which works to stop the replication of the HIV virus, will be listed on the PBS on December 1, which is World AIDS Day.