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.

Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER)

Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study

The Lancet, Published Online May 2, 2019

Background

The level of evidence for HIV transmission risk through condomless sex in serodifferent gay couples with the HIV-positive partner taking virally suppressive antiretroviral therapy (ART) is limited compared with the evidence available for transmission risk in heterosexual couples. The aim of the second phase of the PARTNER study (PARTNER2) was to provide precise estimates of transmission risk in gay serodifferent partnerships.
Findings
Between Sept 15, 2010, and July 31, 2017, 972 gay couples were enrolled, of which 782 provided 1593 eligible couple-years of follow-up with a median follow-up of 2·0 years (IQR 1·1–3·5). At baseline, median age for HIV-positive partners was 40 years (IQR 33–46) and couples reported condomless sex for a median of 1·0 years (IQR 0·4–2·9). During eligible couple-years of follow-up, couples reported condomless anal sex a total of 76 088 times. 288 (37%) of 777 HIV-negative men reported condomless sex with other partners. 15 new HIV infections occurred during eligible couple-years of follow-up, but none were phylogenetically linked within-couple transmissions, resulting in an HIV transmission rate of zero (upper 95% CI 0·23 per 100 couple-years of follow-up).

Interpretation

Our results provide a similar level of evidence on viral suppression and HIV transmission risk for gay men to that previously generated for heterosexual couples and suggest that the risk of HIV transmission in gay couples through condomless sex when HIV viral load is suppressed is effectively zero. Our findings support the message of the U=U (undetectable equals untransmittable) campaign, and the benefits of early testing and treatment for HIV.

 

Healthcare providers should discuss U=U with all their HIV-positive patients

aidsmap/nam, 18/03/2019

Healthcare providers should inform all patients with HIV they cannot transmit HIV to a sexual partner when their viral load is undetectable, argue the authors of  a strongly worded comment in The Lancet HIV.

The authors note that despite overwhelming scientific data supporting the undetectable = untransmittable (U=U) message, significant numbers of healthcare providers do not educate their patients about U=U when telling them their viral load is undetectable.

 

 

 

80% of new HIV cases transmitted by undiagnosed or untreated people

Healio, March 18, 2019

In 2016, more than 80% of new HIV infections in the United States were transmitted by individuals who either did not know they were infected with HIV or had been diagnosed but were not receiving care, according to data released on the first day of the National HIV Prevention Conference in Atlanta.

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.