Summary1

  • The number of HIV notifications newly diagnosed in Australia has remained stable for the past four years, with 1,065 new diagnosis.
  • Based on tests for immune function, over a quarter (29%) of the new HIV notifications in 2015 were determined to be late, in that they were in people likely to have had their infection for at least four years without being tested. HIV is identified through blood tests with a variety of testing options now available.
  • 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 25,313 (range 22,513 – 28,281) people living with HIV in Australia in 2015. Of these an estimated 22,694 (90%) were diagnosed by the end of 2015, 21,560 (85%) were retained in care, 19,051 (75%) were receiving antiretroviral therapy, and 17 544 (69%) had achieved viral suppression.

Based on 38 cases, the age standardised rate of HIV notification in 2015 among Aboriginal and Torres Strait Islander peoples was more than double the rate in the Australian‑born non‑Indigenous population (6.8 versus 3.1 per 100 000).

The prevalence of HIV among injecting drug users in Australia is very low, approximately 1%.2

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. 

Of the estimated 22,694 (90%) people with HIV in Australia who were aware of their HIV-positive status at end of 2015, an estimated 19,051 (84%) were receiving antiretroviral (ARV) treatment. 92% of people accessing ARV treatment were estimated to have an undetectable viral load.

Approximately 49-73% of individuals currently living with HIV and 57-84% of individuals with diagnosed HIV are on antiretroviral treatment and have achieved undetectable viral load.

 

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