Australia’s HIV and Hepatitis C success overshadowed by Aboriginal and Torres Strait Islander neglect
Adelaide: Monday, 14 November 2016
New national statistics released from the Australasian Sexual Health and HIV&AIDS Conferences today reveal that HIV in Aboriginal and Torres Strait Islander people is at an all-time high, with 2015 seeing the highest number diagnosed with HIV since 1992.
The rate of HIV notification among Aboriginal and Torres Strait Islander people is now more than double the rate in non-Indigenous Australians, and has increased each year for the last five years.
Meanwhile HIV notifications in non-Indigenous Australians remain stable for their fourth year in a row.
Other sexually transmissible infections in Indigenous Australians such as chlamydia, gonorrhoea and infectious syphilis are on average 3, 10 and 6 times higher respectively, and hepatitis C is 4 times higher, the reports say, with the gap even more significant in some remote communities.
The new figures cast a shadow over Australia's internationally acclaimed success towards reaching elimination targets for HIV and hepatitis C.
"This is absolutely unacceptable," said Associate Professor James Ward, South Australian Health and Medical Research Institute. "At a time when Australia is showered in praise for being a world leader in HIV and hepatitis C prevention, one of our priority populations is being left behind.
"This, combined with the alarmingly high prevalence of other sexually transmissible infections in Aboriginal and Torres Strait Islander populations, is frankly an international embarrassment," he said.
Over the last five years, significant differences have appeared between HIV in the Aboriginal and Torres Strait Islander populations and non-Indigenous Australians. Although men who have sex with men make up the majority of cases in both groups (60% vs 80%), a greater proportion of Indigenous cases are because of injecting drug use (16% vs 3%) and through heterosexual sex (21% vs 14%).
For non-Indigenous Australia, efforts to prevent new HIV infections through increased access to testing and treatment have been an unparalleled success. Australia has now achieved the first and third international targets for 90% diagnosed, 90% of those on treatment and 90% of those treated virally suppressed.
However, delivery of effective HIV programs to Aboriginal and Torres Strait Islander people, many of whom don't access dedicated HIV clinics, requires a completely different approach, say experts. A focus on cultural appropriateness and delivery through non-specialist clinicians is key, they say.
"This is going to require proper consultation, targeted campaigns and investment in health worker education," said Associate Professor Ward. "We need to harness all the tried and tested strategies that have proven so effective in Australia – test and treat, treatment as prevention and PrEP – and deliver them equitably across Aboriginal and Torres Strait Islander populations."
"These statistics are Australia's wake up call. The danger of HIV spreading within communities with such a high prevalence of STIS is simply too great to be ignored," he said.
New Diagnostic Tool offers STI hope
In many remote Aboriginal communities with high rates of STIs, the distance from laboratories and difficulties recalling patients impedes efficient and effective treatment. A trial of new Point-of-Care tests for STIs found that its use in primary care services substantially improved the timeliness of treatment. Read the abstract: http://bit.ly/SH16_442
Not all bad
Human papilloma virus (HPV)
Over the past nine years there has been a 91% reduction in genital warts in young Aboriginal and Torres Strait Islander females aged less than 21 years, due to the introduction of vaccine programs to adolescents in school. Genital warts were previously a very common sexually transmitted infection caused by the human papillomavirus, but can now be prevented by the same vaccination given to adolescents in schools that is used to prevent cervical cancer.
Donovanosis, once a regularly diagnosed sexually transmissible infection among remote Aboriginal populations, is now close to elimination, with only two cases detected since 2011.
Gonorrhoea and Syphilis
In the Aboriginal and Torres Strait Islander population gonorrhoea rates have declined by 22% in the past five years, but remain 3‑fold higher than the non‑Indigenous population in remote areas, whereas syphilis has increased more than 2‑fold in the past five years. The resurgence of infection in young Aboriginal people in remote communities after years of declining rates, brings with it cases of congenital syphilis and emphasises the need for enhanced health promotion testing and treatment in this population.
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ASHM Media Release: HIV rates in Indigenous Australians at all-time high on 14 November 2016
About the Australasian HIV&AIDS Conference
The 2016 Australasian HIV&AIDS Conference marks the 26th Annual Conference of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM)—and continues its run as the premier HIV Conference in Australia and the Asia and Pacific region.
The conference was first launched in 1989 in response to the emerging area of clinical care for HIV. Since its inception as a small meeting of medical practitioners brought together under the umbrella of ASAP (the Australian Society of AIDS Physicians) the HIV&AIDS Conference has grown into the region’s premier medical/scientific conference in the HIV and related diseases sector, attracting speakers and delegates from around the world.
Since 2005 the Conference has been held back-to-back with the Australasian Sexual Health Conference with one full day of overlap, providing a unique opportunity to look at HIV in the broader context of sexual health. Together, the conferences attract more than 1000 delegates from across the region.
Delegates to the conference come from a range of professional backgrounds including basic science, clinical medicine, community programs, education, epidemiology, indigenous health, international and regional issues, nursing and allied health, policy, primary care, public health and prevention, and social research.
Visit the conference website www.hivaidsconference.com.au