Inner Sydney has reduced new HIV acquisitions by 88%, meaning it may be the first locality in the world to reach the UN target to end AIDS as a public health threat by 2030, according to data released today at IAS 2023, the 12th IAS Conference on HIV Science.
Andrew Grulich of the Kirby Institute at the University of New South Wales and member of the Governing Council of IAS – the International AIDS Society – presented the findings, citing progress in Inner Sydney, where HIV was once most prevalent in Australia, as evidence that stopping new HIV acquisitions is possible. Grulich attributed success in Inner Sydney in part to community outreach and prevention efforts, including widespread availability and use of HIV pre-exposure prophylaxis (PrEP).
The announcement comes just one week after the Kirby Institute released national surveillance data showing that new diagnoses of HIV among gay and bisexual men in Australia has fallen by 57% over the past decade.
“The extraordinary success in HIV prevention in the gay neighbourhoods of Sydney is due to decades of government leadership,” Grulich said. “Working in partnership with community and clinical organisations, effective research-based interventions have been designed and implemented. These numbers show us that virtual elimination of HIV transmissions is possible. Now, we need to look closely at what has worked in Sydney, and adapt it for other cities and regions across Australia.”
“These encouraging findings from inner city Sydney show just how far we have come since the early days of the AIDS pandemic before we had effective testing, treatment or prevention tools,” Sharon Lewin, IAS President, IAS 2023 International Chair and Director of the Peter Doherty Institute for Infection and Immunity at the University of Melbourne in Australia, said. “A durable end to Australia’s HIV epidemic requires a cure and a vaccine, and the scientific community won’t stop until we discover them.”
Nationwide progress toward ending HIV as a public health threat in Australia
Skye McGregor of the Kirby Institute presented a study showing that Australia is on track to achieve the UNAIDS 95-95-95 targets, which call for 95% of all people living with HIV to know their HIV status, 95% of all people diagnosed with HIV to receive sustained antiretroviral therapy, and 95% of all people receiving antiretroviral therapy to achieve viral suppression by 2025.
However, the study authors point out that continued success is not guaranteed. While Australia achieved the 90-90-90 targets in 2020 and saw declines in new HIV diagnoses during the COVID-19 crisis, achieving the more ambitious 95-95-95 targets will require increased efforts to diagnose people living with HIV earlier and immediately link them to ongoing care and treatment.
“As Australia stays on course to become one of the first countries to virtually eliminate HIV, the science produced here has the potential to inform the global HIV response,” said Charles Gilks, IAS 2023 Local Chair and Queensland Professorial Chair of BBVs and STIs at the University of Queensland, Australia. “Key to our national success has been a focus on prevention and on equitable access to care for anyone at risk of HIV, a winning strategy we are proud to share with the world.”
“Achieving the last mile of the virtual elimination of HIV in Australia will require additional interventions – including those specifically designed to reach women. While the gay, bi-sexual and men who have sex with men communities are very aware of the benefit of prevention tools like PrEP, the heterosexual community is pretty much oblivious. We need greater education – including as part of secondary school curricula – to raise awareness around how to prevent HIV, including new tools like long-acting injectable PrEP,” said Heather Ellis, a woman living with HIV and communications and engagement coordinator for Positive Women Victoria, Australia’s only fully funded community organisation supporting and advocating for women living with HIV.
Abstract and session: Australia’s progress towards ending HIV as a public health threat: trends in epidemiological metrics over 2004-2021, Progress towards HIV elimination: Are we there yet? (3538, Track C)