Timely public health surveillance data are crucial to inform policy and programmatic responses. All states and territories of Australia report data on HIV notifications to the Kirby Institute, UNSW Sydney. Detailed analyses of individually line-listed data are undertaken annually, to inform the Australian HIV, viral hepatitis, and sexually transmissible infections annual surveillance report. Bi-annually, jurisdictions report aggregate data to the Kirby Institute, to be included in national HIV quarterly reporting. These aggregate data are broken down by jurisdiction, gender, age group, Aboriginal and Torres Strait Islander status, likely route of HIV transmission (exposure risk), and place of birth. The availability of these data allows for more timely detection of changes in the number of HIV notifications in Australia. The latest report provides quarterly HIV data for the period quarter 1 (January to March) 2019 to quarter 2 (April to June) 2023. This covers the period of COVID-19 restrictions in Australia – with the first restrictions implemented in March 2020, and the last national COVID-19 isolation requirements lifted in October 2022. This means the latest quarterly report provides a summary of HIV notifications, before, during, and after COVID-19 restrictions.
In quarter 1 2019, there were 224 HIV notifications in Australia, 85% (190) male, 13% (29) female and 2% (5) transgender. In quarter 2 2020, when COVID-19 restrictions started, the number of HIV notifications decreased by 38%, to 138. A lower number of HIV notifications were reported throughout 2020, 2021 and 2022, compared to 2019, likely influenced by both HIV treatment and prevention efforts, but also COVID-19 restrictions on the movement of people in and out of, and around Australia; reductions in healthcare access and HIV testing; and reduced sexual activity. Compared to quarter 4 2022, the number of HIV notifications in quarter 1 2023 (post-COVID-19 restrictions) increased by 32%, from 147 to 194. However, it is important to note that the overall increase in quarter 1 2023 still represents a decline in HIV notifications compared to each quarter throughout 2019, and the first quarter of 2020.
If we look at the 2023 data in more detail, we can see that HIV notifications reporting male-to-male sexual contact increased by 51% in quarter 1 2023 (n=112), compared to quarter 4 2022 (n=74), with similar numbers (n=111) reported in quarter 2 2023. There was also an increase in notifications reporting heterosexual contact, with 45 in quarter 4 2022, compared to 58 in quarter 1 2023. Given border closures during COVID-19 restrictions, it is unsurprisingly there was a decrease in HIV notifications among people born overseas in 2020, 2021, and 2022. Between quarter 4 2022 and quarter 1 2023, there was an increase of 38% in HIV notifications among people born overseas.
So, what does the latest national HIV quarterly report mean? It likely reflects both the high coverage of treatment and prevention in Australia, but also demonstrates the impact of COVID-19. The increase in HIV notifications we have seen in the first six months of 2023 still means notifications are lower than pre-COVID, reflecting the public health response in Australia. But the data also serve as a reminder of the need for sustained and enhanced efforts if Australia is to achieve the goals set out in state and territory, and federal HIV strategies.