Australia’s world-leading HIV response

Australia’s world-leading HIV response

Australia’s response to HIV and AIDS is widely recognised as being one of the best in the world. Following the identification of HIV and AIDS in Australia in 1982, federal and state governments responded proactively. They often implemented controversial public health strategies such as condom vending machines and harm reduction strategies such as the implementation of needle and syringe exchange programs. Most importantly, they publicly talked about the risk factors for HIV transmission.

Australian communities have mobilised to prevent HIV transmission and provide vital support to those affected. Since the early stages of the epidemic, effective prevention strategies have been integrated into the response. A cornerstone of this effort has been peer education, which has proven more impactful than approaches led by ‘external’ agencies, especially in marginalised communities. Peers possessing an inherent understanding of cultural nuances and language within specific populations are uniquely positioned to engage and educate. Notably, peer education has yielded significant success among gay, bisexual and other men who have sex with men, as well as within sex worker organisations, where employing current or former sex workers as peer educators has proven effective.

Australia can be proud of its world-leading response to HIV, which is marked by strong partnerships and collaboration among governments, people living with and communities affected by HIV (such as gay, bisexual and other men who have sex with men, sex workers and people who inject drugs), non-government organisations, clinicians and academia.

Australia has always taken an evidence-based approach to HIV/AIDS and has readily embraced new scientific findings on biomedical HIV prevention. This approach has resulted in a lower prevalence of HIV among gay, bisexual and other men who have sex with men, Aboriginal and Torres Strait Islander people, people who inject drugs, and sex workers and their clients, compared with the rest of the world.

Eighth National HIV Strategy: Ending HIV Transmission

Since the launch of the first government response to HIV in 1989, Australia’s national HIV strategies have been pivotal to the success of Australia’s response to HIV prevention and the treatment and care of people living with HIV.

Australia’s Eighth National HIV Strategy 2018 – 2022 aims to virtually eliminate HIV transmission

in Australia. Australia leads the world in HIV prevention and treatment. We are one of the few nations that can end HIV transmission. We have new technologies to prevent, test and treat HIV that can help deliver this. With commitment and investment, achieving our goal is neither complex nor expensive.

To achieve the goal of virtual elimination, the Strategy has a set of key targets, including:

• Increase the proportion of people with HIV who are diagnosed to 95 per cent
• Increase the proportion of people diagnosed with HIV on treatment to 95 per cent
• Increase the proportion of those on treatment with an undetectable viral load to 95 per cent
• Reduce by 75 per cent the reported experience of stigma among people with HIV and expression of stigma concerning HIV status.

The core guiding principles of Australia’s partnership response to HIV have, for the most part, remained unchanged, with a continual focus on the centrality of people with HIV and priority populations, partnerships, and evidence-based policies and programs. The ten principles identified in the strategy are:

1. The centrality of people with HIV and priority populations: People with HIV and other priority populations must be meaningfully involved in the development, implementation, monitoring, and evaluation of effective programs and policies.
2. Human Rights: People with HIV have the right to participate fully in society without stigma or discrimination and should receive comprehensive and appropriate information and healthcare, including confidential handling of personal and medical information.
3. Access and Equity: Health and community care in Australia should be accessible to all, addressing inequalities related to various factors, with particular attention to improving health outcomes for Aboriginal and Torres Strait Islander people.
4. Health Promotion: The Ottawa Charter for Health Promotion guides effective action under the strategy, encouraging active participation of affected communities and individuals in their health determinants and public policies.
5. Prevention: HIV transmission can be reduced through evidence-based biomedical, behavioural, and social approaches within a supportive environment, emphasising education and prevention programs.
6. Quality Health Services: A motivated, trained, and multidisciplinary workforce is essential to delivering culturally appropriate, high-quality services and coordinating and integrating health services to support informed choices about treatment and prevention.
7. Harm Reduction: Harm reduction approaches, such as needle and syringe programs and drug treatment programs, are crucial to preventing HIV transmission and addressing social determinants of health.
8. Shared Responsibility: Individuals and communities share the responsibility to prevent HIV infection and inform educational and support efforts, while governments and organisations must provide necessary information, resources and supportive environments.
9. Commitment to Evidence-Based Policy and Programs: The national HIV response relies on high-quality research, surveillance, monitoring, and evaluation to meet new challenges and develop effective policies and interventions.
10. Partnership: Effective partnerships among affected communities, national organisations, clinical workforce, government, and researchers are characterised by cooperation, clear roles, meaningful contributions, respectful dialogue and appropriate resourcing to achieve strategic goals.