Australia has recorded a 10 percent annual rise in new HIV diagnoses – the largest jump in two decades – according to the latest official figures released by the Kirby Institute, leading to calls for a renewed national HIV strategy that encourages greater condom use and increased testing.
The findings of the 2013 Annual Surveillance Report were released by the Kirby Institute on Monday at the Australasian Society for HIV Medicine Conference in Darwin. The figures show a total of 1,253 cases of HIV were newly diagnosed in Australia in 2012, an increase of 10 per cent from 2011 figures.
In 2011, there were 1,137 cases of new HIV infection, which was an 8.2 per cent increase from rates recorded for 2010.
The report shows that over the past five years, two-thirds (67 percent) of new HIV diagnoses have occurred among men who have sex with men, 25 percent were attributed to heterosexual contact and two percent to injecting drug use.
Among those aged 15-19 there was a 36 percent increase on 2011 figures and a 22 percent rise among 20-24s.
NSW has been the biggest driver of new HIV infections in 2012, with the state recording a 24 percent leap from last year’s figures. There were also rises in Western Australia and Queensland, with slight declines in Victoria and South Australia.
New cases of HIV infection amongst Australia’s indigenous communities are also proving to be worrisome for public health experts, with 13 percent of new HIV cases amongst indigenous people between 2008-2012 linked to drug use and sharing needles. The Kirby Institute estimates that about 10,000 Australians are currently unaware that they are HIV-positive.
According to the Kirby Institute, there have also been worrying increases in rates of other STIs such as gonorrhoea and syphilis. The rate of diagnosis for gonorrhoea has increased 67 per cent in four years, from 35.1 per 100,000 people in 2008 to 58.9 in 2012. In that same time, diagnosis of infectious syphilis also increased among males.
Kirby Institute program head Associate Professor David Wilson said the number of new diagnoses has been gradually increasing over the past 14 years.
“Traditionally, HIV has been diagnosed in the late 30s and early 40s but we are now seeing a trend away from that,” Wilson said. “These people were not around in the [’80s and] ’90s and didn’t experience the fear campaigns.”
Associate Professor John de Wit, director of the UNSW Centre for Social Research in Health (CSRH) and co-author of the Annual Report of Trends in Behaviour 2013, also published this week, said safe-sex messages were clearly not being heeded by younger gay men, with 40 percent of them admitting that they engaged in unprotected casual sex at least once in 2012.
“The prevention benefits of treatment are being offset by increases in risk-taking since treatment became available,” de Wit said. “I would not call it complacency. People know it is serious. But they take risks in the heat of the moment”
Australian Federation of AIDS Organisations (AFAO) executive director Rob Lake said it was crucial that policy makers and the broader health sector understood that a suite of tools was required to drive down the diagnosis rate.
“Prevention remains the critical factor. The best way of doing that is through condom use, but it’s also crucial that we expand access to tools like rapid tests, that allow people to know their HIV status within 30 minutes,” Lake said.
“We’d also like to see a renewed sense of urgency in providing greater access to drugs such as Pre Exposure Prophylaxis, which dramatically reduce the chance of HIV infection.”
Associate Professor Edwina Wright from the Alfred Hospital, Monash University and Burnet Institute said it was important federal health authorities began allowing all people living with HIV to access treatment and appropriate medication via the Pharmaceutical Benefits Scheme (PBS). Currently, only people with advanced stages of HIV receive subsidised antiretroviral treatment, with other HIV-positive people facing annual bills of up to $15,000.
“There’s enough evidence to show that starting treatment early would deliver health benefits and would be cost-effective,” Wright said.
National Association of People Living with HIV/AIDS (NAPWA) President Rob Mitchell said it was time for a new national approach in response to the country’s flagging efforts curbing new HIV infections.
“The Australian community should expect that every appropriate public health program and community initiative is scrutinised to address the trends we are seeing, and then reverse them significantly,” Mitchell said.
“Our fragmented and stretched resources and activities, compounded by complacency or even resistance to change to the models of previous years, must be addressed and in bold and decisive ways.
“Australia’s approach to HIV can be revitalised and this country can once again be a leader in the region and the world for meeting our set targets and implementing new measures for exceptional results.”
Since the HIV epidemic began in the 1980s, a total of 34,029 Australians have been diagnosed with the virus. It is estimated that between 28,000 and 34,000 people are currently living with HIV in Australia, of whom approximately 25,700 have been diagnosed.