HIV rise a puzzle

A dramatic increase in new HIV infections in Victoria was revealed last week, raising questions over whether NSW should heed the Victorian figures as a potential warning sign of things to come.

The Victorian predicament poses a puzzle for NSW. Despite evidence from recent periodic surveys that unprotected male-to-male anal intercourse is on the rise in both states, so far only Victoria has seen an increase in new infections.

The Victorian Infectious Diseases Bulletin reported last week that Victoria had seen a total of 72 newly acquired infections in 2001. This represented a 71 percent increase in new infections over the previous year. The Bulletin also reported a total of 150 HIV-positive diagnoses (comprising the new infections plus diagnoses in people who had not been previously tested) amongst men who had sex with men in the last year. This represented a rise of 88 percent on the previous year.

Dr Robert Moodie, chair of the Victorian Ministerial Committee on AIDS, said the 71 percent increase in new infections could be a warning to NSW to remain vigilant in monitoring the progress of the disease in the community.

The new Victorian figures mark the second period in a row of increased new HIV infections in the state.

Readers of Sydney Star Observer should be asking themselves: what should we learn from the Victorian experience? Initially we thought that when these increases first appeared it was only a blip, we thought we didn’t really have to worry about the situation, Moodie said.

Well, it’s not a blip I can tell you -“ the increases are going on for the first quarter of this year, and we now know that. The crisis is continuing in Victoria, and other states need to learn that you have to act on any rise in new infections immediately.

Dr Darren Russell, president of the Victorian AIDS Council (VAC), also saw the Victorian situation as a potential warning for other states.

We were fairly confident a few years ago that new infections had plateau’d and we were hopeful the figures would not rise. I think that is the warning that other states who think they have got the situation under control should take on, Russell told the Star.

However, so far NSW has avoided an increase in new infections over the same period, raising questions on just how NSW health organisations should approach the Victorian example.

The pattern of new infections for NSW over the same population in the same period is going in the opposite direction, despite what’s happening to behaviour with increased reports of unprotected anal sex in both states, ACON’s acting CEO Alan Brotherton told the Star.

I guess the issue is what to do in a situation like this. We can’t be going around telling people that the sky is falling in when it clearly isn’t. Yes, obviously we have to look at what’s happening in Victoria but there’s no point responding to a situation we don’t have.

However, Brotherton agreed with Moodie’s assertion that any changes in new infections in NSW must be closely monitored.

Because we don’t know the answer to why NSW is producing a different result on new infections, we have to watch things closely, because the stable situation happening in NSW may not always be the case.

Moodie said that a possible explanation for the differing results on new HIV infections between the two states could be related to better compliance to HIV treatments by gay men in NSW, leading to lower viral loads and a consequent reduction in the likelihood of transmission.

A further explanation raised by Moodie suggesting that Sydney’s gay scene may be more open about HIV status was echoed by Brotherton.

The idea is that Sydney has a different sexual subculture to Melbourne. There are different networks of people, there’s more of a culture of openly HIV-positive men on the scene, Brotherton said.

Moodie asserted that AIDS organisations must continue to battle what he saw as community complacency over safe sex practices if increases in new infections are to be contained nationally.

It’s like a spring -“ unless you keep a hand on it, it springs back, he said.

We have to start up a national prevention program, particularly for men who have sex with men, but also for injecting drug users and in prisons. The Ministerial Committee has really been pushing the government to rebuild these programs in the government and rebuild these programs in the community.