AIDS no longer issue, but HIV still remains

Today is a pretty remarkable World AIDS Day - the first since AIDS was declared to no longer be a public health issue in Australia.

Which is great news – but the job is far from done.

While AIDS may no longer be a public health issue in Australia, more than 1000 Australians are diagnosed with HIV – the virus that causes AIDS when untreated – annually. More than 25,000 Australians are living with HIV including 300 Tasmanians.

So what is needed, in Australia and globally, to end the epidemics once and for all?

Firstly, access to prevention is vital. Alongside better-known tools like condoms is Pre-Exposure Prophylaxis - or PrEP – a daily pill that prevents HIV transmission. PrEP has dramatically reduced HIV transmission rates where it is widely used, has been approved by the Therapeutic Goods Administration, but is currently not on the Pharmaceutical Benefits Scheme.

PrEP is available in three states – not in Tasmania – through state-funded trials. Currently, if Tasmanians want to access PrEP, they must purchase it online from overseas, and it is expensive.

Secondly, access to and awareness of testing and treatment must be expanded. With lifelong treatment, people with HIV can live long and healthy lives – but without it people living with HIV are at risk of developing AIDS.

In Australia, 84 per cent of people living with HIV who know their status are on treatment. Globally, this figure is just 46 per cent.

Thirdly, the stigma attached to HIV and AIDS, and the resulting discrimination, must be overcome to ensure people are not afraid to access services.

One third of Tasmanians living with HIV live in poverty, and it is not uncommon for them to report losing their jobs due to stigma, or unexplained absences for medical appointments or sickness fuelled by a fear of disclosing their status.

Finally, HIV and its co-infections must be tackled together.  Globally, tuberculosis is responsible for one in three deaths of people living with HIV, making it the leading killer of people with HIV globally.

Australia’s proximity to Papua New Guinea, where rates of drug-resistant TB are rising, makes TB and HIV a deadly duo we cannot afford to ignore.

It’s definitely not all doom and gloom though.

There is a global goal to end AIDS as an epidemic by 2030, and in Australia to achieve virtual elimination of HIV transmission by 2020.  This may sound ambitious, but we have cause to be hopeful.

Globally, since 2003, AIDS-related deaths have decreased by 43 per cent, and the number of HIV-positive people on treatment has improved beyond what anyone thought possible, to over 17 million.

Of these, 9.2 million people receive their treatment thanks to programs supported by the Global Fund to Fight AIDS, TB and Malaria.

It will be vital for Australian aid to continue to be invested in mechanisms like the Global Fund.

Because of the strong response to HIV in the past we are lucky to say AIDS is history in Australia.  However, there is a long way to go and we cannot rest on our laurels. That effort needs to be maintained if we want an AIDS-free world.

  • Sabine Wagner is CEO of Tasmanian Council for AIDS, Hepatitis and Related Diseases and Gina Olivieri is Grassroots Engagement Manager for global health advocacy group RESULTS.