Calls for clearer HIV elimination targets

Rebecca Gredley
·2-min read

Australia needs clearer targets on the elimination of HIV transmission, experts believe.

The nation's target is to virtually eliminate HIV transmission by 2022, but there's no clarity on what that term precisely means.

The global target set by the Joint United Nations Programme on HIV/AIDS is to end the epidemic by 2030, but this year's targets were missed.

Professor Jason Ong says virtual elimination means getting to a "very, very, very low" level of transmission.

"But what that level is, is also a bit rubbery as well," he told an Australasian HIV&AIDS and Sexual Health Conference on Monday.

"So we don't have a specific target as yet."

There is no vaccine for HIV, with about 29,000 people living with the immunodeficiency virus.

The virus harms people's ability to fight other infections, with the most severe and deadly stage known as AIDS.

UNAIDS has warned the coronavirus pandemic has seriously hurt the AIDS response, with a six-month disruption in HIV treatment having the potential to cause more than 500,000 deaths in sub-Saharan Africa over the next year.

It would take the region back to 2008 AIDS mortality levels.

Dr Ong says Australia's HIV diagnoses peaked in 1987 at about 2400.

He believes Australia is well off its targets but heading in the right direction, with 833 HIV notifications in 2018 down from 937 in 2017.

"I don't think we can get down to zero transmissions with our current technology and understanding of HIV," Dr Ong said.

"We need better, clearer elimination targets. I think Australia is doing better compared to other countries but we may not be the first country to eliminate HIV."

He says it's feasible to eliminate transmission during blood transfusions, mother-to-child transmission and injection drug use, but much harder to eliminate sexual transmission.

Dr Ong noted Australia's progress hasn't benefited everyone equally, with certain groups remaining at higher risk.

The Kirby Institute's epidemiologist Skye McGregor thinks Australia needs a target with local context that can be tracked annually through surveillance reports.

She urged much more consultation on setting targets.

Chris Lemoh from Monash Health told the conference the coronavirus pandemic showed there was money available for HIV work, it just required political will.

A huge innovation in recent years has been the availability of PrEP on the Pharmaceutical Benefits Scheme.

The antiretroviral treatment allows people at high risk of infection to prevent HIV by taking a daily pill.

As of March last year, there was an estimated 23,000 people on the preventive medicine, while another 62,000 were eligible.

The health experts noted issues with aiming to get all at-risk men to be on PrEP, as it may not be optimal for everyone.