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Toward 2020: targeting Australia’s HIV response

Since 2010, there have been major developments in political commitment and scientific evidence in the fight against HIV.

There is a growing body of evidence regarding HIV 'treatment as prevention', and recent research findings show use of the HIV medication Truvada by HIV-negative people as pre-exposure prophylaxis (PrEP) can prevent HIV infection.

Access to HIV testing has also been enhanced, with the development of accurate HIV rapid testing devices suitable for use in community-settings and for self-use at home.

This page details key events and documents that are enabling Australia to make progress towards meeting commitments made under the United Nations 2011 Political Declaration on HIV/AIDS and Australia's Seventh National HIV Strategy.

These documents commit Australia to actions and targets for reducing the sexual transmission of HIV, expanding access to HIV treatment and reducing HIV transmission among people who inject drugs.

 

2011

In June 2011 Australia signed the United Nations 2011 Political Declaration on HIV/AIDS, committing to bold actions and targets by 2015, including reducing the sexual transmission of HIV by 50%, dramatically expanding access to HIV treatment and reducing HIV transmission among people who inject drugs by 50%.

 

2012

In July 2012, AFAO published a discussion paper, endorsed by all AFAO member organisations, considering how the UNPD intersects with Australia’s Sixth National HIV Strategy 2010-2013.

The paper frames the UN Political Declaration as a call on governments, including the Australian Government, to recommit to an effective domestic HIV response.

In September 2012, a coalition of HIV community, research, clinical and other organisations launched The Melbourne Declaration, a petition calling on Australian governments to take actions necessary to achieve the targets that Australia committed to in the UNPD.

The petition focused on four priority areas:

  • increasing testing;
  • increasing access to HIV treatments;
  • making PrEP available; and
  • committing to strengthening Australia’s successful partnership response to HIV.
  • Download The Melbourne Declaration

In November 2012, the Queensland AIDS Council (QuAC -formerly Queensland Association for Healthy Communities), established Testing Point, an after-hours HIV and STI testing clinic, staffed by nurses and GPs.

On World AIDS Day, 1 December 2012, the NSW Government announced a new HIV strategy which incldes targets to virtually eradicate HIV transmission in NSW by 2020. The strategy was hailed as a first of its kind in Australia for being responsive to recent scientific evidence and advances in HIV prevention and treatment.

In December 2012, the Therapeutic Goods Administration (TGA) approved the first rapid HIV test for use in Australia. The Determine rapid HIV test, produced by Alere, is able to provide test results onsite at a clinic or other location within 30 minutes, making the process of HIV testing easier and faster.


2013

In March 2013, ACON launched Ending HIV, a new state-wide education campaign aimed at mobilising NSW’s gay community to help eliminate HIV transmission within the next ten years.

The campaign included a roll out of rapid HIV testing sites. ACON's first community-based rapid testing site opened in June 2013.

The ACON campaign reinforces aims outlined in the NSW HIV Strategy 2012-2015 and the Melbourne Declaration, both of which align with prevention and treatment targets set out in the United Nations 2011 Political Declaration on HIV.

In June 2013 The Queensland HIV Foundation began providing rapid HIV testing at sexual health clinics.

In September 2013 organisers of the 2012 Melbourne Declaration released a report card on Australia's progress on the 4 key Action Areas identified by the Declaration. The report card gave Australia a score of 21/40.

In September 2013 the Victorian AIDS Council opened Australia's first 'shop-front' rapid HIV testing site in Melbourne in collaboration with the Burnet Institute.

The peer-based service, known as PRONTO, aims to offer gay men a convenient alternative HIV testing option. Trained peer facilitators do the test and provide results within 30 minutes.

It is hoped that the service will reduce the number of gay men with undiagnosed HIV in Melbourne.

In December 2013, HIV rapid testing became available in Canberra through two branches of a general practice.

A major barrier to treating HIV was removed in December 2013, when Australia's Pharmaceutical Benefits Advisory Committee (PBAC) decided to remove the CD4 + <500 count criteria for prescribing medicines for HIV treatment.


2014

From May 2014, HIV rapid testing became available in Perth in a twelve month trial.

Screening of participants for the first Australian trial of PrEP began in June 2014. VicPrEP is a Victorian study exploring the safety and feasibility of PrEP. It also explores people's reasons for choosing or deciding against this form of HIV prevention.

In June 2014 the Secretary of the Department of Health signed the legislative instrument to amend the Therapeutic Goods (Excluded Purposes) Specification 2010, to allow the future supply of HIV self-tests. Until this time, this specification had previously excluded HIV self-tests from being able to be assessed by the TGA.

HIV rapid testing became available in Tasmania through the Tasmania Sexual Health Service from early July 2014.

In July 2014, The Queensland AIDS Council (QuAC) opened Clinic 30, a service staffed by male and female GPs, to provide comprehensive sexual health and mental health services to the LGBTI community. The service included the continuation of Testing Point, an after-hours rapid HIV and STI testing service.

July 2014 saw the launch of Australia's Seventh National HIV Strategy and the COAG AIDS 2014 Legacy Statement, key policy documents which commit to the UNAIDS target of ending new HIV infections by 2020. Actions outlined in these documents include a commitment to:

  • a 50% reduction sexual transmission of HIV by 2015
  • lifting restriction on the manufacture and sale of HIV home tests
  • improving access to medications for people living with HIV, by making them available at pharmacies rather than hospitals.

In July 2014 UNAIDS announced the '90-90-90' targets, designed to be the focus for a global commitment to ambitious treatment and prevention targets, where by 2020:

  • 90% of all people living with HIV will know their HIV status
  • 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy
  • 90% of all people receiving antiretroviral therapy will have viral suppression.

With these 'Fast-Track' targets, UNAIDS aims to end the HIV epidemic by 2030.

In July 2014 the government announced that from 1 July 2015, all pharmacies will be able to dispense HIV antiretroviral medications, regardless of where the medicine is prescribed.

In November 2014, a large PrEP study got underway in NSW (the PrELUDE study). The study explores the effectiveness of PrEP as an HIV prevention strategy in Australia, particularly for people at high risk of acquiring HIV.


2015

In February 2015, interim findings announced by the Australian Opposites Attract Study indicate that HIV-positive gay men who are on treatment and have an undetectable viral load are not transmitting the virus to their partners.

While final results of the study are not due until 2017, results to date show a zero transmission rate two years into the four year study, adding to a growing body of evidence on HIV treatment as prevention.

An Australian commentary on guidelines for the use of PrEP was approved by the Australasian Society for HIV Medicine (ASHM) in February 2015.

The commentary includes an overview of the evidence for PrEP's efficacy and safety as well as information on how to effectively apply the Guidelines in Australia. Truvada (the drug used for PrEP) has not yet been licensed by the TGA but generics may be prescribed off-label, and purchased on-line from overseas.

Recruitment for QPrEP, a trial of PrEP among gay men in Queensland, began in March 2015.

In April 2015, the Victorian Government announced that it would introduce legislation to repeal section 19A of the Crimes Act 1958. 19a is the only HIV-specific law in Australia, imposing harsh penalties for HIV transmission. Its repeal will reduce stigma and discrimination for people with HIV.

In June 2015, the TGA approved the second and third rapid HIV tests in Australia for use at the point-of-care. The Uni-Gold rapid HIV test, produced by Trinity Biotech, provides test results in around 10 minutes, and the Oraquick Advance rapid HIV test, produced by Orasure Technologies, provides results in about 20 minutes. The approval of these tests has improved the choices available for services offering rapid HIV testing, which makes the process of HIV testing easier and faster.

From 1 July 2015, people with HIV were able to fill scripts for antiretrovirals at any pharmacy. This improves treatments access because previously these drugs were only available from hospital pharmacies.

In September 2015 the ASHM Sub-Committee for Guidance on HIV Management in Australia strongly recommended that all people with HIV, regardless of their viral load or CD4 count, consider starting HIV treatment. This recommendation was based on the results of two international trials which showed that the benefits of starting ART outweigh potential side effects.


 

 

 

 

 

 


This page was published on 19 April, 2013

This page was reviewed on 11 November 2015