Not over yet

The aids virus (coloured in green) budding from an infected white blood cell, revealed in a scanning electron micrograph. The red ribbon is a symbol for solidarity with people living with AIDS. image source: wikipedia - public domain
11 July 2016

Is the AIDS epidemic finally 'over' in Australia? A recent media headline suggests as much. But the reality may not be quite as straight forward.

According to a statement released by AIDS researchers from the Universities of Melbourne and New South Wales, and the Australian Federation of AIDS Organisations, effective and easily-accessible therapies indeed mean that few people develop aquired human deficiency syndrome - AIDS.

And the means are now at hand to stop the spread of the human immunodeficiency virus (HIV) that causes the disease - at least in Australia.

It is a success of a global effort against one of the great global health scourges of modern times, more than thirty years after the first cases of AIDS were clinically observed in the US.

However, the scientists caution that the elusive goal of ending new HIV infections remains an enduring challenge, with more than 1000 new infections occuring each year. It is now a question of appropriate investments in research, community-led health promotion and access to new HIV prevention technologies to virtually eliminate the risk of getting infected in Australia by 2020.

Prevention tools such as pre-exposure prophylaxis (PrEP) could see the AIDS public health threat morphing into an HIV prevention challenge, according to Professor Grulich, who is heading the HIV Epidemiology and Prevention Program at the Kirby Institute.

But the scientists say that while Australia's effort in fighting AIDS is globally recognised, it will require extra investments to end new HIV infections.

A crucial element to ending HIV in Australia will also be encouraging the uptake of anti-retroviral medicine among HIV positive people.

And it will require focusing advocacy and resources on those people most at risk of getting infected, especially young gay men and people who inject drugs.

The experts are also pointing out that success in Australia will require continued progress against AIDS globally.

AIDS-related deaths are in decline around the world. Nevertheless, 180,000 people died from AIDS-related illness in the Asia-Pacific region in 2015. And of the five million people in the Asia-Pacific who are living with HIV, only two million are on antiretroviral treatment.

Bill Bowtell, the executive director of the Pacific Friends of the Global Fund to Fight AIDS, Tuberculosis and Malaria, called on donors including Australia to increase their support.

“We must continue progress towards expanding access to HIV treatments by supporting the Global Fund, which is the key financing mechanism for fighting HIV/AIDS,” he said.

In a comment released by the Australian Science Media Centre, Professor Andrew Grulich, who heads the HIV Epidemiology and Prevention Program at UNSW's Kirby Institute acknowledged that AIDS in Australia may now be uncommon "but it is not over". He pointed out that 150 people a year present with severe immune deficiency, and while most improve with treatment, they are at risk of dying. And the rate of 1000 new HIV diagnosis each year is actually around 30% higher than a decade ago.

And beating AIDS globally may need more emphasis on preventative measures, according to Emeritus Professor Roger Short from the University of Melbourne.

"Although the world’s developed countries may be able to contain the HIV pandemic by using expensive therapeutic drugs, in developing countries preventative techniques like male circumcision and condoms are likely to be far more acceptable and effective."

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