World AIDS Day the path forward

On Thursday, 1 December 2022, Australia commemorated World AIDS Day.

Around 38.5 million people are thought to be living with Human Immunodeficiency Virus (HIV) globally. In 2021, 1.5 million were newly infected (of which 160,000 children under 15) and some 650,000 died because of HIV-related causes. The World Health Organization (WHO) says that this epidemic is far from over.

Sub-Saharan Africa remains the most critically affected region, where 1 in every 25 adults is thought to be living with the disease. HIV is increasingly being transmitted among heterosexual couples, including in Australia. NSW Health has launched a call to increase HIV testing for all people who might be at risk of exposure to HIV.

40 years since HIV was first characterized by the French scientists

In the 1980s, an epidemic of a “mystery illness” of unknown origins killed thousands of people, thought at first to affect mostly gay men. It is now known that HIV can get transmitted through certain body fluids, blood transfusion, products and injections, as well as from mothers to unborn babies or through breast milk.

Next year marks the 40^th anniversary since the discovery of HIV-1 by the French scientists in 1983—three years after Acquired Immunodeficiency Syndrome (AIDS) was first epidemiologically identified in the United States. Virologist Dr Luc Montagnier, who led the French team of scientists, was jointly awarded the Nobel Peace Prize (with Dr Françoise Barré-Sinoussi) in 2008 for isolating and characterizing HIV1. Montagnier’s research formed the basis for the development of antiretroviral therapy (ART) which has significantly improved the life expectancy of HIV sufferers. Eminent scientist Dr Robert Gallo from the United States co-discovered a causal link between HIV and AIDS, and developed the world’s first HIV blood test.

The first international AIDS conference was held in Atlanta in 1985, while WHO established Special AIDS program in 1987. The following year, WHO decided to hold an annual world AIDS day, “with the aim of increasing HIV awareness, mobilising communities and advocating for action worldwide.”

Australia joins HIV research in the late 1980s

In Australia, social stigma and misinformation unfairly targeted HIV positive people in the 1980s. In Queensland, several babies were infected with HIV through blood transfusion, such as Eve van Grafhorst, who died in New Zealand at age 11 (where her family moved after being ostracised in their local community in Australia). Journalist Simon Royal described Eve’s battle as “not only a medical one—it was also against public panic, hysteria and humiliation.”

Both the federal and state governments responded to the epidemic through improved practices and research funding. The Kirby Institute was established in 1986 to satisfy the need to respond to the epidemic. In 1989, the federal government launched its first HIV/AIDS national strategy. Australia had become the “world’s leading model of best practice” in responding to HIV epidemic.

The federal government is due to release its 9^th HIV strategy paper, following on from the 2018–22 HIV national strategy. The Covid-19 pandemic had a mixed effect on the Australian national HIV statistics, with a smaller number of HIV positive people being recorded while the number of people getting tested for HIV/AIDS having also dropped.  

NSW Health urging people to get tested

On 1 December 2022 NSW Chief Health Officer Dr Kerry Chant called for more people to get tested for HIV/AIDS as the testing rates are still lower than before the pandemic. NSW Health released a statement:

“People can get tested easily and confidentially at their local GP or sexual health service. There are also now more online and home-based testing options including Dried Blood Spot test, a free finger prick test which is mailed to you, and self-test kits which are available in some pharmacies.

“That’s why we are urging people to test for HIV if you think you are at risk, start treatment if you are diagnosed with HIV, or consider PrEP if you are HIV-negative.”

Online services such as you [TEST] provide peer support to help you choose a test.”

In the financial year 2022–23, NSW Health is investing $22.4 million “in services to strengthen HIV testing, treatment and prevention.” 

Due to a wide availability of treatment in Australia, it is no longer considered to be an epidemic in this country, although around 30,000 people are living HIV positive.