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Author Topic: HIV on the rise in straight Australian men, Kirby Institute report  (Read 77 times)

Mary-Jane

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HIV on the rise in straight Australian men, Kirby Institute report

By Kate Aubusson 23 September 2018

Rising numbers of straight men are being diagnosed with HIV in Australia, with many unknowingly living with the infection for years before they get tested.

HIV diagnoses have hit a seven-year-low, but heterosexual people are bucking the positive trend, the latest surveillance report by UNSW's Kirby Institute shows.

As HIV rates fell dramatically among gay and bisexual men, new HIV diagnoses attributed to heterosexual sex rose 10 per cent over the past five years and 14 per cent between 2016 and 2017, according to the detailed analysis released on Monday.

Heterosexual sex accounted for one in four new HIV diagnoses in 2017 (238 people: 145 men and 93 women).

New HIV diagnoses in men that were attributed to heterosexual sex (rather than injecting drugs) rose 19 per cent over the past five years.

Worryingly, almost half of HIV-positive heterosexuals were living with the infection for years before it was detected (48 per cent).

The rise in HIV among heterosexual was small but concerning, said the head of the Kirby Institute’s Surveillance, Evaluation and Research Program and co-author of the report, Professor Rebecca Guy.

One in 10 of all people who are diagnosed late (four or more years after infection) have progressed to AIDS by the time they are tested, Professor Guy said.

“Their immune function had deteriorated to the point where often they are first tested when they are in hospital,” she said.

Healthcare

The first generation to grow old with HIV are ageing faster
HIV testing rates are significantly lower among heterosexuals, Professor Guy said. A 2012-2013 survey of more than 20,000 Australians found just one in three heterosexual people had been tested for HIV in their lifetime.

The delay in getting tested for HIV meant there was a high-risk they were unknowingly passing the infection on to their sexual partners, Professor Guy said.

“Many heterosexuals would be unaware that they have been at risk … and the need for testing,” Professor Guy said.

Associate Professor Limin Mao, Senior Research Fellow at the Centre for Social Research in Health at UNSW, said the belief that HIV was a problem of gay men and drug users, as well as prejudice among the community were major barriers to getting people tested.

A survey of just over 1000 Australians showed almost half would behave negatively toward people with HIV. Roughly 60 per cent said it would bother them if their roommate was HIV positive.

Adjunct Associate Professor Darryl O'Donnell, CEO of Australian Federation of AIDS Organisations (AFAO), said doctors needed to make sure their at-risk patients felt comfortable asking for an HIV test and accepting a test when it was offered.

Overall HIV diagnoses fell to 963 new cases in 2017 – the lowest number since 2010 and a 7 per cent drop in the past five years.

The decline has been driven by Australian-born gay and bisexual men.
Gay and bisexual men driving down HIV rates

Among gay and bisexual men, new diagnoses fell 15 per cent in one year from 2016 to 2017. The decrease was as much as 25 per cent among Australian-born gay and bisexual men (319 men in 2017).

But the HIV rate rose 5 per cent among overseas-born gay and bisexual men (244 men). Dr Mao said this increase could be due to their lack of access to government-funded health services, including the recently PBS-funded PrEP.

“Particularly for overseas-born and international students this is increasingly becoming a priority … I’d like the community members to talk about it,” Dr Mao said.

Overall, gay and bisexual men still account for two-thirds of all HIV infections in Australia. Late diagnoses were also high among bisexual and older men who have sex with men (42 per cent and 38 per cent respectively).

The welcome drop is the result of an increase in HIV testing and treatment, and the rise of preexposure prophylaxis (PrEP) via state-funded access programs prior to its PBS listing, all of which reduce the risk of individuals transmitting the virus, the authors said.

Almost 16,000 gay and bisexual men were on PrEP in 2016-2017 and roughly 74 per cent of people living with HIV in Australia had a suppressed or undetectable viral load, exceeding the UNAIDS target of 73 per cent three years before the 2020 deadline.

“This is a fantastic achievement for Australia, and reflects strengthened clinical and public health initiatives, and the leadership of people living with HIV,” Professor Guy said.

“We need to improve access [to PrEP] for gay and bisexual men living outside of inner-city areas, gay and bisexual men born overseas, and Aboriginal or Torres Strait Islander gay and bisexual men."

HIV outbreaks in Aboriginal communities

HIV diagnoses among Indigenous Australians have also increased in the past five years from 26 to 31 new cases in 2017; 1.6 times the rate among the non-Indigenous Australian population (4.6 versus 2.8 per 100,000 population).

Associate Professor James Ward, head of Aboriginal Health Infectious Diseases, South Australian Health and Medical Research Institute (SAHMRI) said several small HIV outbreaks among rural and remote Aboriginal communities had put “enormous strain” on local health services and confirmed the need for greater access to rapid testing, treatment and PrEP as well as targeted campaigns in these communities.

Ahead of the federal government’s release of a new HIV strategy, Dr O’Donnell urged health minister Greg Hunt to seize the opportunity to champion bold new strategies to reach Australia’s ambitious goal of virtual HIV elimination by 2020.

“We need to make sure everyone can benefit from the gains being made in HIV prevention,” he said.


Definition of Hats aka "Conflict of Interest" Statement: Mary-Jane is Editor of Perth Gay News, The Media Annuncio of the Perth Sisters of Perpetual Indulgence of the Abbey of the Black Swan & Editor @ HIV Institute of WA.

#Twitter @AbbeyBlackSwan1

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