Australia's AIDS Epidemic Declared Over

July 10, 2016 12:37 AM

Good news for Oz: AIDS epidemic no longer a public health issue in Australia, scientists say. The nation's top scientists have declared "the end of AIDS" as a public health issue, as Australia joins the ranks of a select few countries which have successfully beaten the epidemic.
posted by valetta (17 comments total)

Despite the progress, researchers are still quick to point out the end of AIDS is not the end of HIV.

About 1,000 new cases of HIV are reported in Australia each year, and those within the sector worry that young people, who did not witness the horrors of the AIDS epidemic during the 80s and 90s, have become complacent.

Can't wait for people to insist they don't need anti-retrovirals because they're just a tool of the corrupt medical industry.
posted by Punkey at 1:08 AM on July 10, 2016 [4 favorites]

It happens already. And yeah, waiting for funding cutting now. To sex worker, harm minimisation and male to male programs. Just when the Tories come back in with Hanson on their minds. Fuuuuuck.
posted by taff at 3:06 AM on July 10, 2016 [2 favorites]

That's a really weird message. It's like saying typhoid is no longer a public health issue. We spend vast amounts on infrastructure and salaries to manage reticulation and sewage control, and it would be back with a vengeance if we stopped filtering and chlorinating our water, but since we have very few cases of typhoid we can say that it's not an issue.
posted by Joe in Australia at 3:51 AM on July 10, 2016 [46 favorites]

Joe,

What a great analogy. Wow.
posted by effugas at 3:58 AM on July 10, 2016 [8 favorites]

It's like saying typhoid is no longer a public health issue.

Yes (if you are in a developed country), because of public health and other interventions, typhoid is no longer something you have to think about. From my reading of the article, they are saying that Australia has that kind of infrastructure in place now for AIDS, where all or almost all HIV cases get the necessary treatment, effectively eliminating it.

But unlike typhoid, and the article directly acknowledges this, Australia still has an HIV problem -- it's as if we were solving typhoid with fast diagnosis and treatment, rather than water and sewage treatment. If there is an effective HIV vaccine at some point, then we will have a much better method for preventing AIDS, but it is still an impressive accomplishment for Australia to have such an effective response with the tools at hand.
posted by Dip Flash at 4:42 AM on July 10, 2016 [3 favorites]

I find this all very strange. I guess it's no longer an epidemic. I guess it's under control. But where there are still 1000 new cases diagnosed every year, it hasn't really been beaten and it hasn't gone away. And news like this will cause more people to become complacent.
posted by crossoverman at 4:43 AM on July 10, 2016 [2 favorites]

where there are still 1000 new cases diagnosed every year

1000 new cases of HIV, not AIDS. Which is a distinction the article makes clear.
posted by howfar at 5:49 AM on July 10, 2016 [6 favorites]

The point about complacency is perfectly reasonable, however. Apart from the effects of HIV itself short of developing AIDS (along with the side effects of treatment, and the possibility that the infrastructure to deliver it may not always remain in place), there are plenty of other STIs to be worried about.
posted by howfar at 5:55 AM on July 10, 2016 [1 favorite]

Also, the Great Barrier Reef is absolutely not under any kind of threat, and certainly not from coal mining or so-called "global warming". She'll be right, mate!
posted by acb at 6:00 AM on July 10, 2016

There is a fine line to walk in this kind of messaging. Apocalyptic AIDS messaging can also reduce safe-sex compliance by making people think they are inevitably doomed. I think messaging that AIDS can be avoided and HIV managed is a probably a reasonably effective message. It's still a serious disease and worth avoiding but it is neither inevitable nor doom.

People have to have to believe there is some hope both before and after HIV infection otherwise they may go all Deerhunter Russian Roulette.
posted by srboisvert at 6:51 AM on July 10, 2016

🖐🖐🏻🖐🏼🖐🏽🖐🏾🖐🏿 High-Five!

I guess we can all go home now! We did it!
posted by blue_beetle at 6:53 AM on July 10, 2016

People have to have to believe there is some hope both before and after HIV infection otherwise they may go all Deerhunter Russian Roulette.

WWCWD
posted by fairmettle at 6:58 AM on July 10, 2016

1000 new cases on a continent is absolutely amazing.

HIV /AIDS medication reduces the risks of transmission, and PrEP programs may be available to couples with sero-discordant statuses to further reduce risks of transmission.


1000 new cases is a drop in the bucket.
posted by AlexiaSky at 7:01 AM on July 10, 2016 [1 favorite]

Not an expert, but I think PrEP is approved for use in Australia, but is not subsidized by the national healthcare system. Ie, you have to come up with $10,000–$20,000 a year yourself if you want to take medication that helps avoid being one of the 1000 people / year getting infected by HIV.

National healthcare programs funding PrEP is a huge global question right now.
posted by Nelson at 8:50 AM on July 10, 2016 [2 favorites]

Yeah PrEP is one of the few shining examples where the US is actually ahead of the curve on a global health issue.

I can see it being true that "AIDS is no longer a public issue", read very literally and narrowly. Things are much better; there's new retrovirals all the time and PrEP and PEP. I don't think it's particularly helpful for health authorities to say it though.

I keep seeing patient charts with new HIV dx's. Some of them are younger than thirty. Some of them are not even twenty.

There is light at the end of the tunnel but we are still underneath a mountain.
posted by tivalasvegas at 5:12 PM on July 10, 2016 [1 favorite]

Here's the press release. ABC didn't get the messaging exactly right - the point is that almost no one is progressing to AIDS any more, but (as the first line of the presser reads) "Australians need to work together to end HIV as nation marks extraordinary progress against AIDS."

It is perhaps worth noting that in 1994, the peak of Australia's AIDS epidemic, 953 people were diagnosed with AIDS in a year (source). In the US, the 1994 comparator was 70,325 (source). The current HIV prevalence is 0.14%, which is very low - the US and UK prevalences are 0.5% and 0.3%, respectively, and most other countries in the region have higher prevalences as well (source). Unlike many other health problems including other communicable diseases, HIV prevalence is lower among Aboriginal and Torres Strait Islander people (0.11%) than in the general population (ibid.). The Australian epidemic is concentrated in men who have sex with men, where HIV prevalence is still 14-18%, but progression to AIDS is so low the statistics are no longer even published - the last numbers I was able to find were from 2009, when the figure dropped to 100 nationwide.
posted by gingerest at 7:21 PM on July 10, 2016 [1 favorite]

It's a public health triumph, is what I'm saying here, that Australia was able to get ahead of its epidemic, institute controls to limit new infections (with variable success in different populations - HIV incidence here is very low among sex workers and people who inject drugs, but still high among men who have sex with men), and limit progression from HIV to AIDS in people who were infected (by making HAART available through PBS, the national pharmaceutical benefits scheme, as soon as possible).
Nelson's right, PrEP is licensed under the TGA here but not in the PBS yet. You can pay for it privately ($850/30 days), import it under the Personal Importation Scheme ($330/3 months), or join one of the four licensed trials.

Post-exposure prophylaxis and treatment are, of course, available through PBS.
posted by gingerest at 7:45 PM on July 10, 2016 [2 favorites]