Better Safe Than Sorry

"The extraordinary success in HIV prevention in the gay neighbourhoods of Sydney is due to decades of government leadership. Working in partnership with community and clinical organizations, effective research-based interventions have been designed and implemented."

"These numbers show us that virtual elimination of HIV transmissions is possible. Now, we need to look closely at what has worked in Sydney, and adapt it for other cities and regions across Australia."

"My life in research has been over that period [1980s to 1990s]. So, it has been terrible, and it has been extraordinary and now it is getting close to wonderful, really, with the possibility that we have."

"Now, we need to look closely at what has worked in Sydney, and adapt it for other cities and regions across Australia."

Professor Andrew Grulich, epidemiologist, Kirby Institute, University of New South Wales

"Overseas-born men who have sex with men, heterosexual populations, people from culturally and linguistically-diverse backgrounds and Aboriginal and Torres Strait Islander people."

"So, it is a question of equity as well."

Jane Costello, chief executive officer, Positive Life

Safety Sam, The Condom Man, distributes free condoms on the steps of the Sydney Opera House

 

Australia may become the first country where HIV transmission will come to a timely end, following success of a program where the spread was "virtually eliminated" in inner Sydney. In the 1980s and 1990s thousands of men died in inner Sydneym representing an area that has been central to a large population of gay and bisexual men. Last year just eleven new cases were reported. An "extraordinary success" that researchers point to, paving the way for these areas of success to be recognized as the first in the world to succeed in the UN's target to eliminate HIV transmission.

That success is proof that existing strategies available to prevent the spread of the virus worked exceedingly well. The dramatic reduction in infections demonstrated that an end is possible to the decades-long pandemic that caused the death of over 40 million people. New infections fell by 88 percent between 2010 and 2022 in inner city neighbourhoods ravaged at one time by the virus, according to data given at the International Aids Society's HIV science conference.

According to Professor Grulich who made the presentation, the decline was linked to clear government leadership and an approach that was community based, with widespread outreach, testing, prompt treatment and strong uptake of pre-exposure prophylaxis (PrEP) among those at risk of contracting the virus.

The results were localized, however, and not seen city-wide. In Sydney altogether, new cases fell by merely 31 percent since 2010, the researchers discovered, attributing this to lower rates of testing and less use of PrEP, which prevents transmission through sex when used beforehand.

"Achieving the last mile of the virtual elimination of HIV in Australia will require additional interventions – including those specifically designed to reach women."

"While the gay, bi-sexual and men who have sex with men communities are very aware of the benefit of prevention tools like PrEP, the heterosexual community is pretty much oblivious."

"We need greater education – including as part of secondary school curricula – to raise awareness around how to prevent HIV, including new tools like long-acting injectable PrEP."

Heather Ellis, communications and engagement coordinator for Positive Women Victoria

Inner Sydney, where the gay community was devastated by the AIDS crisis in the 1980s, is now leading the world in reducing HIV transmission  (ESTHER LIM)

"These encouraging findings from inner city Sydney show just how far we have come since the early days of the AIDS pandemic before we had effective testing, treatment or prevention tools."

"A durable end to Australia’s HIV epidemic requires a cure and a vaccine, and the scientific community won’t stop until we discover them."

Sharon Lewin, IAS President, IAS 2023 International Chair, Director, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Australia