HIV experts have welcomed the state government’s removal of AIDS as a monitored disease in Queensland, but have warned of upcoming challenges in HIV prevention and treatment.
Queensland Health Minister Steven Miles said on Tuesday new regulation changes will see AIDS removed from the state’s notifiable conditions schedule, to shift the focus to ending HIV.
“The objective of the notifiable conditions schedule is to monitor and respond to diseases that are considered a public health risk because the disease can spread,” he said.
“HIV is the public health risk, not AIDS, which is why we’re making changes to remove it from the notifiable conditions schedule.”
He attributed the move to the introduction of anti-retroviral treatments for HIV in 1996, which meant there were only 12 new cases of AIDS reported in Queensland in 2017.
“Compared to the late 80s and early 90s, where there were hundreds of AIDS cases notified each year, this is a significant achievement which is largely due to highly active anti-retroviral treatments for HIV,” he said.
The treatments lower the viral load of HIV in the blood of a person to undetectable levels, which means they can’t transmit HIV to their partners and do not develop AIDS.
Miles said HIV often had no symptoms and encouraged all sexually active Queenslanders to get regular testing for STIs including HIV.
“The sooner HIV is detected, the sooner treatment can start and the better your chances are of living a long and healthy life,” he said.
“While HIV has reduced significantly in the past three decades, it remains an important health issue in our communities, with 185 new cases reported in 2017.
“Pre-Exposure Prophylaxis (PrEP) for HIV is now available on the Pharmaceutical Benefits Scheme and, coupled with condoms, continues to provide one of the most effective ways to prevent HIV.”
Queensland AIDS Council (QuAC) President Peter Black said the progress was thanks to a combination of scientific advancement and the work of groups such as QuAC and QPP.
“While it is undoubtedly a tribute to the scientific and community response to the HIV/AIDS epidemic over several decades, there remains much work to be done to end HIV transmission in this state,” he said.
Queensland Positive People (QPP) President Mark Counter reminded all those who believe they may have been at risk to get tested for HIV in order to take early advantage of the “life-changing” HIV treatment regimens.
He said the removal of AIDS from the schedule was “a testament to modern science that people living with HIV (PLHIV) on a modern HIV treatment regimen can look forward to a life where the damage previously caused by HIV can now be well managed.”
But he cautioned that it does not equate to the end of the HIV epidemic.
“In addition to the new notifications of HIV transmissions every year, Queensland is also home to approximately 6,000 PLHIV and each of us will continue to need specialist care to remain well,” he said.
“Apart from HIV treatment, PLHIV often experience multiple co-morbidities, and at an earlier age than the general population.
“For PLHIV like myself who have been living with HIV for over 30 years, dealing with multiple HIV-related diseases is commonplace. HIV management really has become the easier part.”
QPP Executive Officer Simon O’Connor said some historical challenges in relation to HIV treatments had eased but new challenges for QPP in relation to an ageing PLHIV population were escalating.
“Unlike southern states, PLHIV in Queensland are spread widely across rural and remote areas, and this will present Queensland and QPP with major challenges as the population continues to age,” he said.
“Keeping PLHIV abreast of their earlier risks of diabetes, heart disease, osteoporosis, liver disease, and a variety of other co-morbidities now represent a newer and very significant challenge.
“In addition to PLHIV taking full advantage of the improvements in treatments to achieve undetectable levels of viral load, it is also vitally important that they undergo regular health checks to prevent early onset of other related diseases.”
The removal of AIDS from the notifiable conditions schedule is part of a number of updates being made to Queensland’s notifiable conditions schedule.
The legislation says AIDS surveillance “is no longer a reliable measure of the HIV epidemic” but HIV will “continue to be prescribed as a controlled notifiable condition to enable Queensland Health to monitor trends in HIV transmission, and assist with HIV prevention planning and delivery of appropriate health services.”
AIDS was removed from the National Notifiable Disease List in 2016.
“The proposal to remove AIDS does not mean that the condition is no longer important or that there should be changes in public messaging around HIV and AIDS,” the federal legislation explained at the time.
“Rather, the change in focus should indicate the public health importance of monitoring HIV infections and the clinical and immunological status of cases at their first HIV diagnosis.”