NSW could end new HIV infections by 2025, experts say

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New South Wales has recorded its lowest number of new HIV infections on record, according to the latest data.

NSW Health figures shows the state recorded a total of 178 new HIV cases last year. That number is a 36 per cent drop compared to the five-year average.

And experts say NSW could be one of the first places in the world to eliminate new HIV infections, ahead of the global target of 2030.

A NSW Health spokesperson said, “This decline in diagnoses is encouraging but is also driven by the effects of COVID-19.

“[These include] restricted movement, altered health-seeking behaviour, lower levels of casual sex activity and testing, as well as altered service provision and access.”

However the spokesperson added, “New ways to prevent, test and treat mean that the virtual elimination of HIV transmission in NSW, once inconceivable, is now a realistic and achievable goal.

“NSW Health is urging people at risk to re-engage with health services and get an HIV test and use PrEP for HIV prevention.”

According to the data, HIV testing and PrEP use increased in 2021 compared to 2020.

But rates are still lower than before the pandemic, though were increasing as people came out of lockdown.

Medication reduces HIV load to undetectable levels

Thanks to major medical advances, HIV is now a manageable chronic disease.

For people living with HIV, modern medication reduces viral load to a level so low the virus is “undetectable”.

This means they can no longer be transmit HIV to their sexual partners.

Also, HIV-negative people at risk of the virus can take pre-exposure prophylaxis (PrEP) medication to dramatically reduce that risk.

Professor Andrew Grulich heads the UNSW Kirby Institute’s HIV Epidemiology and Prevention Program.

He told the Sydney Morning Herald the goal of elimination of the virus in the state now “well within reach by 2025”.

“What we are seeing in NSW is unique on a global scale,” he said.

“The world is watching what NSW is doing. The decline is definitely real, but it has been accelerated by COVID-19 restrictions.”

Grulich said the steep decline in infections during the pandemic followed a steady decline in infections over the previous decade.

“Provided there is a strong uptake in PrEP as people emerge from their post-pandemic bunkers we really do have the potential to drive HIV towards elimination,” he said.

“It’s critical those people who’ve fallen out of regular HIV testing during the pandemic get back to that.”

Grulich said the global goal to end HIV infections by 2030 “has been viewed by many as unrealistic”. However he said the NSW data shows that it is achievable.

“It is now definitely within reach by 2025,” he said.

However he cautioned some groups in NSW “are not seeing declines of the same magnitude as those in Australian-born gay men and those living in cities”.

“We do need to focus driving infections down in young men born overseas and people living in outer Sydney suburban and regional NSW,” he said.

New injectable options for HIV treatment and prevention

Earlier this month, Cabenuva, Australia’s first long-acting HIV treatment, was added to the Pharmaceutical Benefits Scheme making it accessible

The injection, given every two months, suppresses the virus and is an easier alternative to a daily pill.

Similar steps forward are being made in HIV prevention.

Overseas regulators are approving injectable medication for pre-exposure prophylaxis (PrEP) every two months instead of an oral pill.

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