Annual survey reveals significant gains in HIV treatment over the past decade

November 15, 2016, University of New South Wales
Annual survey reveals significant gains in HIV treatment over the past decade
Credit: Shutterstock

There is compelling evidence that treatment greatly reduces HIV transmission but prevention of the disease remains complex, the latest report by UNSW's Centre for Social Research in Health shows.

The proportion of HIV-positive gay men on antiretroviral treatment (ART) has reached a historic high, making HIV treatment as prevention a reality, according to the Annual Report of Trends in Behaviour (ARTB) 2016.

The report, released by the Centre for Social Research in Health (CSRH) at UNSW, also underscores the growing complexity of HIV prevention as more gay men use a growing range of strategies to reduce HIV transmission.

The ARTB was released alongside The Kirby Institute's Australia Annual Surveillance Report (ASR) in HIV, viral hepatitis and sexually transmissible infections at the Australasian HIV/AIDS Conference in Adelaide.

The latest ARTB shows significant gains in HIV treatment over the past decade, with treatment uptake by HIV-positive gay men surging from 60% in 2006 to 87% in 2015. The proportion of HIV-positive gay men achieving (an undetectable viral load) has increased by more than 30 percentage points to 88% (the highest on record), from 55% in 2006.

"Within a world-class supportive environment, HIV-positive gay men, together with their supporting clinicians and community peers, are leading the way in eradicating HIV transmission in Australia," said Dr Limin Mao, Senior Research Fellow at CSRH.

Apart from consistent condom use, gay men look to other prevention strategies to avoid acquiring HIV. Among those who had casual partners in a six-month period, consistent condom use was adopted by about 40% of the men. In the context of more HIV-positive people achieving viral suppression after treatment, the proportion of gay men engaging in any condom-less anal sex with casual partners reached a new high in 2015 (41%), up eight percentage points from ten years ago. This increase was most pronounced among men aged 25 years or younger.

In this rapidly changing HIV landscape, young gay men should be supported by removing any barriers for their access to HIV prevention information and services.

Key findings from the Gay Community Periodic Surveys show that gay men are taking a number of steps to reduce the risk of HIV transmission. These measures include:

  • Disclosing HIV status to casual partners: Both HIV-negative and HIV-positive gay men increasingly disclose their HIV status to sexual partners. Among HIV-positive men, disclosure of HIV status before casual sex reached a record high in 2015 (43%).
  • Frequent HIV testing: In 2015, 66% of non-HIV-positive gay men had been tested for HIV at least once in the preceding year, an increase from 60% in 2013.
  • Increased sexual health testing: In 2015, 44% of gay men (the highest on record) had been tested for STIs in the previous year through at least four different sample sources (blood, urine, anal and throat swabs).

Pre-exposure prophylaxis (PrEP) is HIV medication taken by HIV-negative men before sex to prevent HIV. If taken consistently, PrEP is effective at stopping a person from acquiring HIV. In 2014-15, about 2% of HIV-negative men in the Gay Community Periodic Surveys reported any PrEP use in the previous year, when PrEP was not widely available. More men are expected to take PrEP from 2016 onwards as awareness and availability of PrEP rapidly increase.

Dr Mao continued: "The evidence that HIV treatment greatly reduces HIV transmission is compelling. HIV-positive gay men should be congratulated on achieving such high levels of treatment coverage and viral suppression, making Australia well on its way to achieve the ambitious target of eliminating HIV transmission by 2020. Increased STIs as reported in the Kirby Institute report, however, which brings new challenges for continued health surveillance and broader health promotion in this population."

Associate Professor Martin Holt, the project leader of the Gay Community Periodic Surveys at CSRH, said that maintaining a combination of HIV prevention strategies was vital.

"While high rates of treatment uptake and condom use among gay men must be sustained, priorities should be given to make new prevention tools, like PrEP, more accessible through reimbursement on the Pharmaceutical Benefits Scheme (PBS)," he said.

The Director of CSRH, Professor Carla Treloar, summarised: "Our report highlights the urgent need for HIV prevention messages to reflect the expanding approaches gay men find most suitable. These messages should include biomedical and behavioural tools and address diverse groups of gay men."

Explore further: Unprotected sex among young gay men on the rise

More information: Annual Report of Trends in Behaviour 2016: … -trends-in-behavior/

Related Stories

Unprotected sex among young gay men on the rise

October 21, 2013
Unprotected sex with casual partners - one of the key drivers of HIV transmission among gay men - has risen significantly for those aged under 25.

Australian HIV rates remain stable while other STIs continue to rise

November 14, 2016
New HIV notifications in Australia have remained stable over the past four years, following a steady increase since 1999, according to the 2016 Australian Annual Surveillance Report into sexually transmissible infections ...

Report cites urgent need for revision of HIV prevention practices

October 17, 2012
Trends in the sexual practices of gay men in Australia show that HIV prevention remains firmly embedded in gay communities. However, to curb the epidemic and start driving down numbers of new infections, "a re-invigoration ...

Record numbers accessing hepatitis C treatment, but who is missing out?

September 29, 2016
A mistrust of the health system and ongoing stigma from health workers against injecting drug users are two significant barriers that could prevent people living with hepatitis C from accessing and continuing life-saving ...

Australian law needs a refresher on the science of HIV transmission

November 9, 2016
Being diagnosed with HIV is a confronting experience.

Study finds barriers to accessing HIV prevention pill

September 13, 2016
APLA Health, in partnership with the California HIV/AIDS Research Program (CHRP) of the University of California, today (Sept. 12) released a new report on pre-exposure prophylaxis (PrEP) titled "Addressing PrEP Disparities ...

Recommended for you

Discovery of how HIV hedges its bets opens the door to new therapies

May 10, 2018
A stem cell is one with infinite possibilities. So, for decades, scientists have puzzled over how the cell chooses to keep being a stem cell and continue dividing, or specialize into a specific cell type, like a heart or ...

Researchers find link between crystal methamphetamine and immune changes in HIV

May 4, 2018
A researcher at the University of Miami Miller School of Medicine has found that the use of stimulants, such as methamphetamine, can negatively affect the health of HIV-positive persons even when they are adhering to medical ...

Study challenges 'shock and kill' approach to eliminating HIV

May 1, 2018
Researchers have provided new insight into the cellular processes behind the 'shock and kill' approach to curing HIV, which they say challenges the effectiveness of the treatment.

State-of-the-art HIV drug could curb HIV transmission, improve survival in India

April 30, 2018
An HIV treatment regimen already widely used in North America and Europe would likely increase the life expectancy of people living with HIV in India by nearly three years and reduce the number of new HIV infections by 23 ...

Risks to babies of mothers with HIV from three antiretroviral regimens appear to be low

April 25, 2018
The risk for preterm birth and early infant death is similar for three antiretroviral drug regimens taken by pregnant women with HIV according to a new study from Harvard T.H. Chan School of Public Health.

New method allows scientists to study how HIV persists

April 24, 2018
After 35 years of rigorous research, there is still no cure for HIV. Current drugs can be used to halt the infection, but fall short of reaching hidden reserves of dormant virus that can lurk for life within infected white ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.