No One Should Be Left Behind
One of the key themes of the conference was that no one should be left behind in the race to the 90-90-90 target. There were discussions about the need for tailored responses focussing on groups such as Aboriginal and Torres Strait Islanders, people from CALD backgrounds, heterosexuals and trans people to ensure the Australian response around HIV is equitable.
The Kirby Institute from the University of NSW released their 2018 Annual Surveillance data at the conference. Although there had been an overall decline in diagnoses in Australia over the last 5 years, not all groups shared this decline. There was a 10% increase in heterosexual transmissions between 2013 and 2017 with over half of these being diagnosed late, meaning they were not diagnosed until they had been living with HIV for over 4 years. Heterosexual men were of particular concern as diagnoses in this group had increased 19% over the last 5 years, with over half of the men born in Australia (Kirby, 2018).
Dr Simone Herbert from RPA Sexual Health presented and compared clinical characteristics of heterosexually acquired versus homosexually acquired HIV. Data was taken from the Australian HIV Observational Database (AHOD) and was the first time that this comparison had been undertaken. Key findings from AHOD indicated that the heterosexually acquired group were less likely to be Australian born, had lower CD4 counts at diagnosis, and didn’t reconstitute their CD4 counts to similar levels. Compared to female heterosexuals, male heterosexuals were older, more likely to be Australian born and had lower CD4 counts and higher viral load at diagnosis.
Herbert, SE et.al. Characteristics Of Individuals With Heterosexually- Acquired Compared With Homosexually- Acquired HIV And Implications For Clinical Practice.
The presentation can be viewed here.