Revving up HIV Prevention
Erik Michielsen, Chairperson of the AIDS Council SA says ACSA wants to hear your voice, to further improve the work they do.
The Governing Board of the AIDS Council of SA would appreciate your input into an issue that is revving up right now. In 2011, thirty years in to the HIV epidemic, the United Nations General Assembly adopted the Political Declaration on HIV/AIDS: Intensifying our efforts to eliminate HIV /AIDS . This declaration includes targets to reduce sexual and injecting transmission of HIV by 50% as well as eliminating mother to child transmission by 2015. The declaration notes HIV prevention strategies need to focus on populations at high risk specifically gay men and men who have sex with men, people who inject drugs and sex workers. Further the declaration has called on countries to focus their responses on epidemiological and national contexts, it also highlights the potential role of new biomedical interventions, including HIV pre exposure prophylaxis (PREP), earlier treatment initiation and what we have now come to know as treatment as prevention and calls for these to be implemented as soon as they are validated.
How to achieve this, given that the annual number of new HIV diagnoses in Australia is stable at around 1000 per year? (67 in South Australia in 2011 and 269 between 2007 and 2011). Advocates are proposing a dramatic scaling up of prevention programs and targeting them at populations at higher risk; by widely promoting HIV testing; by expanding HIV education and ensuring wide availability of condoms and sterile injecting equipment; by implementing harm reduction approaches; and by mobilizing communities. It would be fair to say that Australia has fallen behind in its response. Incredibly, there are no time bound targets in any of the National or State HIV strategies or Action Plans and we have lagged well behind the rest of the developed world in adopting new bio medical and HIV testing technologies. If we consider the number of new HIV diagnoses as a marker of success, then traditional HIV prevention activities for gay men either need a substantial re-think and re-allocation of resources, to scale up their reach and effectiveness, or they have failed spectacularly in driving down new HIV diagnoses and should be abandoned for interventions that are likely to get the best results, depending on your point of view.
These time bound targets provide very strong motivation for communities to reinvigorate their HIV prevention efforts, and it means critically examining the effectiveness of traditional HIV prevention activities. ACSA needs to hear your voice to make sure we target our services where we are likely to get the best results in driving down HIV rates.