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Ending HIV Transmissions by 2020

A look at the current state of HIV health care.

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Historically, infection by HIV (human immunodeficiency virus) was considered to be a death sentence. However, significant medical advances have allowed HIV positive people to lead healthy lives with treatment. AIDS (acquired immunodeficiency syndrome) is no longer the norm in Australia.

  The NSW HIV Strategy 2016-2020 aims “to virtually eliminate HIV transmission in NSW by 2020”. With improving treatment and prevention methods, we have the resources to achieve this. This includes HIV Pre-Exposure Prophylaxis (PrEP).

  On April 1, 2018, PrEP was listed on the Pharmaceutical Benefits Scheme (PBS). This ensures access to a highly effective HIV prevention method. A 30 day supply costs $39.50 or $6.40 if eligible for a concession on the PBS.

  People at a higher risk of HIV infection under the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) Guidelines are eligible. They need to be Australian residents 18 or older, have a current Medicare card and have a negative HIV test result. International students may also qualify if their country has an appropriate Reciprocal Health Care Agreement with Australia.

  People at higher risk of HIV infection include sexually active transgender, gay and bisexual men and heterosexual people whose partner is HIV positive without an undetectable viral load (UVL).

  UVL is a treatment as prevention (TasP) method. It improves the health of HIV positive people while ensuring zero risk of HIV transmission to partners. HIV positive people with UVL are not cured, but their viral load is reduced to ‘undetectable’ levels as their treatment has prevented viral replication. According to the Kirby Institute in 2016 72% of HIV positive people in Australia had a suppressed viral load with 93% of people receiving antiretroviral therapy achieving this.

  Using a condom is also a useful preventive measure. When used with silicone or water-based lubes, condoms provide adequate protection against sexually transmitted infections (STIs). When using a condom ensure it is not expired and plenty of lube is used. It is not recommended to use oil-based lube. Make sure it is opened carefully and squeeze the air out of the tip before putting it on. Do not use your teeth or nails to open it. When appropriately used condoms are one of the most effective measures to stay safe. ACON provides free condoms and lube around NSW. Do not reuse condoms.

  As a last resort HIV Post-Exposure Prophylaxis (PEP), can also prevent HIV infection. It involves taking anti-HIV drugs for a month after possible HIV exposure including if a condom breaks or slips off. It should be taken as early as possible and within 72 hours. PEP is available from sexual health clinics and most emergency departments of public hospitals. Near USyd you can get PEP from the emergency department of the Royal Prince Alfred Hospital or the RPA sexual health clinic.

  It is still essential to protect yourself from other STIs as well. It is recommended for high-risk groups including men who have sex with men to get vaccinated for Hepatitis A and B. Also consider getting vaccinated for human papillomavirus (HPV). Consult your doctor for more information. It is good practice to use condoms during sex.

  With many prevention methods, we can end HIV transmissions. By staying safe, we can all help end HIV. It is recommended if you are a sexually active gay or bisexual man to test at least twice a year and more if necessary. If you test positive getting to treatment early is important and remember UVL means zero risk of HIV transmission. HIV can affect anyone and if you think you have been infected get tested. According to the Kirby Institute in 2016 heterosexual sex accounted for 209 (21%) of new HIV diagnoses in Australia while male-to-male sex accounted for 712 (70%). Together we can end HIV transmissions in NSW by 2020.

  If you think you have been recently exposed to HIV, please call 1800 737 669 (1800 PEP NOW).

This article appeared in the autonomous queer edition, Queer Honi 2018.