TOGETHER WE HAVE BEEN ABLE TO KEEP OUR EPIDEMIC UNDER CONTROL AND FOR THE LAST TWO DECADES WE HAVE EXPERIENCED A RELATIVELY SMALL EPIDEMIC BY GLOBAL STANDARDS.
However, ‘relatively small’ is still not good enough. In some ways we were victims of our own success and keeping to about 1000 infections a year in Australia was seen in some circles as ‘good enough’. Well, we think we can do better.
We believe that every new infection is one too many and if we are going to get serious about ending new HIV infections and preventing AIDS diagnoses we need to shake things up. ACON will be doing this in a number of ways.
One of the main ways ACON is committing to Ending HIV by 2020 is through sustained advocacy efforts on behalf of our community. There remain many policy and political barriers that prevent us from having the best response possible.
ADVOCACY – TESTING
Testing Services Capacity
If we are going to find all the currently undiagnosed HIV cases and test enough to pick up new cases early, we need an expansion in testing service capacity.
Some testing clinics are already acting on this by making appointments quicker, opening outside normal business hours and providing some results over the phone. But this needs to be the norm rather than the exception, so we will be working with Government agencies, Local Health Districts and individual sexual health clinics to expand the range of testing options available to gay men.
Rapid HIV Testing
The biggest advance that will help our community to test more is the widespread introduction of rapid HIV testing. These are currently being trialled at a number of sites, which is a great step forward. However, these tests have been widely available around the world for over 5 years and it is to Australia’s shame that it has taken so long for these tests to become available here.
These test need to be available widely and they need to be available now and we will do everything we can to make this a reality.
There will be some challenges in implementing home-based testing, however these are not insurmountable and this would give gay men another option when deciding how and when to get tested. We will monitor the implementation of this type of testing in the US and use the results of that process to advocate for change in the Australian context.
ADVOCACY – TREATMENTS
We believe that Australia should once again fully embrace the Treatment Guidelines developed in the US. The latest version allows for any person with HIV to start treatment as soon as they feel is right for them, rather than waiting for certain clinical markers to change. Treatment should be available to any person who wants it and the decision of when to start should be theirs.
Access to treatment
It is also important that it become easier and cheaper to access treatment. Until recently, collecting meds meant a trip to a hospital or specialist pharmacy and often a long wait.
This is starting to change with introduction of the Enhanced Medication Access scheme, but this needs to be expanded further so that people with HIV can pick up several months’ supply from their chosen place and as small a cost as possible. We have already been assisting with the roll out of this program and we will continue to work to make it as successful as possible.
ADVOCACY – BIOMEDICAL PREVENTION
There are emerging technologies which, alongside regular testing, early treatment and condom use will help reduce the number of new transmissions.
PrEP (Pre-Exposure Prophylaxis) is the use of HIV treatments by HIV negative people for the purpose of preventing HIV transmission. While there are number of questions still to be answered about this approach, including understanding what dose is required and how the cost will be met, existing studies have shown it to be effective and we believe it should be available as an option for gay men, particularly for guys in pos-neg relationships.
Microbicides are a gel that can be applied before sex that includes an agent that will kill HIV before transmission can occur. There has been some success in developing a microbicide that works with women and there is now interest in making sure that a version will be available for gay men as well. We also believe it should be an option for gay men.
A vaccine or cure for HIV is still a long way off but there has been renewed enthusiasm in these areas in the last couple of years. A partially effective vaccine was developed a couple of years ago and while it was nowhere near effective enough to be used, it gave people hope that a full vaccine would be possible.
COMMUNITY EDUCATION AND UPDATES
As new information comes out about the effectiveness of early treatment on health outcomes and reducing HIV risk we will feed this information back to the community.
Additionally, if our goal to increase testing is achieved, we will see a spike in HIV notifications as we will be finding the currently undiagnosed cases, however this should drop off rapidly and we will keep gay men updated on this process.
We will continue to provide gay men the services that they need to make informed decisions about their sex lives. Just because we have exciting new options available for our community, doesn’t mean we will abandon the tried and true methods which have led to our community having such a strong response to HIV. This includes ongoing campaigns sexual behaviour, condom use and risk reduction strategies.
We will continue to provide and improve services such as HIV health promotion programs, peer education workshops and outreach, and counselling. We will continue to work with our community partners, venues, government agencies and research centres to ensure that gay men’s voices remain at the centre of the response and that they have the best resources available.
We are also committing to providing 6 monthly report backs to the community in the following areas:
- Testing uptake
- Treatment uptake
- 2020 Targets
These report backs will occur in a variety ways, including public forums, online discussions and media stories.