HIV (Human Immunodeficiency Virus) is a virus that attacks the human immune system. The immune system stops disease and infections in the body. Someone with the virus can live with HIV for many years without becoming ill or showing symptoms. However HIV will remain in the body, damaging the immune system and the person remains infectious, able to spread the virus to others. Over time, HIV can damage the immune system, leaving them vulnerable to diseases and infections that their body would normally be able to fight off.
HIV in Australia
- The number of HIV notifications newly diagnosed in Australia has remained stable for the past four years, with 1,065 notifications in 2012, 1,030 in 2013, 1,082 in 2014 and 1,025 in 2015. Overall, no jurisdiction has observed a long‑term decreasing trend in the past ten years.
- The main route of HIV transmission in Australia continues to be sexual contact between men, which accounted for 68% of notifications in 2015, a further 20% of cases were attributed to heterosexual sex, 5% to sexual contact between men and injecting drug use, and 3% to injecting drug use only.
- Among notifications attributed to heterosexual sex, 19% were in people born in countries recognised by UNAIDS as having a national prevalence above 1% (high prevalence), and 17% in people with sexual partners born in high prevalence countries.
- Based on tests for immune function, over a quarter (29%) of the new HIV notifications in 2015 were late. This means that they were in people likely to have been living with HIV for at least four years without being tested.
- Over the last five years the proportion with late diagnoses was highest in people born in South-East Asia (48%) and sub‑Saharan Africa (46%). Over ten years, there was a decline in the proportion with late diagnoses among men engaging in male‑to‑male sex or male‑to‑male sex and injecting drug use (27% to 20%).
- Based on 38 cases, the age standardised rate of HIV notification in 2015 among Aboriginal and Torres Strait Islander peoples was more than double the rate in the Australian‑born non‑Indigenous population (6.8 versus 3.1 per 100 000).
- In the most recent five year reporting period (2011 – 2015), a greater proportion of HIV notifications in the Aboriginal and Torres Strait Islander population were attributed to heterosexual sex (21%) or injecting drug use (16%), compared with the Australian‑born non‑Indigenous population (14% and 3% respectively).
- Among 205 children born to HIV-positive mothers in Australia in the five year period 2011 – 2015, the transmission rate to newborns was 1.5%, compared to 31.9% in the period 1991 – 1995, with zero transmissions from 2013 onwards.
Source: Australian Federation of AIDS Organisations, 2018.
What is AIDS?
If a person is living with HIV they may start developing a number of illnesses due to damage by the virus to their immune system. When this occurs, a person is considered to have progressed to AIDS or Acquired Immune Deficiency Syndrome. That is, AIDS is a collection of recognised illnesses.
HIV must be present for a person to develop AIDS. With access to effective treatments, people living with HIV are able to live long and healthy lives. It is now rare for people in Australia to be classified as having AIDS or to pass away from AIDS.
How is HIV Transmitted?
A number of conditions must be met for HIV to be transmitted.
1. Source of HIV infection. Someone has to be HIV positive for the virus to be transmitted.
2. Transmission to the bloodstream of an uninfected (HIV negative) person. Unprotected sexual contact or sharing drug-injecting equipment are the most common routes of HIV transmission.
3. A sufficient amount of HIV must enter the blood of an uninfected person. HIV can only be transmitted with certain bodily fluids of a person infected with HIV; these include blood, semen, vaginal fluid and breast milk. If insufficient HIV enters the bloodstream, transmission of HIV infection will not occur.
The most common ways for these body fluids to enter the bloodstream is:
- Unprotected sex (anal or vaginal)
- Sharing injecting equipment
- Breastfeeding (mother to child)
HIV transmission cannot take place if all of these conditions are not present.
When someone becomes HIV positive, it is called seroconversion. Some people can experience a short ‘seroconversion’ illness between two and six weeks after becoming infected. These symptoms are common in other illnesses and so may not be remarkable at the time of the illness. Only getting an HIV test can determine if you are HIV positive.
If you think that you have been exposed to HIV in the last 72 hours – you may be able to prevent HIV infection. Find out more about PEPhere.
Preventing HIV Transmission
HIV transmission can be stopped or reduced by limiting the amount of HIV a person is exposed to. Stopping HIV is not just the responsibility of the person living with HIV, but of all people involved in having sex or participating in other activities where HIV could happen.
There are some simple ways to reduce the risk of HIV transmission:
Consistently using condoms with water based lube for vaginal and anal sex is one of the easiest ways to stop HIV transmission, as well as stopping many other STIs. They stop semen, vaginal fluids and blood from being shared during sex.
You can purchase a range of safe sex products from the AIDS Action Council. Check out our list of safe sex products or contact us for more information.
Oral sex presents a lower risk for HIV transmission, and this can be reduced by using condoms and dental dams, and ensuring that there are no cuts or breaks in the gum or lining of your mouth for HIV to enter the bloodstream.
There are a range of Risk Reduction Strategies that are used, especially by gay and bisexual men, and other men that have sex with men, to limit HIV transmission. These don’t eliminate the chances of transmission, but are effective when done correctly, at reducing the risks. Strategies include; only having sex with a guy with the same HIV status as you (neg-neg or poz-poz), the negative guy being the insertive/top partner and the HIV positive guy being the receptive/bottom.
Post-Exposure Prophylaxis (PEP) can be provided to someone who has had a high-risk exposure to HIV. It is most effective when provided within 72 hours of the risk incident. PEP can be accessed from Canberra and Calvary Hospital Emergency Departments 24hours and Canberra Sexual Health Centre during operating hours. You can find out more information about PEP here.
Pre-Exposure Prophylaxis (PrEP) can be taken prior to HIV exposure to stop transmission. You can find out more about PrEP here.
Treatment as Prevention (TasP) can help someone living with HIV achieve an undetectable viral load (UVL). When an HIV positive person has reached an UVL, they have significantly less chance of transmitting HIV. This is something that must be closely monitored with their HIV specialist doctor.
To find out more about how to reduce HIV transmission as a gay or bisexual man, check out endinghiv.org.au
Ensuring that people do not share injecting equipment. This includes syringes, spoons, filters, water, water containers and tourniquets. Sterile equipment for injecting drugs is freely available through the ACT’s needle and syringe exchange program.
Infection control in worksplaces and the community help to reduce HIV transmission and also stigma related to HIV and other blood-borne viruses. There are a number of standard guidelines that are followed in these settings to prevent infection. These are effective in preventing HIV by covering use of sterile equipment and disposal for clinical services, tattooing and piercing, as well as standard operating procedures for body fluid spills and potential exposure. More information can be found in the National Code of Work-Related Exposure to Hepatitis and HIV here.