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Episode 68: HIV diagnoses drop to 18 year low, but it's not all good news

Australia has recorded the lowest number of H-I-V diagnoses since 2001, according to a new report.

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Italian

Il numero delle diagnosi di HIV è ai minimi dal 2001, con solo 835 casi segnalati in Australia nel 2018.

L'ultimo studio del Kirby Institute della University of New South Wales mostra che negli scorsi cinque anni c'è stato un calo del 23% nel numero di diagnosi di HIV.

La professoressa Rebecca Guy, direttrice del programma di sorveglianza, valutazione e ricerca sull'HIV del Kirby Institute, ha dichiarato che l'anno scorso il numero dei casi si è ridotto in quasi tutti gli stati e territori.

"In 2014 there were close to 1100 H-I-V diagnoses in Australia, steady declines and in 2018, 834 new HIV diagnoses. It is the lowest number we've seen in 18 years. Last year we reported a 7 per cent decline, this year we are able to report a 23 per cent decline and the decline has been seen right across Australia."

Il motivo principale del calo è collegato alla decisa diminuzione nei numeri di casi riportati tra uomini con partner sessuali maschili.

Tra il 2014 e il 2018 c'è stata una riduzione del 30% tra questo gruppo di persone a cui è stato diagnosticato l'HIV.

Il calo nei numeri di persone colpite tra gli uomini omosessuali e bisessuali è attribuito alle possibilità di analisi diventate più facili, al miglioramento dei trattamenti anti-HIV e all'introduzione di medicine preventive.

Il professor Andrew Grulich, direttore dell'HIV Epidemiology and Prevention Program al Kirby Institute, ritiene che l'aver reso l'anno scorso la profilassi pre-esposizione, o PrEP, disponibile nel Pharmaceutical Benefits Scheme, ha notevolmente ridotto il numero di casi.

"PrEP is a one pill once a day treatment which is highly effective in preventing H-I-V. It's a reduced combination of the same drugs that are used for treating H-I-V and when taken as prescribed it is close to 100 per cent effective in preventing H-I-V."

Secondo il professor Grulich, entro la fine del 2018 circa 18.500 persone ricevevano PrEP con questo piano.

Grulich ritiene che, sebbene i dati siano promettenti, è necessario che più persone utilizzino PrEP per mettere fine alla diffusione dell'HIV in Australia.

"We're really quite pleased with the way many gay and bisexual men have embraced PrEP as a way to protect themselves from H-I-V. We do have research data that suggests that 41 per cent of gay men in 2017, 41 per cent of those at high risk of H-I-V were taking PrEP. The date from mathematical modelling however would suggest that PrEP coverage has to be significantly higher if we want to keep moving towards H-I-V elimination."

Mentre c'è stata una decisa diminuzione delle diagnosi di HIV nella comunità degli uomini omosessuali e bisessuali nella sua interezza, all'interno di questo gruppo il numero di uomini a cui è stato diagnosticato l'HIV non nati in Australia non è diminuito.

Anche per quanto riguarda gli uomini eterosessuali, il numero delle diagnosi di HIV non è diminuito.

Allo stesso modo, le popolazioni indigene e dello Stretto di Torres hanno visto il numero delle diagnosi di HIV rimanere stabile nel corso dei cinque anni passati.

Il professore associato James Ward è il presidente della Aboriginal Health Infectious Diseases al South Australian Institute for Health and Medical Research.

Secondo lui il numero delle diagnosi è il doppio rispetto ai gruppi non-indigeni o delle isole dello Stretto di Torres.

Ward sostiene che ci sia bisogno di prevenzione mirata e strategie di trattamento.

"There has been no significant change or certainly not a corresponding decrease as has occurred in the non-Aboriginal population. And that's despite Aboriginal and Torres Strait Islander people noted as a priority population in policy and clinical guidelines around Australia. We think that the impact of PrEP is not having a great effect in our population and this requires targetted inventions to make sure that Aboriginal and Torres Strait Islander people are not left behind."


English

The number of H-I-V diagnoses is at its lowest since 2001, with only 835 cases reported in Australia in 2018.

The latest report from the University of New South Wales' Kirby Institute shows over the last five years, there has been a 23 per cent drop in the number of H-I-V diagnoses.

Head of the Kirby Institutes's HIV surveillance, evaluation and research program, Professor Rebecca Guy says the number of cases reduced across almost all states and territories over the past year.

"In 2014 there were close to 1100 H-I-V diagnoses in Australia, steady declines and in 2018, 834 new HIV diagnoses. It is the lowest number we've seen in 18 years. Last year we reported a 7 per cent decline, this year we are able to report a 23 per cent decline and the decline has been seen right across Australia."

The main cause of the decline is linked to a significant reduction in the number of reported cases among men who have male sexual partners.

Between 2014 and 2018, there was a 30 per cent reduction amongst this group of people being diagnosed with H-I-V.

The decrease in the number of people amongst gay and bisexual men is attributed to testing options becoming easier, H-I-V treatment improving and the introduction of preventative medication.

Head of H-I-V Epidemiology and Prevention Program at the Kirby Institute, Professor Andrew Grulich says making pre-exposure prophylaxis, or PrEP medication, available on the Pharmaceutical Benefits Scheme last year has greatly reduced the number of cases.

"PrEP is a one pill once a day treatment which is highly effective in preventing H-I-V. It's a reduced combination of the same drugs that are used for treating H-I-V and when taken as prescribed it is close to 100 per cent effective in preventing H-I-V."

Professor Grulich says by the end of 2018, around 18,500 people were receiving PrEP on the P-B-S.

He says while the data is promising, more people need to be embracing PrEP in order to end H-I-V in Australia.

"We're really quite pleased with the way many gay and bisexual men have embraced PrEP as a way to protect themselves from H-I-V. We do have research data that suggests that 41 per cent of gay men in 2017, 41 per cent of those at high risk of H-I-V were taking PrEP. The date from mathematical modelling however would suggest that PrEP coverage has to be significantly higher if we want to keep moving towards H-I-V elimination."

While there has been significant reductions in the number of H-I-V diagnoses amongst the gay and bisexual male community as a whole, within the group, the number of men who were not born in Australia being diagnosed with H-I-V has not decreased.

When it comes to heterosexual men, the number of H-I-V diagnoses has also not decreased.

Similarly, Indigenous and Torres Strait Islander populations have also seen the number of H-I-V diagnoses remain stable over the past five years.

Associate Professor James Ward is the Aboriginal Health Head of Infectious Diseases Research at the South Australian Institute for Health and Medical Research.

He says the number of diagnoses is double that of non-Indigenous and Torres Strait Islander groups.

He says targetted prevention and treatment strategies are needed.

"There has been no significant change or certainly not a corresponding decrease as has occurred in the non-Aboriginal population. And that's despite Aboriginal and Torres Strait Islander people noted as a priority population in policy and clinical guidelines around Australia. We think that the impact of PrEP is not having a great effect in our population and this requires targetted inventions to make sure that Aboriginal and Torres Strait Islander people are not left behind."

Report by Bethan Smoleniec

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