'A lot of work to be done': Australia's major health win faces its next challenge

HIV diagnoses have fallen significantly over the past decade, with Australia on track to achieve preliminary UN targets as part of a world-leading response, but experts say progress remains uneven across communities.

The latest Australian HIV and sexually transmitted infection data show that, overall, HIV diagnoses in Australia have fallen 25 per cent in a decade.

From 2016 to 2025, there was a 28 per cent decline in HIV diagnoses among males, and no change among women, a feature of the data attributed to high rates of testing, treatment and use of pre-exposure prophylaxis medicine, known as PrEP, among men who have sex with men.

Australia is a signatory to the Joint United Nations Programme on HIV/AIDS (UNAIDS), which leads the global effort to end AIDS as a public health threat by 2030.

Currently in Australia, 94 per cent of people living with HIV have been diagnosed, 95 per cent of HIV-positive people are receiving treatment. Of that figure, 98 per cent of treatments have resulted in suppressing HIV to undetectable and virtually untransmittable levels.

While it is expected Australia will achieve the preliminary UNAIDS targets, where 95 per cent of people living with HIV are diagnosed, 95 per cent of those diagnosed are on treatment, and 95 per cent of those on treatment have HIV that is virally suppressed, analysis from the Kirby Institute at the University of New South Wales has shown that some groups are being left behind.

What does the data show?

The HIV notification rate — a figure that accounts for the change in growing populations — showed that the overall rate of HIV notification per 100,000 people had dropped from approximately 4 in 2016 to just under 3 in 2025.

The notification rate was seven times higher among males than females in Australia.

In 2025, the transmission of the majority of HIV cases was attributed to male-to-male sexual contact, at 64 per cent, while 26 per cent were attributed to heterosexual sexual contact, and a small proportion, 3 per cent, were attributed to injection drug use.

Rates of HIV remain low among people who inject drugs in Australia and among sex workers, which Kirby Institute epidemiologist Dr Skye McGregor said reflected the strong and long-running community response to HIV among priority populations.

The groups falling behind

The most recent period, 2025, saw the highest number of HIV diagnoses in First Nations peoples, with 3.9 notifications per 100,000 — 1.9 times the diagnosis rate for Australian-born non-Indigenous people.

McGregor said this reflected a need to work closely with communities to ensure prevention, treatment and testing responses were appropriate.

More than half of gay and bisexual men diagnosed with HIV were born overseas, and from 2016-2025, while diagnoses among gay and bisexual men born in Australia reduced by 48 per cent, for those born overseas, that figure was only 18 per cent.

Scientia professor at the Kirby Institute, professor Andrew Grulich, said that while there have been significant advancements in self-testing and other outreach activities such as the installation of HIV testing vending machines in universities, equity in care was the next challenge.

"When we look at the data, we find reductions in HIV are not as good outside of the city as they are in the city. We need better access to testing and to PrEP outside of the city centres," he said.

President of the National Association of People with HIV, Scott Harlum, said Australia was in a good position to confront these issues head-on.

"In Australia we do this better than anywhere else in the world, that's our track record. We have the best people in the world; we have a government that's committed to it; nothing is lacking.

"But there are disparities in these numbers that are only going to be answered by speaking to these communities, especially for new arrivals to the country."

Late diagnosis of HIV was also an emerging issue: in 2025, one-third of diagnoses were considered "late", which often meant someone had been living with undiagnosed HIV for four years.

McGregor from the Kirby Institute said there was a clear need for a range of testing strategies that are accessible for all populations, including Australian-born and overseas-born populations, adding that HIV tests should be normalised as a regular part of sexual health.

"We're lucky to have self-testing in Australia, but we also need accessible healthcare and clinician education, so when someone goes for a sexual health checkup, it should include HIV and gonorrhoea," she said.

Jessica Michaels, deputy chief financial officer at the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, said there was "a lot of work to be done" around stigma and discrimination reduction, especially for healthcare workers, who she said were still discussing prevention and testing with people "based on preconceived ideas of who is at risk".

"We really need to move away from that, and to have all healthcare workers thinking 'could it be HIV?' regardless of who is sitting in front of them."

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