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The report reveals that there is still
significant work to be done promoting safe
sex and drug use.
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Aboriginal people, injecting drug users and men who have sex with other men are increasingly affected by conditions including HIV/AIDS, viral hepatitis and other sexually transmissible infections, according to new research released on Wednesday 9 September.

Three linked 2009 Annual Surveillance Reports, to be presented at the Australasian HIV/AIDS Conference 2009 in Brisbane, are compiled by the National HIV Research Centres based at the University of New South Wales (UNSW). They track the effectiveness of Australia’s public health programs in these areas.

The report “HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2009” indicates that the annual number of new HIV diagnoses has remained relatively steady at about 1,000 over the past three years. This level of HIV diagnoses was last recorded in Australia in 1994, indicating the need for strengthening safer sexual and injecting messages to minimise the risk of HIV infection. Despite the number of new infections, HIV prevalence in Australia remains one of the lowest in the world, at about 0.1 percent.

The pattern of HIV transmission in the Aboriginal and Torres Strait Islander population differs from that in the non-Indigenous population. The report “Bloodborne viral and sexually transmitted infections in Aboriginal and Torres Strait Islander People:  Surveillance and Evaluation Report 2009”, also to be released today, indicates that HIV infection among Aboriginal and Torres Strait Islander people was attributed to injecting drug use in 22 per cent of cases over the past five years.

“We are following the path of the Canadian Indigenous population, where HIV and huge numbers of hepatitis C diagnoses are reported following increased drug injecting patterns,” said James Ward, head of the Aboriginal and Torres Strait Islander Health Program at the National Centre in HIV Epidemiology and Clinical Research (NCHECR). “We need to act urgently to bring down injecting drug use rates and high rates of bacterial STIs in Aboriginal communities before HIV becomes entrenched.”

The Annual Surveillance Report on HIV/AIDS provides the good news that rates of hepatitis C infections have declined by about half in the past decade, particularly in younger age groups. However despite this, hepatitis C prevalence remains high among injecting drug users across Australia and the burden of advanced liver disease continues to grow among infected people. Greater numbers of people are progressing into more advanced stages of fibrosis of the liver. Levels of HCV treatment uptake have plateaued over the last 2 years, despite this growing burden of disease.

Diagnoses of chlamydia have continued their steady rise, particularly among young Australians aged 15 to 25.

“This could be due to increases in testing but chlamydia continues to affect young people having unprotected sex,” said Associate Professor David Wilson, head of the Surveillance and Evaluation Program for Public Health at the National Centre in HIV Epidemiology and Clinical Research. “We have also had an epidemic of infectious syphilis in men having sex with men over the past five years, which has started to stabilise but remains at high and concerning levels.”

During 2008 the Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS) Project was launched, funded through the Department of Health and Ageing Chlamydia Pilot Program, and the first findings from this project are released today. Over 80 clinical sites are involved in the ACCESS project.  Importantly, this system will provide the first national chlamydia surveillance system among priority populations such as young heterosexuals, Aboriginal and Torres Strait Islander people, men who have sex with men, and sex workers.

Rates of gonorrhoea, chlamydia and infectious syphilis are much higher in Aboriginal communities compared with the non-Indigenous population, particularly among the 15 to 19 year age group, partly reflecting poor access to appropriate primary health care services for many Aboriginal people in remote and regional communities.

The third report released today, the “Annual Report of Trends in Behaviour 2009” by the National Centre in HIV Social Research, indicates that an increase in unprotected sex with casual partners may have contributed to an increase in diagnoses of HIV among Queensland men who have sex with men.

“Unprotected sex remains risky for acquiring HIV infection and other sexually transmissible diseases,” said the director of the National Centre in HIV Social Research, Professor John de Wit. “Using condoms consistently with sexual partners is still the best strategy for minimizing risk.”

Unprotected sex with casual partners remains stable high among gay men in other jurisdictions, as does unprotected sex with regular partners, underscoring the importance of continued behavioural surveillance and prevention.

The report of trends in behaviour also shows that the sharing of injection equipment remains high among some people who inject drugs, which suggests that access to sterile needles and syringes remains less than ideal. Particularly concerning is that more than 40 per cent of young people who attended music festivals in Sydney, Melbourne and the Gold Coast had been offered drugs to inject or had a partner or friend who injected drugs.