San Francisco Frontiers - Sydney's former HIV epicentre close to ending transmission

UNAIDS has set a goal of ending AIDS as a global health threat by 2030, which includes reducing the number of new HIV cases by 90 percent compared to 2010.

In inner Sydney, new infections among gay men dropped by 88 percent from 2010 to 2022, researchers announced at the International AIDS Society's HIV science conference being held in the Australian city of Brisbane.

Andrew Grulich, an epidemiologist at the University of New South Wales who presented the research, told AFP that "we're very nearly there" some eight years ahead of the 2030 target.

Just 11 new HIV cases were recorded in inner Sydney last year, "an extraordinarily small number of infections for what was the heart of the Australian HIV epidemic," Grulich said.

Gay men make up an estimated 20 percent of the male population in inner Sydney, and they represent the large majority of the city's HIV cases.

Grulich said that several areas in the UK and Western Europe have also seen rapid drops in new HIV cases.

But "I don't think anywhere has gotten close to 90 percent," he added.

However Grulich emphasised that this does not mean that HIV is close to being eliminated in the city of more than 5.2 million people.

"HIV can only be eliminated if we have a vaccine and a cure," he said.

And the fall in new HIV cases was far less precipitous in other parts of Sydney.

In the city's outer suburbs, new cases have only fallen by 31 percent since 2010, the researchers found.

This disparity was due to a much higher rate of HIV testing and use of pre-exposure prophylaxis (PrEP) -- which reduces the risk of transmitting HIV during sex -- in the inner city, Grulich said.

He said another cause for progress was that around 95 percent of HIV-positive people in Australia are now on antiretroviral treatment, which suppresses the level of the virus in the blood.

Another study announced at the AIDS conference, which was published in The Lancet journal, said that people on antiretrovirals who have low but detectable levels of HIV have almost zero risk of sexually transmitting the virus to others.

- 'Beyond exciting' -

Sharon Lewin, the president of the International AIDS Society, said the progress in inner Sydney was "beyond exciting".

"It affirms that Australia is poised to be one of the first countries, if not the first, to achieve virtual elimination of HIV," she said in a statement.

Heather Ellis, a woman living with HIV in the southern state of Victoria, said that "the last mile" of eliminating HIV in Australia will require measures specifically designed to reach women.

While gay men are now well aware of prevention tools like PrEP, "the heterosexual community is pretty much oblivious," said Ellis, a communications coordinator for the NGO Positive Women Victoria.

The Sydney research, which has not been peer-reviewed, was based on data from the New South Wales health department as well as annual surveys taken by gay men.

Grulich said the progress in inner Sydney was particularly significant because "this was a community that was completely devastated in the 80s and 90s -- a few thousand men died in these areas".

V.Mitchell--SFF