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RESEARCH ARTICLE

Characteristics of HIV diagnoses in Australia, 1993–2006

Rebecca J. Guy A B K , Ann M. McDonald C , Mark J. Bartlett D , Jo C. Murray E , Carolien M. Giele F , Therese M. Davey G , Ranil D. Appuhamy H , Peter Knibbs I , David Coleman J , Margaret E. Hellard A , Andrew E. Grulich C and John M. Kaldor C
+ Author Affiliations
- Author Affiliations

A Centre for Epidemiology and Population Health Research, Burnet Institute, Melbourne, Vic. 3181, Australia.

B Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic. 3181, Australia.

C National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, NSW 2010, Australia.

D Communicable Diseases Branch, New South Wales Health Department, Sydney, NSW 2059, Australia.

E AIDS Medical Unit, Queensland Health, Brisbane, Qld 4000, Australia.

F Communicable Disease Control Directorate, Department of Health, Perth, WA 6849, Australia.

G STD Services, Royal Adelaide Hospital, Adelaide, SA 5000, Australia.

H Health Protection Service, ACT Health, Canberra, ACT 2611, Australia.

I Sexual Health and Blood Borne Viruses Unit, Centre for Disease Control, Darwin, NT 0811, Australia.

J Communicable Disease Prevention Unit, Department of Health and Human Services, Hobart, Tas. 7001, Australia.

K Corresponding author. Email: rebecca.guy@burnet.edu.au

Sexual Health 5(2) 91-96 https://doi.org/10.1071/SH07070
Submitted: 12 September 2007  Accepted: 14 February 2008   Published: 2 June 2008

Abstract

Objective: To describe recent trends in the diagnosis of HIV infection in Australia. Methods: National HIV surveillance data from 1993 to 2006 were analysed with a focus on geographic differences by HIV exposure route and late presentation (HIV within 3 months of a first AIDS-defining illness or a CD4 count of less than 200 cells μL–1). Results: In 1993–99, the number of HIV diagnoses declined by 32%, and then increased by 39% from 1999 to 2006. From 2000 onwards, rates increased significantly in Victoria, Queensland, South Australia and Western Australia. The most frequently reported routes of HIV exposure were male to male sex (71%) and heterosexual contact (18%), and the population rate of diagnoses have increased in both categories. Among the cases reported as heterosexually acquired (n = 2199), 33% were in people born in a high-prevalence country and 19% in those with partners from a high-prevalence country. Late presentation was most frequent in heterosexually acquired infections in persons who had a partner from a high-prevalence country: 32% compared with 20% overall. Conclusions: Recent increases in annual numbers of HIV diagnoses in Australia underline the continuing need for HIV-prevention programs, particularly among men having male to male sex. Early diagnosis and access to care and treatment should also be emphasised, as a substantial proportion of people with HIV infection are unaware of their status until late in the course of disease.

Additional keywords: epidemiology, surveillance.


Acknowledgements

The National Centre in HIV Epidemiology and Clinical Research (NCHECR) is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, University of New South Wales. The NCHECR Surveillance Program is a collaborating unit of the Australian Institute of Health and Welfare. Its work is overseen by the Ministerial Advisory Committee on AIDS, Sexual Health and Hepatitis. National HIV surveillance is overseen by the National Blood Borne Virus and Sexually Transmissible Infections Surveillance Committee.


References


[1] McDonald AM,  Crofts N,  Blumer CE,  Gertig DM,  Patten JJ,  Roberts M, et al. The pattern of diagnosed HIV infection in Australia, 1984–1992. AIDS 1994; 8 513–9.
CrossRef | PubMed |

[2] National Centre in HIV Epidemiology and Clinical Research. HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia. Annual surveillance report 2006. Sydney: National Centre in HIV Epidemiology and Clinical Research, University Of New South Wales; 2006.

[3] Guy R,  McDonald A,  Bartlett M,  Murray J,  Giele C,  Davey T, et al. HIV diagnoses in Australia: diverging epidemics within a low-prevalence country. Med J Aust 2007; 187 437–40.
PubMed |

[4] Hull P , Prestage GIZ , Rawstorne P , Kippax S , Horn G , Kennedy M , Hussey G , Batrouney R . Melbourne gay community periodic survey 2006. Sydney: National Centre in HIV Social Research, University of New South Wales; 2006.

[5] Zablotska I , Prestage G , Frankland A , Crawford J , Kippax S , Sutherland R , et al Sydney gay community periodic survey 1996–2006. Sydney: National Centre in HIV Social Research, University of New South Wales; 2006.

[6] Zablotska I , Prestage G , Imrie J , Kippax S , Hakala T , Martin P , et al Queensland gay community periodic survey 2006. Sydney: National Centre in HIV Social Research, University of New South Wales; 2006.

[7] Prestage G,  Jin F,  Zablotska IB,  Imrie J,  Grulich AE,  Pitts M. Trends in HIV testing among homosexual and bisexual men in eastern Australian states. Sex Health 2008; 5 119–23.
CrossRef |

[8] Australian Bureau of Statistics. Australian demographic statistics, catalogue no. 3101.0-A. Canberra: Australian Bureau of Statistics; 2006.

[9] Australian Bureau of Statistics. Population by age and sex, Australian states and territories, catalogue no. 3201.0-A. Canberra: Australian Bureau of Statistics; 2006.

[10] Gillieatt SJ,  Mallal SA,  French MA,  Dawkins RL. Epidemiology of late presentation of HIV infection in Western Australia. Med J Aust 1992; 157 117–8.
PubMed |

[11] Hocking JS,  Rodger AJ,  Rhodes DG,  Crofts N. Late presentation of HIV infection associated with prolonged survival following AIDS diagnosis – characteristics of individuals. Int J STD AIDS 2000; 11 503–8.
CrossRef | PubMed |

[12] McDonald AM,  Li Y,  Dore GJ,  Ree H,  Kaldor JM. Late HIV presentation among AIDS cases in Australia, 1992–2001. Aust N Z J Public Health 2003; 27 608–13.
CrossRef | PubMed |

[13] Chadborn TR,  Delpech VC,  Sabin CA,  Sinka K,  Evans BG. The late diagnosis and consequent short-term mortality of HIV-infected heterosexuals (England and Wales, 2000–2004). AIDS 2006; 20 2371–9.
CrossRef | PubMed |

[14] Couturier E,  Schwoebel V,  Michon C,  Hubert JB,  Delmas MC,  Morlat P, et al. Determinants of delayed diagnosis of HIV infection in France, 1993–1995. AIDS 1998; 12 795–800.
CrossRef | PubMed |

[15] Girardi E,  Aloisi MS,  Arici C,  Pezzotti P,  Serraino D,  Balzano R, et al. Delayed presentation and late testing for HIV: demographic and behavioral risk factors in a multicenter study in Italy. J Acquir Immune Defic Syndr 2004; 36 951–9.
CrossRef | PubMed |

[16] Intercooled stata [computer program]. Version 9.0. College Station: Stata Corporation; 2004.

[17] UNAIDS. Guidelines for second generation HIV surveillance. Geneva: UNAIDS; 2000. WHO/CDS/CSR/EDC/2000.5.

[18] Combs BC,  Giele C. Increasing heterosexual HIV notifications among non-Aboriginal people in Western Australia, 2002 to 2006. Sex Health 2008; 5 in press.


[19] National Centre in HIV Epidemiology and Clinical Research. HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia. Annual surveillance report 2007. Sydney: National Centre in HIV Epidemiology and Clinical Research 2007.

[20] Middleton MG,  McDonald AM,  Grulich AE,  Donovan B,  Kaldor JM. Could sexually transmissible infections be contributing to the increase in HIV infections among men who have sex with men in Australia? Sex Health 2008; 5 131–40.
CrossRef |

[21] Marrone J,  Fairley CK,  Chen M,  Hocking JS. Comparisons of trends in antiretroviral use and HIV notification rates between three Australian states. Aust N Z J Public Health 2007; 31 131–4.
CrossRef | PubMed |

[22] Brown A,  Sadler K,  Tomkins S,  McGarrigle C,  LaMontagne D,  Goldberg D, et al. Recent trends in HIV and other STIs in the United Kingdom: data to the end of 2002. Sex Transm Infect 2004; 80 159–66.
CrossRef | PubMed |

[23] Hamers FF,  Downs AM. The changing face of the HIV epidemic in fwestern Europe: what are the implications for public health policies? Lancet 2004; 364 83–94.
CrossRef | PubMed |

[24] Grulich AE,  de Visser RO,  Smith AM,  Rissel CE,  Richters J. Sex in Australia: homosexual experience and recent homosexual encounters. Aust N Z J Public Health 2003; 27 155–63.
CrossRef | PubMed |

[25] Guy RJ,  Breschkin AM,  Keenan CM,  Catton MG,  Enriquez AM,  Hellard ME. Improving HIV surveillance in Victoria: the role of the ‘detuned’ enzyme immunoassay. J Acquir Immune Defic Syndr 2005; 38 495–9.
CrossRef | PubMed |

[26] McDonald A , Cunningham P , Kelleher A , Kaldor J . Comparison of two assays for identifying incident infection among cases of newly diagnosed HIV infection. In: STARHS Workshop in association with the 16th International Conference on AIDS; 2006 August 13–18; Toronto, Canada. Year of Publication.

[27] Guy R,  Lim MS,  Wang YH,  Medland N,  Anderson J,  Roth N,  Hellard ME. A new surveillance system for monitoring HIV infection in Victoria, Australia. Sex Health 2007; 4 195–9.
CrossRef | PubMed |

[28] Hellard ME,  Nguyen OK,  Guy RJ,  Jardine D,  Mijch A,  Higgs PG. The prevalence and risk behaviours associated with the transmission of blood borne viruses among ethnic Vietnamese injecting drug users in Victoria. Aust N Z J Public Health 2006; 30 519–25.
CrossRef | PubMed |

[29] Tang PC,  LaRosa MP,  Newcomb C,  Gorden SM. Measuring the effects of reminders for outpatient influenza immunizations at the point of clinical opportunity. J Am Med Inform Assoc 1999; 6 115–21.
PubMed |

[30] Vidanapathirana J,  Abramson MJ,  Forbes A,  Fairley C. Mass media interventions for promoting HIV testing: Cochrane systematic review. Int J Epidemiol 2006; 35 233–4.
PubMed |



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