Australia has been a global leader in balancing public health law, human rights and HIV. The first National HIV/AIDS Strategy launched in 1989 set the agenda for law reform. The Intergovernmental Committee on AIDS subsequently established a legal working party with one of its key tasks to formulate public health legislation that would protect public health and human rights. The NSW Public Health Act 1991 has provided the framework for managing HIV in NSW over the subsequent decades. Recent changes to criminal law in NSW and opportunities to redefine public health law may affect how HIV transmission risks are managed in the future.