Stocktake Sale on now: wide range of books at up to 70% off!
Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

HIV incidence trends vary between jurisdictions in Australia: an extended back-projection analysis of men who have sex with men

Kylie-Ann Mallitt A , David P. Wilson A B , Ann McDonald A and Handan Wand A
+ Author Affiliations
- Author Affiliations

A National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Corner Boundary and West Streets, Darlinghurst, Sydney, NSW 2010, Australia.

B Corresponding author. Email: dwilson@nchecr.unsw.edu.au

Sexual Health 9(2) 138-143 https://doi.org/10.1071/SH10141
Submitted: 8 November 2010  Accepted: 12 May 2011   Published: 29 July 2011

Abstract

Background: Trends in HIV diagnoses differ across Australia and are primarily driven by men who have sex with men (MSM). We use national population surveillance data to estimate the incidence of HIV infections among MSM by jurisdiction and infer the proportion of undiagnosed infections. Methods: Annual surveillance data for AIDS diagnoses, HIV diagnoses and recently acquired HIV infections were obtained from 1980 to 2009. A modified statistical back-projection method was used to reconstruct HIV incidence by jurisdiction. Results: HIV incidence among MSM peaked for all jurisdictions in the early 1980s and then declined into the early 1990s, after which incidence increased. Trends then differ between jurisdictions. In New South Wales (NSW) and South Australia, estimated HIV incidence peaked at 371 and 50 cases respectively in 2003, and has since decreased to 258 and 24 cases respectively in 2009. HIV infections in Queensland (Qld) have more than doubled over the past decade, from 84 cases in 2000 to 192 cases in 2009. Victoria and Western Australia have seen a rise in HIV incidence from 2000 to 2006 (to a peak of 250 and 38 incident cases respectively), followed by a plateau to 2009. HIV incidence in the Northern Territory, Tasmania and Australian Capital Territory have increased since 2000; however, case numbers remain small (<20 per year). The estimated proportion of HIV infections not yet diagnosed to 2009 ranges from 10% (NSW) to 18% (Qld), with an average of 12% across Australia. Conclusions: HIV diagnosis trends among MSM in Australia reflect changes in estimated incidence to 2009, and reveal the largest increase in the past 10 years in Qld.

Additional keywords: AIDS, Australia, back-calculation, gay men, HIV testing, undiagnosed HIV.


References

[1]  NCHECR. HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia annual surveillance report 2009. Sydney: National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales; 2009.

[2]  Fairley CK, Grulich AE, Imrie JC, Pitts M. Introductory editorial: the analysis of a natural experiment in HIV control. Sex Health 2008; 5 89
Introductory editorial: the analysis of a natural experiment in HIV control.Crossref | GoogleScholarGoogle Scholar | 18686332PubMed |

[3]  Brookmeyer R, Gail MH. Minimum size of the acquired immunodeficiency syndrome (AIDS) epidemic in the United States. Lancet 1986; 328 1320–2.
Minimum size of the acquired immunodeficiency syndrome (AIDS) epidemic in the United States.Crossref | GoogleScholarGoogle Scholar |

[4]  Wand H, Yan P, Wilson D, McDonald A, Middleton M, Kaldor J, et al Increasing HIV transmission through male homosexual and heterosexual contact in Australia: results from an extended back-projection approach. HIV Med 2010; 11 395–403.
| 20136660PubMed |

[5]  Wand H, Wilson D, Yan P, Gonnermann A, McDonald A, Kaldor J, et al Characterizing trends in HIV infection among men who have sex with men in Australia by birth cohorts: results from a modified back-projection method. J Int AIDS Soc 2009; 12 19
Characterizing trends in HIV infection among men who have sex with men in Australia by birth cohorts: results from a modified back-projection method.Crossref | GoogleScholarGoogle Scholar | 19761622PubMed |

[6]  Guy RJ, McDonald AM, Bartlett MJ, Murray JC, Giele CM, Davey TM, et al HIV diagnoses in Australia: diverging epidemics within a low-prevalence country. Med J Aust 2007; 187 437–40.
| 17937639PubMed |

[7]  Australian Bureau of Statistics. 3101.0 – Australian Demographic Statistics, September 2010. Canberra: ABS; 2010.

[8]  Savage J, Crooks L, McLean S. Models of access and clinical service delivery for HIV positive people in Australia. Sydney: Australasian Society for HIV Medicine; 2009.

[9]  Gurran N, Squires C, Blakeley E. Meeting the sea change challenge: best practice models of local and regional planning for sea change communities in coastal Australia. Sydney: University of Sydney; 2005.

[10]  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.
Trends in HIV testing among homosexual and bisexual men in eastern Australian states.Crossref | GoogleScholarGoogle Scholar | 18588776PubMed |

[11]  Frankland A, Zablotska I, Prestage G, O’Connor S, Martin P. Gay community periodic survey: Queensland, 2008. Sydney: National Centre in HIV Social Research, The University of New South Wales; 2008.

[12]  Frankland A, Lee E, Zablotska I, Prestage G, Down I, Holt M, et al. Gay community periodic survey: Sydney, February 2009. Sydney: National Centre in HIV Social Research, The University of New South Wales; 2009.

[13]  Zablotska I, Prestage G, Batrouney C, Kennedy M, Clift P, Dixon M, et al. Gay community periodic survey: Melbourne 2009. Sydney: National Centre in HIV Social Research, The University of New South Wales; 2009.

[14]  Centers for Disease Control and Prevention (CDC). Advancing HIV prevention: new strategies for a changing epidemic also emphasize the need to promote testing and knowledge of serostatus. MMWR Morb Mortal Wkly Rep 2003; 52 329–32.
| 12733863PubMed |

[15]  Wilson DP, Hoare A, Regan DG, Law MG. Importance of promoting HIV testing for preventing secondary transmissions: modelling the Australian HIV epidemic among men who have sex with men. Sex Health 2009; 6 19–33.
Importance of promoting HIV testing for preventing secondary transmissions: modelling the Australian HIV epidemic among men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 19254488PubMed |

[16]  Wilson DP, Regan DG, Heymer KJ, Jin F, Prestage GP, Grulich AE. Serosorting may increase the risk of HIV acquisition among men who have sex with men. Sex Transm Dis 2010; 37 13–7.
Serosorting may increase the risk of HIV acquisition among men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 20118674PubMed |

[17]  Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr 2005; 39 446–53.
Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs.Crossref | GoogleScholarGoogle Scholar | 16010168PubMed |

[18]  Brookmeyer R. Measuring the HIV/AIDS epidemic: approaches and challenges. Epidemiol Rev 2010; 32 26–37.
Measuring the HIV/AIDS epidemic: approaches and challenges.Crossref | GoogleScholarGoogle Scholar | 20203104PubMed |

[19]  Working Group on Estimation of HIV Prevalence in Europe. HIV in hiding: methods and data requirements for the estimation of the number of people living with undiagnosed HIV. AIDS J 2011; 25 1017–23.
HIV in hiding: methods and data requirements for the estimation of the number of people living with undiagnosed HIV.Crossref | GoogleScholarGoogle Scholar |

[20]  Prestage G, Ferris J, Grierson J, Thorpe R, Zablotska I, Imrie J, et al Homosexual men in Australia: population, distribution and HIV prevalence. Sex Health 2008; 5 97–102.
Homosexual men in Australia: population, distribution and HIV prevalence.Crossref | GoogleScholarGoogle Scholar | 18588772PubMed |