HIV Diagnoses in Australia: Diverging Epidemics Within a Low-Prevalence Country

In order to track recent trends in HIV infection in Australia, the authors undertook an analysis of national surveillance system data from 1993 through 2006.

During the study years, 12,313 new diagnoses of HIV infection were reported in Australia. From 1993 to 1999, annual diagnoses fell from 1,056 to 718 - a 32 percent decline. Then, however, diagnoses increased from 763 in 2000 to 998 in 2006 -- a 31 percent increase. In 2000-2006, significant rates of increase were noted in Victoria, Queensland, South Australia and Western Australia.

Male-to-male sex accounted for 70 percent of HIV transmissions. Heterosexual sex accounted for 18 percent of diagnoses, with just over one-half of these infections occurring in people born in or having a sex partner from a high-prevalence country. Exposure via drug injection was an infrequent route of infection. New South Wales, which has long had Australia's highest HIV rates, did not see an increase during the seven-year period.

"The differences in rates between states/territories are likely to be due to divergent trends in sexual risk behavior in men having male-to-male sex, which remains the predominant route of HIV transmission in Australia," the authors concluded. "There is a need for effective, innovative, and evidence-based programs for HIV prevention, particularly among men having male-to-male sex."

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