HIV 'eliminated' from inner-city Sydney

Health officials in Australia say they have “virtually” eliminated HIV transmission in parts of inner-city Sydney that were once the centre of the AIDS epidemic in Australia. It follows the announcement that new infections among gay men in that part of Sydney fell by 88% between 2010 and 2022. Professor Sharon Lewin - an infectious disease expert and president of the International AIDS Society - has been telling us about the significance of the data...

Sharon - This is pretty remarkable and it is approaching the targets of how HIV elimination or elimination of transmission is defined, which means a drop in 90% of infections. This is an area where there is a very large number of gay men who are actively involved and engaged in health promotion, who have high uptake of antiretroviral therapy in people who are infected with HIV, and that makes them non-infectious and also high uptake of HIV prevention measures. Significantly pre-exposure prophylaxis, which is taking antiviral tablets to prevent you becoming infected.

Chris - So, could other parts of Australia benefit from the great work that has been going on in inner-city Sydney?

Sharon - Well, this is one small part of Australia, but a very significant part because that was the epicenter of the HIV epidemic, where we saw the largest deaths in the early 80s. It tells us that these interventions work when you use them properly, and when you have community engagement and community-led education. So other parts of Sydney and then other cities across Australia are doing all of these interventions. But I guess it's inspiring and it gives people hope that this, you can reach these sorts of numbers with a concerted effort. And of course in Australia there has been a number of factors that have led to a very good HIV response, including bipartisan political support for the HIV response since the early 80s. Universal Health Coverage, partnership models of working between government scientists and the community. And so I think it does tell us that if you have these ingredients, you apply the interventions in the way that we've seen inner city Sydney, we really could get to an elimination of HIV transmission. That of course doesn't mean we've eliminated HIV because there are still, in Australia, 28,000 people living with HIV, but we've stopped new infections, which is a very significant milestone.

Chris - Regular listeners will know that it has been 40 years since HIV was first identified. We’ve been reporting just how far treatment has come since the 1980s and, as part of a brand new series coming out soon, we’ll be hearing from the former head of the National Institute of Allergy and Infectious Diseases in the United States, who also played a massive role in America’s response to HIV; that was Dr Anthony Fauci...

Anthony - We went from a disease with an almost uniform fatality to a disease now where you can give a combination of drugs, sometimes in a single pill once a day, that can bring the level of virus to below detectable level and keep it there and allow persons with HIV, with few exceptions now, to lead almost the normal lifespan, like maybe a year or two less than what would considered the normal life expectancy. That is a major, major accomplishment, which over a period of decades went from despair about no interventions that were of use to a couple of decades later to be able to have transformed the lives of persons with HIV.

Chris - Dr Anthony Fauci. You can hear much more from him next month when we launch a brand new podcast series - which is called Titans of Science. Also on the billing are the former chief medical officer Dame Sally Davies; the fertility expert Lord Robert Winston; and the first Briton in space, Helen Sharman.