The human immunodeficiency virus (HIV) is a blood-borne virus (BBV) and sexually transmitted infection (STI) that affects the immune system.
People living with HIV who take effective antiretroviral treatment will not develop AIDS and have a normal life expectancy. This is because these medicines control the amount of virus in the blood (viral load) and protect the immune system. Effective HIV treatment can reduce a person’s viral load to such low levels (undetectable) that they cannot transmit HIV to sexual partners (untransmittable). This is known as Undetectable equals Untransmittable (U=U). There is currently no cure for HIV, however modern treatment is considered a functional cure.
Untreated HIV gradually destroys CD4 cells – the cells that help the body stay healthy by fighting off disease. When HIV is not treated, most people will develop severe immune deficiency within 10 years. At this point, the body can no longer fight infections or stop cancers from developing. This late stage of HIV infection is called acquired immunodeficiency syndrome (AIDS). AIDS is rare in Australia with the highly effective HIV treatments now available.
People with HIV on treatment live normal lives and do the same things as everyone else. There is still a stigma which is a hangover from the 1980s when we didn’t know much about it and people were afraid.
Over half the people with HIV in Australia are aged over 50. Many lived through the early days without treatment and often have multiple health issues to contend with as they age.
HIV in Australia today
In 2022, it was estimated that there were 28,870 people with HIV in Australia, and of these, an estimated 93% were diagnosed by the end of 2022. Research also shows that approximately 95% of people diagnosed were receiving HIV treatment, and of those on treatment, 98% had an undetectable viral load.
In 2022, 49% of HIV notifications were attributed to sexual contact between men. 30% of cases were attributed to heterosexual sex, 8% to a combination of sexual contact between men and injecting drug use, 3% to injecting drug use alone, and 10% to other/unspecified.
Between 2013 and 2016, the HIV notification rate among Aboriginal and Torres Strait Islander peoples increased from 4.4 to 6.5 per 100,000 and then declined to 2.3 per 100,000 in 2021. In 2022, the HIV notification rate increased slightly again, to 3.2 per 100,000 among Aboriginal and Torres Strait Islander peoples but were stable among non-Indigenous people, at 2.2 per 100,000.
Of the HIV notifications in 2021 with male-to-male sex as their risk exposure, approximately 47% were overseas-born men.
Untreated HIV is only transmitted through certain bodily fluids: blood, semen, vaginal fluids, rectal fluids, and breast milk.
The most common ways for the virus to pass to another person is through anal or vaginal intercourse or sharing drug equipment like needles. HIV cannot be transmitted through contact with skin that has no sores or open cuts. It also cannot pass through water or air.
Universal safety precautions are perfectly adequate for caring for people with HIV. HIV is NOT passed on in saliva or urine or faeces. There have been very few cases of HIV being transmitted in occupational settings and none in Australia in over twenty years.
HIV transmissions occur more often when a person is unaware of having the virus and therefore their viral load is unchecked. This is why regular testing and Preexposure Prophylaxis (PrEP) is recommended for those at risk, and early treatment prescribed for those who test positive.