Eden Caceda investigates the reasons behind escalating rates of HIV/AIDS in Australia.
In July this year, thousands of people from across the world travelled to Melbourne to attend the biennial International AIDS Conference. Held by the International AIDS Society (IAS), the conference is the largest on any health or development issue globally.
With the height of HIV/AIDS infections 29 years ago, many people have grown complacent and believe that the disease is no longer a threat due to medical progress. This International AIDS Conference proved to be the most important in recent years with Australia experiencing a sustained rise in new diagnoses of HIV infections and the fight against AIDS restarting.
Originating in western Central Africa at the beginning of the 20th Century, HIV/AIDS spread internationally within 40 years. Scientifically, Human Immunodeficiency Virus (HIV) is the virus that renders the immune system deficient and prevents it from fighting other infections and diseases, and Acquired Immunodeficiency Syndrome (AIDS) is the final stage of HIV infection and consists of a wide range of complications and symptoms.
HIV is primarily transferred through blood and semen, meaning that the disease spreads easily through blood transfusions, hypodermic needles, and from mother to child through pregnancy, delivery or breastfeeding. Many HIV victims do not die from AIDS, but from a variety of other diseases including pneumonia and tuberculosis.
HIV/AIDS was initially recognised by the United States Centre for Disease Control and Prevention (CDC) in 1981. At the time the disease was primarily isolated to homosexual men and injecting drug users. In 1981, five per cent of gay male residents in NewYork and San Francisco were infected with HIV. However, by 1983, it was apparent that HIV/AIDS was not isolated to the gay community. As of 2012, AIDS had taken the lives of 36 million people, and in 2013, 1.5 million people died of AIDS-related diseases. Fortunately medical progress allows us to test an individual for HIV, however a cure for AIDS has not been discovered yet. Observing the statistics, HIV/AIDS appears to be a disease that mainly affects the marginalised and vulnerable groups of society.
Many social factors contribute to the spread of HIV/AIDS including higher likelihood to handle contaminated blood, participate in high-risk sex practices and sharing needles. Transmission through contaminated needles or unsafe sex practices often means that HIV/AIDS is not associated with high income earners or upper class citizens, and unfortunately stigma of the infection is typically expressed in conjunction with one or more other already stigmatised labels including homosexuality, promiscuity, prostitution and intravenous drug use.
There has been remarkable progress in turning back the tide of HIV/AIDS since its spread in the 1980s. Between 2001 and 2012, 26 countries reduced new infections by more than 50 per cent and accessibility to preventative measures is higher than ever before. However as Dr. Norman Swan of ABC’s Health Report said during the opening of the panel discussion from this year’s AIDS Conference, “It has not gone away, we have not solved the problems.”
This year, in Australia, HIV rates are at a 20- year high. There are now over 1,000 new HIV infections per year and roughly 80 per cent of these victims are gay men, with the highest rates among those over 50 and under 30 years old. The UNSW Kirby Institute for Infection and Immunity in Society reported that as of 2014, 26,000 people were living with HIV in Australia.
These shocking statistics echoed in the alarming rates of HIV/AIDS diagnoses throughout Europe and the United States with 2.1 million people infected with HIV every year, however a majority of Australians are still ignoring the growing severity of the situation. In the developed world, HIV/AIDS is perceived as something that affected us in the 1980s before going off the radar. In reality, HIV/AIDS has never left our society. While we are particularly fortunate to have decreased AIDS-related deaths in Australia, the growing rates of HIV infections signal it becoming a big part of our society once more.
Changes in laws and culture have developed our understanding of HIV/AIDS and suppressed the epidemic of the 1980s in modern-day developed nations. However, despite legal reform and social change, HIV/AIDS is rising at an unexpectedly high rate. Currently in Australia, the two groups currently most at risk appear to be individuals who were not in the midst of the tragedy during the peak of HIV/AIDS and older citizens who may believe that the worst of the disease may not affect them.
While it may be easy to blame these groups for neglecting their responsibility, this new rise in HIV/AIDS can be easily attributed to a general social lack of care and urgency today. Long gone are the cautionary tales of people unknowingly spreading a disease that could kill hundreds and the promotions for using clean needles and condoms to prevent HIV/AIDS are no longer as effective as they once were. Prevention programs have not been updated since they were put in place and there is a general notion that HIV/ AIDS is no longer a public health threat.
In November 1991, Freddie Mercury, the gay lead singer of Queen, died of pneumonia brought on by AIDS one day after he publicly acknowledged he had the disease, joining the ranks of Anthony Perkins, Rock Hudson and Liberace. These public figures shared their experience of the effects of HIV. Because of this, people were exposed to the reality of the disease and the seriousness of HIV/AIDS was made more public.
The role of sex education in teaching young people about human sexuality, anatomy, reproduction and health is an important part of primary and high schooling. In current sex education classes, HIV/AIDS is commonly thrown into the category of simple STIs and the full extent of the infection isn’t explored in depth. Studies have shown that comprehensive sex education is more effective in preventing sexually transmitted infections than education that focuses solely on teaching abstinence until marriage. UNAIDS, the Joint United Nations Programme on HIV/AIDS, claims that universal primary education is not a substitute for prevention but a necessary component. Without a thorough explanation of the cause, effects and nature of HIV/AIDS, many young people do not receive the necessary education from primary or secondary education that could change the future of HIV/AIDS.
When doctors learnt that AIDS could be a sexually transmitted disease and the use of condoms were encouraged to prevent the transmission of HIV, their use exponentially grew after the 1980s. However, today, many sexually active people view condoms as unnecessary, and the statistics confirm this. Current condom advertisements focus more on pleasure and not protection against STDs and HIV. This lack of reinforcement sidelines STDs and HIV/AIDS and fails to highlight or remind people about the medical advantages of using condoms. Gottfried Hirnschall, Director of HIV at the World Health Organisation said at the AIDS Conference, “Condoms are by no means redundant. Our position is clearly that condoms should be used in all circumstances. But we also know not everybody uses condoms all the time.” Hirnschall proposed a combination prevention system, merging condom usage with education so that there is zero per cent chance of transmission between parties.
The Kirby Institute this year claimed that unprotected sex between casual male partners continues to be the major cause of HIV with lesser rates attributing AIDS to intravenous drug use and blood transfusions. “Fortunately [there] was pioneering in the 1980s and [it] has really led the world in large-scale implementation of needle and syringe programs and that has led to effectively no epidemic taking off,” Associate Professor David Wilson said during the AIDS Conference.
Since 1996, treatments for HIV have vastly improved and it is now easier to live with the disease in developed nations. Victims of HIV are now able to take one to three pills per day to keep AIDS at bay and retain use of their immune system. Scientists have also revealed a new approach to get rid of the HIV virus, called the “kick and kill” approach which used an anti- cancer drug to kick the virus out of where it is hiding in the body. Dr Ole Schmeltz Sogaard from Denmark’s Aarhus University said at the AIDS Conference that he gave patients anti- cancer drugs which increased the production of HIV-infected cells by more than three times, be traced and targeted with existing treatments.
Many activist organisations within Australia are continuing to promote awareness around the rise of HIV/AIDS. Pozhet is an organisation that is the heterosexual HIV service in NSW and provides programs and services to the heterosexual community of people living with HIV. The organisation is particularly interested in raising awareness around heterosexual people living with HIV and advocates for HIV-positive heterosexuals in Government and non-government settings.
Another new organisation committed to HIV/AIDS is the AIDS Council of NSW (ACON). The organisation has a central focus on ridding Australia of HIV through prevention promotion, advocacy and support services for people currently living with HIV/AIDS. Their “Ending HIV’ campaign is currently aiming to test every sexually active gay man and aims to ensure that every gay man diagnosed with HIV has access to treatment as early after detection as possible. The program outlines that “more testing, more guys on treatment earlier and maintaining good risk reduction practice […] are what we need.”
Fortunately modern HIV testing is highly accurate and the accessibility to it with the ‘Ending HIV’ campaign and other organisations is effective in Australia. Professor Sharon Lewin, co-chair of the conference, commented on the progress of on-the-spot tests to discover if an individual is HIV positive or not. “The licensing arrangements have just changed in Australia around that point, so that in the future we will be able to have home testing, and they are on-the-spot HIV tests – are you positive or not,” Lewin said at the AIDS Conference. With faster HIV testing and earlier detection comes the possibility of eradicating the disease.
Observing the statistics of those groups affected by HIV in Australia, it has become apparent that young people who are not aware of the effects of the disease and older people who lived through the dark times of the HIV/ AIDS epidemic must bond to innovate and empower society once more to protect their friends and their community, bridging the gap between different age groups is essential.
We now live in an age where we have the ability to defeat the modern disease for good. However science alone will not achieve that daring goal.We must not forget the lives lost to HIV/AIDS. As Bill Clinton declared at this year’s AIDS Conference, “An AIDS free generation is within our reach” – now we have to fight for it.
Originally published in BULL Magazine, August 18, 2014.