‘Milestone’ step for national HIV response

Morgan Liotta

22/05/2024 2:52:06 PM

Australia has formally endorsed recognition of an undetectable viral load in people with HIV, a move hoped to further reduce transmission and stigma.

Close up of HIV
When a person living with HIV is on effective antiretroviral treatment, they reach an undetectable viral load and are unable to transmit the virus to sexual partners.

As part of its HIV elimination strategy, the Australian Government has this week signed onto the principles of the multi-national Undetectable=Untransmittable (U=U) call to action, recognising and committing to embedding U=U into the national HIV response.
It marks the fourth country, joining the US, Canada, and Vietnam to commit to incorporating U=U into efforts to prevent, diagnose and treat HIV, as well as reducing associated stigma.
When a person living with HIV is on effective antiretroviral treatment, they reach an undetectable viral load and will be unable to transmit the virus to sexual partners.
Dr Sara Whitburn, Chair of RACGP Specific Interests Sexual Health Medicine, told newsGP while the signing of the document signals an important step, it also raises a good opportunity to highlight HIV care in general practice.
‘This announcement supports and recognises the work GPs do in screening and treating for sexually transmitted infections (STIs), as well as supporting people living with HIV to achieve U=U as part of their holistic healthcare,’ she said.
‘It is great chance for GPs to talk about what U=U is to patients and how it can support decreasing stigma and improved sexual wellbeing by giving advice and reassurance that if someone has undetectable viral load, they are not able to transmit the virus to negative partners. 
‘It is also a great reminder to offer HIV screening as part of an asymptomatic STI screening. This will support early HIV identification and it reinforces early HIV treatment.’
The announcement comes following last week’s Federal Budget 2024–25, which delivered $43.9 million over three years to expand activities addressing priorities identified in the national HIV Taskforce Report recommendations released late last year. Key funding areas include:

  • $26 million over two years for subsidised pre-exposure prophylaxis (PrEP) HIV prevention medication for those without access to Medicare
  • $3.8 million over two years for a national implementation of the HIV testing vending machine initiative
  • $3.7 million over two years to peak organisations to continue activities that support the national response to HIV
Health and Aged Care Minister Mark Butler said these measures will result in better prevention of HIV, access to testing and information, reduced stigma, and training on HIV for the health and support workforce, as part of keeping Australia on track to eliminate transmission of HIV by 2030.
According to ASHM – Australasia’s peak professional body representing healthcare professionals working in HIV, blood-borne viruses, and sexual and reproductive health – not only does having an ‘undetectable status’ mean the virus cannot be transmitted, it can also alleviate anxiety and fear people living with HIV might have about passing the virus on to a partner.
Additionally, ASHM said it is a vital part of reducing HIV stigma. With more awareness of U=U and the advancements in HIV treatment, such as PrEP, fear and stigma around the virus are decreasing, including within the healthcare setting.
ASHM CEO Alexis Apostolellis said Australia signing the U=U call to action marks a ‘major milestone’ that will ‘further empower’ Australia’s HIV healthcare workforce.
‘The U=U message allows healthcare workers to give people living with HIV confidence and agency over their sexual health and wellbeing,’ he said.
‘We applaud the Government’s commitment to formally endorsing U=U, which will ultimately help us work towards the virtual elimination of HIV transmission.’
Recently published research examining Australian GPs’ views of and discussion with patients about U=U revealed that while most (74%) agreed with U=U, only 34% had discussed it with their patients.
Dr Whitburn said the Government’s announcement presents an opportune time for communicating the U=U message to patients that a person with an undetectable viral load has zero risk of transmitting HIV to sexual partners.
However, as U=U does not stop transmission of other STIs, she notes the importance of also continuing to offer appropriate asymptomatic testing as guided by the RACGP’s Red Book and the Australian STI primary care guidelines.
‘As part of the Government’s commitment to the multinational U=U call to action, it is committed to health professional education and supporting U=U as part of primary prevention,’ Dr Whitburn said.
‘I hope to see further support of GP S100 prescribers and HIV primary care services to make this happen.’
More information for healthcare professionals about U=U and how it can be embedded into practice is available on the ASHM website.
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elimination strategy HIV sexual health STIs U=U undetectable viral load

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