The history of HIV/AIDS in Australia is distinctive, as Australian government bodies recognised and responded to the AIDS pandemic relatively swiftly, with the implementation of effective disease prevention and public health programs, such as needle and syringe programs (NSPs). As a result, despite significant numbers of at-risk group members contracting the virus in the early period following its discovery, Australia achieved and has maintained a low rate of HIV infection in comparison to the rest of the world.
AIDS is no longer considered an epidemic or a public health issue in Australia, due to the success of anti-retroviral drugs and extremely low HIV-to-AIDS progression rates.
History
1980s–1990s The first Australian case occurred in 1981: the patient was a 72-year-old man who died in September that year. However, the case was only diagnosed retrospectively in 1994. Until then, the first reported case was a 27-year-old New York resident on a working holiday, who was diagnosed in Sydney in October 1982.
In May 1983, Sixty Minutes, a then highly-popular television current affairs programme that was broadcast on a national free network, Channel 9, featured a 15 minute report The AIDS Mystery. As the first significant media account in the country, the programme's large audience reach caused it to have wide impact. The first reported death in Australia from HIV/AIDS was reported in Melbourne in July 1983.
Spurred to action both by the emergence of the disease amongst their social networks and by public hysteria and vilification, gay and lesbian, people who use drugs illicitly, and sex worker communities and organisations were instrumental in the respective rapid creation of AIDS councils, Drug User Organisations (DUOs), sex worker organisations, and positive people's groups. The AIDS councils were formed in South Australia, Victoria, and Western Australia in 1983, and in New South Wales, Queensland, Tasmania, and the Australian Capital Territory in 1985. The Victorian Aids Council (VAC) was headed by South Australian activist and community leader Jim Hyde from 1990 until 1994, who had been a co-founder of the AIDS Council of South Australia, and remained an active board member of VAC until his death in 2018. The peer-based DUOs were first founded between 1985 and 1992 to prevent the transmission of HIV among people who injected drugs illicitly.
The state and territory AIDS councils, along with the national peak organisations representing at-risk groups: the Australian Injecting & Illicit Drug Users League (AIVL) - formerly the Australian IV League, the National Association of People with HIV Australia (NAPWHA), Anwernekenhe National Aboriginal and Torres Strait Islander HIV/AIDS Alliance (ANA), the Scarlet Alliance, and the Australian Federation of AIDS Organisations (AFAO), all contribute actively to Australia's response to HIV.
Non-governmental organisations formed swiftly and have remained prominent in addressing AIDS in Australia. The most notable include the AIDS Trust of Australia, formed in 1987, The Victorian AIDS Council (VAC), now known as Thorne Harbour Health, formed in July 1983, and the Bobby Goldsmith Foundation, founded in mid 1984. The Bobby Goldsmith Foundation is one of Australia's oldest HIV/AIDS charities. The Foundation is named in honour of Bobby Goldsmith, one of Australia's early victims of the disease, who was an athlete and active gay community member, who won 17 medals in swimming at the first Gay Olympics, in San Francisco in 1982. The Foundation had its origins in a network of friends who organised care for Goldsmith to allow him to live independently during his illness, until his death in June 1984. This approach to supporting care and independent living in the community is the basis of the Foundation's work, but is also an approach reflected in the activities and priorities of many HIV/AIDS organisations in Australia.
In 1985, Eve van Grafhorst was ostracised since she had contracted HIV/AIDS caused by a transfusion of infected blood. The family moved to New Zealand, where she died at the age of 11.
A 1993 article by Brisbane newspaper columnist Lawrie Kavanagh, in which he alleged a HIV education and support program for gay youth was government-sponsored recruitment for "a sewer practice," provoked a crowd 'Die-In' protest outside the offices of The Courier Mail.Queensland Pride, 24 (May 1993), pp1-2; 25 (June 1993), pp 1-2, 30; Campaign, 207 (June 1993), p14.
2000–present While the spread of the disease has been limited with some success, the AIVL Network of DUOs and partner NSPs successfully achieved low prevalence among people who use drugs and the Scarlet Alliance did the same among sex workers, HIV/AIDS continues to present challenges in Australia. The Bobby Goldsmith Foundation reports that nearly a third of people with HIV/AIDS in New South Wales (the state with the largest infected population) are living below the poverty line. Living with HIV/AIDS is associated with significant changes in employment and accommodation circumstances. The Centre of Social Research in Health also reported rising stigma and discrimination against people who inject drugs illicitly reducing access to testing, treatment and care.
Survival time for people with HIV has improved over time, in part through the introduction of antiretroviral drug treatments with post-exposure prophylaxis treatments reducing the possibility of seroconversion and minimising the likelihood of HIV progression to AIDS. However, HIV does have its own health issues.
After the initial success in limiting the spread of HIV, infection rates began to rise again in Australia, though they remained low by global standards. After dropping to 656 new reported cases in 2000, the rate rose to 930 in 2005. Transmission continued to be predominantly through sexual contact between men, in contrast to many high-prevalence countries in which it was increasingly spread through heterosexual sex. Indeed, the majority of new Australian cases of HIV/AIDS resulting from heterosexual contact have arisen through contact with a partner from a high-prevalence country (particularly from sub-Saharan Africa or parts of south-east Asia).
The new trend toward an increase in HIV infections prompted the government to indicate it was considering a return to highly visible advertising. Reflecting this concern with the rise in new cases, Australia's fifth National HIV/AIDS Strategy (for the period 2005–2008) was titled Revitalising Australia's Response, and placed an emphasis on education and the prevention of transmission.
On 19 October 2010, The Sydney Morning Herald reported that 21,171 Australians were living with HIV, with 1,050 new cases diagnosed in 2009. The Sydney Morning Herald also reported that 63% of Australians living with HIV were men who have sex with men, and 3% were people who inject drugs.
In 2016, the Australian government and AFAO announced that AIDS was no longer a public health crisis, given the decline in numbers of new cases and the availability of treatment.
Australian responses to HIV/AIDS The Australian health policy response to HIV/AIDS has been characterised as emerging from the grassroots rather than top-down, and as involving a high degree of partnership between government and non-government stakeholders. The capacity of these groups to respond early and effectively was instrumental in lowering infection rates before government-funded prevention programs were operational. The response of both governments and NGOs was also based on recognition that social action would be central to controlling the disease epidemic.
In 1987, a well-known advertising program was launched, including television advertisements that featured the grim reaper rolling a ten-pin bowling ball toward a group of people standing in the place of the pins. These advertisements garnered a lot of attention: controversial when released, and continuing to be regarded as effective as well as pioneering television advertising.
The willingness of the Australian government to use mainstream media to deliver a blunt message through advertising was credited as contributing to Australia's success in managing HIV. However the campaign also contributed to stigma for those living with the disease, particularly in the gay community, an impact one of the advertising scheme's architects later regretted.
Australian Governments began in the mid-1980s to pilot or support programs involving needle exchange for intravenous drug users. These remain occasionally controversial, but are reported to have been crucial in keeping the incidence of the disease low, as well as being extremely cost-effective.
HIV/AIDS quickly became a more severe problem for several countries in the region around Australia, notably Papua New Guinea and Thailand, than it was within Australia itself. This led Australian governments and non-government organisations to place an increasing emphasis on international initiatives, particularly aimed at limiting the spread of the disease. In 2000, the Australian government introduced a $200 million HIV/AIDS prevention program that was targeted at south-east Asia. In 2004, this was increased to $600 million over the six years to 2010 for the government's international HIV/AIDS response program, called Meeting the Challenge. Australian non-government organisations such as the AIDS Trust are also involved in international efforts to combat the illness.
HIV/AIDS and Australian law
Deliberate or reckless transmission In response to the risks of HIV transmission, some governments (e.g. Denmark) passed legislation designed specifically to criminalise intentional transmission of HIV. Australia has not enacted specific laws, there have been a small number of prosecutions under existing state laws, with four convictions recorded between 2004 and 2006.
The case of Andre Chad Parenzee, convicted in 2006 and unsuccessfully appealed in 2007, secured widespread media attention as a result of expert testimony given by a Western Australian medical physicist that HIV did not lead to AIDS.
In February 2008, Hector Smith, aged 41, a male prostitute in the Australian Capital Territory who is HIV-positive, pleaded guilty in the ACT Magistrates Court to providing a commercial sexual service while knowing he was infected with a sexually-transmitted disease (STD) and failing to register as a sex worker. Under ACT law it is illegal to provide or receive commercial sexual services if the person knows, or could reasonably be expected to know, that he or she is infected with a sexually transmitted infection (STI).
In January 2009 Melbourne man Michael Neal was jailed for 18 years (with a minimum term of thirteen years, nine months) for deliberately infecting and trying to infect sexual partners with HIV without their knowledge, despite multiple warnings from the Victorian Department of Human Services.
Discrimination Australian governments have made it illegal to discriminate against a person on the grounds of their health status, including having HIV/AIDS; for example, see . However HIV positive individuals may still be denied immigration visas on the grounds that their treatment takes up limited resources and is a burden for taxpayers. To end HIV discrimination in Queensland and Australia in general, there is a plan to raise awareness and educate local people on HIV by 2020. This program is supported by government, as well as by many educational and volunteer organizations. The main aim of the program is to educate people about HIV as it will help to prevent it and stop HIV discrimination in the area.
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