New diagnoses of HIV among men who have sex with men are down over five years, the latest data from NSW Health shows – a promising sign that the state’s HIV strategy is close to achieving its goal of virtual elimination of the virus.
Sixty-four people were diagnosed with HIV in the first quarter of the year. Sixty-nine per cent of those were men who have sex with men while 28 per cent had heterosexual risk exposure.
For men who have sex with men, 69% represents a 2% drop over the last five years. For heterosexuals, the latest figures are a 67% increase on the five-year average.
Compared to the five-year average, new HIV diagnoses were down 32% overall in the state but up 11% over the first quarter of 2023.
This was driven by people with heterosexual exposure and overseas-born men who have sex with men.
Both of these groups often presented with evidence of more late diagnoses (there were 13 diagnoses classified as late among the group).
Overall, almost half (48%) presented with evidence of a late diagnosis, a 28% increase over five years.
One of the key reasons behind fewer diagnoses among men who have sex with men is the increased availability of pre-exposure prophylaxis medication, otherwise known as PrEP.
PrEP is an anti-viral prescription medicine taken by a person who does not have HIV to lower their chance of infection. While it is recommended by professionals to be taken daily, it can also be taken “on-demand” at a higher dose at least two hours before sex.
However, there have been several breakthrough HIV cases worldwide where people who took PrEP on-demand contracted it, including one in Sydney. More than 27,000 NSW residents were prescribed PrEP at least once over the last five years.
Since 2019, its usage by NSW residents has increased 181%.
The data also shows a dip in new PrEP prescriptions that coincides with the first COVID lockdown of 2020 and the August lockdown in 2021.
The same dips can be seen in the HIV testing data; people tested for HIV significantly less during the lockdowns. Testing numbers are still down from 2019 but they are increasing. Tests for HIV in the first quarter of this year were up 22% on the fourth quarter of last year.
NSW LGBTI+ health organisation ACON told GSN that the latest data showed that progress towards ending HIV transmissions was heading in the right direction.
“There is still a long way to go and we can’t afford to lose any momentum,” ACON said.
“We’re encouraged by the increasing uptake of PrEP use among our communities, as well as people accessing effective treatment that prevents transmission of HIV.”
Progress towards the elimination of HIV transmission has been greatest in inner Sydney, where roughly 20% of adult men are estimated to be gay.
Men who have sex with men and live in outer suburbs or rural areas with fewer gay men have not experienced the same decline in diagnoses.
Areas with more than 20% of the population estimated to have gay men are Surry Hills/Darlinghurst, Erskineville and Eveleigh/Alexandria, according to NSW Health data.
More than 20% of the population of Elizabeth Bay/Potts Point/Rushcutters Bay, Redfern and Newtown are also estimated to be gay, the data shows.
Other areas like Waterloo, St Peters, Chippendale, Pyrmont, Forest Lodge, Woollahra, Mascot, North Sydney and Bondi Junction are all estimated to have a gay population of 5% to 19%
ACON said it was important that all communities had access to HIV prevention options, including overseas-born arrivals.
“We’re encouraged that HIV and STI testing rates have returned to pre-COVID-19 levels, but we continue to urge everyone in our communities to look after their health,” ACON said.
For more information about PrEP, HIV testing, sexual health and HIV treatment, visit endinghiv.org.au, where you’ll find a list of places you can go to get tested for sexually transmitted infections.