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Progress Against HIV: Clinical & Community-led Breakthroughs

  • 28 Jun 2023
IMG 1669 Mark Stoové

For decades, Burnet has led the world in responses to HIV, pursuing both lab-based discoveries, and community-led interventions focused on education and prevention.

Efforts to ease the burden of HIV have historically been hampered by the social stigma and discriminatory practices surrounding the groups most likely to be affected, especially gay men.

The first breakthrough of significance emerged from Burnet laboratories in the 1990s with the identification of an attenuated strain of HIV-1 that raised the possibility of an HIV vaccine.

Subsequently, Burnet developed a sentinel surveillance system that provided data insights into the impact of treatment on overall prevention rates in HIV, and undertook a bio-prevalence study that revealed levels of undiagnosed HIV far higher than what was then expected. The evidence generated in these activities have proved fundamental to the development of the National HIV Strategy and related policies and services.

“The WHO elimination target is about reducing the incidence of HIV by 90% by 2030, compared to 2010. That's the global target, that's the target Australia has signed up to. And we're close. In inner city Melbourne and Sydney, where communities are wrapped around with high quality services, we've actually probably achieved that goal. So, now it’s about equity: geographic and social equity, and getting that same response.” —Professor Mark Stoové

Through the years, Burnet’s medical researchers and public health experts have continued to collaborate, generating advances such as point-of-care tests and peer-led testing services, both of which contribute to making HIV diagnosis and treatment more accessible to the communities that need them the most.

Focus is increasing now on research into HIV detection, prevention and care in other marginal and disadvantaged communities, including among girls and young women.

 

Where are we now?

  • Sophisticated surveillance systems are in place in more than 100 clinics and laboratories across Australia, linking anonymous data from thousands of interactions with the health system, and providing a robust view of the impact of treatment as prevention.
  • PRONTO! Community-Based Rapid HIV Testing Services were established in 2013, providing Australia with its first shop-front, community-based, peer-led HIV testing service for gay men. Now run by Thorne Harbour Health (formerly the Victorian AIDS Council), the service has expanded to include testing services for sexually transmitted infections (STIs), as well as an on-site clinic to support uptake of the highly effective HIV-preventative ‘pre-exposure prophylaxis’ or PrEP.
  • Studies undertaken by Burnet in 2014 and 2018 changed perceptions about the prevalence of undiagnosed HIV among gay and bisexual men. These results informed changes in policy and practice, emphasising the need for testing to be more accessible and more frequent.
  • The VISITECT® CD4 point-of-care test has been endorsed by the World Health Organisation and is in use throughout the world, making it easier for health systems in resource-limited nations to assess patients and prioritise care needs.