Image: Burnet Institute Econometrician Dr Nick Scott
Burnet Institute modelling demonstrates that more than 2000 transmissions of HIV could be averted in Australia over the next three years through better prevention, testing and treatment programs.
The modelling, conducted by Dr Nick Scott, forms the basis of the Australian Federation of Aids Organisations’ (AFAO) HIV Blueprint to make Australia the first nation to end HIV transmission.
It involved a reworking of the UNAIDS 90-90-90 treatment targets where, by 2020, 90 percent of people living with HIV know their status; 90 percent of people with HIV receive antiretroviral therapy (ART); and 90 percent of people on ART have viral suppression.
“AFAO were interested in particular scenarios about what we could achieve if we improved beyond the UNAIDS 90-90-90 targets to make them all 95s,” Dr Scott said.
“AFAO were also interested in the impact of the scale up of PrEP – the use of medications to prevent HIV – within the 2020 time frame.
“We had the model to run this and we found that even though Australia is doing quite well in terms of the 90-90-90 targets, there’s still impact to be had if we go further and we can potentially avert about 2000 cases over the next few years by doing that.”
Dr Scott said to achieve this will require more testing, in particular among high-risk men who have sex with men, better access to testing services and facilities, and a significant scale up of PrEP, which will need to be affordable to those who want to use it.
“It’s really important in the context of scaling up PrEP and going for these targets that we don’t forget about primary methods of prevention, other ways of reducing incidence such as condom use and risk behaviour – they need to be a part of any strategy,” Dr Scott said.
Burnet Head of Public Health, Associate Professor Mark Stoové said there are important lessons in Dr Scott’s research around the impact of different interventions and levels of scale-up.
“The work underscores the challenges that we have not only in Australia but also in other parts of the world in controlling the HIV epidemic, despite having all these new tools at our disposal,” Associate Professor Stoové said.
“Locally and internationally people have been looking at biomedical prevention as the panacea for HIV control and our modelling suggests that we need to maintain and even enhance our focus on primary prevention alongside the scale up of these new biomedical prevention tools."
Dr Scott’s original research, which was adapted to address AFAO’s HIV Blueprint, will shortly appear in the journal Clinical Infectious Diseases.