A new study from La Trobe University has identified significant gaps in HIV testing, diagnosis and prevention that are leaving some people vulnerable to infection, despite major advances in treatment and care.
The Newly Positive study, completed by the Australian Research Centre in Sex, Health and Society (ARCSHS), found many participants had interacted with the health system before their diagnosis, but HIV testing was either not offered or key warning signs were missed.
Barriers to diagnosis included low HIV awareness among women and heterosexual men, uncertainty about access to HIV prevention and testing services among migrants, and failures by clinicians to recognise symptoms of early HIV infection.
Australia has experienced substantial declines in HIV notifications over the past decade, but progress has slowed in recent years and almost 40 per cent of new diagnoses are classified as late.
Lead researcher Dean Murphy said the findings showed Australia must strengthen testing and prevention efforts if it is to achieve its goal of eliminating HIV transmission by 2030.
“Australia’s HIV treatment system is working exceptionally well once people are diagnosed, but this research shows too many people are still falling through the cracks before they reach care,” Dr Murphy said.
“We heard from people who experienced symptoms consistent with early HIV infection but were not tested. Others delayed seeking a test because they didn’t know where to go, assumed services would be expensive or worried about the impact a diagnosis might have on their visa status.”
The study found women and heterosexual men generally had lower awareness of HIV and less experience with routine HIV testing.
Some women reported regular sexual health screening that did not include HIV testing, while other participants described missed opportunities for diagnosis after presenting to healthcare services with symptoms consistent with HIV seroconversion illness.
Researchers also found newly arrived migrants faced unique challenges navigating Australia’s healthcare and prevention systems.
Many were unfamiliar with how to access testing, PrEP or post-exposure prophylaxis (PEP) and some delayed testing because they were uncertain about the implications of a positive result for residency applications.
The report recommends integrating HIV testing into routine STI screening, increasing awareness of early HIV symptoms among both clinicians and the community, and developing targeted education programs for newly arrived migrants.
Despite the challenges, the study paints a positive picture of Australia’s HIV treatment and care systems.
Most participants were linked to HIV care quickly after diagnosis, commenced treatment within days or weeks, and achieved an undetectable viral load within a short period. Participants described modern HIV treatment as highly effective, easy to manage and life changing.
“Once people entered care, their experiences were overwhelmingly positive,” Dr Murphy said.
“Many participants spoke about the relief of achieving an undetectable viral load and learning they could live long, healthy lives and could not pass HIV on to sexual partners.
“The challenge now is making sure everyone who could benefit from testing, prevention and care is able to access those services early.”
Brent Clifton, Deputy Director of the National Association of People With HIV Australia (NAPWHA) said: “These findings confirm what our community has long known: early treatment, an undetectable viral load and strong peer support all contribute to a good quality of life for people with HIV. They’re also a reminder that stigma persists and that testing needs to stay easy and accessible.”
The Newly Positive study interviewed 51 people diagnosed with HIV in the previous 12 months and 15 physicians providing HIV care.
