An uptake in early diagnosis, testing and treatment has meant HIV transmission in NSW is well on its way to being eliminated. But concern remains among particular target in the community.
The NSW HIV Strategy 2021-2025 aims to achieve a 90 per cent reduction in the rate of preventable infection. The latest data reveals the goal is a realistic one.
In the fourth quarter of 2021, a total of 36 NSW residents were newly diagnosed with HIV. This was a 51 per cent drop compared to the fourth quarter average for the past five years.
Testing in public sexual health clinics increased by 43 per cent, lower than pre-pandemic testing, but appeared to be on the recovery track.
Experts say the decline in HIV transmission has been driven by COVID-19 restrictions, which resulted in fewer people meeting for casual sex.
There has also been more online and home-based testing options available, including a free finger prick test (the Dried Blood Spot test) that is posted in the mail and the ATOMO self-test.
Director of Sexual Health for South Eastern Sydney Local Health District, Phillip Read, said testing was a "game-changer", and has had a huge impact in reducing new infection.
"Testing has gone up dramatically in the past 12 years. Not only are we identifying as many people with HIV at risk but also much earlier in their disease course," Dr Read said.
In St George and Sutherland Shire, HIV diagnosis has reduced by more than 50 per cent between 2017/18-2020/21.
"That's really encouraging," Dr Read said. "The biggest reduction has been among gay Australian-born men. They've seen the messaging, they speak English, they have access to Medicare."
He said other groups within the community including recent overseas arrivals and those from culturally diverse backgrounds, were still of concern.
"The groups missing out are from linguistically diverse backgrounds, particularly overseas-born gay men and overseas-born heterosexuals who may have come from a country where HIV or being gay is stigmatised," Dr Read said.
Areas not considered "strongly gay suburbs" outside of Sydney's CBD he said, were also a focus, including people younger than 25 years of age.
"In areas such as our district, it is thought that there is a higher proportion of non-gay identified men who have sex with other men - they may be married, or not particularly connected to the gay scene or feel part of the gay community", Dr Read said.
He said during previous periods of lockdown, fewer people were presenting to testing clinics.
"Many sexual health clinics weren't doing face-to-face work because of attendance restrictions of staff got seconded into COVID-19 work," Dr Read said. "So there was a service issue, but there was also a reduction in people meeting for casual sex, and brothels needed to close for a while."
Although NSW Health is on track with its HIV reduction goal, other sexually transmitted infections are also front of mind.
"Chlamydia, gonorrhea and syphilis are relatively widespread in the community," Dr Read said. "Chlamydia is the most common STI, and diagnosis has remained stable but we've noticed an increase in the rate of gonorrhea diagnosis in the past couple of years and syphilis in past five years."
In 2021-22 the NSW Government is investing $23.7 million in services to strengthen HIV testing, treatment, and prevention, and for activities that will support the health and mental well-being of people living with blood borne viruses and sexually transmissible infections.
Short Street Centre, a specialist service providing management of STIs and HIV and are located on the grounds of St George Hospital.
