New report finds gaps in HIV testing, diagnosis and prevention

A new study conducted by La Trobe University has uncovered significant gaps in HIV testing, diagnosis and prevention efforts in Australia, leaving some individuals vulnerable to infection despite advancements in treatment and care. The "Newly Positive" research, carried out by the Australian Research Center in Sex, Health and Society (ARCSHS), revealed that many participants had previously interacted with the healthcare system but were not offered HIV testing or had key warning signs overlooked.

Factors contributing to delayed diagnosis included low HIV awareness among women and heterosexual men, uncertainty among migrants regarding access to prevention and testing services, and clinicians' failure to recognize early HIV infection symptoms. While Australia has seen substantial declines in HIV notifications over the past decade, progress has slowed in recent years, with nearly 40% of new diagnoses being classified as late.

Lead researcher Dean Murphy emphasized the urgent need to strengthen testing and prevention efforts to achieve the goal of eliminating HIV transmission by 2030. The study interviewed 51 people diagnosed with HIV in the past year and 15 healthcare providers, uncovering that women and heterosexual men generally had lower awareness of HIV and less familiarity with routine testing.

Some women reported regular sexual health screenings that didn't include HIV testing, while others faced missed opportunities for diagnosis after presenting with symptoms of early HIV infection. Newly arrived migrants also encountered unique challenges in navigating Australia's healthcare and prevention systems, including unfamiliarity with accessing testing, PrEP, and post-exposure prophylaxis (PEP), and delaying testing due to uncertainty about the consequences for residency applications.

The researchers recommend integrating HIV testing into routine STI screening, raising awareness of early HIV symptoms among both medical professionals and the community, and developing targeted education programs for newly arrived migrants. Despite the hurdles, the study highlights the positive aspects of Australia's HIV treatment and care systems, with most participants linked to care quickly after diagnosis, initiating treatment within days or weeks, and achieving an undetectable viral load swiftly.

Participants praised modern HIV treatment for its effectiveness, ease of management, and life-changing impact. Once enrolled in care, most participants reported positive experiences, expressing relief at achieving an undetectable viral load and confident in living long, healthy lives without transmitting HIV to sexual partners. However, the key challenge remains ensuring that everyone who could benefit from testing, prevention, and care can access these services early.

Brent Clifton, deputy director of the National Association of People With HIV Australia (NAPWHA), confirmed the findings align with the community's long-held knowledge: early treatment, an undetectable viral load, and strong peer support contribute to a high quality of life for people with HIV. The report also underscores the persistence of stigma and the ongoing necessity for accessible and easy testing options.