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Sydney's former HIV epicenter close to ending transmission

The inner-city area of Sydney, once the epicenter of Australia's HIV epidemic, is very close to becoming the first place in the world to reach the UN's target for ending transmission of the virus.

New infections among gay men in inner Sydney dropped by 88 percent from 2010 to 2022, according to research presented at the International AIDS Society's HIV science conference in Brisbane.

Just 11 new HIV cases were recorded in inner Sydney last year, "an extraordinarily small number of infections for what was the heart of the Australian HIV epidemic," said Andrew Grulich, an epidemiologist at the University of New South Wales who presented the research.

Grulich said that several areas in the UK and Western Europe have also seen rapid drops in new HIV cases, but "I don't think anywhere has gotten close to 90 percent."

However, Grulich emphasized that this does not mean that HIV is close to being eliminated in Sydney. "HIV can only be eliminated if we have a vaccine and a cure," he said.

The fall in new HIV cases in inner Sydney was due to a number of factors, including:

  1. High rates of HIV testing and use of pre-exposure prophylaxis (PrEP), which reduces the risk of transmitting HIV during sex.

  2. Around 95 percent of HIV-positive people in Australia are now on antiretroviral treatment, which suppresses the level of the virus in the blood.

  3. People on antiretrovirals who have low but detectable levels of HIV have almost zero risk of sexually transmitting the virus to others.

  4. Sharon Lewin, the president of the International AIDS Society, said the progress in inner Sydney was "beyond exciting."

"It affirms that Australia is poised to be one of the first countries, if not the first, to achieve virtual elimination of HIV," she said in a statement.

Heather Ellis, a woman living with HIV in the southern state of Victoria, said that "the last mile" of eliminating HIV in Australia will require measures specifically designed to reach women.

While gay men are now well aware of prevention tools like PrEP, "the heterosexual community is pretty much oblivious," said Ellis, a communications coordinator for the NGO Positive Women Victoria.

The Sydney research, which has not been peer-reviewed, was based on data from the New South Wales health department as well as annual surveys taken by gay men.

Grulich said the progress in inner Sydney was particularly significant because "this was a community that was completely devastated in the 80s and 90s—a few thousand men died in these areas."

He said that the success of the HIV prevention efforts in inner Sydney shows that it is possible to end the HIV epidemic, but "it will take a lot of hard work and sustained investment."

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