While Australia maintains a high level of testing for HIV continuing patterns of late diagnosis suggest there is still room for improvement. The principles of informed consent and confidentiality underpin high rates of voluntary testing, and these principles remain central to managing the epidemic nationwide. A coordinated, accessible and affordable HIV testing system allows for:
- access to treatment for those diagnosed with HIV to optimise therapeutic effects
- minimised sexual transmission through partner notification
- protection of the blood supply and of organ and tissue donation
- the prevention of transmission from a mother with HIV infection to foetus and newborn
- mapping the epidemic to aid the development of evidence-based public health interventions.
Improving access to, and the uptake of, testing is important to reduce late diagnosis of HIV. Targeted campaigns to promote HIV testing on its own, and in the context of the STI testing, is important. Emerging data suggests that newly diagnosed gay men have low rates of testing in the 12 months before infection and there is recognition that some gay men are reducing the frequency of testing due to inconvenience and lack of perceived benefit.
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The National HIV Testing Policy recommends routine offering of HIV testing to pregnant women. The risk of transmission is now dramatically being reduced through control of HIV in the mother. As a result, the prevalence of HIV infection in the antenatal population remains very low.
Approximately a quarter of people living with HIV are diagnosed by a general practitioner (GP) who has not previously diagnosed HIV. This indicates the need for support for these general practitioners, linked to the testing process with attention to the need to facilitate shared care with experienced clinicians.11
Priority actions in HIV testing
- Increase the number of people in priority populations who voluntarily seek HIV testing and increase the rate of testing among people at higher risk of exposure to HIV infection to decrease the burden of undiagnosed HIV in the community.
- Promote HIV testing among gay men, including gay men from CALD backgrounds and other priority populations through targeted campaigns.
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11 Savage J, ‘Models of Access and Clinical Services Delivery Report—HIV populations in Australia: Implications for access to services and delivery’, May 2009.