U=U is Drastically Reducing HIV Rates in Australia

Findings from a 10-year study examining HIV “treatment as prevention” (TasP) in Australia between 2010 to 2019, published in Lancet HIV, showed a 27% increase in people accessing effective HIV treatment, which has resulted in a 66% decrease in new HIV transmissions.

TasP, a global public health strategy built on evidence of HIV treatment results, effectively reduces an individual’s risk of transmitting HIV to zero. These days, in many parts of the world, this concept is also referred to as U=U, or "undetectable equals untransmittable." U=U is a globally accepted scientific consensus that means when an HIV-positive person is on treatment and the virus reaches undetectable levels in their body, they then have zero chance of transmitting HIV to a sexual partner, even without use of a condom.

Dr. Denton Callandar, who led the research at the University New South Wales Kirby Institute, told UNSW Sydney, “To test the ‘big picture' impacts of this important HIV prevention strategy, we examined 10 years of clinical data from over 100,000 gay and bisexual men in New South Wales and Victoria. We found that over time, as viral suppression increased, HIV incidence decreased.”

He added, “Indeed, every percentage point increase in successfully treated HIV saw a fivefold decrease in new infections, thus establishing treatment as prevention as a powerful public health strategy. Our research shows that investing in HIV testing is crucial for HIV elimination.”

The past decade has seen governments, community-based organizations, and clinics in NSW and Victoria working to remove restrictions for antiretroviral prescriptions, which enables community pharmacy dispensing, reduced patient treatment costs, and heightened education.

The time period covered also included the introduction of PrEP, a pill that became a game changer in preventing HIV-negative people from contracting the virus.

“Australia is on track to become one of the first countries globally to virtually eliminate the transmission of HIV,” said Professor Mark Stoové from the Burnet Institute, co-senior author on the paper. “The results of this research show that further investment in HIV treatment — especially alongside PrEP — is a crucial component of HIV elimination."