Immediate action is needed to stem new cases of HIV among Australia's Indigenous people, researchers have argued.
National data shows a 33 per cent increase in new cases of HIV diagnosed in Indigenous people, from 4.8 per 100,000 people in 2012 to 6.4 per 100,000 people in 2016.
More needs to be done to reduce new HIV cases among Indigenous people in Australia, researchers say.
At the same time, newly diagnosed HIV rates among Australian-born non-Indigenous people decreased by 22 per cent, from 3.7 per 100,000 population to 2.9 per 100,000.
In an article in the latest Medical Journal of Australia, authors James S. Ward, Karen Hawke and Rebecca J. Guy argued Australia's target of the virtual elimination of HIV transition by 2020 was at risk if rates of diagnosis continued to increase among Aboriginal and Torres Strait Islanders.
The data shows the rate of diagnosis among Indigenous Australians is more than double the rate for non-Indigenous people for the first time since full data was collected in 1992.
"HIV in Australia is currently considered to be a low-level epidemic, but there is general consensus that it could rapidly transition to a concentrated epidemic among Aboriginal and Torres Strait Islander people, as has occurred among First Nations people in some provinces of Canada," the paper reads.
The authors said higher proportions of Indigenous people were living with HIV while undiagnosed and there was a low uptake of preventative drugs, such as PrEP, among Aboriginal and Torres Strait Islander people.
Of the almost 17,000 people enrolled in PrEP trials in Australia, about 200 were Indigenous.
The ways Indigenous and non-Indigenous people acquired HIV had differed since 2012.
A lower proportion of HIV diagnoses occurred among men who had sex with men for Aboriginal and Torres Strait Islander people (51 per cent) than non-Indigenous (74 per cent).
A higher proportion of diagnoses were attributable to injecting drug use for Indigenous people (14 per cent versus 3 per cent), and heterosexual acquisition (20 per cent versus 15 per cent).
The rate of diagnosis among Aboriginal and Torres Strait Islander women was also three times higher than the rate for non-Indigenous women, although the numbers were small.
The authors said Australia had readily available diagnostics and treatments and well-established prevention programs.
"But it is clear that the approach requires strengthening and modifying in terms of reach, potency and sustainability to connect with different priority population groups within the Aboriginal and Torres Strait Islander population," they wrote.
The authors said action was needed now to avoid HIV becoming a concentrated epidemic among Aboriginal and Torres Strait Islander people and should be a national priority.
They recommended making use of every opportunity to offer HIV testing, increasing the number of at-risk Indigenous people using PrEP and sustained efforts to reduce the high rates of other sexually transmitted infections.
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