Driving down infections together

Gay men in NSW have a unique opportunity right now to push HIV diagnoses down to record lows. This would mean that rather than just being stable, with the same number of men being diagnosed every year, this number could instead get lower and lower. This would be a great development for our community.

There are a few things we all can do in order for this to happen:

  • Maintain condom use

    The fact that condoms are used as consistently as they are by most gay men has played an important role in keeping HIV stable in NSW. A decline in condom use could result in the number of men being diagnosed with HIV each year going up, rather than down.

    What would happen if condom use declined?

    What would happen if condom use declined?
  • Increase HIV testing

    Some of the men diagnosed with HIV recently had not been tested in the last two years and some had never been tested before. These men may have had HIV for a long time before they found out. All sexually active gay men should be tested for HIV/STIs at least once a year and up to every three months if you have lots of partners - more than ten in six months. Being diagnosed as early as possible means these men can avoid passing HIV on to their sexual partners.

  • Encourage the disclosure of HIV status

    Gay men have become more likely to tell each other their HIV status before sex, although many see no need if they use condoms. HIV positive men are more likely than HIV negative men to tell their HIV status. But many HIV negative men react badly to this disclosure, even though they expect disclosure from HIV positive men. This is a big disincentive for HIV positive men to tell their HIV status. It's important that we create an atmosphere where it's ok for HIV status to be discussed.

  • Restrict sex without condoms to men of the same HIV status

    If sex without condoms only happened between men who have the same HIV status, the number of diagnoses each year would go down significantly. This means all men would need to know whether they are HIV negative or HIV positive so that they are able to accurately and openly disclose their HIV status.

    Guessing your status or relying on an old negative test result from two or three years back is not very reliable, particularly if you have had unprotected sex since your last test.

    For men starting a relationship and thinking about having unprotected sex, it's recommended that both get tested at the same time to check their HIV status before they have unprotected sex.

    What can we do
  • Increase the use of PEP

    Post-Exposure Prophylaxis (PEP) is a course of HIV treatment that can prevent infection if it's started within 72 hours of exposure to HIV - and the earlier, the better. If HIV negative men use PEP following a high risk episode like unprotected sex with a man who is HIV positive or whose HIV status they don't know, this would also bring down the number of diagnoses each year. You can get PEP from any HIV GP, sexual health clinic or hospital emergency department.

  • Maintain an undetectable viral load

    There's growing evidence that an undetectable viral load makes HIV positive guys much less likely to transmit HIV.

    It's important to monitor viral load regularly to ensure that it continues to be undetectable and to also test regularly for other STIs - sores associated with some STIs can make it easier for HIV to be transmitted. And low risk isn't the same as no risk.

None of these six things are big changes in behaviour for most of us. But together they would have a powerful effect on reducing the number of HIV diagnoses in NSW even further.

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I probably think a little bit more consciously about my health and things like that. At the moment, now that I've found my medications and it's under control, I feel good about it.

David, HIV positive

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