HIV- AIDS Prevention

People once thought that ending the spread of HIV would be impossible, but that is no longer true. I commend the Minister for Health on her long-term commitment to, and comprehensive understanding of, HIV-AIDS and the Government for implementing the Ending HIV campaign, which encourages regular testing, early treatment and safe-sex practices, to end this epidemic. I also acknowledge the commitment of the shadow Minister for Health and the Opposition to that campaign. Contracting HIV is no longer a death sentence, and the rate of infection in New South Wales has been stable for the past decade. However, according to ACON, about 250 gay men a year still contract HIV in this State. That is why we must continue our efforts.

For the benefit of the House, I will provide an historical context for the HIV epidemic that hit us more than 30 years ago. I get a great deal of inspiration from the way in which the gay community came together and showed such strength in the face of devastation. Indeed, many people of a certain age in Sydney would know of someone who contracted HIV-AIDS or who cared for a family member or close friend who contracted the disease in the 1980s. At that time Australia developed a compassionate, evidence-based response with responsible leadership and strong partnerships between governments, the scientific community, health professionals and, importantly, affected communities. Fortunately, Australia was not overwhelmed by fear and panic; instead, we enjoyed multi-partisan political support.

In New South Wales, the gay community established the AIDS Action Committee, which became the AIDS Council of New South Wales and which is now known as ACON, and the Bobby Goldsmith Foundation to provide care and support. Sex worker and injecting drug use communities set up similar organisations, including the Sex Worker Outreach Project and the NSW Users and AIDS Association. Consumer bodies such as People Living with HIV/AIDS NSW, Positive Living NSW and other community groups followed, representing those affected in policymaking and service planning. There are now fundraising bodies such as the AIDS Trust of Australia, support services such as Ankali, remembrance projects such as the Sydney Park AIDS, or SPAIDS, memorial groves and the annual candlelight memorial honouring those who have died.

The largest of these bodies is ACON and it is Australia's largest community-based gay, lesbian, bisexual and transgender health and HIV-AIDS organisation. With a large volunteer and staff base, ACON provides services dealing with sexual health, mental health, alcohol and other drugs, ageing, homophobic violence, domestic violence, housing and workplace equality. In 2010, ACON celebrated 25 years of work to improve gay, lesbian, bisexual and transgender health and wellbeing, provide support for people living with HIV and take action to reduce HIV transmission. The ACON organisation has an holistic understanding of health that recognises the negative impact of social factors including exclusion and discrimination, such as our exclusive and discriminatory marriage laws. Indeed, removing all discrimination from our laws would reduce the negative health impacts caused by stigma and make ACON's job easier.

With support and funding from this Government and previous governments and from community, arts, business and other organisations, we have prevented the wider spread of HIV and other bloodborne viruses. We should be proud of what we have achieved. I acknowledge all those who have worked together to save lives and prevent illness throughout the history of HIV-AIDS. The advent of combination drug therapies about 20 years ago changed HIV from a killer disease to one that could be managed. Thankfully, we have witnessed significant drops in the number of people dying or having serious health crises. Health services no longer need to provide dedicated wards for people with HIV-defined illnesses, and most have integrated their responses to HIV into all health services.

Massive advances in treatment and understanding of how to prevent transmission of the HIV virus have been made. These advances mean that the lives of people with HIV are almost the same as others' lives. Early treatment can reduce the presence of the HIV virus in the body and help prevent HIV-related illnesses, as well as transmission to others. I encourage all sexually active gay men to get tested regularly throughout the year. If HIV is diagnosed early men can be offered early treatment to drastically reduce further risks. It is essential that we remember that people in poorer countries and places where homophobia is rife do not have the same support. The cost to them, their families and communities is far greater. It is incumbent on us to share our knowledge and expertise. Australians overseas are doing important work, particularly in our neighbouring countries such as Papua New Guinea and Timor.

I acknowledge the important work of the Pacific Friends of the Global Fund to increase education and awareness to fight HIV and AIDS, as well as tuberculosis and malaria, in the Pacific region. They are supported by the Bill and Melinda Gates Foundation and are headed up in Australia by Executive Director Bill Bowtell. Last year Bill, who is a friend of mine, was made an Officer of the Order of Australia for his distinguished service to public health, particularly for his leading role in HIV-AIDS awareness and prevention. In the 1980s he played a large part in Australia's well-regarded response to the first wave of HIV-AIDS cases.

For the first time there is a real chance to eradicate this illness and effectively stop HIV by 2020. This is a bold yet achievable target. The Ending HIV campaign aims to encourage regular testing and early treatment, and to renew efforts to educate and encourage safe behaviours. This progress is a credit to successive Ministers, especially the current New South Wales Minister for Health, Federal and State government bodies and research and health professionals. Most importantly, it is a credit to organisations such as ACON and the wider lesbian, gay, bisexual, transgender and intersex community, especially those most affected by HIV-AIDS.

Mr MARK SPEAKMAN (Cronulla) [11.03 a.m.]: I thank the member for Sydney for his gracious remarks about government initiatives and for bringing this fundamental public health matter to the attention of the House. HIV-AIDS first appeared in New South Wales in 1983 and Sydney became the epicentre of HIV-AIDS in Australia. New South Wales quickly became a world leader in responding to HIV-AIDS. The early New South Wales response to the challenge of HIV included the introduction of needle and syringe programs and education programs aimed at those communities most at risk. Thanks to a practical, evidenced-based and bipartisan approach, effective programs have been developed and implemented over time to address the epidemic.

According to NSW Health, rates of HIV have remained relatively stable in this State, with 330 new diagnoses notified in 2011, compared with 307 in 2010 and 329 in 2009. In 2011 the New South Wales health system provided health and support services to more than 10,000 HIV-positive people. Most new HIV notifications in New South Wales continue to occur among gay men. Rates of HIV infection in other populations, including injecting drug users, sex workers, Aboriginal people and heterosexuals, remain low. The advent of effective HIV treatments has allowed people to live longer with HIV, with less morbidity and a better quality of life. New research shows that effective treatment for people with HIV can reduce onward sexual transmission by 96 per cent. That demonstrates why it is important that people know their HIV status and that there is ready access to HIV testing and treatment.

Last year on World AIDS Day the Minister for Health launched the "NSW HIV Strategy 2012-2015, A New Era" campaign. The Minister stated that it is possible to dramatically reduce new HIV infections in New South Wales by increasing testing, improving access to treatment and reinforcing proven methods such as condom use and harm reduction. The strategy adopts challenging targets that are based on the targets in the 2011 United Nations political declaration on HIV-AIDS. Key targets of the strategy include: reducing sexual transmission of HIV among homosexual men by 60 per cent by 2015 and 80 per cent by 2020; decreasing rates of HIV infection in other populations such as Aboriginal people and heterosexuals by 50 per cent; reducing the average time between infection and diagnosis from 4.5 years to 1.5 years; and increasing to 90 per cent the number of people with HIV on antiretroviral treatment.

These targets are to be reached by six broad methods. The first is to maintain high levels of safe behaviour. The strategy builds on HIV prevention efforts in New South Wales. Protective behaviours by people at risk of HIV have resulted in stable rates of transmission in gay and other homosexually active men, injecting drug users and sex workers. The first method will include continuing to promote condom use, a focus on harm reduction, promotion of targeted education campaigns and creating an enabling legal environment. NSW Health, ACON, Positive Life NSW, the New South Wales Sexually Transmissible Infections Programs Unit and HIV and related programs in local health districts, with the support of the Australasian Society of HIV Medicine, are some of the organisations that will carry out the promotion of those campaigns.

The second broad method to achieve the strategic targets is to intensify HIV prevention in priority populations—namely, gay and other homosexually active men, people who inject drugs, Aboriginals and sex workers, as well as those from culturally and linguistically diverse backgrounds. The third method will be to improve access to the needle and syringe program, which is a proven and cost-effective public health intervention of considerable success and has the potential to further reduce the number of HIV infections attributable to injecting drug use.

In 1988 New South Wales became the first jurisdiction to pass legislation to enable the needle syringe program. It has been estimated that $27 has been returned for every dollar invested in needle syringe programs by Australian governments in the past decade. That makes it one of the most cost-effective public health measures of all time. Whatever our abhorrence of injecting drug use, it is clear that the needle syringe program has been a roaring success and an appropriate public health measure to combat the spread of HIV-AIDS. The program has saved countless lives. The fourth method will be to promote HIV testing, making it easier to have an HIV test, and faster testing. The fifth method will be to promote treatment uptake, make access to treatment easier and support treatment adherence.

The sixth method will be to provide treatment, care and support services in the community. Paragraph (3) of the motion relates to ACON. The successful response to HIV in New South Wales started and continues as a partnership between the government, clinicians, researchers, health services and affected communities. In 1983 the gay community in Sydney established ACON in response to the emerging threat of HIV. The ACON organisation has taken a leading role in HIV prevention and care as well as in the health of gay, lesbian, bisexual and transgender people. A key action of the New South Wales HIV strategy is that ACON leads community mobilisation efforts for gay and other homosexually active men, including the delivery of HIV awareness testing campaigns.

In response to the strategy, ACON launched a major new health promotion initiative, Ending HIV, which aims to end the transmission of HIV among gay men in New South Wales within the decade. It is a ground-breaking, interactive social marketing and education engagement platform incorporating communication, campaign and community mobilisation initiatives. In conclusion, I point out that here in New South Wales we have the evidence and the tools with which to end the epidemic. Now it is time to put them to use through our partnerships and collective action. I commend the motion to the House.

In Response to Debate
Our State can be very proud of the Ending HIV campaign conducted by ACON and the coordinated response to the treatment of HIV-AIDS from health professionals, government and the community. New South Wales is leading the nation in this response. I thank the member for Cronulla and the member for Canterbury for their contributions to the debate. The member for Canterbury reminded us of the power of the Grim Reaper television commercials in the 1980s. I know that this motion has the strong support of the member for Coogee and the member for Balmain. I thank the Minister for Health and the shadow Minister for Health for their support for ACON and for Ending HIV.

I thank and acknowledge the staff and volunteers of ACON and particularly highlight the work of Nick Parkhill and Mark Orr. I also thank ACON for its great advocacy on issues such as the medical use of cannabis, the rights of the terminally ill and marriage equality, which are strongly supported in my electorate of Sydney. The Ending HIV program also shows the importance of funding and supporting early intervention strategies. Its success will be testament to how this State could, and indeed should, do more in this and many other mental health areas in terms of early intervention work. This motion is a tribute and a thank you to ACON. Indeed, it is a tribute to the work that has been done by those who have lost loved ones through HIV-AIDS and who are motivated by that loss to make the world a better place for people who suffer from that condition and, moreover, to end HIV. I commend the motion to the House.

Question—That the motion be agreed to—put and resolved in the affirmative.

Motion agreed to.

For full debate go to parliament.nsw.gov.au or click HERE.